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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Atención primaria en la transición
1Department of Medicine, University of California Medical Center, San Francisco.
JAMA
|November 16, 1994
Resumen
La oferta de médicos de atención primaria está disminuyendo debido a la atención administrada y los problemas de reembolso. Las soluciones propuestas incluyen esquemas de tarifas y presupuestos separados para apoyar la práctica de atención primaria.
Área de la Ciencia:
- Política de salud Política de salud
- Economía médica La economía médica.
- Medicina de la Atención Primaria Medicina de la Atención Primaria.
Sus antecedentes:
- La escasez de médicos en la atención primaria es un problema reconocido.
- La atención administrada y la implementación de la escala de valor relativo basado en recursos (RBVS) tienen un impacto negativo en los médicos de atención primaria.
- Los médicos de atención primaria se enfrentan a desafíos debido a la menor riqueza, influencia y número en comparación con los especialistas.
Objetivo del estudio:
- Analizar el impacto de las tendencias actuales de la atención médica en los médicos de atención primaria.
- Proponer estrategias para proteger y mejorar la práctica de atención primaria y el suministro de médicos.
Principales métodos:
- Análisis cualitativo de la política de salud y los factores económicos que afectan a la atención primaria.
- Revisión de los modelos de reembolso existentes y las estructuras de atención administrada.
- Identificación de las barreras para la contratación y retención de médicos de atención primaria.
Principales resultados:
- La atención administrada y la implementación de RBVS han tenido consecuencias negativas no deseadas en los médicos de atención primaria.
- Los médicos de atención primaria están en desventaja en las negociaciones con los pagadores y entre sus pares.
- El apoyo existente para la atención primaria puede ser insuficiente o superficial.
Conclusiones:
- Se proponen horarios y presupuestos de tarifas de atención primaria separados dentro de los planes de salud.
- Se sugieren modificaciones a las normas de protección al consumidor que afectan a la atención primaria.
- Se recomienda el desarrollo de asociaciones estatales de atención primaria para aumentar el poder de negociación y el apoyo mutuo.
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