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Managed Care and The Treatment of Chronic Illness
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Managed Care and The Treatment of Chronic Illness


Other Titles in:
Substance Abuse Counselling

October 2001 | 256 pages | SAGE Publications, Inc
This book provides a comprehensive overview and analysis of the current thinking on managed care, exploring the issues related to treating chronic illness in Managed Care Organizations; chronic care in MCOs versus that provided under traditional insurance arrangements; specific programs MCOs have develped and there effectiveness; and futre avenues for development and research.
E. Wagner
Foreword
 
Preface
 
1. Introduction
Defining Chronic Illness

 
Defining Managed Care/Managed Care Organizations

 
Organizing the Literature Review and Synthesis

 
Searching for Relevant Literature

 
Appendiz: Description of Illnessq

 
 
2. Chronic Illness and Managed Care: What Are the Issues?
People With Chronic Illness

 
The Shift to Managed Care

 
Early Concerns

 
Current Debate

 
Research Issues

 
 
3. Individuals With Chronic Illness: MCO Versus Fee-for-Service Comparisons
Discussion

 
 
4. The Prevalence of Chronic Illness Management Programs in Managed Care Organizations
Background

 
Small-Scale Studies

 
The Wagner et al. Study

 
The InterStudy Survey

 
Vendor Products and Chronic Illness "Carve-Outs"

 
Vendor Products for Use With Multiple Diseases

 
Vendor Products for Specific Chronic Illness

 
Discussion

 
 
5. Use of Administrative and Medical Records Data by MCOs for Chronic Illness Management
Benchmarking

 
Assessment of Quality of Care

 
Identification of Opportunities for Improvement

 
Profiling of Clinics and Providers

 
Characterization of High-Risk Patients

 
Simulation of Disease Management Interventions

 
Summary

 
 
6. The Effectiveness of Targeted Initiatives in Treating Chronic Illnesses
Some Definitions

 
Criteria for Study Selection

 
Overview of Review Process

 
Diabetes

 
Asthma

 
Congestive Heart Failure

 
Cardiovascular Disease

 
Arthritis

 
Overall Summary and Conclusions

 
Appendix A

 
Appendix B

 
Appendix C

 
Appendix D

 
Appendix E

 
 
7. Conclusions and Future Research Directions
Observations on Existing Research

 
Research Challenges for the Future

 
 
Index
 
About the Authors

"Managed Care and the Treatment of Chronic Illness will be a stepping stone for health service researchers, policy analysts and policymakers, managed care administrators, and educators in the fields of medicine, epidemiology, economics, and sociology. The book makes an important addition to the growing literature advocating more comprehensive system change to improve the outcomes of patients with chronic illness."

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ISBN: 9780761919674
£141.00