Promises and perils of managed care for older patients with cardiac disease

G C Friesinger1, J Francis

  • 1Division of Cardiology, School of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.

Cardiology Clinics
|March 27, 1999
PubMed

Insights

Managed care for elderly cardiovascular patients offers comprehensive, cost-controlled solutions. Physician leadership is key to navigating market challenges and improving patient satisfaction in this growing field.

Area of Science:

  • Geriatric Medicine
  • Cardiovascular Health
  • Healthcare Management

Background:

  • Managed care models are increasingly adopted for elderly patients with cardiovascular disease.
  • Aging presents unique challenges, including comorbidity, necessitating holistic clinical decision-making.
  • The current managed care market for the elderly is dynamic, with varied success rates.

Purpose of the Study:

  • To explore the role and challenges of managed care in elderly cardiovascular health.
  • To highlight the importance of integrated clinical decision-making for older adults.
  • To identify physician leadership as a critical factor in managed care success.

Main Methods:

  • Review of current managed care models for elderly cardiovascular patients.
  • Analysis of factors influencing financial viability and patient satisfaction.
  • Examination of the impact of aging and comorbidity on care management.

Main Results:

  • Managed care demonstrates potential for comprehensive and cost-effective elderly cardiovascular care.
  • Variability in success exists across different managed care models.
  • Physician leadership is identified as a crucial element for effective problem-solving.

Conclusions:

  • Managed care is poised for growth in elderly cardiovascular patient management.
  • A shift towards comprehensive, age-sensitive clinical decision-making is essential.
  • Strategic physician leadership can optimize managed care outcomes for this population.

Related Concept Videos

Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy VI: Nursing Management01:29

Cardiomyopathy VI: Nursing Management

Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...