Dictionary of Evidence-based Medicine.pdf

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M Macroeconomics Macroeconomics is one of the two main branches (the other is microeconomics) of economic theory. It deals with the 'macro' or larger economic issues such as growth in gross domestic product, inflation and unemployment. Main effect In the analysis of the results of experiments, a main effect is a response caused by changing a single factor. Malthus, Thomas Robert Malthus was a British economist (1776-1834) who predicted poverty and starvation as inevitable consequences of the conflict between the laws of nature and human behaviour. He based his prediction on a model which assumed geometric growth in population and an arithmetic growth in food production. Fortunately, however, his prediction was wrong (Figure 15). Managed care In health services terminology, managed care refers to a variety of methods for managing the efficient delivery of comprehensive health care. Costs are contained through the control of the provision of services and the use of formularies while an attempt is made to maintain quality of care through careful clinical audits. The concept was developed in the United States in response to the escalating costs of health care and the perceived lack of accountability by the providers of health care. While there are many managed care structures, most fall into two categories: health maintenance organizations (HMOs) and preferred provider organizations (PPOs). HMOs provide comprehensive managed health care in return for prepayment. Such organizations may set up contracts with independent medical practices (independent practice association (IPA) model) to provide the services or hire their own salaried physicians (non-IPA or staff model).
96 Dictionary of Evidence-based Medicine [Source: Food and Agriculture Organization] Figure 15 Actual population growth and food production since 1951 (= 100%) Independent doctors may organize themselves as independent groups to provide their services through the HMOs (group model). In return for guaranteed work, physicians agree to discounted payment and defined cost and quality controls. The managed care system is still undergoing rapid evolution. The initial system consisting of little more than contracts with preferred providers is evolving into programmes keenly attuned to health outcomes, performance and league tables, and medical informatics. Patients within the managed care system are increasingly well informed and the delivery of care is being increasingly integrated across the primary-secondary care interface. Surprisingly, there has been little published on the systematic evaluation of the performance of the managed care organizations. In Europe, the concept is applied to maximizing health gain of the community within limited resources. Close monitoring is undertaken to ensure that an appropriate range and level of services are provided within a framework of continuous improvement. National targets are set for both societal health and the meeting of individual health needs (Ingelhart JK
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Dictionary of Evidence-based Medici
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Preface This book was conceived at
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A Ability to pay Ability to pay is
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Figure I Audit: Clinical audit cycl
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B Balanced design In an experiment,
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Page 66 and 67: Figure 9 Concept of externality Dic
Page 72 and 73: G Game theory Game theory, first de
Page 86 and 87: I ICD (see International Classifica
Page 94 and 95: K Keynes, John Maynard (1883-1946)
Page 112 and 113: N N of I trial An N of 1 trial is a
Page 116 and 117: o OBM (see Opinion-based medicine)
Page 140 and 141: Figure 25 Measuring quality of life
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S Scarcity Scarcity is often referr
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T TDM (see Therapeutic drug monitor
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u Unique value effect This term is
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Z Z variate A random variable which
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