Managed Care : A Nursing Perspective

by Finkelman, Anita Ward

• ISBN13: 9780805381528
• ISBN10: 080538152X
• Format: Paperback
• Copyright: 2001-01-01
• Publisher: Prentice Hall

Summary

For graduate courses in nursing, and junior/senior-level courses in managed care, administration and management, health care policy and ethics, case management, trends and issues, health care and nursing history, and health care financing.This text focuses on the impact of managed care on the health care delivery system and its effect on nursing. It guides students through the maze of the managed care environment with four major themes: The Health Care Environment: What It Is and How It Is Affected by Managed Care, Managed Care: What It Is and How It Works, Issues Affecting the Results of Managed Care, Managed Care: Implications for the Nurse. The text covers a wide variety of topics related to health care organizations, reimbursement, quality care, legal and ethical issues, changes in roles and responsibilities, tools and strategies used to monitor care, and changes in clinical practice. It incorporates the most recent information available to prepare nurses for practice in the 21st century.

Table of Contents

Preface	xvii
About The Author	xix
Acknowledgments	xx
Part I THE HEALTH CARE ENVIRONMENT	1	(48)
The Changing Health Care Environment	2	(13)
Reimbursement: A Driving Force	15	(34)
Part II MANAGED CARE: WHAT IS IT AND HOW DOES IT WORK?	49	(130)
Managed Care Organization: The Managed Care Maze	50	(29)
Managed Care Strategies: Performance and Cost	79	(44)
Case Management And Collaborative Care	123	(27)
Clinical Pathways And Other Tools For Managing Care	150	(29)
Part III ISSUES AFFECTING THE RESULTS OF MANAGED CARE	179	(160)
Legal And Ethical Issues	180	(40)
Quality Care In The Managed Care Environment	220	(36)
Managed Care And The Consumer	256	(34)
Medicare And Medicaid: A Managed Care Approach	290	(49)
Part IV MANAGED CARE: IMPLICATIONS FOR THE NURSE	339	(114)
The Nurse And Managed Care	340	(45)
Managed Care And Its Effect On Patient Care	385	(31)
Advanced Practice Nurse And Managed Care	416	(31)
Future: Are We Up To The Challenge?	447	(6)
Appendices	453	(26)
Glossary	479	(14)
Index	493