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Managed Care and the Patient-Physician Relationship, 1997.
This paper evaluates how managed care services are changing the dynamics of the patient-physician relationship.
3,270 words (approx. 13.1 pages), 14 sources, MLA, $ 93.95
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Abstract
This paper evaluates managed care and its negative implications on the patient-physician relationship. The author views managed health care as a serious threat to the trust embodied within the traditional patient-physician relationship. It is further argued that if this trust erodes, there cannot be any assurance about the adequacy of that health care system.
A Physician's Conflicting Loyalties
Managed Care Compromises Patient Autonomy
Ethical Problems Associated with Financial Incentives to Limit Care
Solution: Preserving the Physician's Role
From the Paper
"The foundation of the physician-patient relationship is the trust embodied within. It is based on the premise that physicians are primarily dedicated toward their patients, who can expect that physicians will honorably serve them even if it means putting the physician's own health at risk. They can rely on physicians to do everything in their power to help them. (Morreim, 23) It is this trust that enables patients to communicate private information and to place their health, and indeed their lives, in the hands of their physicians. No other individual in the health care system is in a position to assume such an important responsibility, such as the one that physicians have towards their patients. It is this trust between physicians and patients which is the backbone of any successful health care system; without it, there can be no assurance about the adequacy of that system."
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Managed Care and Physicians, 2002.
Presenting the physician's view on managed care within the health sector of the United States.
1,145 words (approx. 4.6 pages), 6 sources, MLA, $ 39.95
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Abstract
Many physicians agree that managed care is not doing the job it was originally created to do. This paper shows that, although reform efforts have not worked in the past, many doctors believe now is the time to revisit reform to combat the lack of health care access to a growing number of Americans, escalating costs, and deteriorating quality. This paper explores the evolution of managed care, and its problems and possible solutions from the viewpoint of two organizations representing the interests of physicians.
From the Paper
"In 1993, President Clinton introduced a plan for regulated health care reform in response to escalating costs and the growing ranks of the uninsured. From 1970 until the time of the reform proposal, health care spending had increased from $74.4 billion to $752 billion annually. The Clinton proposal was met with huge opposition from the ?medical industrial complex? comprised of insurance firms, pharmaceutical companies, hospital suppliers and medical device companies and from the public who had been led to believe that the plan would give the average American less choices and higher costs. After the plan was rejected, Americans turned to managed care to control health care costs, to improve the quality of care, and to preserve their choice of provider and insurance plan. By 1999, ninety-one percent of all employees with health insurance were enrolled in managed care programs ranging from Health Maintenance Organizations (HMOs) that require enrollees to select from a network of doctors, to Preferred Provider Organizations (PPOs) that provide more flexibility in doctor selection at a higher cost than HMOs."
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Managed Health Care Systems, 2004.
Presents a new model of model of managed health care in the U.S. using a systems approach.
7,200 words (approx. 28.8 pages), 14 sources, APA, $ 160.95
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Abstract
Health care in the United States has a long history; from the traveling physician who provided services in private homes and charity organizations, to government programs such as Medicare and Medicaid that proceeded hospital construction, and the relatively recent trend of managed health care. Along the way, innovation and competition facilitated new health care technologies and services that offered numerous approaches to prevention, treatment, and management of diseases. In a bold new health care policy, integration and collaboration between the public and private sectors of health care is not only an option, but a necessity in providing the most efficient and sound health care services and options. This paper examines health care in the U.S. from a historical and current perspective and concludes by introducing a new model of managed health care utilizing a systems approach.
Table of Contents
Introduction
Historical Examination of Health Care
Public Sector Health Care in the USA
Private Sector Health Care in the USA
Types of Managed Care Organizations
HMO Models
The Merging of Public and Private Health Care Models
A New Universal Managed Health Care Model
Conclusions
References
Appendices
From the Paper
"The managed health care industry did slow the growth in health care spending. Moreover, by extending coverage to services provided in an outpatient setting, it reversed the artificial preference for in-patient care that was created by indemnity insurance benefit designs. By focusing on clinical variability in physician practices, the shift to managed care forced the elimination of some unnecessary care. It also provided a stabilizing force to professional fees and institutional charges."
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Managed Care and Changes in the Nursing Profession, 2002.
An overview of managed care in the U.S. and discussion of its impact on the nursing profession.
650 words (approx. 2.6 pages), 5 sources, $ 26.95
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Abstract
This paper gives a brief history of managed care in the US, and discusses how the practice and the profession of nursing has changed with the growth of HMOs, PPOs, and other managed care organizations. Generally, this has meant a greater involvement with insurance liability, increased patient access (for the employed population), and increased nurse involvement in decision making. The paper also discusses differences between nurse and physician "culture" that have been brought to the fore in the managed care environment.
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Understanding the Managed Care System, 2006.
This well-researched paper examines the history and current state of the managed care system which began in the 1940s with the creation of prepaid group health cooperatives.
3,110 words (approx. 12.4 pages), 7 sources, APA, $ 90.95
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Abstract
This in-depth paper explores the managed health care system in America. The writer of this paper details the evolution of the managed care system from its inception in the 1940s when health care was developed through the arrangements of an enrolled population and a group of physicians who agreed to work on salary versus on a fee-for-service basis. Also discussed is the government-led reform which resulted in the 1973 passing of the HMO Act, as well as the political and ethical issues regarding doctor-patient confidentiality.
From the Paper
"The trend is gradually changing as local officials become better educated and experienced with human service programs and supportive local interest groups. This is the result of human service personnel and advocates beginning to realize the need for understanding and working effectively with the local political officials. The matter of politics is a two way street. Human service personnel need to learn more about politics. Political officials in turn can benefit from human service personnel involvement. Citizens and policy makers both recognize that better ways are necessary to conduct politics."
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Ethical Issues in Managed Health Care, 2004.
A look at the background and structure of managed care in an effort to reveal the underlying ethical issues and come up with a solution to the problem.
3,334 words (approx. 13.3 pages), 6 sources, MLA, $ 95.95
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Abstract
This paper examines how health care is a unique category of business in that every decision, whether it be clinical or economic, has an ethical component. It looks at how the ethical issues for "managed care" create four major categories of concern: professional, medical, business, and social. It also discusses how some of the most important areas for attention include the lack of professional code of ethics for physician executives, interference with the principles of informed consent and patient autonomy, violation of consumer rights, and social maleficence in obstruction to access and delivery.
Outline
Introduction
The Basics of Managed Health Care
Prioritizing Ethical Issues
Conclusion and Recommendations
From the Paper
"Medical directors and administrators in managed health care organizations today face those kinds of decisions every day (Woodstock Theological Center, 1999). For doctor like Stanley to be able to make good ethical decisions, they must understand the ethical issue involved in managed health care. Many doctors initially feel that the problems lie with the managed health care organizations, as they have seen first-hand many of the "unethical" decisions that managed care organizations make. However, recently, it has become apparent that people who are assumed to have the same perspective, such as the doctors, do not always agree on what would be the right decision. Second, doctors have begun to understand the perspectives of those with whom they disagreed."
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Managed Health Care, 2006.
A definition of managed health care and a discussion about the importance of educating the public about their options.
6,587 words (approx. 26.3 pages), 12 sources, MLA, $ 151.95
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Abstract
This paper defined managed care as the effort to coordinate, rationalize, and channel the use of services to achieve desired access, service and outcomes while controlling costs. It then explains that risk-based managed care are organizations which provide or contract to provide health care in broad/specified areas for a defined population for a fixed, prepaid price. Various strategies are used to control costs and this is accomplished by offering a broad range of services at least the areas of hospitalization, physician care, various types of ancillary care and/or medications. The paper explains the importance of presenting the benefits in advance, along with payments expected from the covered individual or member, so that the person can make an educated decision.
From the Paper
"Health care expenses frequently are too expensive for the average individual to pay as they go, but are suitable for health insurance coverage. Managed care provides either the service directly or contracts to provide them. This differs from conventional health insurance, where the insurer would underwrite the coverage, but not become involved the delivery of services. Managed care providers take a financial risk for part or all of the cost of service. There are three levels of risk. First, full risk whereby the provider accepts all of the financial risk for providing services, as well as all profits and losses. Secondly, partial risks where the provider accepts a portion of the risk. Third, no direct risk to the provider, but receive incentives to control cost. The last one is found in various case-managed primary care arrangements."
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Managed Care and the Poor, 2000.
An examination of HMOs and their effectiveness in delivery of health care to poor and low-income communities. Includes access, capitation, Medicare, structure, physician autonomy, case management, performance analysis, care quality and more.
8,775 words (approx. 35.1 pages), 41 sources, $ 135.95
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From the Paper
"Assessing the Effectiveness of HMOs in the Delivery of Health Care to Poor and Low-Income Communities
Introduction
Managed care programs are increasing in number with the goals of controlling health care costs and continuing to provide quality care. Questions exist, however, regarding the maintenance of quality assurance.
Managed care is becoming the ?backbone of health care delivery in the United States? (Wells, Astrachan, Tischler, & Unutzer, 1995, p. 57). Managed care has two goals in particular?to control health care costs and to provide quality services that are sufficient enough to satisfy the enrollees. Several strategies based on direct control of care and indirect economic incentives are used. Payment incentives include..."
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Caring for Alzheimer's Patients, 2003.
An evaluation of the Calista Roy nursing model for caring for patients with Alzheimers.
690 words (approx. 2.8 pages), 3 sources, APA, $ 23.95
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Abstract
This paper paper applies the Calista Roy nursing practice model to the care of elderly Alzheimer's patients. The paper begins by discussing the five major concepts of nursing, according to the model. Next the paper evaluates the impact of both internal and external environments on patient care. Finally, the paper discusses how the burden of care for Alzheimer's patients most often falls on family members and asks whether the Calista Roy model might alleviate this burden.
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Nurse-Physician Relationships, 2005.
This paper discusses research projects that have resulted in positive nurse-physician relationships.
1,935 words (approx. 7.7 pages), 3 sources, APA, $ 61.95
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Abstract
This paper explains that the relationship between physicians and registered nurses is important because it shapes the healthcare environment by increasing nurse satisfaction, decreasing nurse turnover, creating a better working environment and better patient with an emphasis on patient safety. The author points out that, when nurses and physicians establish an environment where they are collaborating and consulting, the physician views the nurse as an associate rather than a subordinate, this results in a better quality of care. The paper relates that a comprehensive healthcare project designed to assess the differences in diagnosis and treatment among nurses, general practitioners and consulting physicians, revealed that the relaxed atmosphere between the healthcare professionals created an environment in which the nurses felt comfortable making diagnosis and prescribing treatment.
Table of Contents
Introduction
Descriptions
Discussion and Conclusion
From the Paper
"The shortage of nurses places a special burden on the healthcare systems ability to retain nurses. In many cases, the work environment is a contributing factor in a nurse leaving the profession. In particular, the relationship that a registered nurse has with the physicians is critical. Registered nurses are under a great deal of stress because they are forced to work long hours and deal with difficult situations. This stress is compounded when the nurses and physicians have a bad relationship. Stress is reported as one of the leading health and safety problems that affect nursing and therefore patients."
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Caring for Patients with Alzheimer's Disease, 2006.
This paper presents a care plan for a particular patient suffering from Alzheimer's disease.
900 words (approx. 3.6 pages), 2 sources, $ 35.95
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Abstract
William has many needs related to Alzheimer's disease; he needs help with memory and needs to be oriented to his environment. Since he has urinary tract infections and is incontinent of urine he needs good pericare. He needs new glasses and health teaching about his hearing aid. He needs a quieter environment. He needs more nutrition and more fluids. This paper describes the many needs of a patient suffering from Alzheimer's disease and then presents a care plan designed to address those needs.
From the Paper
"William has many needs. Related to Alzheimer's disease, he needs help with memory, and needs to be oriented to his environment. Since he has urinary tract infections and is incontinent of urine, he needs good pericare. He needs new glasses and health teaching about his hearing aid. He needs a quieter environment. He needs more nutrition and more fluids. He has needs related to mobility since he is in danger of falling. He has needs related to elimination. He needs to be assessed because the 'peculiar glare on his face' seems to be a serious matter, and his Alzheimer's might be progressing."
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"Caring for Patients from Different Cultures" by Geri-Ann Galanti, 1991.
This paper analyzes the book, "Caring for Patients from Different Cultures", by Geri-Ann Galanti: Ethnic groups, sex roles, customs and diet.
1,575 words (approx. 6.3 pages), 1 source, $ 55.95
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From the Paper
"The purpose of this paper is to analyze and critique the book, "Caring for Patients from Different Cultures", by Geri-Ann Galanti.
The positive aspects of this book are numerous. The author begins by discussing the problems involved with caring for patients of different races and ethnic backgrounds. On page 1, the author asks the most important question, "What happens if the health care providers do not understand why Asian patients rarely ask for pain medication and Mediterranean patients want it for the slightest discomfort", and why Middle Eastern patients will not allow a male physician to examine their women, and others will.
Ethnic diversity in America has always been regarded as a good thing, but it leads to serious problems where patients in ... "
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Diabetic Foot Care Patient Education, 2006.
A review of educating diabetes patients on how to correctly care for their feet.
1,125 words (approx. 4.5 pages), 5 sources, $ 44.95
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Abstract
This paper describes how patient education is implemented form a nursing care perspective. This paper focuses on diabetic foot care. It details what will be needed in carrying out patient education, using a multi-modality and return demo approach. It also explains the steps to take in order to implement teaching. It is emphasized that the patient must accept his illness in order to maximize learning, which may become a major impediment in promoting foot care education.
From the Paper
"It cannot be emphasized enough how important foot care in diabetics is. In addition, it is one of the easiest preventive measures to teach diabetic patients. The most dreaded complications arising from the lack of proper foot care can range from toe, foot or leg amputation, which is more common than blindness (International Working Group on the Diabetic Foot, in Young, 2005). Taking this into consideration, it may well be the most cost-effective preventive measure that can be imparted to the diabetic patient. In order to encourage active participation by the patient, such materials as a life-size, life-like, anatomically accurate foot model, written material in the form of take-home, "must-know' brochures."
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Plan of Care for an Elderly Patient, 2008.
An assessment of an elderly patient suffering from constipation, incontinence, and urinary tract infection, and a proposed plan of care.
740 words (approx. 3.0 pages), 3 sources, APA, $ 26.95
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Abstract
This case study analyzes the health problems of an elderly patient that mainly involve constipation, incontinence, and urinary tract infection. The paper points out that these problems are very common among people over 65 years of age. The study proposes that the patient be provided with a program of good nutrition and health teaching by qualified nursing staff. The program will also require regular check-ups. The paper concludes that the successful implementation of this program should help to eliminate the patient's problems.
Outline:
Introduction
Analysis of Data
Assessment
Plan of Care
Nursing Orders
Implementation
Evaluation
From the Paper
"For older adults, if the food plan is going to meet nutritional needs, it must account for changes related to aging (Collis, 2002). Joan must receive enough calories per day to meet her needs for protein, calcium, iron, and vitamins. Because of the presence of the pressure sore, Joan needs protein to allow the sore to heal. Protein also is needed to build and maintain muscle and tissues (Collins, 2002). Because of such serious problems with constipation, Joan most especially needs a high amount of fibre in her diet. She can obtain fibre from such foods as bran products, raw fruits, prunes, and whole grain breads and cereals (Kozier, et. al., 2000)."
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Ethics and Dilemmas of Patient Care, 2008.
A case study illustrating the lack of basic care afforded patients and what nurses must do as advocates for their patients.
1,584 words (approx. 6.3 pages), 6 sources, APA, $ 51.95
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Abstract
The paper presents a nursing situation that demonstrates the role and responsibility of nurses as advocates of patient safety and quality of care. The paper discusses the issues raised in this particular situation such as lack of time for nurses to offer even basic care to their patients, harm caused to patients because of not getting basic care, the patient's and family's right to know, how the truth should be told, and the problems connected with whistle-blowing. The paper then looks at possible options and resolutions for dealing with the issues.
Outline:
Introduction
Core Issues in the Situation
Potential Options
Analysis of Each Option
Theoretically Defensible Position
What Made the Situation Challenging?
Conclusion
From the Paper
"refers to adhering to high moral principles or professional standards.
In this series on the heart of nursing, the role of integrity in nursing practice merits a mention. Every year, market researchers conduct a poll in various countries to find out how the population surveyed rate a range of professions and occupations in relation to honesty and ethical standards. In Australia, the UK and the United States, nurses are frequently ranked number one, or pretty close to it. In the US, nurses have been ranked top for 'honesty and integrity' every year since 1999, except 2001, when they were ranked second.
"Being honest is at the heart of our work. That is why the charge nurse is still upset about the part he played in Meg's care, and why nurses often go home troubled because they have not, in their own eyes, been able to maintain integrity in their practice."
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