ABSTRACT
Effective information management and other shared costs can reduce agencies' operating expenses as well as make new products available while providing opportunities to gain a competitive advantage. By taking a close look at ways of controlling documentation, such as the use of a management services organization for information system/computer-based management, agencies can prepare for the challenges of the next century.
Subject(s)
Home Care Agencies/organization & administration , Management Information Systems , Practice Management , Contract Services , Cost Savings , Home Care Agencies/economics , Humans , Information Management/economics , Information Management/organization & administration , United StatesSubject(s)
Continuity of Patient Care/organization & administration , Subacute Care/organization & administration , Case Management , Continuity of Patient Care/standards , Cost Control , Home Care Services/organization & administration , Organizational Innovation , Outcome Assessment, Health Care , Quality Assurance, Health Care , Rehabilitation/organization & administration , Skilled Nursing Facilities/organization & administration , Subacute Care/standards , United StatesSubject(s)
Continuity of Patient Care/organization & administration , Hospitals, Group Practice/organization & administration , Length of Stay , Patient Care Planning/organization & administration , Home Care Services/organization & administration , Hospitals, Group Practice/statistics & numerical data , OhioABSTRACT
Home health care in the United States is highly developed involving, for example, complex therapies and durable medical equipment. Access to home care has been shaped by government reimbursement policies requiring recipients to be homebound and in need of intermittent services under medical direction. Due to strict and extensive documentation for reimbursement the Medicare regulatory structure has stifled innovation in the field of home care. Other factors affecting the provision and growth of home care services include the Joint Commission on Accreditation of Health Care Organizations, changes in hospital reimbursement policies, and the role of physicians in integrating and coordinating home care services.
Subject(s)
Fluid Therapy/economics , Home Care Services/economics , Infusions, Parenteral/economics , Medicare/trends , Reimbursement Mechanisms/trends , Fluid Therapy/trends , Forecasting , Home Care Services/trends , Humans , Infusions, Parenteral/trends , Medicare/economics , Quality of Health Care , Reimbursement Mechanisms/economicsABSTRACT
We report two cases of nocardial endophthalmitis. Case 1 is a 66-year-old man whose left eye was enucleated about one month after onset of decreased vision. Ophthalmoscopic examination disclosed multiple choroidal masses. Six weeks before the onset of ocular manifestations he had undergone a prolonged carotid endarterectomy with intraoperative complications. The source of the ocular infection was probably exogenous. Case 2 is a 49-year-old woman who had systemic sclerosis (scleroderma) with severe pulmonary insufficiency. She had received moderate doses of corticosteroids. Seventeen months after initiation of therapy she developed ocular manifestations leading to enucleation of the eye one month later. Histopathologically, the enucleated eyes in both cases showed numerous branching, Gram-positive, filamentous organisms involving mainly the plane of Bruch's membrane and the subretinal space. The nosological and microbiological aspects of nocardiosis are reviewed.
