Immunodeficiency: Quantitative and qualitative phagocytic cell defects.

The immune system is divided into two major branches: innate and adaptive. The innate immune system is the body's first line of defense and rapidly responds in a nonspecific manner to various microorganisms, foreign materials, or injuries. Phagocytes, which include macrophages, monocytes, and neutrophils, are innate immune cells that can surround and kill microorganisms, ingest foreign material, and remove dead cells.

A data accounting system for clinical investigators.

Clinical investigators often preprocess, process, and analyze their data without benefit of formally organized research centers to oversee data management. This article outlines a practical three-file structure to help guide these investigators track and document their data through processing and analyses. The proposed process can be implemented without additional training or specialized software.

A quality measurement framework for managed care organizations.

This article presents a framework for a quality measurement system and its corresponding principles for quality improvement within a managed care environment. The quality measurement system comprises four modes: quality assessment, comparison, improvement, and system evaluation. If these modes are to be effective, the measurement system must incorporate the following five principles: (a) maintain and continually improve the data systems, (b) develop and utilize sound methodology and valid indicators, (c) build a competent measurement team, (d) develop effective strategies for implementation, and (e) protect member confidentiality.

Profiling primary care physicians for a new managed care network.

We developed methods for comparing physicians who would be selected to participate in a major employer's self-insurance program. These methods used insurance claims data to identify and profile physicians according to deviations from prevailing practice and outcome patterns, after considering differences in case-mix and severity of illness among the patients treated by those providers. The discussion notes the usefulness and limitations of claims data for this and other purposes.

Using claims data to select primary care physicians for a managed care network.

An insurance claims databased profiling system was developed to help select new primary care physicians (PCPs) for a managed care network. PCPs (family practitioners, internists, and pediatricians) were ranked based on how closely their actual use of outpatient services conformed to the predictions of a mathematical model that adjusted for differences in age, sex, and case mix.