The Impact of Managed Care on Physicians

Warren, Mary Guptill; Weitz, Rose; Kulis, Stephen

doi:10.1097/00004010-199904000-00005

Cited by 40 publications

(16 citation statements)

References 8 publications

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“…In July 2002, a generic RUMA protocol was developed based on existing urban malaria research protocols [41,42]. The relevant institutions in each setting were contacted and city-specific proposals were then produced.…”

Section: Methodsmentioning

confidence: 99%

Rapid urban malaria appraisal (RUMA) in sub-Saharan Africa

Wang

Lengeler

Smith

et al. 2005

Malar J

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BackgroundThe rapid urban malaria appraisal (RUMA) methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology.MethodsThis work was done in Yopougon municipality (Abidjan), Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1) a literature review, 2) the collection of available health statistics, 3) a risk mapping, 4) school parasitaemia surveys, 5) health facility-based surveys and 6) a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness.ResultsA substantial amount of literature (including unpublished theses and statistics) was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,500–13,000 USD for a six to ten-week period.ConclusionRUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.

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Section: Methodsmentioning

confidence: 99%

Rapid urban malaria appraisal (RUMA) in sub-Saharan Africa

Wang

Lengeler

Smith

et al. 2005

Malar J

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“…A standard study protocol Rapid Urban Malaria Appraisal (RUMA) was developed in June 2002 based on a WHO proposal and an Environmental Health Project draft protocol [13,14]. RUMAs were commissioned by Roll Back Malaria (RBM) for three francophone countries (Ivory Coast, Burkina Faso and Benin) and one anglophone country (Tanzania).…”

Section: Introductionmentioning

confidence: 99%

Rapid urban malaria appraisal (RUMA) I: Epidemiology of urban malaria in Ouagadougou

Wang

Lengeler

Smith

et al. 2005

Malar J

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“…The existing literature regarding managed care's influence on career satisfaction among physicians is mixed 7–12 . Prior studies have examined impacts of managed care on satisfaction using various measures, including HMO arrangements, 7,9,13 individual‐level managed care participation, 11,14 and market‐level managed care penetration 9,15,16 . The negative impact of managed care on physicians' satisfaction that has been found in some studies may be due to reduced income or may be attributable to reduced levels of clinical autonomy, or both 15 .…”

mentioning

confidence: 99%