Information needs in a changing health care system: capitation and the need for a population-oriented view.
Information systems needed for managing the health care of populations under at-risk (capitation) contracts must be designed differently than those used in fee-for-service practice. Under capitation, providers must deliver health care to enrollees with financial resources that are fixed in advance. Therefore, the information systems they use must enable them to understand the health status of health plan enrollees and how health care is provided. These systems should facilitate the detection of underservice and of inadequate quality of health care as well as overuse of health care resources. They should permit clinical-epidemiologic and statistical analysis; facilitate disease management and the adoption of preventive programs, and lend themselves to use by planners, group leaders, and practicing physicians.
Braun
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Codman Research Group, Inc., Andover, Massachusetts, USA.
Caper
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D000555:Ambulatory Care Information Systems; D002204:Capitation Fee; D003627:Data Interpretation, Statistical; D019468:Disease Management; D006279:Health Maintenance Organizations / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D006300:Health Services Misuse / Q000706:statistics & numerical data; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D010816:Physician Incentive Plans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011787:Quality of Health Care; D020414:Risk Sharing, Financial; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data