The Healthcare Continuum and the Lived Experience of Managed Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/147232
Type:
Presentation
Title:
The Healthcare Continuum and the Lived Experience of Managed Care
Abstract:
The Healthcare Continuum and the Lived Experience of Managed Care
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Williams, Carol G., RN, BS, MS, DNSc
P.I. Institution Name:Central Connecticut State University
Title:Associate Professor, Chairperson
Co-Authors:Judith W. Pollmann, BSN, MSN, PhD, RN
[Clinical session research presentation] The Health Care Continuum and The Lived Experience of Managed CareThis qualitative research study is discussed in the context of the health care continuum in America over time. A brief history of financing health care is discussed. As cost of health care escalated managed care organizations (MCOs) were developed to control access to and cost of medical care. Financing of health care is analyzed related to American values, ethics, cost, choice, autonomy, and numbers of uninsured.This research is the story of The Lived Experience of a colleague who was insured by an MCO that denied her oncologist's request for an autologous stem cell transplant. Hermeneutics, which is based on Heidigger's Philosophy of Science is the theory used in this study. The method used in Hermeneutics is story telling. Story telling is a powerful vehicle for communicating the complex emotions of the heart felt experience defined as The Lived Experience. Journaling, observing, listening and writing are included in story telling. The research question asks, "What is going on here?". The story focuses on a 30 hour interval after the MCO administrators denied services. Strategies used to reverse the decision are described. Reversals occur in only 2% of cases. Ethical and legal implications are discussed. Ways in which MCOs can enhance consumer trust, choices, access to primary care providers, and specialist are explored.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Healthcare Continuum and the Lived Experience of Managed Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/147232-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Healthcare Continuum and the Lived Experience of Managed Care</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Williams, Carol G., RN, BS, MS, DNSc</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Central Connecticut State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor, Chairperson</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">cgwnest@juno.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Judith W. Pollmann, BSN, MSN, PhD, RN</td></tr><tr><td colspan="2" class="item-abstract">[Clinical session research presentation] The Health Care Continuum and The Lived Experience of Managed CareThis qualitative research study is discussed in the context of the health care continuum in America over time. A brief history of financing health care is discussed. As cost of health care escalated managed care organizations (MCOs) were developed to control access to and cost of medical care. Financing of health care is analyzed related to American values, ethics, cost, choice, autonomy, and numbers of uninsured.This research is the story of The Lived Experience of a colleague who was insured by an MCO that denied her oncologist's request for an autologous stem cell transplant. Hermeneutics, which is based on Heidigger's Philosophy of Science is the theory used in this study. The method used in Hermeneutics is story telling. Story telling is a powerful vehicle for communicating the complex emotions of the heart felt experience defined as The Lived Experience. Journaling, observing, listening and writing are included in story telling. The research question asks, &quot;What is going on here?&quot;. The story focuses on a 30 hour interval after the MCO administrators denied services. Strategies used to reverse the decision are described. Reversals occur in only 2% of cases. Ethical and legal implications are discussed. Ways in which MCOs can enhance consumer trust, choices, access to primary care providers, and specialist are explored.</td></tr></table>en_GB
dc.date.available2011-10-26T09:30:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:30:23Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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