McSweeney M H
Public Administration Institute, Fairleigh Dickinson University, Teaneck, NJ, USA.
J Health Care Finance. 1995 Fall;22(1):82-9.
This article presents findings from a recently completed Health Insurance Association of America-sponsored survey that sought to measure the extent to which long-term care insurers utilize case/care management services in their policies. The survey sought to measure the extent to which long-term care insurers paid for newer, long-term care alternatives. Contrary to previous findings in the literature, the survey results show that case management services are typically delivered through a combination of internal and external networks, and are utilized primarily by insurers in employer markets. In light of national health care reform, these survey results indicates a need to reexamine the role of case management in delivering long-term care services, particularly within private financing mechanisms such as long-term care insurance.
本文展示了美国健康保险协会近期完成的一项调查结果。该调查旨在衡量长期护理保险公司在其保险政策中利用病例/护理管理服务的程度。该调查还试图衡量长期护理保险公司为更新的长期护理替代方案支付费用的程度。与以往文献中的研究结果相反，调查结果显示，病例管理服务通常通过内部和外部网络相结合的方式提供，并且主要被雇主市场中的保险公司所采用。鉴于国家医疗保健改革，这些调查结果表明有必要重新审视病例管理在提供长期护理服务中的作用，尤其是在长期护理保险等私人融资机制中。
