The American journal of managed care
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To determine if ethnic minority physicians experience more barriers in acquiring and maintaining managed care contracts than white physicians, and to determine if the physician's perceptions of his or her ability to provide appropriate care to patients varies with physician ethnicity. ⋯ Although we did not find overwhelming evidence of discrimination against ethnic minority physicians, differences in rates of termination, type of practice, board certification rates, and managed care affiliation were related to physician ethnicity.
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Editorial Comment
Equal employment opportunity in managed care organizations.
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Comparative Study
Managed care issues and rheumatoid arthritis treatment. Based on a presentation by Michael Ward, MD.
System of payment (whether managed care or fee-for-service) can impact long-term health outcomes and treatment options. Two studies focussing specifically on rheumatoid arthritis found little or no difference in outcomes for patients covered by these payment systems. However, it was found that unrestricted access to treatment from rheumatologists and the continuity of care provided by these specialists did have a strong positive influence on improving function and reducing disability overall.
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The direct, indirect, and intangible costs of rheumatoid arthritis (RA) represent an enormous burden to patients, clinicians, and to society in general. Quality of life is consistently worse--at any age--for RA patients and they tend to die at younger ages. Lessening the burden may be possible through more accurate and careful measurement of quality of life, disease progression, and therapeutic outcomes. Predicting the likely progression of RA and determining which patients will show improvement and which can expect disability is important in discovering which therapeutic approaches are the most useful in ultimately lessening the burden of RA.
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To determine the need for routine third-trimester antibody screening in Rh+ women. ⋯ Based on the patient and hospital records studied, a repeat third-trimester antibody screen for Rh+ patients is clinically and economically unjustified. Eliminating this laboratory test from clinical practice will not adversely affect pregnancy outcomes and will decrease the costs of prenatal care.