The new health care for profit : doctors and hospitals in a competitive environment

The new health care for profit doctors and hospitals in a competitive environment

Detalles Bibliográficos
Autor Corporativo: Institute of Medicine (U.S.) (-)
Otros Autores: Gray, Bradford H., 1942- (-)
Formato: Libro electrónico
Idioma:Inglés
Publicado: Washington, D.C. : National Academy Press c1983.
Edición:1st ed
Materias:
Health facilities, Proprietary > United States.
Medical corporations > United States.
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009622265106719
Tabla de Contenidos:
  • The New Health Care for Profit
  • Copyright
  • Preface
  • Contents
  • An Introduction to the New Health Care for Profit
  • THE CHANGING HEALTH CARE ENVIRONMENT
  • PROFESSIONAL AUTONOMY, TRUST, AND HEALTH POLICY
  • IMPLICATIONS OF THE CURRENT CHANGES IN FOR-PROFIT HEALTH CARE
  • THE INSTITUTE OF MEDICINE PROJECT
  • CONCLUSION
  • REFERENCES AND NOTES
  • Legal Differences Between Investor-Owned and Nonprofit Health Care Institutions
  • ORGANIZATIONAL DIFFERENCES
  • Investor-Owned Hospitals
  • Nonprofit Hospitals
  • FINANCIAL DIFFERENCES
  • Tax Exemptions
  • Reimbursement Factors
  • Sources of Capital
  • Restrictions On Transfers of Property
  • OTHER LEGAL DIFFERENCES
  • CONCLUSION
  • REFERENCES AND NOTES
  • Wall Street and the For-Profit Hospital Management Companies
  • ANALYSTS' SOURCES OF INFORMATION
  • FINANCIAL ANALYSES OF COMPANIES
  • THE IMPORTANCE OF STOCK PRICES TO THE COMPANIES
  • REASONS FOR SUCCESS OF THE HOSPITAL MANAGEMENT COMPANIES
  • DIFFERENCES AMONG COMPANIES
  • ACQUISITIONS
  • MAKING HOSPITALS HEALTHIER
  • OUTLOOK FOR THE FUTURE
  • REFERENCES AND NOTES
  • When Investor-Owned Corporations Buy Hospitals: Some Issues and Concerns
  • THE FIVE CASES
  • County Hospital A
  • County Hospital B
  • Doctors Hospital
  • Osteopathic Hospital
  • Suburban County Hospital
  • MAJOR ISSUES
  • Control
  • Job Security and Benefits
  • Plant and Equipment
  • Charges for Care
  • Quality of Care
  • Admission Policies
  • Buy-Back Provision
  • THE PROCESS
  • CONCLUSIONS
  • Appendix Principal Interviews Conducted for This Paper
  • Physician Involvement in Hospital Decision Making
  • A TYPOLOGY OF HOSPITAL DECISION MAKING
  • CONVERGENCE VERSUS DIVERGENCE OF INTERESTS
  • THE DECISION MAKERS
  • The Dual Authority Model
  • The Shared Authority Model
  • STRAIN AMONG DECISION MAKERS AND BETWEEN THE TWO MODELS
  • TYPES OF PHYSICIAN DECISION-MAKING INVOLVEMENT.
  • HOSPITAL/PHYSICIAN DECISION MAKING AND THE COST AND QUALITY OF CARE
  • Evidence Regarding Costs
  • Evidence Regarding Quality
  • Evidence Regarding Possible Trade-Offs Between Cost and Quality
  • FUTURE ISSUES
  • The Changing Context of Clinical Decision Making
  • The Changing Context of Institutional Decision Making
  • The Demise of the Voluntary Medical Staff
  • Factors Promoting or Impeding Shared Decision-Making Models
  • SUMMARY
  • REFERENCES AND NOTES
  • Economic Incentives and Clinical Decisions
  • MODELS OF CLINICAL DECISION MAKING
  • INCENTIVES FROM THE PERSPECTIVE OF THE PHYSICIAN AND THE ECONOMIST
  • Incentives and the Use of Technology
  • Payment and Practice Setting Incentives
  • Individual versus Collective Patterns of Practice
  • SUMMARY AND CONCLUSIONS
  • REFERENCES
  • Ethical Dilemmas of For-Profit Enterprise in Health Care
  • HISTORY OF THE ETHICS CONTROVERSY
  • The International Context
  • The American Medical Association
  • Advertising
  • Patents
  • Dispensing Pharmaceuticals and Receiving Rebates
  • Fee Splitting
  • Ownership of Health Facilities and Corporate Relations
  • A SUMMARY OF THE PROFESSIONAL PHYSICIAN STANCE
  • Basic Principles of the Professional Stance
  • Service to the Patient
  • Physician Control of Decision Making and Fees
  • Acceptance of Profit Motive
  • Suspicion of Commercialization
  • An Interpretation of the Professional Stance
  • PHYSICIANS COMPARED WITH OTHER PROFESSIONALS
  • A PHILOSOPHICAL EVALUATION OF THE PROBLEM
  • Problems with Evaluations Based on Professional Codes
  • Basic Philosophical Themes
  • Business Ethics and Physician Ethics: The Role of Altruism
  • Deontological versus Consequentialist Ethics
  • Health Care as a Commodity
  • The Double Agent Problem
  • Differences Between Business and Physician Ethics
  • Lying and Deception
  • Competitor's Use of Outdated Information.
  • Enticement of Customers into Needless Consumption
  • Exclusion of Inefficient Customers
  • The Duty to the Indigent
  • Supplying Unprofitable Products and Services
  • Differing Concepts of Self-Regulation
  • CONCLUSION
  • REFERENCES AND NOTES
  • Secondary Income From Recommended Treatment: Should Fiduciary Principles Constrain Physician Behavior?
  • THE PHYSICIAN-PATIENT CONFLICT OF INTEREST PROBLEM
  • BACKGROUND OF FIDUCIARY LAW
  • FIDUCIARY THEORY IN MEDICAL LITIGATION
  • Physician As Guardian of Patient Property
  • Kickback Cases
  • Reimbursement Cases
  • Girl and Contract Cases
  • Physician As Advisor
  • Confidentiality Cases
  • Statute of Limitations Cases
  • Informed Consent Cases
  • Physician as Agent
  • CONCLUSION
  • REFERENCES AND NOTES
  • Biographical Sketches of Contributors
  • Index.

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