Objective.-Because we found examples where courts of law ruled against insurance carriers that had been sued for reimbursement for unproven medical procedures, we conducted a case study to determine the reasoning behind these decisions that run counter to accepted medical science.
Such actions circumvent health technology assessment and could contribute to escalating health care costs and poorer quality health care.
Data Sources.-A literature search identified 17 cases between 1980 and 1989 in which an insurance company was sued to reimburse a patient who had received an unproven or questionable health technology; 14 of these suits were decided in favor of the plaintiff, and the insurance company was ordered to pay.
Mots-clés Pascal : Système santé, Exploration, Homme, Etude cas, Assurance maladie, Technologie, Médecine, Non prouvé
Mots-clés Pascal anglais : Health system, Exploration, Human, Case study, Health insurance, Technology, Medicine
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 93-0453201
Code Inist : 002B30A01B. Création : 199406.