RESUMO
The American Medical Association's long-standing commitment to improving the quality of medical care has been marked by a variety of efforts, from improvement of medical education and accreditation to technology assessment and peer review. But with increasing nationwide attention on evaluating quality of care, the AMA, as well as many other physician organizations, has focused on developing practice parameters that identify appropriate medical care.
Assuntos
Padrões de Prática Médica/normas , Qualidade da Assistência à SaúdeRESUMO
Effects of financial arrangement and organizational setting on the socioeconomic aspects of four health care delivery systems are assessed. Analysis of variance tests are used to analyze differences between group and solo fee-for-service practices, prepaid group practices, and independent practice associations. Solo fee-for-service physicians tended to be older, to be non-board-certified, to prefer autonomy over earnings, and to have more patient visits, longer hours, and shorter waits for an appointment. Prepaid group physicians tended to be younger, to prefer a specific practice location and predictable schedule, to have lower incomes and expenses coupled with fewer patient visits, shorter work weeks, and longer patient waiting times. If current trends continue, new physicians may develop practice arrangements combining elements of fee-for-service and prepayment.
Assuntos
Atenção à Saúde/organização & administração , Adulto , Fatores Etários , Honorários Médicos , Prática de Grupo/organização & administração , Prática de Grupo Pré-Paga/organização & administração , Sistemas Pré-Pagos de Saúde/organização & administração , Humanos , Pessoa de Meia-Idade , Médicos , Administração da Prática Médica , Prática Privada/organização & administração , Estados UnidosRESUMO
The organization and delivery of health services in the United States is currently being re-evaluated in light of emerging trends in the supply and distribution of physicians. The recent GMENAC report identified an impending physician surplus in many specialties and a near-balance situation for dermatology by 1990. In this paper we examine the supply, distribution, and economics of medical practice for dermatologists relative to other specialties. To address the prospect of increasing physician supply, we evaluate emerging national health manpower policies. In addition, we discuss potential effects of market forces in the health care sector.
