understanding professional roles in surveillance and monitoring,
ensuring availability of data,
promoting sharing of data,
tracking nosocomial infections,
accurate reporting of encounter-level data, and
overcoming structural barriers.
Managed care organizations are interested in improving the health of the entire community, not just their own members. However, infectious diseases may not be as high a priority as other diseases to health maintenance organizations, and consequently fewer resources are committed to any systematic, large-scale education or outreach initiatives. Although this direction may not seem beneficial to patients, it is driven by the purchasers of managed care who give a lesser priority to infectious diseases. Opportunities do exist, however, for educational institutions or pharmaceutical manufacturers to play a larger role in health education, both to providers and to purchasers of health care. The hope is that such efforts will then spread throughout the managed care industry. The following challenges to and opportunities for the development of education and outreach programs in the managed care setting are discussed in this workshop summary:
promote professional education efforts,
encourage judicious antibiotic use, and
invest in educational programs.
Drug formularies were originally intended to help reduce prescription drug costs while maintaining good health care. Recent evidence suggests that formulary policies concerning antibiotics may have contributed to the rise in the rate of antibiotic resistance by microorganisms even while the expected goals of cost containment have not been realized. To examine these concerns, this session was organized around three basic issues: (1) how managed care makes formulary decisions, (2) the relationship between pharmaceutical companies (manufacturers and distributors) and managed care, and (3) the impacts of these formulary decisions on the discovery and development of new antimicrobial agents. Although further studies are needed to address the increasing costs associated with formularies, some practices that could provide quality health care without adverse repercussions were identified. The following challenges and opportunities to the development of drug formularies in managed care organizations are discussed in this workshop summary: