Managed care: evaluation and performance measurement of integrated care systems
International Journal of Integrated Care, 1 July 2002 - ISSN 1568-4156
Book review
Managed care: evaluation and performance measurement of integrated care systems
Edited by Klaus-Jurgen Preuss, J Räbiger, JH Sommer
Stuttgart: Schattauer GmbH, 2001,
ISBN 3794520998
Bernhard Güntert

The title of the book is probably a little misleading. Not traditional managed care is the main focus, but integrated care systems. In 23 contributions, different authors give an overview on the actual development of integrated care models in Germany (9 contributions), Switzerland (2), some EU (4) countries and the US (4) as well as on general problems of their evaluation (4). The list of the authors reads like the “Who is Who” in the European managed care scene. Due to this international approach to integrated care, 7 of the contributions are in English.

The first part deals with the situation of integrated care in Germany. The integration of the health care providers was on the political agenda of the Health Reform 2000. These political constraints, but also the problems of implementing integration in the German health care system are described in the first chapter (Glaeske). Several models of integration however, mainly networks of doctors offices in the outpatient sector, show some positive effects and at least the start of a horizontal integration of physicians (Chapter 5 to 9). The results of an empirical study on the acceptance of integrated or managed care systems in the German population show that the main expectations in such systems are the improved quality in the provision of health services (Chapter 2, Andersen/Schwarze). Three chapters on the benchmarking and evaluation of integrated care and on appropriate evaluation indicators for the German system conclude this part of the book.

Since 1990 managed care can be found in the Swiss health care system and since 1996 on a larger scale (about 10% of the market). In two contributions the Swiss situation and experience is discribed. In the first paper by Bauer and Stock an evaluation study of the early managed care models is presented. In the second paper by Indra the managed care approaches of the leaching Swiss insurer are all described.

In the next section of the book, evaluation and performance measurement of integrated care systems are described in general but also for the French situation (Launois et al.). A series of contributions deals with managed care in the US. In the first paper accreditation criteria for managed care organisations and consumer information by the National Committee for Quality Assurance is discussed (Tucker/Schilling). Seidman chooses a more methodological approach to evaluation. He discusses indicators for assessing health service quality. Crabill then presents the results of a study on the use of evaluation by purchases to improve quality, safety and costs.

In the last, rather short section of the book four contributions deal with the methods of evaluation in the German health care system. The book is completed with an overview on internet addresses on topics of evaluation, managed care and integrated care. A glossery with good discriptions in German of the mostly English terminology is also added.

All in all it is a very informative book on the actual situation of integrated care in Germany. But, it also looks into different other European countries. The other focus is a good discussion on evaluation methodology. This may be interesting not only for scientists in the field, but also for providers of managed and integrated care.