Kanwit S W
Groom Law Group, Chartered, Washington, DC, USA.
Oncology (Williston Park). 1998 Nov;12(11A):162-5.
As both public and private health plans move increasingly to managed care, a vigorous debate is occurring about how to ensure health care quality for the American public, while at the same time managing the cost of that care. Health plans generate large volumes of data related to their networks and providers, plan sponsors, member care, and medical protocols. This data can help assure quality, and at the same time help managed care organizations deal with one of the most critical tasks facing them--risk management. This paper may be helpful in providing an outline of two key areas--managed care liability for quality of patient care, and privacy and confidentiality concerns from a managed care organization perspective--followed by suggestions to avoid or minimize liability.
随着公共和私人健康计划越来越多地转向管理式医疗，关于如何确保美国公众的医疗保健质量，同时控制医疗成本的激烈辩论正在展开。健康计划会生成大量与网络、提供者、计划赞助商、会员护理和医疗协议相关的数据。这些数据有助于确保质量，同时帮助管理式医疗组织处理它们面临的最关键任务之一——风险管理。本文可能有助于概述两个关键领域——患者护理质量的管理式医疗责任，以及从管理式医疗组织角度出发的隐私和保密问题——随后提出避免或尽量减少责任的建议。
