Table 6 Positive and negative features of the program implementation for various parties concerned
Parties involved | Positive features of program implementation | Negative features |
|---|---|---|
Decision-makers | Â | Â |
Management of Socio-Medical Department | More public support Meets ministry requirements Fewer appeals and complaints | (Initial) loss of production Research takes time |
Implementers | Â | Â |
(Regional) managers | Increased quality Fewer complaints | Loss of production, possibly temporary Appeals are not reduced |
(Regional) staff physicians | Better-quality assessments More transparent decisions Easier test procedure to check reports | Guidelines must not be rigid Legal status of guidelines: implication for appeals? |
Users | Â | Â |
Insurance physicians | Useful guidelines and EBM information Guidelines with instruments tailored to IPs in practice Focus on quality and content Scope for professional assessment maintained | Learning a new approach takes time; integration in personal routine is an effort Stricter requirements made regarding examination and reporting Will the extra workload be appraised and supported by staff and management? Legal status of guidelines: implication for appeals? |
Concerned | Â | Â |
Claimants | More thorough and uniform claim assessment | Longer, more structured consultations (not necessarily a drawback) |
Researchers | Â | Â |
Experts | Influence on content | Time input |