In 1990, the Florida Legislature established the Florida Healthy Kids Corporation to implement the concept of school enrollment-based health insurance coverage for children.
The county school districts are used as a grouping mechanism to negotiate health insurance policies.
The Florida Healthy Kids Corporation negotiates contracts with health maintenance organizations (HMOs) to assume financial risk and to provide health care services at each program site.
In 1994, there were five sites with four different participating HMOs.
Assessing quality of care is particularly important when contracting with HMOs because of the perception that financial and utilization review arrangements may restrict the enrollees'access to needed health care.
One essential component of health care quality is the extent to which health care services are used in a manner consistent with the expected pattern of use for the population of enrolled children.
The purpose of this study is to compare children's health care use across five different Florida Healthy Kids Program sites.
Specifically, we compare the enrollees'actual health care use across HMO settings and program sites to the expected health care use based on the enrollees'case-mix.
Each HMO provided child-specific health care use data including Physician's Current Procedural Terminology codes and International Classification of Diseases, 9th Revision codes. (...)
Mots-clés Pascal : Pauvreté, Soin intégré, Etats Unis, Amérique du Nord, Amérique, Programme sanitaire, Organisation santé, Enfant, Homme, Soin
Mots-clés Pascal anglais : Poverty, Managed care, United States, North America, America, Sanitary program, Public health organization, Child, Human, Care
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0069116
Code Inist : 002B30A07E. Création : 14/05/1998.