Access to emergency care under TennCare: do patients understand the system?
Improvements in communication of pertinent information must be implemented in managed care systems such as TennCare to better inform participants of the proper use of the system. MCOs will not reduce inappropriate use of the ED if patients are not aware of their responsibilities and do not know their PCPs or how to gain access to them. PCP responsiveness to patients must also be improved.
Although anal sphincter injury was increased five-fold at next delivery, compared with all multiparae, 95% of women delivering vaginally after previous third degree tear did not sustain further overt sphincter damage. Recurrence was not predictable using pre-delivery anal physiology testing.