The Health Maintenance Organization: I. Historical perspective and current status.

Psychotherapy ◽  
1988 ◽  
Vol 25 (3) ◽  
pp. 441-448 ◽  
Author(s):  
Jeremy Kisch ◽  
Carol Shaw Austad
1996 ◽  
Vol 17 (10) ◽  
pp. 357-369
Author(s):  
Theodore J. Pysher ◽  
Phillip R. Bach

Historical Perspective and Current Status of the Multitest Chemistry Profile The development of a single instrument that could reproducibly sample a specimen, mix it with the required reagents at appropriate intervals, and analyze the resulting reaction revolutionized the chemical analysis of clinical specimens. Not long after its development, several of these Auto AnalyzersTM, each dedicated to measuring a different analyte, were linked, and the Sequential Multiple Analyzer (SMATM) was born. Because these systems were automated, they could perform the analyses for which they were designed at less expense, with greater precision, and in less time than when the tests were performed by hand. Moreover, it was claimed that the integration of the measurement of these chemical markers of disease into the routine health maintenance examination would lead to earlier detection of disease and improved patient care. These early multitest analyzers had only limited application in pediatrics because they required so large a specimen. The SMA-12TM, for example, required 3 mL of serum for each 12-test panel. Two developments, however, made the multitest chemistry analyzer accessible to pediatric-sized samples-microcomputes and ever smaller components. The early multitest analyzers were marvels of creative plumbing in which each specimen ran the full course of the instrument and, therefore, the same amount had to be sampled whether one or all of the 6, 12, or 24 available tests were requested.


1993 ◽  
Vol 9 (2) ◽  
pp. 96-100 ◽  
Author(s):  
Thomas Payne ◽  
Susan Kanvik ◽  
Richard Seward ◽  
Doug Beeman ◽  
Angela Salazar ◽  
...  

1995 ◽  
Vol 23 (3) ◽  
pp. 247-265 ◽  
Author(s):  
E. Haavi Morreim

Several prominent cases have recently highlighted tension between the interests of individuals and those of the broader population in gaining access to health care resources. The care of Helga Wanglie, an elderly woman whose family insisted on continuing life support long after she had lapsed into a persistent vegetative state (PVS), cost approximately $750,000, the majority of which was paid by a Medi-gap policy purchased from a health maintenance organization (HMO). Similarly, Baby K was an anencephalic infant whose mother, believing that all life is precious regardless of its quality, insisted that the hospital where her daughter was born provide mechanical ventilation, including intensive care, whenever respiratory distress threatened her life. Over the hospital's objections, courts ruled that aggressive care must be provided. Much of Baby K's care was covered by her mother's HMO policy. In the 1993 case of Fox v. HealthNet, a jury awarded $89 million to the family of a woman whose HMO had refused, as experimental, coverage for autologous bone marrow transplant in treating her advanced breast cancer.


1998 ◽  
Vol 88 (6) ◽  
pp. 897-902 ◽  
Author(s):  
C M McBride ◽  
P Lozano ◽  
S J Curry ◽  
D Rosner ◽  
L C Grothaus

2016 ◽  
Vol 23 (4) ◽  
pp. 319-328 ◽  
Author(s):  
Fagen Xie ◽  
Chengyi Zheng ◽  
Albert Yuh-Jer Shen ◽  
Wansu Chen

The left ventricular ejection fraction value is an important prognostic indicator of cardiovascular outcomes including morbidity and mortality and is often used clinically to indicate severity of heart disease. However, it is usually reported in free-text echocardiography reports. We developed and validated a computerized algorithm to extract ejection fraction values from echocardiography reports and applied the algorithm to a large volume of unstructured echocardiography reports between 1995 and 2011 in a large health maintenance organization. A total of 621,856 echocardiography reports with a description of ejection fraction values or systolic functions were identified, of which 70 percent contained numeric ejection fraction values and the rest (30%) were text descriptions explicitly indicating the systolic left ventricular function. The 12.1 percent (16.0% for male and 8.4% for female) of these extracted ejection fraction values are <45 percent. Validation conducted based on a random sample of 200 reports yielded 95.0 percent sensitivity and 96.9 percent positive predictive value.


2007 ◽  
Vol 143A (6) ◽  
pp. 564-569 ◽  
Author(s):  
Brenda Diergaarde ◽  
Deborah J. Bowen ◽  
Evette J. Ludman ◽  
Julie O. Culver ◽  
Nancy Press ◽  
...  

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