The American journal of managed care
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To identify the resource use and costs associated with the diagnosis of common problems in primary care practice and to investigate the influence of physician characteristics, practice organization, and financial incentives on physician behavior. ⋯ Multispecialty group practice and compensation by salary consistently predict lower costs for evaluation of common problems in primary care practice. Financial incentives such as capitation, withholds, and bonuses were not associated with an effect on costs of diagnostic evaluation.
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To assess the effects of health need, enabling factors, and predisposing factors on entry into any type of care, volume of care, use of emergency services, hospitalization, and receipt of preventive services. ⋯ Access to care for Hispanics remains a major problem, significantly affected by structural and financial factors, personal experiences with the healthcare system, and predisposing factors. Policy solutions that address the health service needs of the uninsured will largely benefit Hispanics. In addition, as managed care plans compete for contracts and become more multicultural, access to care for Hispanics, including the uninsured, may improve through market forces.
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To gauge women's flexibility about seeing a nurse or an unfamiliar physician, to assess their interest in telephone visits, and to identify the characteristics of women who are least flexible. ⋯ The flexibility of most women regarding redesigned models of healthcare is encouraging. More attention needs to be paid, however, to education of women about multidisciplinary roles, enhancement of coordination of care, and customization of care to match patients' preferences.
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Comparative Study
The cost of Medicaid-covered services provided to disabled adults with neurologic disorders: implications for managed care.
To estimate the mean annual per capita cost of care provided to disabled adult Medicaid recipients with neurologic conditions and to compare mean annual costs for disabled adult Medicaid recipients with those of nondisabled adult Medicaid recipients. ⋯ States may want to separately capitate rehabilitation and support services given the large differences in the magnitude and relative distribution of costs for disabled and nondisabled Medicaid recipients.