Biomaterial Database

Healthcare reform: past and future. 1994

K C McDermott

Memorial Sloan-Kettering Cancer Center, New York, NY.

OBJECTIVE To review changes in the healthcare delivery system and project the challenges that practitioners and consumers will face in a reformed environment. METHODS Professional journals and books, print media, and government releases. RESULTS Analysis of projected reform plans, discussions of issues related to complex social, economic, and political factors, and considerations for practice changes for oncology nurses. CONCLUSIONS The pending dominance of healthcare delivery through managed-care systems will challenge oncology care providers and consumers. CONCLUSIONS Oncology nurses must identify the opportunities, master the challenges, and adapt to the trends of the reformed healthcare system. The delivery of long-term care to senior citizens, patients with AIDS, and individuals from diverse cultures will shift to more community, ambulatory, and rural managed-care settings. Oncology nursing practice in these environments raises questions about prevention and screening, diagnosis, treatment, follow-up, alternative care, and research. Oncology nurses, especially advanced practice nurses, will play a pivotal role in reshaping the delivery of patient care and in designing the future of their profession.

UI	MeSH Term	Description	Entries
D008119	Lobbying	A process whereby representatives of a particular interest group attempt to influence governmental decision makers to accept the policy desires of the lobbying organization.	Lobbyings
D008329	Managed Care Programs	Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.	Case Management, Insurance,Insurance Case Management,Managed Health Care Insurance Plans,Managed Care,Care, Managed,Managed Care Program,Management, Insurance Case,Program, Managed Care,Programs, Managed Care
D009859	Oncology Nursing	A nursing specialty concerned with the care provided to cancer patients. It includes aspects of family functioning through education of both patient and family.	Nursing, Oncologic,Oncologic Nursing,Cancer Nursing,Oncological Nursing,Nursing, Cancer,Nursing, Oncological,Nursing, Oncology
D009936	Organizational Innovation	Introduction of changes which are new to the organization and are created by management.	Organizational Change,Change, Organizational,Innovation, Organizational,Changes, Organizational,Innovations, Organizational,Organizational Changes,Organizational Innovations
D009937	Organizational Objectives	The purposes, missions, and goals of an individual organization or its units, established through administrative processes. It includes an organization's long-range plans and administrative philosophy.	Goal Setting, Organizational,Goals, Organizational,Objectives, Organizational,Organizational Goals,Goal Settings, Organizational,Goal, Organizational,Objective, Organizational,Organizational Goal,Organizational Goal Setting,Organizational Goal Settings,Organizational Objective,Setting, Organizational Goal,Settings, Organizational Goal
D011057	Politics	Activities concerned with governmental policies, functions, etc.	Political Activity,Conservatism,Decentralization,Liberalism,Political Factors,Activities, Political,Activity, Political,Factor, Political,Factors, Political,Political Activities,Political Factor
D003695	Delivery of Health Care	The concept concerned with all aspects of providing and distributing health services to a patient population.	Delivery of Dental Care,Health Care,Health Care Delivery,Health Care Systems,Community-Based Distribution,Contraceptive Distribution,Delivery of Healthcare,Dental Care Delivery,Distribution, Non-Clinical,Distribution, Nonclinical,Distributional Activities,Healthcare,Healthcare Delivery,Healthcare Systems,Non-Clinical Distribution,Nonclinical Distribution,Activities, Distributional,Activity, Distributional,Care, Health,Community Based Distribution,Community-Based Distributions,Contraceptive Distributions,Deliveries, Healthcare,Delivery, Dental Care,Delivery, Health Care,Delivery, Healthcare,Distribution, Community-Based,Distribution, Contraceptive,Distribution, Non Clinical,Distributional Activity,Distributions, Community-Based,Distributions, Contraceptive,Distributions, Non-Clinical,Distributions, Nonclinical,Health Care System,Healthcare Deliveries,Healthcare System,Non Clinical Distribution,Non-Clinical Distributions,Nonclinical Distributions,System, Health Care,System, Healthcare,Systems, Health Care,Systems, Healthcare
D005544	Forecasting	The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology.	Futurology,Projections and Predictions,Future,Predictions and Projections
D006285	Health Planning	Planning for needed health and/or welfare services and facilities.	Health and Welfare Planning,National Health Planning and Resources Development Act of 1974,Planning, Health and Welfare,State Health Planning, United States,PL93-641,Public Law 93-641,Planning, Health,Public Law 93 641
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man