まとめ
医療維持機関 (HMO) に登録した個人では,入院利用率と医療費が,有料サービス (FFS) 保険を保持した人と比較して,著しく低下しました. これは,自己選択が,ヘルスケアモデル間の観察された差異に役割を果たしていることを示唆しています.
科学分野:
- 医療サービス 研究 医療サービス
- ヘルスケア・マネジメント・ヘルスケア・マネジメント
- 比較効果研究 比較効果研究
背景:
- 従業員の健康保険には,従来のサービス代金制度 (FFS) と,健康維持機関 (HMO) のようなマネージドケアプランの選択肢が含まれる.
- 入学前に利用率とコストの違いを理解することは,ヘルスケアプランの有効性を評価する上で極めて重要です.
研究 の 目的:
- HMOに登録した従業員と,FFSのカバーを継続した従業員の間で,入院患者の利用と医療費を比較する.
- 医療モデル間の利用とコストの格差に影響を与える潜在的な要因を特定する.
主な方法:
- ミネアポリス・セントポール地区の11の従業員グループにおける入院利用と医療費の分析.
- 任意のHMO登録前の年のデータと比較.
- 入院患者の使用パターンの年齢別分析.
主要な成果:
- HMOの加入者は,FFSの加入者と比較して,1000人あたりの入院日数が平均53%少ない (470 vs. 994日/1000).
- HMOに登録した個人では,病院費と専門費の両方が低かった.
- すべての年齢層において,継続的なFFS加入者の間で,より高い入院利用が観察されました.
結論:
- 自己選択は,HMOとFFSのプラン間の利用とコストの観察された差異に影響を与える重要な要因であるようです.
- HMOの登録は,FFSのカバーと比較して,入院患者の利用率と医療費の減少と関連しています.
関連する概念動画
Self-Schemas
In general, a schema is a mental construct consisting of a cluster or collection of related concepts (Bartlett, 1932). There are many different types of schemata, and they all have one thing in common: schemata are a method of organizing information that allows the brain to work more efficiently. When a schema is activated, the brain makes immediate assumptions about the person or object being observed.
Self-Evaluation: Self-Enhancement and Self-Verification
Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our...
Models of Health Promotion and Illness Prevention I
A model is a theoretical way to understand a concept or an idea. Models can overcome barriers to health regardless of diverse economic and cultural backgrounds. In addition, models make the task easier by providing different ways to approach complex issues. There are two major health promotion models: the health belief model and the health promotion model.
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
Purpose of Health Records I
The vital purpose of health records is to provide a complete and accurate account of a patient's medical history, including communication, diagnostic and therapeutic orders, care planning, research, and quality review.
Here's a breakdown of how health records serve these purposes:
Here's a breakdown of how health records serve these purposes:
Methods of Documentation VI: Case Management Model
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
For example, a patient with a chronic illness...
Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities

