Question about a managed care system and pt. with end-stage renal disease

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Hello all,

I have a take home assingment due on Fri. and I am driving myself crazy with these two questions. I can't decide between two of the answers. If someone could please help me out I would very much appreciate it!

The question is:

A managed care system focuses on:

1. Control over primary care health services of a defined population

2. Comprehensive instead of fragmented approaches to health

and

The family of a pt. with end-stage renal disease wishes to take the pt. home from the hosptial. The nurse should refer the family to a:

1. Home health agency

2. Hospice

I want say number 2 for both questions, but keep looking it over and going back and forth between 1 and 2 on both questions.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

well, managed care exercises control over primary health care services, but the defined population part of #1 has me a bit stumped. some mcos define who can be the members of their group (i.e. employees of certain companies). i guess the choice to whether or not you chose #1 is what the definition of "defined population" is. on the other hand, while comprehensive care includes primary care, my textbook for trends in healthcare says the major features of managed care primarily focus on cost containment and management of resource consumption. primary care is a byproduct of that because it is the way that allows the mco to contain costs and manage their resources efficiently. so, call me wrong, but i would answer #1 for question #1.

on question #2, i would answer #1. the reason is that the definition of hospice is services for the dying. the question doesn't say anything about the patient being in any immediate danger of dying. so, call me wrong, but i would answer #1 for question #2.

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Specializes in ICU, PACU, Cath Lab.

I have to say for the second part you should answer 1...I work in Dialysis and patients with ESRD...are far from dying many live very long lives!!! So hospice would be inappropriate in my opinion!!

On the first part I would agree with you and put 2...mosty cause that is what we have talked about in class...but I imagine that every school approaches this slightly differently!!! Sorry I could not be more help!!

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Thank you for your reply Daytonite and Calla2114!

I considered what you said and took your advice. I have my fingers crossed now and am hoping for the best!

Thank you !

Sharon

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