Referrals are a central component of the American health care system, defining the relationship among generalists, patients, and specialists.
The dynamics of the referral process as they existed in a fee-for-service medical environment will evolve under managed care, but retain the basic « Try-out » approach of the generalist and « Rule-out » approach of the specialist.
A managed care, contract-based health care system alters some of the assumptions on which the referral relationship has been structured.
A four-step approach to assuring quality interactions among patient, generalist, and specialist within the managed care environment is described, including :
(1) engage ;
(2) anticipate ;
(3) feedback ;
and (4) reassess.
When the referral process is structured as suggested, it can be evaluated for quality and efficacy.
Armed with mutual respect and understanding, the forces that polarized specialist and generalist care in the 1980s can be redirected to enhancing patient care in the 1990s.
Mots-clés Pascal : Système santé, Etats Unis, Centre santé, Pratique professionnelle, Article synthèse, Conduite à tenir, Orientation malade, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Health system, United States, Health center, Professional practice, Review, Clinical management, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0193635
Code Inist : 002B30A01B. Création : 199608.