Health Outcomes and Managed Care: Discussing the Hidden Issues
Chin, Marshall H.
American Journal Of Managed Care. 1997 May; 3(5): 756-762.
Too often the debate over health outcomes and managed care has glossed over a series of complex social, political, and ethical issues. Exciting advances in outcomes research have raised hopes for logical medical reform. However, science alone will not optimize our patients' health, since value judgements are necessary and integral parts of attempts to improve health outcomes within managed care organizations. Therefore, to form healthcare policy that is both fair and efficient, we must examine the fundamental values and ethical concerns that are imbedded in our efforts to shape care. We must openly discuss the hidden issues including: (1) trade-offs between standardization of care and provider-patient autonomy; (2) effects of financial incentives on physicians' professionalism; (3) opportunity costs inherent in the design of insurance plans; (4) responsibilities of managed care plans for the health of the public; (5) judicious and valid uses of data systems; and (6) the politics of uncertainty.
Autonomy; Costs and Benefits; Consultation; Economics; Ethics; Evidence-Based Medicine; Gatekeeping; Guidelines; Health; Health Care; Health Care Reform; Health Insurance; Health Services; Health Services Research; Incentives; Indigents; Institutional Ethics; Insurance; Managed Care Programs; Medicine; Managed Care; Obligations to Society; Organizations; Patient Satisfaction; Patients; Physicians; Politics; Practice Guidelines; Preventive Medicine; Professional Autonomy; Public Policy; Quality of Health Care; Referral and Consultation; Remuneration; Research; Resource Allocation; Review; Responsibilities; Science; Treatment Outcome; Uncertainty; Values; Vulnerable Populations; Withholding Treatment;
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Ethical Cautions in the Use of Outcomes for Resource Allocation in the Managed Care Environment of Mental Health Olsen, Douglas P. (1995-08)Increasingly, resources are being allocated through competitive contracting based on outcome data. This context for outcome research renews ethical concern about the nature of outcome data in the field of mental health. ...