PRAKTICKÁ APLIKACE ŘÍZENÉ PÉČE V ZAMĚSTNANECKÉPOJIŠŤOVNĚ ŠKODA

P r a c t i c a l A p p l i c a t i o n o f M a n a g e d C a r e i n t h e E m p l o y e e s ’ I n s u r a n c e C o m p a n y Š K O D A

The paper deals with the practical application of the follow up of comprehensive costs of patients registered with generalpractitioners. Based on robust statistical methods evaluation and classification are made and on their basis individual levelsof capitation fees for a particular general practitioner are worked out. The latter is supported by a detailed information servicemotivated to monitor the major volume of costs of health care used by the registered patients.

Key words:
managed care –⁠ funding of general practitioners –⁠ capitation fee –⁠ disease management –⁠ regulatory mechanisms