Abstract:
:Payment systems in the US healthcare system have rewarded physicians for services and attempted to control healthcare spending, with rewards and penalties based upon projected goals for future spending. The incorporation of quality goals and alternatives to fee-for-service was introduced to replace the previous system of rewards and penalties. We describe the history of the US healthcare payment system, focusing on Medicare and the efforts to control spending through the Sustainable Growth Rate. We describe the latest evolution of the payment system, which emphasizes quality measurement and alternative payment models. We conclude with suggestions for how to influence physician behavior through education and payment reform so that their behavior aligns with alternative care models to control spending in the future.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Hauswald E,Sklar Ddoi
10.14423/SMJ.0000000000000626subject
Has Abstractpub_date
2017-04-01 00:00:00pages
249-254issue
4eissn
0038-4348issn
1541-8243pii
SMJ50355journal_volume
110pub_type
杂志文章abstract::A case of SLE with the unique association of gastric polyps and vasculitis is reported. Gastrointestinal symptoms, surgical indications, and complications of SLE with gastrointestinal involvement are reviewed. The unusual patterns of ileus or lupus peritonitis secondary to mesenteric vasculitis must be differentiated ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1976-04-01 00:00:00
abstract::Inhalation abuse of volatile solvents, previously known generically as "glue sniffing," is typically pursued by adolescents. A wide range of legal, easily obtained products containing volatile substances are available for abuse. We report two illustrative cases of fatal volatile substance abuse: gasoline sniffing in a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::The topical anesthetic solution TAC (tetracaine, adrenaline, cocaine) has gained widespread acceptance as the preferred local anesthetic for repairing skin lacerations in children. Despite this popularity, there are no universally accepted guidelines for its application. We report the case of a 6-month-old infant who ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198911000-00004
更新日期:1989-11-01 00:00:00
abstract::The urushiol dermatitis caused by plants of the Anacardiaceae family is the most common cause of acute allergic contact dermatitis. We have reported a case of cashew nut urushiol dermatitis due to ingestion of homemade cashew nut butter contaminated by cashew nut shell oil. With the precautions taken today to avoid co...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199404000-00026
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Patient comfort is an important part of laceration repair. METHODS:The study was a randomized single-blind cross-over trial in which each participant received 250 ml warmed and 250 ml room temperature saline irrigation in simple linear wounds after a local anesthetic was instilled. The solutions and the ord...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.SMJ.0000056657.63336.6C
更新日期:2003-05-01 00:00:00
abstract::Transposition of the inferior vena cava, duplication of the inferior vena cava, circumaortic renal collar, and retroaortic renal vein constitute the four most common major venous anomalies occurring in the retroperitoneum. Recent clinical cases are presented to review the embryogenesis, incidence, and clinical importa...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197910000-00012
更新日期:1979-10-01 00:00:00
abstract::A case is reported of megaloblastic anemia resulting from folate deficiency in a vegetarian who had been taking oral contraceptives for eight years. A brief report of the pertinent literature is included, ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197502000-00029
更新日期:1975-02-01 00:00:00
abstract:OBJECTIVES:Community violence is associated with health-compromising behaviors (HCBs) and adverse general health and pregnancy outcomes. It is unknown whether these effects persist after adjusting for health behaviors. METHODS:Retrospective cohort study of 36,637 pregnancies, 2005-2009, using birth certificate/hospita...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000143
更新日期:2014-08-01 00:00:00
abstract::Diabetic peripheral neuropathy affects 5 to 50% of people with diabetes in the United States. It is a progressive disorder that results in a gradual decrease in peripheral sensation and eventually complete loss of sensation. Patients with diabetic peripheral neuropathy are challenging to treat because of intolerable a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000060886.57804.2E
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:We sought to determine predictors of coronary events (cardiac death, acute myocardial infarction, and urgent revascularization) within 30 days after admission. METHODS:We prospectively collected data on 400 patients admitted through our emergency room for unstable angina and acute coronary syndromes. Patient...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000053481.49309.58
更新日期:2003-11-01 00:00:00
abstract::A marked increase in the number of cases of shigellosis was reported in Kentucky in 1988. To examine reasons for this increase, we reviewed the 389 cases of shigellosis reported from 1986 through 1989. Ninety-three percent (285/305) of cases due to known species were due to Shigella sonnei. Sixty-two percent (243/389)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199107000-00002
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:The use of lasers has assumed an increasingly important role in the treatment of a variety of cutaneous lesions over the past few decades. Because of their effectiveness, physicians from a variety of specialties have incorporated lasers into their practices. Unfortunately, widespread availability of lasers a...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199809000-00002
更新日期:1998-09-01 00:00:00
abstract::Seven patients with diabetes of ten to 24 years' duration and renal insufficiency were treated with fluphenazine and amitriptyline in an attempt to control severe pain in the extremities. Six patients had relief of pain within five days of initiation of therapy. One patient had no pain relief despite mood alteration. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::We have described three patients with diabetes and renal insufficiency who had hyperkalemia during heparin therapy. These cases lend support to previous findings, and emphasize the clinical importance of this entity. We believe that heparin-induced hyperkalemia is a potentially life-threatening problem that is more co...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198711000-00029
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVES:To determine the comparative impact of the standard Parents as Teachers (PAT) to the nutrition and physical activity enhanced version (PATE) of the perinatal educational curriculum on compliance with infant feeding recommendations and changes in maternal infant feeding knowledge and beliefs. METHODS:Women a...
journal_title:Southern medical journal
pub_type: 杂志文章,随机对照试验
doi:10.14423/SMJ.0000000000001024
更新日期:2019-10-01 00:00:00
abstract::We have described a patient with strangulation of a Meckel's diverticulum in a femoral hernia. In the case of Littre's hernia, true diagnosis before surgical intervention is rare if not impossible. It is therefore important that the surgeon be well versed in the management of such cases, as well as in distinguishing a...
journal_title:Southern medical journal
pub_type: 历史文章,杂志文章
doi:10.1097/00007611-198705000-00027
更新日期:1987-05-01 00:00:00
abstract::Perioperative consultations may play a major role in the care of surgical patients in an era of prospective payments. Since insurance reimbursement policy favors limitations in the number of consultants on a case, general medicine ("holistic") consultation services may become preferred perioperative consultants in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198903000-00004
更新日期:1989-03-01 00:00:00
abstract::In this study, the pelvic retroperitoneal anatomy was dissected during 140 consecutive exploratory laparotomies for benign gynecologic disease. In addition, 110 bilateral hypogastric artery ligations were done both to teach the technique and to attempt to determine whether such a procedure reduces blood loss in electi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198703000-00005
更新日期:1987-03-01 00:00:00
abstract::Carbon monoxide (CO) has been widely recognized as an exogenous poison, although endogenous mechanisms for its formation involve heme-oxygenase (HO) isoforms, more specifically HO-1, in the setting of oxidative stress such as acute respiratory distress syndrome, sepsis, trauma, and nitric oxide use have been studied. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181fd7f69
更新日期:2011-01-01 00:00:00
abstract::This paper discusses the pathology produced by pit viper venom and the pharmacologically active substances released by the action of venom on human tissue. The risks of many of the popular methods of treatment such as tourniquets, cryotherapy, incisions, excisions, and cortisone are also discussed. A prospective treat...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197908000-00002
更新日期:1979-08-01 00:00:00
abstract::We have described the radiographic features of a case of solitary giant hepatocellular carcinoma in a noncirrhotic liver. It was angiographically avascular and resembled a massive metastatic tumor. Most hepatocellular carcinomas appear highly vascular on angiography. Hypovascularity may sometimes be encountered in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00027
更新日期:1983-10-01 00:00:00
abstract::Highly trained medical specialists now possess a vast array of sophisticated technical apparatus with which to fight diseases. These tools, coupled with a growing emphasis on cost accounting and a medical paradigm emphasizing facts and depicting the human body as a machine, depersonalize health care by militating agai...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199307000-00017
更新日期:1993-07-01 00:00:00
abstract::The use of silver wire retention sutures requires added operating room time and expense, and it incurs the potential hazards of caught viscera, the possibility of more adhesions, leakage of intraperitoneal fluid through the exit wound, mild infection of exit wounds, and, on removal of the sutures, pain despite sedatio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197905000-00013
更新日期:1979-05-01 00:00:00
abstract::Each year about 1.5 million people suffer from a traumatic brain injury. Many of these are seen in primary care settings and most recover completely. Traumatic brain injury can show many signs and symptoms, some of which are readily identified and treated. Often the neurobehavioral sequelae appear months to years late...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181aba321
更新日期:2009-08-01 00:00:00
abstract::Bile acid sequestrants (BAS) continue to command a position in the treatment of dyslipidemias 25 years after their introduction. Partial diversion of the enterohepatic circulation using BAS depletes the endogenous bile acid pool by approximately 40%, thus stimulating an increase in bile acid synthesis from cholesterol...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.smj.0000208120.73327.db
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To determine whether racial disparities occurred among specialty and allied health inpatient consultations for patients admitted to adult hospital services at an academic hospital. METHODS:A retrospective data analysis of the first 2000 patients, ages 18 years or older, admitted to an academic hospital. RES...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001084
更新日期:2020-04-01 00:00:00
abstract::We evaluated the medical history, physical examination, and laboratory tests done on 245 patients with laparoscopically proven ectopic pregnancies. The absence of abdominal pain was the only clinically useful negative predictive value (91%) regarding tubal rupture. Although mean levels of serum human chorionic gonadot...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199112000-00014
更新日期:1991-12-01 00:00:00
abstract::In this series, thorough evaluation of 250 mediastinal lesions by various diagnostic methods showed that contrast enhanced CT scans of the mediastinum were superior to other modalities in differentiation and precise localization of the various types of lesions. Such superior evaluation may have a profound effect on th...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198504000-00009
更新日期:1985-04-01 00:00:00
abstract::We have described a case of thrombocytopenic purpura caused by methyldopa. A methyldopa-dependent antiplatelet antibody as the mechanism of the patient's thrombopenia was suggested by a positive clot retraction inhibition test. This simple in vitro test should be done more often in suspected cases of drug-induced thro...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198203000-00036
更新日期:1982-03-01 00:00:00
abstract::A 35-year-old, previously healthy woman, known to be thyrotoxic, was transferred from a community hospital for "acute abdomen." Abdominal pain, distention, and hyperemesis resolved with placement of nasogastric tube (NGT) and return of 2,600 mL of bilious fluid. Continued high NGT output made oral or NGT administratio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199711000-00018
更新日期:1997-11-01 00:00:00