Subject(s)
Censuses , Mortality , Women's Health , Adolescent , Adult , Age Distribution , Aged , Bias , Child , Child, Preschool , Global Health , Humans , Infant , Male , Middle Aged , Reproducibility of Results , Residence Characteristics/statistics & numerical data , Sex Distribution , United States/epidemiologySubject(s)
Child Abuse , Stress, Psychological/physiopathology , Adult , Child , Child Abuse/psychology , Female , Humans , Male , Neurosecretory Systems/physiologySubject(s)
Clinical Trials as Topic/statistics & numerical data , Neoplasms/therapy , Patient Selection , Age Factors , Aged , Female , Humans , Male , Sex FactorsABSTRACT
The National Committee for Quality Assurance (NCQA) has adopted 12 gender-specific standards for HMO accreditation. None of the 12 pertain to men's health. This article analyzes possible explanations for the exclusion of men's health standards. The data suggest the following conclusions: (1) men are the higher-risk population, (2) current medical research budget allocations favor women by almost a 3:1 margin, (3) a sufficient research basis exists to develop male-specific standards, and (4) there is no clear basis to the claim that medical services are systematically biased against women; in fact, it is men who are underutilizers of primary care services. The paper concludes with a discussion of possible male-specific standards and operational considerations for managed care organizations.
Subject(s)
Accreditation/standards , Health Maintenance Organizations/standards , Men , Quality Indicators, Health Care , Health Maintenance Organizations/statistics & numerical data , Health Services Research , Humans , Male , Medicine , Patient Acceptance of Health Care , Prejudice , Sex Factors , Specialization , Surveys and Questionnaires , United StatesABSTRACT
Diagnostic errors account for one-fifth of lawsuits against hospitals and physicians. Virtually all medical specialties are at risk for these lawsuits. To this point, risk managers have done little to assist physicians to reduce their risk of failure-to-diagnose (FTD) lawsuits. This article describes a collaborative effort to reduce FTD lawsuits in the primary care setting.
Subject(s)
Diagnostic Errors/legislation & jurisprudence , Malpractice/legislation & jurisprudence , Primary Health Care/legislation & jurisprudence , Risk Management/methods , Breast Neoplasms/diagnosis , Clinical Protocols , Colorectal Neoplasms/diagnosis , Diagnostic Errors/statistics & numerical data , Female , Humans , Liability, Legal , Medicine/statistics & numerical data , Organizational Innovation , Pilot Projects , Primary Health Care/standards , Risk Management/organization & administration , Specialization , United StatesABSTRACT
Stress management has become an issue for managed care medical directors, quality improvement coordinators, and others affected by the changing face of the health care industry and their role in it. This article offers insight on how to foster better ties with staff and network physicians, and to develop tools that could alleviate professional stress.
Subject(s)
Burnout, Professional/prevention & control , Managed Care Programs , Physicians/psychology , Cost Control , Humans , Job Satisfaction , Managed Care Programs/economics , Managed Care Programs/organization & administration , Professional Autonomy , Quality of Health Care , Relaxation Therapy , United States , WorkforceABSTRACT
The Early Diagnosis Project was established in an effort to improve quality and reduce malpractice risk in managed care practice environments. The first project, which addressed breast cancer, utilized practice guidelines, patient handouts, and follow-up forms in an integrated attempt to improve the quality of care and reduce litigation involving "failure-to-diagnose" claims.
Subject(s)
Malpractice , Managed Care Programs/standards , Quality of Health Care/legislation & jurisprudence , Risk Management/methods , Breast Neoplasms/diagnosis , Clinical Protocols , Colorectal Neoplasms/diagnosis , Diagnostic Errors , Employee Retirement Income Security Act , Female , Humans , Liability, Legal , Malpractice/legislation & jurisprudence , Managed Care Programs/organization & administration , Pilot Projects , United StatesABSTRACT
Diagnostic errors account for one-fifth of lawsuits against hospitals and physicians. Of greatest concern is the rising severity of lawsuits alleging diagnostic errors--over a 12-year period the average indemnity for these claims has risen by 258%. The hospital departments most affected are the emergency room, obstetrics, radiology and pathology. This article probes the structure of diagnostic errors and makes recommendations how to reduce the frequency and severity of these claims.
Subject(s)
Diagnosis, Differential , Diagnostic Errors/legislation & jurisprudence , Liability, Legal , Physicians/psychology , Physicians/standards , Cognition , Emergency Service, Hospital , Humans , Malpractice/legislation & jurisprudence , Obstetrics and Gynecology Department, Hospital , Pathology Department, Hospital , Pattern Recognition, Visual , Radiology Department, Hospital , Risk Management/organization & administration , United StatesABSTRACT
Breast cancer is the leading cancer diagnosis among women. Systematic use of mammography and other screening modalities can reduce mortality. The gap between potential benefit and clinical reality appears to be widening, however, as suggested by the fact that failure to diagnose is now the number one cause of malpractice lawsuits against physicians.
Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/prevention & control , Diagnostic Errors , Female , Follow-Up Studies , Humans , Malpractice , Mammography , Middle Aged , Patient Education as Topic , Physical Examination , Physician-Patient Relations , Quality of Health Care , Risk Management , United StatesABSTRACT
As the growth of healthcare continues to outpace inflation, health policy makers are increasingly concerned with cost containment. This article summarizes studies of the cost-benefit of patient education studies in managed care and other settings, including comprehensive approaches to healthcare delivery that emphasize education. On the average, for every dollar invested in patient education, $3-4 were saved. The article concludes with recommendations for healthcare policy makers and administrators.
Subject(s)
Patient Education as Topic/economics , Cost Control , Cost Savings , Cost-Benefit Analysis , Health Policy , Health Services Research , Humans , Managed Care ProgramsABSTRACT
Managed care is becoming the predominant model of health care delivery in the United States, and cost containment pressures are being felt by physicians and patients alike. As a result, the doctor-patient relationship is being subjected to greater pressures and conflicts. These conflicts can result in patients being viewed as "difficult." Difficult patients represent a clinical challenge which many providers feel unprepared to address. When difficult patients become dissatisfied and angry with care, a professional liability claim can result. This article presents difficult patient cases and management recommendations, along with evaluation results of three seminars based on the difficult patient concept.
