The impacts of Malaysian managed care on doctor–patient relationships, ethical practice of medicine, and quality of care: A study on primary care physicians' perception

2016 ◽  
Vol 9 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Paul Chan Hong Kit ◽  
Siti Zaleha Abdul Rasid ◽  
Maizaitulaidawati Md Husin
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Managed Care ◽  
Primary Care Physicians ◽  
Ethical Practice ◽  
Practice Of Medicine ◽  
Patient Relationships

scholarly journals Utilization of Services by Chronically Ill People in Managed Care and Indemnity Plans: Implications for Quality

2003 ◽  
Vol 40 (1) ◽  
pp. 57-70 ◽  
Author(s):  
Stephen M. Davidson ◽  
Harriet Davidson ◽  
Heidi Miracle-McMahill ◽  
J. Michael Oakes ◽  
Sybil Crawford ◽  
...  
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Chronic Conditions ◽  
Primary Care Physicians ◽  
Chronically Ill ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Utilization Of Services ◽  
Managed Care Organizations

Because incentives for managed care organizations favor cost containment, concerns have been raised that quality of care has suffered, especially for chronically ill people. This study compares utilization rates of managed care and indemnity patients with three chronic conditions, using five years of claims records (1993–97) from private plans and Medicare in one market. Findings show that for all three conditions, managed care patients were more likely to see both primary care physicians and specialists within a year, but less likely to use a hospital emergency department or to be an inpatient. Assuming that patients with these illnesses should see a physician annually and that good primary care reduces the need for emergency and inpatient services, it appears that the patterns of care used by chronically ill managed care patients in this market do not reflect lower quality than that received by similar indemnity patients.

scholarly journals State Funding for Health Information Technology and Selected Ambulatory Healthcare Quality Measures

2014 ◽  
Vol 05 (02) ◽  
pp. 594-602 ◽  
Author(s):  
M. Silver ◽  
R. Kaushal ◽  
L. M. Kern ◽  
Keyword(s):  
Primary Care ◽  
New York ◽  
Quality Of Care ◽  
Primary Care Physicians ◽  
New York State ◽  
Quality Measures ◽  
State Funding ◽  
Health It ◽  
York State

SummaryBackground: Previous studies on the effects of health information technology (health IT) on ambulatory quality have had mixed results. New York State has invested heavily in health IT throughout the State, creating a unique opportunity to assess effects on health care quality across multiple communities.Objective: To determine any association between primary care providers’ receipt of funding from New York State’s Healthcare Efficiency and Affordability Law for New Yorkers Program (HEAL NY) and ambulatory quality of careMethods: A statewide, longitudinal cohort study of primary care physicians in New York State was conducted. Data regarding which primary care physicians received funding through the HEAL NY program (Phase 5 or Phase 10) in 2008 or 2009 were obtained from the New York State Department of Health. Health care quality in 2010 was measured using claims data that had been aggregated across 7 commercial health plans across the state. Physicians were divided into 2 groups, based on receipt of HEAL funding (yes/no). Any association was measured between study group and each of 7 quality measures, all of which appear in the Stage 1 federal Meaningful Use program. Negative binomial regression was used, adjusting for provider gender and specialty.Results: The study included 3,988 primary care providers, of whom 863 (22%) had received HEAL NY funding. The HEAL-funded physicians provided higher quality of care on 5 of the 7 measures: breast cancer screening, eye exams in patients with diabetes, nephropathy screening in patients with diabetes, influenza vaccination and pneumococcal vaccination (p<0.0001 for all adjusted comparisons). The HEAL-funded group provided higher quality of care by an absolute 2 to 6 percentage points per measure for those 5 measures.Conclusion: Primary care physicians who received state funding for health IT provided higher quality of care than those who did not receive such funding.Citation: Kern LM, Silver M, Kaushal R; with the HITEC Investigators. State funding for health information technology and selected ambulatory healthcare quality measures. Appl Clin Inf 2014; 5: 594–602 http://dx.doi.org/10.4338/ACI-2013-12-RA-0108

Identifying individuals with multiple sclerosis in an electronic medical record

2014 ◽  
Vol 21 (2) ◽  
pp. 217-224 ◽  
Author(s):  
Kristen M Krysko ◽  
Noah M Ivers ◽  
Jacqueline Young ◽  
Paul O’Connor ◽  
Karen Tu
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Primary Care Physicians ◽  
Policy Makers ◽  
Patient Profile ◽  
Physician Billing ◽  
Chart Abstraction

Background: The increasing use of electronic medical records (EMRs) presents an opportunity to efficiently evaluate and improve quality of care for individuals with MS. Objectives: We aimed to establish an algorithm to identify individuals with MS within EMRs. Methods: We used a sample of 73,003 adult patients from 83 primary care physicians in Ontario using the Electronic Medical Record Administrative data Linked Database (EMRALD). A reference standard of 247 individuals with MS was identified through chart abstraction. The accuracy of identifying individuals with MS in an EMR was assessed using information in the cumulative patient profile (CPP), prescriptions and physician billing codes. Results: An algorithm identifying MS in the CPP performed well with 91.5% sensitivity, 100% specificity, 98.7% PPV and 100% NPV. The addition of prescriptions for MS-specific medications and physician billing code 340 used four times within any 12-month timeframe slightly improved the sensitivity to 92.3% with a PPV of 97.9%. Conclusions: Data within an EMR can be used to accurately identify patients with MS. This study has positive implications for clinicians, researchers and policy makers as it provides the potential to identify cohorts of MS patients in the primary care setting to examine quality of care.

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