Miller B, Rosenbaum S, Stange P V, Solomon S L, Castro K G
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Infect Dis. 1998 Oct;27(4):677-86. doi: 10.1086/514962.
Increasingly, patients with tuberculosis are receiving clinical care in managed care organizations as a result of enrollment in Medicaid or Medicare, or coverage under privately purchased insurance policies or employee benefit plans. This represents a change from the system that has been in place for decades, where the clinical care and public health functions concerning treatment and control of tuberculosis occurred primarily in local health departments. The separation of individual patient care from the public health aspects of tuberculosis control has created challenges for managed care administrators, medical providers, and public health officials. To assist in the integration of the goals of managed care and public health with respect to the prevention and control of tuberculosis, we developed a set of model contract specifications for use by purchasers of managed care and by managed care organizations concerning the management of patients with tuberculosis and other related public health issues. These specifications can assist health officials in continuing their leadership roles by ensuring that managed care contracts address public health needs.
由于参加医疗补助计划或医疗保险，或受私人购买的保险政策或员工福利计划覆盖，越来越多的结核病患者在管理式医疗组织中接受临床护理。这与已实施数十年的系统有所不同，在过去，有关结核病治疗和控制的临床护理及公共卫生职能主要由地方卫生部门承担。将个体患者护理与结核病控制的公共卫生方面分开，给管理式医疗管理人员、医疗服务提供者和公共卫生官员带来了挑战。为协助在结核病预防和控制方面整合管理式医疗与公共卫生的目标，我们制定了一套示范合同规范，供管理式医疗购买者和管理式医疗组织用于管理结核病患者及其他相关公共卫生问题。这些规范可通过确保管理式医疗合同满足公共卫生需求，帮助卫生官员继续发挥其领导作用。
