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Health and Pre-Professional Health care is currently Canada's  

E-print Network

Health and Pre-Professional Health care is currently Canada's second-largest service industry. In addition to traditional health-related roles (e.g., physician, nurse, dentist, pharmacist), a wealth of new health care careers are opening as a result of recent scientific, medical and technological advances


Mental health care financing in Italy: current situation and perspectives.  


Through a review of the studies conducted on the analysis of the costs of the Italian mental health provision of care, this study aimed at describing the current financing system for mental health care in Italy. From the deinstitutionalization to the present days, Italian mental health care financing has evolved in line with both national plans and the actual European directives. The description of the current situation of mental health care financing in Italy can be useful to inform service planning and resource allocation, and to offer a wider European perspective. PMID:24840087

Amaddeo, Francesco; Grigoletti, Laura; Montagni, Ilaria



Our current geriatric population: demographic and oral health care utilization.  


This article describes the rapidly growing geriatric population in the United States. Current and emerging living arrangements include the subgroups of older adults who live at home, retirement villages, assisted living facilities, various levels of nursing homes, and hospice care. The degree of isolation and social connection is discussed and the need for dental care has been summarized from the literature. Demographic trends imply a substantial increase in both the need and demand for dental care by the senior age groups. A proposal to integrate oral health and dental care with primary care is provided. PMID:25201537

Douglass, Chester W; Jiménez, Monik C



The Cuban health care system and factors currently undermining it.  


This paper explores the dynamics of health and health care in Cuba during a period of severe crisis by placing it within its economic, social, and political context using a comparative historical approach. It outlines Cuban achievements in health care as a consequence of the socialist transformations since 1959, noting the full commitment by the Cuban state, the planned economy, mass participation, and a self-critical, working class perspective as crucial factors. The roles of two external factors, the U.S. economic embargo and the Council of Mutual Economic Cooperation (CMEA), are explored in shaping the Cuban society and economy, including its health care system. It is argued that the former has hindered health efforts in Cuba. The role of the latter is more complex. While the CMEA was an important source for economic growth, Cuban relations with the Soviet bloc had a damaging effect on the development of socialism in Cuba. The adoption of the Soviet model of economic development fostered bureaucracy and demoralization of Cuban workers. As such, it contributed to two internal factors that have undermined further social progress including in health care: low productivity of labor and the growth of bureaucracy. While the health care system is still consistently supported by public policy and its structure is sound, economic crisis undermines its material and moral foundations and threatens its achievements. The future of the current Cuban health care system is intertwined with the potentials for its socialist development. PMID:7593738

Nayeri, K



The current state of health care reform: the physicians' burden.  


Congress has passed expansive legislation to "fix" health care. US health care, however, is not "broken"; rather, it functions according to purpose. The legal standard sets health care's purpose as high-quality care, not care at a pervasive quantity or low cost. Juries focus on quality irrespective of cost, and the court's concern is not cost but whether the defendant physician has met the standard of care. As the US health system does deliver high-quality (albeit high-cost) care, it is not broken; instead, the system that defines it is broken. The legal system defines the standard of care as the care that an average physician would deliver under similar circumstances. As 91% of physicians admit to practicing defensively excessive care, the legal care standard is therefore excessive care. However, the new health care legislation passed by Congress does not address tort reform. Instead, it reduces physician remuneration and increases penalty-driven cost care control regulations. Caught between a care standard that demands high quality regardless of cost and penalty-driven federal mandates demanding low-cost care regardless of the legal care standard, physicians bear the new law's ultimate burden. US health care should not continue to focus on quality over cost and quantity; more important, the law should not continue to dictate that it do so. Rather, the system must import cost-effective care, and the law must so direct. To reduce health care costs, the legal system must first recognize a standard of care that respects cost-or tort reform that protects those physicians who do. PMID:22328692

Horton, J Bauer; Hollier, Larry H



The Cuban health care system and factors currently undermining it  

Microsoft Academic Search

This paper explores the dynamics of health and health care in Cuba during a period of severe crisis by placing it within its economic, social, and political context using a comparative historical approach. It outlines Cuban achievements in health care as a consequence of the socialist transformations since 1959, noting the full commitment by the Cuban state, the planned economy,

Kamran Nayeri



The Current State of Health Care for People with Disabilities  

ERIC Educational Resources Information Center

The National Council on Disabilities (NCD) undertook this study in 2007 to focus the nation's attention on the health care disparities experienced by people with disabilities, and to provide information and recommendations that can help to eliminate health care inequities for people with disabilities. Among the key findings were that: (1) People…

Breslin, Mary Lou; Yee, Silvia



Current Bibliographies in Medicine: Prison Health Care (1132 Citations).  

National Technical Information Service (NTIS)

The bibliography lists monographs, journal articles, audiovisuals, government reports, and selected meeting abstracts and law case reports from January 1986 through September 1990 on many aspects of prison health care. Some earlier cited materials are inc...

R. L. Gordner



Family-Centered Care: Current Applications and Future Directions in Pediatric Health Care  

Microsoft Academic Search

Family-centered care (FCC) is a partnership approach to health care decision-making between the family and health care provider.\\u000a FCC is considered the standard of pediatric health care by many clinical practices, hospitals, and health care groups. Despite\\u000a widespread endorsement, FCC continues to be insufficiently implemented into clinical practice. In this paper we enumerate\\u000a the core principles of FCC in pediatric

Dennis Z. KuoAmy; Amy J. Houtrow; Polly Arango; Karen A. Kuhlthau; Jeffrey M. Simmons; John M. Neff


Current status of maternal health care in China.  


The Chinese government has given a great deal of attention since the founding of the Republic in 1949 to maternal and child health (MCH) in the interest of protecting the health of mothers and children. MCH, preventive, and curative medicine are considered the three major tasks of China's health work. Safe motherhood and the decrease of maternal and infant mortality have been particularly marked since 1949, with maternal mortality declining from 1500/100,000 in 1949 to 94.7/100,000 in 1989, while infant mortality has been reduced by a factor of four as of 1986. There were 3181 MCH organizations in 1990, 35 times the number in 1949, 328 of which were maternity hospitals. 102,930 persons excluding the staff in general hospitals worked for MCH throughout the country in 1989, 23,538 more than in 1985. The number of women village doctors increased to 321,730 persons and that of birth attendants to 494,791 persons. MCH has clearly improved over the past ten years with the reform of the economic system and a newly adopted policy of openness. The author describes program organizations, manpower, professional education, perinatal health care service, risk approach in perinatal surveillance, the implementation of national policy on family planning, the prevention of common gynecologic diseases, perimenopausal and adolescent health care, international exchanges and cooperation, and problems encountered over the years. PMID:7924586

Hua, J Z



Primary health care in the Czech Republic: brief history and current issues  

PubMed Central

Abstract The objective of this paper is to describe the recent history, current situation and perspectives for further development of the integrated system of primary care in the Czech Republic. The role of primary care in the whole health care system is discussed and new initiatives aimed at strengthening and integrating primary care are outlined. Changes brought about by the recent reform processes are generally seen as favourable, however, a lack of integration of health services under the current system is causing various kinds of problems. A new strategy for development of primary care in the Czech Republic encourages integration of care and defines primary care as co-ordinated and complex care provided at the level of the first contact of an individual with the health care system. PMID:16902697

Holcik, Jan; Koupilova, Ilona



Current use of chelation in American health care.  


The National Center for Health Statistics estimates that more than 100,000 Americans receive chelation each year, although far fewer than 1 % of these cases are managed by medical toxicologists. Unfortunately, fatalities have been reported after inappropriate chelation use. There are currently 11 FDA-approved chelators available by prescription although chelation products may also be obtained through compounding pharmacies and directly over the internet. Promotion of chelation training is prominent on some alternative and complementary medicine websites. PMID:24113860

Wax, Paul M



Music therapy in cardiac health care: current issues in research.  


Music therapy is a service that has become more prevalent as an adjunct to medical practice-as its evidence base expands and music therapists begin to join the cardiology team in every phase of care, from the most serious cases to those maintaining good heart health. Although applications of music medicine, primarily listening to short segments of music, are capable of stabilizing vital signs and managing symptoms in the short-term, music therapy interventions by a qualified practitioner are showing promise in establishing deeper and more lasting impact. On the basis of mind-body approaches, stress/coping models, the neuromatrix theory of pain, and entrainment, music therapy capitalizes on the ability of music to affect the autonomic nervous system. Although only a limited number of randomized controlled trials pinpoint the efficacy of specific music therapy interventions, qualitative research reveals some profound outcomes in certain individuals. A depth of understanding related to the experience of living with a cardiovascular disease can be gained through music therapy approaches such as nonverbal music psychotherapy and guided imagery and music. The multifaceted nature of musical responsiveness contributes to strong individual variability and must be taken into account in the development of research protocols for future music therapy and music medicine interventions. The extant research provides a foundation for exploring the many potential psychosocial, physiological, and spiritual outcomes of a music therapy service for cardiology patients. PMID:23535529

Hanser, Suzanne B



Continuing Trends in Health and Health Care  

ERIC Educational Resources Information Center

Discusses current trends in health and health care, assesses significance of current data, and investigates causes and implications of the data for future health and health care. For journal availability, see SO 506 144. (Author/DB)

Wilson, Ronald W.; And Others



Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment  

PubMed Central

Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stake-holders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships. PMID:23653802

Linder, Regina



Women Veterans Health Care  


... Health Care » Women Veterans Health Care Women Veterans Health Care Womens Health Women Veterans Health Care Home Program ... Breast Cancer Awareness Healthy Aging WVCC Women Veterans Health Care Did you know that women are the fastest ...


Health policies and intervention strategies: a description of current issues and approaches to care of the public health and health care system in the United Arab emirates.  


The demographic factors of the United Arab Emirates (UAE) have changed drastically within one generation. This is evident in how quickly it has moved from a developing nation, where fishing was once the main source of income, to a country that is quite developed, competing on a global level. From one perspective, socio-economic progress has brought many benefits to the population. These include improved education, better access to health care, and safe drinking water. However, on the other hand, economic development has been the cause for changes in lifestyles, eating habits, and traditional societal and family structures. Over time, these changes have added up, creating an unprecedented impact on the population's health. This impact has crept up onto the society until suddenly a notable epidemic has become recognized in the country. According to the UAE Ministry of Health, 19.5 percent of the UAE population has diabetes, making it the second highest rate in the world. The structure and responsibilities of the current UAE health care systems along with other cultural factors were investigated in order to determine their impact on the growing epidemic. PMID:25223161

Mosaad, Aliye T; Younis, Mustafa Z



The health care system for female workers and its current status in Japan.  


In this paper we describe female workers' health care, the women's and maternal protection system within the Japanese legal system, the current status of female workers in Japan, and problems regarding methods of advancing health care and the women's or maternal protection system. Motherhood is respected in the workplace in Japan, and in order to provide an environment in which women can work and still bear and rear children with a sense of security, laws concerning maternal protection of female workers, and revisions in terms of the system have been made, and a new system has been in effect since the fiscal year of 1998. Nevertheless, gender discrimination against women and the disparagement of women, rooted in gender role stereotypes concerning the division of labor, remain firmly planted in the social environment and in long-established custom. PMID:11100954

Nohara, M; Kagawa, J



The current state of mental health care in Italy: problems, perspectives, and lessons to learn.  


After legislative changes in 1978, Italian psychiatry underwent a thorough overhaul, with the gradual closure of all Mental Hospitals. A nation-wide network of Departments of Mental Health now deliver outpatient and inpatient care, but also run semi-residential and residential facilities (the latter with 2.9 beds per 10,000 inhabitants). Hospital care is delivered through small psychiatric units (with no more than 15 beds). There are also many private inpatient facilities operating in Italy, and the number of private inpatient beds per 10,000 inhabitants exceeds the number of public beds; overall there are 1.7 acute beds per 10,000 inhabitants - one of Europe's currently lowest numbers. There is marked quanti- and qualitative variation in the provision of out- and inpatient care throughout the country, and service utilization patterns are similarly uneven. Studies examining quality of life report a fairly high degree of patient satisfaction, whereas patients' families frequently bear a heavy burden. In conclusion, the Italian reform law led to the establishment of a broad network of facilities to meet diverse care needs. Further efforts are required to improve quality of care and to develop a more effectively integrated system. Greater attention must be paid to topics such as quality of care and outcomes, public and private sector balance, and the coordination of various resources and agencies. PMID:17200877

de Girolamo, Giovanni; Bassi, Mariano; Neri, Giovanni; Ruggeri, Mirella; Santone, Giovanni; Picardi, Angelo



Mobile Communications for Medical Care a study of current and future healthcare and health promotion applications, and  

E-print Network

Mobile Communications for Medical Care a study of current and future healthcare and health examines the use of mobile networks to enhance healthcare (so-called "mHealth"), as an example of how mobile communications can contribute to sustainable development. We define mHealth as "a service

Talbot, James P.


Get Affordable Health Care  


... Digg Facebook Google Bookmarks Get Affordable Health Care The Health Resources and Services Administration (HRSA) is ... and other care facilities to help people get health care they can afford. Health Centers Health centers provide ...


Mental Health Services for Children Placed in Foster Care: An Overview of Current Challenges  

PubMed Central

Given the evidence from studies indicating that children in care have significant developmental, behavioral, and emotional problems, services for these children are an essential societal investment. Youth in foster care and adults who formerly were placed in care (foster care alumni) have disproportionately high rates of emotional and behavioral disorders. Among the areas of concern has been the lack of comprehensive mental health screening of all children entering out-of-home care, the need for more thorough identification of youth with emotional and behavioral disorders, and insufficient youth access to high-quality mental health services. In 2001, the American Academy of Child and Adolescent Psychiatry (AACAP) and the Child Welfare League of America (CWLA) formed a foster care mental health values subcommittee to establish guidelines on improving policy and practices in the various systems that serve foster care children (AACAP and CWLA, 2002). Because of the excellent quality and comprehensiveness of these statements, the Casey Clinical Foster Care Research and Development Project undertook consensus development work to enhance and build upon these statements. This article presents an overview of mental health functioning of youth and alumni of foster care, and outlines a project that developed consensus guidelines. PMID:19653451

Pecora, Peter J.; Jensen, Peter S.; Romanelli, Lisa Hunter; Jackson, Lovie J.; Ortiz, Abel



Health Care Team  


... Story About the NKF You are here Home » Health Care Team Good health care is always a team effort - especially for people ... chronic kidney failure. Since each member of the health care staff contributes to your care, it is important ...


Health Care Economics  

Microsoft Academic Search

\\u000a “It was the best of times it was the worst of times.” How prophetic was Charles Dickens when applied to health care in America\\u000a today.1 We are currently experiencing unprecedented technologic and therapeutic advancements; however, these come at a tremendous\\u000a price. Health care expenditures have increased by double digits for the past decade, physician reimbursement has decreased\\u000a by over the

David A. Margolin; Lester Rosen


Current views of health care design and construction: practical implications for safer, cleaner environments.  


Infection preventionists (IP) play an increasingly important role in preventing health care-associated infection in the physical environment associated with new construction or renovation of health care facilities. The Guidelines for Design and Construction of Hospital and Healthcare Facilities, 2010, formerly known as "AIA Guidelines" was the origin of the "infection control risk assessment" now required by multiple agencies. These Guidelines represent minimum US health care standards and provide guidance on best practices. They recognize that the built environment has a profound affect on health and the natural environment and require that health care facilities be designed to "first, do no harm." This review uses the Guidelines as a blueprint for IPs' role in design and construction, updating familiar concepts to the 2010 edition with special emphasis on IP input into design given its longer range impact on health care-associated infection prevention while linking to safety and sustainability. Section I provides an overview of disease transmission risks from the built environment and related costs, section II presents a broad view of design and master planning, and section III addresses the detailed design strategies for infection prevention specifically addressed in the 2010 Facility Guidelines Institute edition. PMID:20569851

Bartley, Judene M; Olmsted, Russell N; Haas, Janet



Child Care Health Connections, 2002.  

ERIC Educational Resources Information Center

This document is comprised of the six 2002 issues of a bimonthly newsletter on children's health for California's child care professionals. The newsletter provides information on current and emerging health and safety issues relevant to child care providers and links the health, safety, and child care communities. Regular features include columns…

Guralnick, Eva, Ed.; Zamani, Rahman, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Oku, Cheryl, Ed.; Kunitz, Judith, Ed.



Consumerism in Health Care Services  

ERIC Educational Resources Information Center

Discusses the current trend toward a corporate health care system in which services are often paid for by a third party (insurance company or government). Says this results in the consumer's loss of control over the quality and type of health care rendered. Recommends adoption of a federated health care system. (GC)

Carmichael, Lynn P.



Reform of Primary Health Care  

Microsoft Academic Search

Never before has American society undergone such dramatic and pervasive changes as those currently effecting national health care needs. New strategies to meet the health care needs created by societal changes must be identified. Consumers, employers, providers, and third-party payers are calling for more cost effective health care, better access and better quality. Simultaneously, the United States has a shortage

Jeanette Lancaster; Wade Lancaster



Sick Care vs Health Care: The Crisis in US Health  

Microsoft Academic Search

Increasingly, the United States is challenging conventional wisdom that wealth = health. Current estimates put US health care spending at approximately 15% of gross domestic product (GDP), the highest in the world(1), but the health system fails to deliver efficient, effective, and equitable health services. Overall, there is a systemic problem: a huge gap between the care that everyone should

White African; Hispanic White African



Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector  

PubMed Central

Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP) policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing), as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It is critical that there is more extensive debate on the advantages and disadvantages of alternative funding mechanisms, supported by a solid evidence base, and with the policy objective of universal coverage providing the guiding light. PMID:23102454



Health care technology assessment  

NASA Astrophysics Data System (ADS)

The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

Goodman, Clifford



Home health care  


... and exercises, wound care, and daily living. Home health care nurses can help manage problems with your wound, ... Centers for Medicare and Medicaid Services. Home health care: what it is and what to expect. ... ...


Intra-household allocation of food and health care: current findings and understandings--introduction.  


This work offers an anthropological analysis of intra-household processes underlying gender- and age-specific differences in individual nutritional and health care allocations and outcomes in particular cultures. Based on recent ethnographic studies in India, Nepal, Madagascar, Mexico, and Peru, correspondences are analyzed between local cultural ("emic") and scientist-policy maker practitioner ("etic") understandings of nutrition, health, and human development, and the relative "values" of females, males, and children of different ages. The data and analyses clarify specific epidemiological and demographic findings on age and gender bias in nutrition and health and highlight the multiple cultural, economic, and biological factors that contribute to gender- or age-based discrimination or neglect. Recent advances in nutrition policy have argued for a broader concept of nutritional security, one that incorporates both food quantity and quality, and of nutrition as "food, health and care" (International Conference on Nutrition, World Declaration and Plan of Action for Nutrition, FAO/WHO, Rome, 1992). These ethnographic findings; lend strong support for such broader nutrition concepts and associated nutrition policies. The studies also suggest ways in which anthropological questions, methods, and data and community-based research can help predict or identify the nutritionally vulnerable within households and help other social and medical scientists design more effective interventions. PMID:9178411

Messer, E



Improving regional health care in West Africa using current space systems and technology  

Microsoft Academic Search

This paper discusses the issues involved with establishing an integrated satellite health network in West Africa based on currently available technology. The system proposed makes use of a central national facility capable of transmitting and receiving voice\\/data and video signals from the entire country. Regional, field and local facilities provide timely epidemiologic information, sharing of medical expertise through telemedical consultations,

Mae C. Jemison; J. Segun Thomas



FastStats: Home Health Care  


... and Territorial Data NCHS Home FastStats Home Home Health Care Data are for the U.S. Number of current ... diabetes, 11 percent of discharges (2007) Source: Home Health Care and Discharged Hospice Care Patients: United States, 2000 ...


Adherence and health care costs  

PubMed Central

Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e)-prescribing. PMID:24591853

Iuga, Aurel O; McGuire, Maura J



The 'Global Outcomes Score': a quality measure, based on health outcomes, that compares current care to a target level of care.  


The quality of health care is measured today using performance measures that calculate the percentage of people whose health conditions are managed according to specified processes or who meet specified treatment goals. This approach has several limitations. For instance, each measure looks at a particular process, risk factor, or biomarker one by one, and each uses sharp thresholds for defining "success" versus "failure." We describe a new measure of quality called the Global Outcomes Score (GO Score), which represents the proportion of adverse outcomes expected to be prevented in a population under current levels of care compared to a target level of care, such as 100 percent performance on certain clinical guidelines. We illustrate the use of the GO Score to measure blood pressure and cholesterol care in a longitudinal study of people at risk of atherosclerotic diseases, or hardening of the arteries. In that population the baseline GO Score was 40 percent, which indicates that the care being delivered was 40 percent as effective in preventing myocardial infarctions and strokes as our target level of care. The GO Score can be used to assess the potential effectiveness of different interventions such as prevention activities, tests, and treatments. PMID:23129674

Eddy, David M; Adler, Joshua; Morris, Macdonald



Health care agents  


... do not have a living will or an advanced directive, your health care agent will be the one ... organs, unless you've stated otherwise in your advance directive Before you choose a health care agent, you ...


Vacation health care  


... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 - 6 ... If you are taking medicine, talk to your health care provider before leaving. Carry all medicines with you ...


National Health Care Reform, Medicaid, and Children in Foster Care.  

ERIC Educational Resources Information Center

Outlines access to health care for children in out-of-home care under current law, reviews how health care access for these children would be affected by President Clinton's health care reform initiative, and proposes additional measures that could be considered to improve access and service coordination for children in the child welfare system.…

Halfon, Neal; And Others



Your Health Care Team  


... Size: A A A Listen En Espańol Your Health Care Team You You are the most important member of your health care team. After all, you are the one who ... are the first to notice any problems. Your health care team depends on you to talk to them ...


Health Care Indicators  

PubMed Central

This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data. PMID:25372574

Donham, Carolyn S.; Maple, Brenda T.; Letsch, Suzanne W.



Health Care Reform and the Academic Health Center.  

ERIC Educational Resources Information Center

A discussion of the implications of health care reform for academic health centers (a complex of institutions which educate health professionals) looks at problems in the current system, the role of academic health centers in the current system, financial pressures, revenue sources other than patient care, impact on health research, and human…

Kimmey, James R.



Current Health Care System Policy for Vulnerability Reduction in the United States of America: A Personal Perspective  

Microsoft Academic Search

Aim. To raise questions about how the United States of America - which spends 1.3 trillion dollars on health care, con- ducts cutting-edge biomedical research, has the most advanced medical technology, and trains a cadre of highly com- petent health professionals - cares for the most vulnerable members of its population. Methods. Relevant statistical data were extrapolated from the most

Edward J. Eckenfels



Improving oral health and oral health care delivery for children.  


National and state-level evidence has documented ongoing disparities in children's health and utilization of oral health care services, prompting a re-examination of factors associated with poor oral health and low use of oral health services. These efforts have yielded a wide array of proposals for improving children's oral health and oral health care delivery. This paper offers a perspective on the current context of efforts to improve children's oral health and oral health care delivery. PMID:21485933

Crall, James J



Health Care and Dependent Care Flexible  

E-print Network

Health Care and Dependent Care Flexible Spending Accounts Discovery Benefits, Inc. (866) 451 for certain health care and child care expenses with pre-tax dollars. FSA's may allow you to save money of money that is withheld from your pay on a pre-tax basis. Note: Health Care Reform extends medical FSA


The national health care imperative.  


In summary, the nation's health care system is in serious need of reform. It is expensive and woefully inefficient. Millions of people are excluded from coverage, while others receive limited or second-class care. For those millions who suffer serious chronic problems that require long-term care, there is virtually no help. There is no help for the family whose loved one suffers from Alzheimer's disease. There is no help for the family whose child is born with cerebral palsy or epilepsy. There is no help for the middle-aged father, disabled in an automobile accident. Providing good care to all Americans is not a matter of money. America currently spends some 13% of its gross national product on health care, and yet the health statistics of Americans are the worst in the industrialized world. What America needs is a comprehensive system of health care that includes both acute and long-term care. Congress must take action to restore health care as a basic constitutional right of all Americans. Coverage for long-term care must be included within the context of any new national health care program. Funding for such a program should come from the most progressive tax that the Congress can fashion, which to this point is the federal income tax. Although there is an appropriate role for private insurance, it should function as a supplement to rather than as a substitute for a new national program. There are several other elements that are key to a national health care program: Home care must be the first line of any national long-term care program.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10106451

Halamandaris, V J



Health Care for College Students  


... Health Care for College Students Ages & Stages Listen Health Care for College Students Article Body I'll be ... student health service before starting an exercise program. Health care on campus If you are going to live ...


Soviet health care and perestroika.  

PubMed Central

Health and health care in the Soviet Union are drawing special attention during these first years of perestroika, Mikhail Gorbachev's reform of Soviet political and economic life. This report briefly describes the current state of Soviet health and medical care, Gorbachev's plans for reform, and the prospects for success. In recent years the Soviet Union has experienced a rising infant mortality rate and declining life expectancy. The health care system has been increasingly criticized for its uncaring providers, low quality of care, and unequal access. The proposed measures will increase by 50 percent the state's contribution to health care financing, encourage private medicine on a small scale, and begin experimentation with capitation financing. It seems unlikely that the government will be able to finance its share of planned health improvements, or that private medicine, constrained by the government's tight control, will contribute much in the near term. Recovery of the Soviet economy in general as well as the ability of health care institutions to gain access to Western materials will largely determine the success of reform of the Soviet health care system. PMID:2297064

Schultz, D S; Rafferty, M P



What is the health care product?  


Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations. PMID:10119211

France, K R; Grover, R



Health care in Africa.  


This is the third and last article reporting professional exchange tours between American nurses and nurses of other countries. In this article, the health care system of Kenya is discussed and comparisons made between this system and our own. Out of this comparison come several insights into our own way of doing things and possibilities for improving them. "Health Care in the Soviet Union" appeared in the April 1984 issue of The Nurse Practitioner. "Health Care in China" appeared in the May 1984 issue of the journal. PMID:6462542

Brown, M S



E-Medicine and Health Care Consumers: Recognizing Current Problems and Possible Resolutions for a Safer Environment  

Microsoft Academic Search

Millions of Americans access the Internet forhealth information, which is changing the waypatients seek information about, and oftentreat, certain medical conditions. It isestimated that there may be as many as 100,000health-related Web sites. Theavailability of so much health informationpermits consumers to assume more responsibilityfor their own health care. At the same time,it raises a number of issues that need to

Maria Brann; James G. Anderson



Mercury and health care  

PubMed Central

Mercury is toxic heavy metal. It has many characteristic features. Health care organizations have used mercury in many forms since time immemorial. The main uses of mercury are in dental amalgam, sphygmomanometers, and thermometers. The mercury once released into the environment can remain for a longer period. Both acute and chronic poisoning can be caused by it. Half of the mercury found in the atmosphere is human generated and health care contributes the substantial part to it. The world has awakened to the harmful effects of mercury. The World Health Organization and United Nations Environmental Programme (UNEP) have issued guidelines for the countries’ health care sector to become mercury free. UNEP has formed mercury partnerships between governments and other stakeholders as one approach to reducing risks to human health and the environment from the release of mercury and its compounds to the environment. Many hospitals are mercury free now. PMID:21120080

Rustagi, Neeti; Singh, Ritesh



Health care in Armenia today.  

PubMed Central

Although one of the smallest of the new independent states of the former Soviet Union, the Republic of Armenia has an ancient tradition and a strong ethnic identification, greatly enhanced by the diaspora. In addition to the problems following the dissolution of the Soviet Union, Armenia has had to contend with a draining war in Nagorno-Karabakh and the after-effects of a devastating earthquake in 1988. Humanitarian efforts have ranged from emergency supply deliveries to longer-term sustainable health care partnerships. The United States government, through the Agency for International Development, has organized such partnerships, partially as a result of a multinational mission in 1992 and a subsequent hospital-to-hospital program developed by the American International Health Alliance. We describe the current state of health care in Armenia and some of the problems that need to be addressed to improve health care services to its citizens. PMID:8023481

Farmer, R G; Chobanian, A V



Engineering VA Health Care  

E-print Network

Engineering VA Health Care The Department of Veterans Affairs is offering a unique career engineers to be effective Healthcare Technology Program Managers in the Veterans Health Administration to serve a very special class of citizens ­ our nation's Veterans. Overview Program Description Roles

Adams, Mark


Shared Primary Health Care  

PubMed Central

Primary health care delivery in large urban centers may be shared between family physicians and specialists. This study examined screening and health promotion interventions by obstetrician-gynecologists as part of an annual examination of asymptomatic women. Procedures most closely linked to gynecological practice were performed most frequently. PMID:21229004

Yaffe, Mark J.; Toop, Jo-Ann



Controlling Health Care Costs  

ERIC Educational Resources Information Center

This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…

Dessoff, Alan



Enhancing transgender health care.  

PubMed Central

As awareness of transgender men and women grows among health care educators, researchers, policymakers, and clinicians of all types, the need to create more inclusive settings also grows. Greater sensitivity and relevant information and services are required in dealing with transgender men and women. These individuals need their identities to be recognized as authentic, they need better access to health care resources, and they need education and prevention material appropriate to their experience. In addition, a need exists for activities designed to enhance understanding of transgender health issues and to spur innovation. PMID:11392924

Lombardi, E



Current Practices for Training Staff to Accommodate Youth with Special Health Care Needs in the 4-H Camp Setting  

ERIC Educational Resources Information Center

The theory of inclusion is the foundation for the study reported here; inclusion is a focus not only of formal education, but also of nonformal educational settings such as 4-H. Ideally, 4-H camps are designed to serve youth of all backgrounds and abilities. By accommodating youth with special health care needs, 4-H camps are effectively meeting…

Mouton, Lauren; Bruce, Jacklyn



Nondisclosure of Smoking Status to Health Care Providers among Current and Former Smokers in the United States  

ERIC Educational Resources Information Center

An unintended consequence of tobacco control's success in marginalizing smoking is that smokers may conceal their smoking from those who are best positioned to help them quit: health care providers (HCPs). The purpose of this study was to identify the prevalence of, and factors related to, nondisclosure of smoking to HCPs. Data were obtained from…

Curry, Laurel Erin; Richardson, Amanda; Xiao, Haijun; Niaura, Raymond S.



Native-American elders. Health care status.  


This article reviews current data relevant to the health care status of elderly Native Americans, a population cohort encompassing American Indians and Alaskan Natives/Aleutians. Several topics are addressed, including the history of Native American health policy, heart disease, diabetes mellitus, cancer, oral health, nutrition, long-term care, and the circumstances of urban Native American elders. PMID:7720023

Rousseau, P



[Current situation of the demand for health care in neuropaediatrics. Characteristics of consultations and comparison with other paediatric specialties].  


INTRODUCTION. In recent years it seems we are witnessing an increasing demand for neuropaediatric care. Epidemiological studies are needed to make this demand more widely known and thus promote appropriate management of health care resources. AIMS. To determine what proportion of all visits to the paediatric department in our hospital are neuropaediatric consultations, the annual consultation rate in child neurology per 1,000 inhabitants under 14 years of age, and the characteristics of that consultation (demographic data, reasons for the visit and others). PATIENTS AND METHODS. We conducted a retrospective, descriptive study on the health care activity of paediatric and neuropaediatric units in a level-II public hospital in the south of Madrid, over the period 2008-2012. RESULTS. Since our centre opened, the number of paediatric consultations has increased sharply, neuropaediatric visits being the most frequently demanded. In the year 2012 a total of 2,129 patients were seen (718 first visits), with a successive/first visit index of 1.96. Of all the paediatric consultations carried out in the hospital, 23.49% took place in neuropaediatrics. The mean rate of first visits in the period under study was 72.86/1,000 children. The main reasons for the consultation were learning disabilities/conduct disorders (24.1%), followed by headaches (21.9%), paroxysmal episodes (14.8%) and delayed psychomotor development (9%). CONCLUSIONS. The increase in demand for neuropaediatrics health care was clearly higher than that of other paediatric specialities over the same period of time. In the five years included in the study, the rate of first visits increased threefold. This health care overload could condition the care dispensed to patients with severe neurological pathologies. Further studies of a similar nature in different regions are required to determine the real situation of neuropaediatrics in Spain. PMID:25342052

Blanco-Lago, R; Garcia-Ron, A; Granizo-Martinez, J J; Ruibal, J L



Diversity, Health, and the State of Patient Care in the US Health Care System  

Microsoft Academic Search

The current supplement adds to a growing body of literature by examining factors related to quality of health care with an emphasis on patient-centered care in the context of the Latino population. Despite being the largest of the racial\\/ethnic groups within the US, we have only begun to explore Latino perspectives on health and health care and the ways in

Hayden B. Bosworth; Ronnie D. Horner



Values in health care.  


The first part of the paper is concerned with the health care values of various groups; namely, those which are resource oriented, disease oriented, political decision-makers, organized sellers and purchasers of health care and patients. These groups are further divided according to selected political/ideological and socio-economic characteristics, essentially along capitalist and socialist lines. Some of the ways in which the values held by these groups are determined, formulated and, by implication at least, changed and the political, economic and other bases for some of their practical applications are identified. The second part of the paper focuses upon values in public health education and related practice. It is argued that to become more useful to the 'health of the public' the new public health worker will have to become more activist, assuming an adversarial stance toward the market economy in capitalist countries and oppressive governmental structures everywhere. A wider integration of knowledge concerning the effects of health of all types of economic, social and political practices is required; this, in turn, would contribute to the emergence of alternative forms of public health analysis and practice. The recognition of wider forms of public health leadership should follow, coupled with organizational changes directed at the greater participation of popular groupings in all types of public health activities. PMID:6484620

Gish, O



Medicine and health care: implications for health sciences library practice.  

PubMed Central

The American health care system is experiencing a period of unprecedented change. This paper identifies and discusses the major changes in patient care, research, control of the health care system, and medical education, and their implications for health sciences librarians. These changes have resulted in new demands for effective information delivery and a broader health sciences library clientele. There are both challenges and opportunities for health sciences librarians as they respond to information pressures of the current health care environment and anticipate future needs. PMID:3708196

Hafner, A W; Schwarz, M R



Health care in Moscow.  

PubMed Central

In the Russian Federation privatisation is affecting the health care sector as much as it is industry and commerce. That the general public support the transfer of state clinics to the private sector is a mark of their dissatisfaction with the old state run system. Doctors too see better opportunities to practise good medicine and be paid better for doing so. In Moscow the health department has set up a commission to license all clinics providing treatment, which should ensure standards of safety, training, and equipment. The Russian Federation is also trying to establish a medical insurance system to cover its citizens for health care, but in Moscow and elsewhere its implementation has been delayed by arguments and bureaucracy. In the meantime the health of Muscovites remains poor, with a high incidence of birth defects, and illnesses among the young. Images p783-a PMID:8219954

Ryan, M



Current Status of Infant Mental Health in Day-Care Centres in Japan: An Investigation of Okinawa and Aomori Prefectures  

ERIC Educational Resources Information Center

Grasping both the extent and the actual situation of psychosomatic disorders, neurotic habits and developmental disorders of infancy and childhood is vital for their prevention and for taking appropriate measures to deal with the current situation. The purpose of this study is to explore the current situation of infant mental health in Japanese…

Takizawa, Tohru; Kondo, Tsuyoshi; Tanaka, Osamu; Wake, Norie; Naka, Kuoichi; Todoriki, Hidemi; Ishizu, Hiroshi



Mental Health Care in Primary Care Settings  

Microsoft Academic Search

OBJECTIVE To assess family physicians' interactions with mental health professionals (MHPs), their satisfaction with the delivery of mental health care in primary health care settings, and their perceptions of areas for improvement. DESIGN Mailed survey. SETTING Province of Saskatchewan. PARTICIPANTS All FPs in Saskatchewan (N = 816) were invited to participate in the study; 31 were later determined to be

C. C. Doebbeling; Syed M. Shah



Hurdles to health: immigrant and refugee health care in Australia  

Microsoft Academic Search

Refugees and asylum seekers face a number of barriers to accessing health care and improved health status. These include language difficulties, financial need and unemployment, cultural differ- ences, legal barriers and a health workforce with generally low awareness of issues specific to refugees. Importantly, current Australian govern- ment migration and settlement policy also impacts on access to health and health

Sally B Murray; Sue A Skull



Evaluating health care efficiency.  


In this chapter we propose a three-pronged approach to assessing efficiency of health care, including financial performance, performance in the production of (intermediate) medical outcomes and performance relating medical outcomes to patient health outcomes. Throughout we use frontier models which can be estimated in a number of ways, including DEA, stochastic frontiers and index numbers. We illustrate the health outcomes model with an application to cataract surgery patients in Sweden and use DEA as our estimator. Again, other frontier estimation methods as well as index numbers could be employed to explore other procedures' effectiveness and overall performance of services and/or hospitals and clinics. PMID:19725364

Färe, Rolf; Grosskopf, Shawna; Lundström, Mats; Roos, Pontus



Health Care: A Brave New World.  


The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care (all life is sacred), the issue of who provides health care has evolved as individual rights have trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a 'negative right to health care' (e.g., prevention of a socially-caused, preventable health hazard), to various forms of a 'positive right to health care'. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a 'right', which is unconditional, a 'privilege' has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one's health must for elevated. To have access to health care in the future will mean some loss of personal rights (e.g., unhealthy behaviors) and an increase in personal responsibility for gaining or maintaining one's health. PMID:23494290

Morrisette, Shelley; Oberman, William D; Watts, Allison D; Beck, Joseph B



Navigating the Health Care System  


... Patients Patient Safety Measure Tools & Resources Pharmacy Health Literacy Center Surveys on Patient Safety Culture Quality Measure Tools & Resources Search Professional Resources Search Health IT Health Information Technology Portfolio Comparative Effectiveness Effective Health Care Program ...


Environmental Health: Health Care Reform's Missing Pieces.  

ERIC Educational Resources Information Center

A series of articles that examine environmental health and discuss health care reform; connections between chlorine, chlorinated pesticides, and dioxins and reproductive disorders and cancers; the rise in asthma; connections between poverty and environmental health problems; and organizations for health care professionals who want to address…

Fadope, Cece Modupe; And Others



Integrated networks and health care provider cooperatives: new models for rural health care delivery and financing.  


Minnesota's 1994 health care reform legislation authorized the establishment of community integrated service networks (CISNs) and health care provider cooperatives, which were envisioned as new health care delivery models that could be successfully implemented in rural areas of the state. Four CISNs are licensed, and three organizations are incorporated as health care provider cooperatives. Many of the policy issues Minnesota has faced regarding the development of CISNs and health care provider cooperatives in rural areas are similar to those raised by current Medicare reform proposals. PMID:9143900

Casey, M M



Parkland Health Care Campus  

E-print Network

Planning for Sustainability at the New Parkland Hospital November 8, 2011 Walter Jones, AIA, LEED, IFMA, CHD - Sr. Vice President, Facilities CATEE 2 0 1 1 Clean Air Through Energy Efficiency ESL-KT-11-11-19 CATEE 2011, Dallas..., Texas, Nov. 7 ? 9, 2011 Since 1894, Parkland has been Dedicated to the health and well-being of individuals and communities entrusted to our care Parkland Hospital Mission Statement By our actions, we will define the standards of excellence...

Jones, W., Sr.



National Health Care Skill Standards.  

ERIC Educational Resources Information Center

This booklet contains draft national health care skill standards that were proposed during the National Health Care Skill Standards Project on the basis of input from more than 1,000 representatives of key constituencies of the health care field. The project objectives and structure are summarized in the introduction. Part 1 examines the need for…

Far West Lab. for Educational Research and Development, San Francisco, CA.


Commensurate Ratings of Health Care.  

ERIC Educational Resources Information Center

Proposes a new descriptive item statistic, the mean cumulative logit, for scoring ratings of health care at the population level. Demonstrates the advantages of the method using data from the Consumer Assessment of Health Plans Study and shows that the perceived quality of health care is greater for fee-for-service plans than managed care plans in…

Bectel, Gordon G.



KDOQI Hypertension, Dyslipidemia, and Diabetes Care Guidelines and Current Care Patterns in the United States CKD Population: National Health and Nutrition Examination Survey 1999–2004  

Microsoft Academic Search

Background\\/Aims: National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines aim to slow chronic kidney disease (CKD) progression and reduce morbidity and mortality. This study aimed to assess current CKD population health and adherence to recommendations in National Health and Nutrition Examination Survey 1999–2004 participants aged ?20 years (n = 14,213). Methods: We assessed hypertension and dyslipidemia management and

Jon J. Snyder; Allan J. Collins



The primary health care service experiences and needs of homeless youth: a narrative synthesis of current evidence.  


Homeless youth are a growing, vulnerable population with specific primary health care (PHC) requirements. There are no systematic reviews of evidence to guide the delivery of PHC interventions to best address the needs of homeless youth in Australia. We present a narrative synthesis of peer reviewed research designed to determine: (1) the PHC services homeless youth access; (2) experiences of services, reported outcomes and barriers to use; and, (3) the PHC service needs of homeless youth. Findings show that homeless youth access a variety of services and delivery approaches. Increased PHC use is associated with youth who recognise they need help. Street-based clinic linked services and therapy and case management alongside improved housing can positively impact upon mental health and substance use outcomes. Barriers to service use include knowledge; provider attitudes, financial constraints and inappropriate environments. Findings support targetted, co-ordinated networks of PHC and housing services with nurses working alongside community workers. PMID:23721389

Dawson, Angela; Jackson, Debra



Thinking Through Health Care Reform  

Microsoft Academic Search

Emotionality truly shapes critical thinking in the development of American health policy. President Obama has misgauged the\\u000a emotions and thoughts of the Nation and Congress about the health care reform bill. Most Americans don’t approve of the design\\u000a or impetus of health care legislation under the Obama administration. The enacted legislation provides health care insurance\\u000a for all Americans. However, health

Paul J. Flaer; Mustafa Z. Younis; Muhammed Alotaibi; Maha Al Hajeri


Health care reforms in Poland.  


This paper examines the shape of the recently reformed health care system in Poland. Until December 31,1998 everyone had access to free health care and the medical institutions were financed by the State. Since January 1, 1999, under the provisions of the Universal Health Insurance Act, hospitals became independent from the State budget and gained more financial resources for their activities. 17 regional health insurance funds contract for medical services with hospitals and individual practices. Most services provided to the insured are paid by the funds that receive premiums, but some are still financed from the State budget. The revised legislation on Medical Care Establishments intended to create a better management of health care institutions and administrative control over the quality of care. The system has been severely criticised: it is too bureaucratic, there are too many insurance funds, patients have experienced problems with access to health care, particularly to special treatment or to treatment available outside the area of the health insurance fund to which the patient belongs. The new Minister for Health suggested that the 17 funds should be replaced by 5 "health funds" that would finance health care and be closely connected to the local government answerable for their activities. This paper will deal with the scope of health care packages, the conditions of provision of health services, obligations of health care providers, patient rights, and the quality of health care. PMID:15685913

Baginska, Ewa



Advance Health Care Directives and "Public Guardian": The Italian Supreme Court Requests the Status of Current and Not Future Inability  

PubMed Central

Advance health care decisions animate an intense debate in several European countries, which started more than 20 years ago in the USA and led to the adoption of different rules, based on the diverse legal, sociocultural and philosophical traditions of each society. In Italy, the controversial issue of advance directives and end of life's rights, in the absence of a clear and comprehensive legislation, has been over time a subject of interest of the Supreme Court. Since 2004 a law introduced the “Public Guardian,” aiming to provide an instrument of assistance to the person lacking in autonomy because of an illness or incapacity. Recently, this critical issue has once again been brought to the interest of the Supreme Court, which passed a judgment trying to clarify the legislative application of the appointment of the Guardian in the field of advance directives. PMID:24729977

Busardo, Francesco Paolo; Bello, Stefania; Gulino, Matteo; Zaami, Simona; Frati, Paola



Target Audience: Health care professionals  

E-print Network

(palliative care, chronic ill- ness), child welfare, and do- mestic violence. Valerie is an AssistantTarget Audience: Health care professionals Workshop Facilitator: Valerie Spironello, MSW, RSW Valerie has been a social worker for over 20 years working in a variety of settings including health care

Haykin, Simon


Health Care System Responses to Children Exposed to Domestic Violence.  

ERIC Educational Resources Information Center

Summarizes health care approaches to identifying and treating child and adult victims of domestic violence. Describes innovative programs that tie children's well-being to that of their mothers and proposes strategies for improving current health care system responses. (SLD)

Culross, Patti L.



The promise of Lean in health care.  


An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations. PMID:23274021

Toussaint, John S; Berry, Leonard L



[External and internal financing in health care].  


The objective of this contribution is to characterize the functional and institutional features of the German health-care system. This takes place after a short introduction and examination of the ongoing debate on health care in Germany. External funding describes the form of revenue generation. Regarding external funding of the German health care system, one of the favored alternatives in the current debate is the possibility of introducing per capita payments. After a short introduction to the capitation option, focus is on the so-called health fund that is currently debated on and being made ready for implementation in Germany, actually a mixed system of capitation and contributions based on income. On the other hand, internal funding is the method of how different health-care services are purchased or reimbursed. This becomes a rather hot topic in light of new trends for integrated and networked care to patients and different types of budgeting. Another dominating question in the German health-care system is the liberalization of the contractual law, with its "joint and uniform" regulations that have to be loosened for competition gains. After a discussion of the consequences of diagnosis-related groups (DRGs) in Germany, the article is concluded by a note on the political rationality of the current health-care reform for increased competition within the Statutory Health Insurance and its players as exemplified by the health fund. To sum up, it has to be said that the complexity and specific features of how the German system is financed seem to require ongoing reform considerations even after realization of the currently debated health-care reform law which, unfortunately, is dominated by political rationalities rather than objective thoughts. PMID:17497087

Henke, Klaus-Dirk



Health needs of adolescents in secondary gynaecological care: results of a questionnaire survey and a review of current issues.  


The objective of this study was to undertake a survey of all obstetrics and gynaecology units in the United Kingdom to identify current views and facilities for the management of adolescents with gynaecological problems. A postal questionnaire was sent to all 248 departments of obstetrics and gynaecology in the UK. The survey was carried out by the Royal College of Obstetricians and Gynaecologists on behalf of the Royal College of Paediatrics and Child Health Intercollegiate Working Group on Adolescent Health. In total, 137 replies were received, giving a response rate of 55%. Only eight centres were able to quote an exact figure for the number of adolescent attendees and this ranged from 0.0035% to 4.8% of new gynaecological referrals. The cut-off age for paediatric patients ranged from 12 to 18 years. In response to the question regarding the definition of 'adolescence', most units that responded stated the range 12-16 years (81 units) and a further 30 units stated 12-18 years. Despite these large variations and also the lack of certainty of both the age range of adolescents and local criteria, 64 units considered that adolescents in their area had special needs, mainly for family planning issues, teenage pregnancy and drug or alcohol abuse. Sixty-three units (46%) provided family planning clinics for adolescents, 24 (17.5%) had a teenage pregnancy clinic, 22 (16.1%) had an adolescent sexual health clinic and 11 (8%) had a clinic for intersex conditions and developmental disorders. In conclusion, there is no consensus on the age range of the adolescent population and a lack of data on the numbers of adolescents with different obstetric and gynaecological problems. There is a perceived need for better data collection and designated facilities for adolescents who have gynaecological problems. Currently, there are no national guidelines for the management and referral of specialized problems, which should be addressed as a matter of urgency. PMID:12193797

Balen, Adam H; Fleming, Charlotte; Robinson, Angela



"Cloud" health-care workers.  

PubMed Central

Certain bacteria dispersed by health-care workers can cause hospital infections. Asymptomatic health-care workers colonized rectally, vaginally, or on the skin with group A streptococci have caused outbreaks of surgical site infection by airborne dispersal. Outbreaks have been associated with skin colonization or viral upper respiratory tract infection in a phenomenon of airborne dispersal of Staphylococcus aureus called the "cloud" phenomenon. This review summarizes the data supporting the existence of cloud health-care workers. PMID:11294715

Sherertz, R. J.; Bassetti, S.; Bassetti-Wyss, B.



Gypsies and health care.  

PubMed Central

Gypsies in the United States are not a healthy group. They have a high incidence of heart disease, diabetes mellitus, and hypertension. When they seek medical care, Gypsies often come into conflict with medical personnel who find their behavior confusing, demanding, and chaotic. For their part, Gypsies are often suspicious of non-Gypsy people and institutions, viewing them as a source of disease and uncleanliness. Gypsy ideas about health and illness are closely related to notions of good and bad fortune, purity and impurity, and inclusion and exclusion from the group. These basic concepts affect everyday life, including the way Gypsies deal with eating and washing, physicians and hospitals, the diagnosis of illness, shopping around for cures, and coping with birth and death. PMID:1413769

Sutherland, A



Progress in health care, progress in health?  

Microsoft Academic Search

This paper examines the potential impact of changes in medical care on changing population health in Lithuania, Hungary and Romania, with west Germany included for comparison. We used the concept of deaths from certain causes that should not occur in the presence of timely and effective health care (amenable mortality) and calculated the contribution of changes in mortality from these

Ellen Nolte; Martin McKee; Rembrandt D. Scholz



Health care's move toward differentiation.  


As the basis of competition changes, so will the focus of the health care industry's senior managers. The author believes that health plans that differentiate their product offerings, in the eyes of their customers, will be most successful. PMID:10164789

Kaminsky, R



Health Care for Gulf War Veterans  


... Toll Free Numbers VA » Health Care » Public Health » Military Exposures » Gulf War Veterans' Illnesses » Benefits » Health Care ... Veterans Public Health Public Health Public Health Home Military Exposures Military Exposures Home 4 Ways to Find ...


Improving Incentives in Health Care Spending  

Microsoft Academic Search

Although U.S. economic growth is likely to continue to\\u000a be robust, the growth of private and public spending on\\u000a health care presents long-run public policy challenges.\\u000a To meet these challenges health care resources must be\\u000a used more efficiently. Currently, there are few incentives\\u000a to put health care dollars to the highest value use. This\\u000a is true in both public and

Katherine Baicker



Space age health care delivery  

NASA Technical Reports Server (NTRS)

Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.

Jones, W. L.



Multicultural Health Care in Practice  

Microsoft Academic Search

This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive

Gert Olthuis; Godelieve van Heteren



Prospects for Health Care Reform.  

ERIC Educational Resources Information Center

This editorial reviews areas of health care reform including managed health care, diagnosis-related groups, and the Resource-Based Relative Value Scale for physician services. Relevance of such reforms to people with developmental disabilities is considered. Much needed insurance reform is not thought to be likely, however. (DB)

Kastner, Theodore



Contagious Ideas from Health Care  

ERIC Educational Resources Information Center

Financial problems plague both higher education and health care, two sectors that struggle to meet public expectations for quality services at affordable rates. Both higher education and health care also have a complex bottom line, heavy reliance on relatively autonomous professionals, and clients who share personal responsibility for achieving…

Chaffee, Ellen



Health care reform and the primary care workforce bottleneck.  


To establish and sustain the high-performing health care system envisioned in the Affordable Care Act (ACA), current provisions in the law to strengthen the primary care workforce must be funded, implemented, and tested. However, the United States is heading towards a severe primary care workforce bottleneck due to ballooning demand and vanishing supply. Demand will be fueled by the "silver tsunami" of 80 million Americans retiring over the next 20 years and the expanded insurance coverage for 32 million Americans in the ACA. The primary care workforce is declining because of decreased production and accelerated attrition. To mitigate the looming primary care bottleneck, even bolder policies will be needed to attract, train, and sustain a sufficient number of primary care professionals. General internists must continue their vital leadership in this effort. PMID:22042605

Schwartz, Mark D



Service quality in health care.  


Although US health care is described as "the world's largest service industry," the quality of service--that is, the characteristics that shape the experience of care beyond technical competence--is rarely discussed in the medical literature. This article illustrates service quality principles by analyzing a routine encounter in health care from a service quality point of view. This illustration and a review of related literature from both inside and outside health care has led to the following 2 premises: First, if high-quality service had a greater presence in our practices and institutions, it would improve clinical outcomes and patient and physician satisfaction while reducing cost, and it would create competitive advantage for those who are expert in its application. Second, many other industries in the service sector have taken service quality to a high level, their techniques are readily transferable to health care, and physicians caring for patients can learn from them. PMID:10029131

Kenagy, J W; Berwick, D M; Shore, M F



Teens, technology, and health care.  


Teens are avid users of new technologies and social media. Nearly 95% of US adolescents are online at least occasionally. Health care professionals and organizations that work with teens should identify online health information that is both accurate and teen friendly. Early studies indicate that some of the new health technology tools are acceptable to teens, particularly texting, computer-based psychosocial screening, and online interventions. Technology is being used to provide sexual health education, medication reminders for contraception, and information on locally available health care services. This article reviews early and emerging studies of technology use to promote teen health. PMID:25124206

Leanza, Francesco; Hauser, Diane



Educating primary care clinicians about health disparities  

PubMed Central

Racial and ethnic health disparities inarguably exist in the United States. It is important to educate primary care clinicians regarding this topic because they have the ability to have an impact in the reduction of health disparities. This article presents the evidence that disparities exist, how clinicians contribute to these disparities, and what primary care clinicians can do to reduce disparities in their practice. Clinicians are able to impact health disparities by receiving and providing cross-cultural education, communicating effectively with patients, and practicing evidence-based medicine. The changes suggested herein will have an impact on the current state of health of our nation. PMID:17371577

Cardarelli, Roberto; Chiapa, Ana L



Academic Health Centers and Health Care Reform.  

ERIC Educational Resources Information Center

A discussion of the role of academic health centers in health care reform efforts looks at the following issues: balancing academic objectivity and social advocacy; managing sometimes divergent interests of centers, faculty, and society; and the challenge to develop infrastructure support for reform. Academic health centers' participation in…

Miles, Stephen H.; And Others



Health Professionals' Knowledge of Women's Health Care.  

ERIC Educational Resources Information Center

Survey responses from 71 health professionals, benchmarking data from 8 hospitals, continuing education program evaluations, and focus groups with nursing, allied health, and primary care providers indicated a need for professional continuing education on women's health issues. Primary topic needs were identified. The data formed the basis for…

Beatty, Rebecca M.



Community mental health care in the Asia-Pacific region: using current best-practice models to inform future policy  

PubMed Central

The reporting of child sexual abuse (CSA) and physician-patient sexual relationships (PPSR) are currently the focus of professional, legal and media attention in several countries. This paper briefly reviews mental health policies on these issues and reports on a WPA survey of them. While the WPA Madrid Declaration permits breaching confidentiality for mandatory reporting of CSA and clearly prohibits PPSR, it is not known how or to what extent these policies are implemented in WPA Member Societies’ countries. It is also not known whether policies or laws exist on these topics nationally or to what extent psychiatrists and the public are aware of them. Representatives of WPA Member Societies were e-mailed a survey about issues pertaining to CSA and PPSR. Fifty-one percent of 109 countries replied. All reporting countries had laws or policies regarding the reporting of CSA, but this was often voluntary (63%) and without protection for reporting psychiatrists either by law (29%) or by Member Societies (27%). A substantial number of psychiatric leaders did not know the law (27%) or their Society’s policy (11%) on these matters. With respect to PPSR, some reporting countries lacked laws or policies about PPSR with current (17%) or past (56%) patients. Fewer than half of responding representatives believed that their Society’s members or the public were well informed about the laws and policies pertaining to CSA or PPSR. There is clearly a wide range of laws, policies and practices about CSA and PPSR in WPA Member Societies’ countries. There is a need in some countries for laws or supplemental policies to facilitate the protection of vulnerable child and adult patients through clear, mandatory reporting policies for CSA and PPSR. Mechanisms to protect and support reporting psychiatrists should also be developed where they do not already exist. There is also a need in some countries to develop strategies to improve the education of psychiatrists, trainees, and the public on these issues. PMID:19293961




Community mental health care in the Asia-Pacific region: using current best-practice models to inform future policy.  


The reporting of child sexual abuse (CSA) and physician-patient sexual relationships (PPSR) are currently the focus of professional, legal and media attention in several countries. This paper briefly reviews mental health policies on these issues and reports on a WPA survey of them. While the WPA Madrid Declaration permits breaching confidentiality for mandatory reporting of CSA and clearly prohibits PPSR, it is not known how or to what extent these policies are implemented in WPA Member Societies' countries. It is also not known whether policies or laws exist on these topics nationally or to what extent psychiatrists and the public are aware of them. Representatives of WPA Member Societies were e-mailed a survey about issues pertaining to CSA and PPSR. Fifty-one percent of 109 countries replied. All reporting countries had laws or policies regarding the reporting of CSA, but this was often voluntary (63%) and without protection for reporting psychiatrists either by law (29%) or by Member Societies (27%). A substantial number of psychiatric leaders did not know the law (27%) or their Society's policy (11%) on these matters. With respect to PPSR, some reporting countries lacked laws or policies about PPSR with current (17%) or past (56%) patients. Fewer than half of responding representatives believed that their Society's members or the public were well informed about the laws and policies pertaining to CSA or PPSR. There is clearly a wide range of laws, policies and practices about CSA and PPSR in WPA Member Societies' countries. There is a need in some countries for laws or supplemental policies to facilitate the protection of vulnerable child and adult patients through clear, mandatory reporting policies for CSA and PPSR. Mechanisms to protect and support reporting psychiatrists should also be developed where they do not already exist. There is also a need in some countries to develop strategies to improve the education of psychiatrists, trainees, and the public on these issues. PMID:19293961

Ng, Chee; Herrman, Helen; Chiu, Edmond; Singh, Bruce



Social Networks in Health Care: Communication, collaboration and insights  

E-print Network

Social Networks in Health Care: Communication, collaboration and insights Foreword At Chirp and explore its current and potential impacts on the health care industry. We believe that social networking and leverage other consumers' knowledge before making health care decisions.3 Social networks hold considerable

Klein, Ophir


Changing roles and responses of health care workers in HIV treatment and care.  


A key limiting factor in the scale up and sustainability of HIV care and treatment programmes is the global shortage of trained health care workers. This paper discusses why it is important to move beyond conceptualising health care workers simply as 'inputs' in the delivery of HIV treatment and care, and to also consider their roles as partners and agents in the process of health care. It suggests a framework for thinking about their roles and responses in HIV care, considers the current evidence base, and concludes by identifying key areas for future research on health care workers' responses in HIV treatment and care in low and middle income settings. PMID:19055620

Rajaraman, Divya; Palmer, Natasha



Primary health care in India--plans.  


In India a draft Health Policy has been formulated with the following objectives: to improve and expand the health care delivery system to make primary health care services available to each individual; to make people conscious of their health needs and to encourage their involvement and participation in the planning and implementation of the health programs; to improve the standards of environmental sanitation and personal hygiene leading to reduction in the incidence of diseases and a healthier life; to improve maternal and child health services and to create such services; to control and eradicate common communicable and infectious desease; and to lower by about 50% maternal and infant mortality rates and other mortality rates. To achieve the general objectives, it is proposed to use certain specific indicators to plan and monitor the health programs. The indicators proposed, which are outlined, fall into the categories of health status indicators and indicators for provision of health services. The main objective of primary health care will be to provide better health care services to the rural areas and urban slums. The population will be encouraged both individually and collectively to participate in the development of health. The government and the medical profession will help the people to realize their responsibility by providing a large band of health volunteers from among the community itself to take care of the basic health needs of the community. There will be a more equitable distribution of health resources, and, to correct past imbalances, preferential allocations will be made for developing health facilities in rural areas. The primary emphasis will be on preventive, promotive, and rehabilitative aspects of health which will be integrated with functions and responsibilities of all these institutions which currently are providing only curative services. In providing primary health care, full advantage will be taken of the traditional methods and techniques which are scientifically sound, familiar and acceptable to the community, and easy to adopt. Primary health care will form an integral part of the health system. At this time 5739 primary health centers are operating in India, each covering a population of between 80,000-125,000. Primary health care to the rural population will be backed up by proper referral services. PMID:7183715

Saigal, M D



Distrust of the health care system and self-reported health in the United States  

Microsoft Academic Search

CONTEXT: Despite theoretical concerns that health care related distrust may lead to poor health outcomes by interfering with effective\\u000a health care, little is currently known about the prevalence or outcomes of distrust of the health care system in the United\\u000a States.\\u000a \\u000a \\u000a OBJECTIVE: To investigate the association between distrust of the health care system and self-reported health status among the general

Katrina Armstrong; Abigall Rose; Nikki Peters; Judith A. Long; Suzanne McMurphy; Judy A. Shea



Solid health care waste management status at health care centers in the West Bank - Palestinian Territory  

SciTech Connect

Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m{sup 3} (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

Al-Khatib, Issam A. [Institute of Environmental and Water Studies, Birzeit University, P.O. Box 14, Birzeit, Ramallah, West Bank (Palestinian Territory, Occupied)], E-mail:; Sato, Chikashi [Department of Civil and Environmental Engineering, Idaho State University, Pocatello, Idaho (United States)




E-print Network

Spring 2014 CAN WE FIX HEALTH CARE? HEALTH ECONOMICS & POLICY 1 Dr. Katie Fitzpatrick UCOR1630 in health care policy. You will analyze health-related issues in the news, create and interpret graphical- plexity of the health care system and an appreciation of the tradeoffs in health care policy. Course

Carter, John


Health care reform in Russia  

Microsoft Academic Search

The break-up of the former Soviet Union has created a greater realisation of the health and health care deficiencies of what are now independent states and the need for reform. The purpose of these two papers is to describe these deficiencies and set the scene for the establishment of some form of national health insurance in Russia and the other

O P Schepin; V Yu Semenov; Igor Sheiman



Managing Home Health Care (For Parents)  


Intensive Health Care at Home Kids can need intensive health care at home after they have been in the hospital ... dolls to help you practice different procedures. Home Health Care Assistance The hospital social worker can help families ...


Health care system factors affecting end-of-life care.  


The field of palliative care in the United States developed in response to a public health crisis--namely, poor quality of life for patients with serious illness and their families--and most palliative care research to date has been appropriately focused on identifying patient and family needs and identifying gaps in the current health care system and in the education of our health care professionals. Research has also begun to develop and evaluate new interventions and systems to address these care gaps. Preliminary studies suggest modest benefits of an array of programs designed to deliver palliative care services. These benefits include improved pain and other symptoms, increased family satisfaction, and lower hospital costs. Unfortunately, the validity and reliability of these findings are limited by important methodological weaknesses including small sample sizes, poorly described and nongeneralizable interventions, diverse and nonstandardized outcome measures, and poor study designs (i.e., lack of appropriate control groups, nonblinded designs). Comprehensive and rigorous research is needed to evaluate the effect of well-delineated and generalizable palliative care structures and processes on important clinical and use outcomes. Large multisite studies that have adequate power to detect meaningful differences in clinical and use outcomes, and that use well-defined and generalizable structures and evidence-based care processes, well-defined uniform outcome measures, and analyses that link the outcomes of interest to individual components of the interventions, are needed to guide further development of the field. PMID:16499472

Morrison, R Sean



78 FR 26036 - Medicare and Medicaid Programs: Application From the Accreditation Commission for Health Care for...  

Federal Register 2010, 2011, 2012, 2013

...the Accreditation Commission for Health Care for Continued CMS-Approval of...the Accreditation Commission for Health Care (ACHC) for continued recognition...The Accreditation Commission for Health Care's (ACHC's) current term...



Asian American health care attitudes.  


This paper describes the results of a survey of health care attitudes of a sample of respondents primarily of Asian American background. The importance of bilingualism, Asian background, age, and other attributes of a physician are discussed with relation to subgroups in the sample. The relative importance of the influence of doctors, family, and friends on the choice of physician and health care facility are also presented. The findings may help with the development of effective market segmentation and improved health care service to the Asian American community. PMID:10538733

Perttula, W; Lowe, D; Quon, N S



Consumer-directed health care and case management: Part 1.  


Consumer-directed health care (CDH) is here. A quick look at the current health care market shows that CDH is quickly gaining a foothold. Most health plans either already offer some type of a plan or are in the midst of developing one for the next enrollment period. Early adopter health plans have gained significant market traction, gaining new employer clients on the basis of a consumer-directed health care strategy. PMID:16061162

Gupta, Amit



Specialization in psychology and health care reform.  


This article begins by contextualizing specialization and board certification of psychologists, with attention paid to relevant definitions and expectations of other health care professionals. A brief history of specialization and board certification in professional psychology is offered. The benefits of board certification through the American Board of Professional Psychology are highlighted. Consideration is then given to the primary reasons for psychologists working in academic health sciences centers to specialize in the current health care climate and to obtain board certification as a mark of such specialization. PMID:22105540

Kaslow, Nadine J; Graves, Chanda C; Smith, Chaundrissa Oyeshiku



Accreditation Association for Ambulatory Health Care  


... HIPAA compliance Federal and State Regulations/Legislative Resources Health Care Resources Press Releases Contact Us Find a Health Care Organization Accreditation Programs General information Application for survey ...


Helping You Choose Quality Behavioral Health Care  


Helping You Choose Quality Behavioral Health Care Selecting quality behavioral health care services for yourself, a relative or friend requires special thought and attention. The Joint Commission on ...


Advanced practice nursing in performing arts health care.  


Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care. PMID:20644180

Weslin, Anna T; Silva-Smith, Amy



Agents of Change for Health Care Reform  

ERIC Educational Resources Information Center

It is widely recognized throughout the health care industry that the United States leads the world in health care spending per capita. However, the chilling dose of reality for American health care consumers is that for all of their spending, the World Health Organization ranks the country's health care system 37th in overall performance--right…

Buchanan, Larry M.



Delivering Health Care and Mental Health Care Services to Children in Family Foster Care after Welfare and Health Care Reform.  

ERIC Educational Resources Information Center

Describes the essential features of a health care system that can meet the special needs of children in out-of-home care. Discusses some of the major recent changes brought about by welfare and health care reform. Notes that it remains to be seen whether the quality of services will improve as a result of these reforms. (Author)

Simms, Mark D.; Freundlich, Madelyn; Battistelli, Ellen S.; Kaufman, Neal D.



[Calculation of workers' health care costs].  


In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference subjects as cost objects and taking account of all their interrelations. Final products, specific assignments, resources and activities may all be regarded as cost objects. The ABC method is characterized by a very high informative value in terms of setting prices of products in the area of workers' health care. It also facilitates the assessment of costs of individual activities under a multidisciplinary approach to health care and the setting costs of varied products. The ABC method provides precise data on the consumption of resources, such as human labor or various materials. PMID:17533995

Rydlewska-Liszkowska, Izabela



Respiratory Home Health Care  


... patients and caregivers to perform on a routine basis. Use a liquid soap and lots of warm ... care equipment should be cleaned on a regular basis. Besides washing with a mild detergent and rinsing ...


Health Care Resource Guide  

E-print Network

, and children, simple diagnostic tests, medical assistance, limited immunizations, sports physicals, DOT Program 13 Project Access 14 Riverstone Family Health Clinic 15-16 Shriners Hospital for Children

Collins, Gary S.


Determinants of Children's Primary Health Care Use  

Microsoft Academic Search

We review factors that influence children's use of primary health care services. Predictors of pediatric health care use include child health status, child mental health, parent and family functioning, demographic characteristics, and access to health care services. Health services research is marked by inconsistencies due to varying approaches to measurement, population sampling, and analysis, and models that do not incorporate

David M. Janicke; Jack W. Finney



Help Yourself to Health Care.  

ERIC Educational Resources Information Center

A booklet on health care for limited English speakers provides information on choosing the right doctor, buying medicine, paying the bill, and the individual's role in maintaining his or her health. Cartoons, questions and puzzles concerning the message in cartoons and narrative passages, checklists about an individual's personal habits related to…

Snyder, Sarah


Health Care Reform's Effect on Private Medical Practices  

Microsoft Academic Search

In March of 2010, the 44th President of the United States, Barack Obama, signed into law a health care reform bill that will change the medical and business approach to healthcare that has been witnessed for quite some time. The Patient Protection and Affordable Care Act, aims to eliminate several inefficiencies encountered in our current health care system, as well

Spencer R Clark



Counseling and Mental Health Care in Palestine  

ERIC Educational Resources Information Center

The authors provide a brief overview of counseling and mental health care in Palestine, including their history and a summary of their current status. Finally, a discussion is presented of future trends in the development of the profession with regard to recent changes in the region.

Shawahin, Lamise; Ciftci, Ayse




E-print Network

UNIVERSITY OF CONNECICUT HEALTH CENTER CORRECTIONAL MANAGED HEALTH CARE POLICY AND PROCEDURES SERVICES Effective Date: 04/01/01 POLICY: University of Connecticut Health Center (UCHC), Correctional Managed Health Care (CMHC) shall ensure that newly admitted inmates to Connecticut Department

Oliver, Douglas L.


Optimization of preventive health care facility locations  

Microsoft Academic Search

BACKGROUND: Preventive health care programs can save lives and contribute to a better quality of life by diagnosing serious medical conditions early. The Preventive Health Care Facility Location (PHCFL) problem is to identify optimal locations for preventive health care facilities so as to maximize participation. When identifying locations for preventive health care facilities, we need to consider the characteristics of

Wei Gu; Xin Wang; S. Elizabeth McGregor



Health care reform, behavioral health, and the criminal justice population.  


The 2010 Patient Protection and Affordable Care Act (ACA) has a number of important features for individuals who are involved with the criminal justice system. Among the most important changes is the expansion of Medicaid to more adults. The current study estimates that 10% of the total Medicaid expansion could include individuals who have experienced recent incarceration. The ACA also emphasizes the importance of mental health and substance abuse benefits, potentially changing the landscape of behavioral health treatment providers willing to serve criminal justice populations. Finally, it seeks to promote coordinated care delivery. New care delivery and appropriate funding models are needed to address the behavioral health and other chronic conditions experienced by those in criminal justice and to coordinate care within the complex structure of the justice system itself. PMID:24807645

Cuellar, Alison Evans; Cheema, Jehanzeb




... MD 21244 × Get Email/Text Updates Learn more about new health insurance options ... Northern Mariana Islands Puerto Rico Virgin Islands For Text Messages Optional Privacy Policy Subscription Complete! Now that ...


Health Care Reform and Alzheimer's Disease  


... care and research. Subscribe now Medicare and the health care reform law Drug rebates for seniors At a ... Detection of possible cognitive impairment under Medicare The health care reform law created a new Medicare benefit to ...


A systems view of health care for the poor.  

PubMed Central

A systems view is a synthesis of health policy, medical sociology, public health, and common clinical problems to describe the current crisis in health care for the poor. Medical sociology and public health are particularly relevant to understand the complexity of clinical issues. Although preventive medicine is in desuetude, it is crucial if we are to reduce the future liability of postponed medical care among the poor. Medicaid metamorphosed to Medicare, as half of its outlays are spent on care of the elderly in nursing homes. Health care for the poor will remain a moral challenge to the architects of health policy and the medical profession. PMID:2659807

Prasad, N.



School Readiness Goal Begins with Health Care Reform.  

ERIC Educational Resources Information Center

Currently 59 bills are awaiting Congressional action. Meanwhile, a national coalition of economists and medical specialists (the National Leadership Coalition for Health Care Reform) are circulating a sensible consensus health reform plan proposing national practice guidelines; universal health care access; and efficient cost control, delivery,…

Penning, Nick



Matching Census Database and Manitoba Health Care Files  

Microsoft Academic Search

Introduction: In the current economic context, all partners in health care delivery systems, be they public or private, are obliged to identify the factors that influence the utilization of health care serv- ices. To improve our understanding of the mechanisms that underlie these relationships, Statistics Canada and the Manitoba Centre for Health Policy and Evaluation have set up a new

Christian Houle; Jean-Marie Berthelot; Pierre David


Pharmacy and the health-care environment.  


The current revolution in the delivery of health care is examined, possibilities for the future are considered, and preparations for meeting the challenges of the future are discussed. The main elements in the revolution involve changes in the economic, business, and technological aspects of health-care delivery. The economic influences have included diagnosis-related groups (DRGs) and the Gramm-Rudman-Hollings legislation as it affects Medicare. Hospitals and hospital pharmacists have had to look closely at their own involvement and take measures to cut costs. The care of the elderly and the indigent and the issue of malpractice will require particular attention. Diversification and incorporation have brought many changes. Among them are the blurring of the traditional roles of pharmacy practice, as evidenced, for example, in the area of home health care. The changes made possible by technology are inseparable from the other current trends, and they add another dimension to health-care considerations--that of moral choices. Furthermore, pharmacy practitioner organizations will have to develop strategies for controlling the destiny of the profession in a corporate atmosphere. Pharmacists can achieve their full potential as society's drug therapy experts if they are flexible and creative enough to apply, in this new environment, the basic principles for which the profession has long stood. PMID:3728477

Oddis, J A



Providers Caring for Adolescents with Perinatally-Acquired HIV: Current Practices and Barriers to Communication About Sexual and Reproductive Health.  


Abstract The population of adolescents and young adults (AYA) with perinatally-acquired HIV (PHIV) present challenges to HIV healthcare providers (HHCPs). Originally not expected to survive childhood, they are now living well into young adulthood. Little is known about the type of sexual and reproductive (SRH) information/services offered to AYA with PHIV by HHCPs. HHCPs (n=67) were recruited using snowball sampling, and completed an online survey. Providers' most frequently endorsed SRH topics discussed with both male and female patients included condom use (77.3%), STD prevention (73.1%), and screening (62.1%). Providers' reports indicated that females received significantly more education about SRH topics overall. The most frequently noted barriers to SRH communication included more pressing health concerns (53.0%), parent/guardian not receptive (43.9%), and lack of time during appointment (43.9%). Provider-reported SRH conversations with HHCPs were highly focused on horizontal transmission and pregnancy prevention. Salient social aspects of SRH promotion for AYAs with PHIV (e.g., managing disclosure and romantic relationships) were less commonly discussed, though such conversations may serve to reduce secondary transmission and enhance the overall well-being of AYA with PHIV. Findings indicated that further work must be done to identify strategies to address unmet SRH needs of the aging population of AYA with PHIV. PMID:25290765

Albright, Jamie N; Fair, Cynthia D



National Lesbian Health Care Survey: Implications for Mental Health Care  

Microsoft Academic Search

This article presents demographic, lifestyle, and mental health information about 1,925 lesbians from all 50 states who participated as respondents in the National Lesbian Health Care Survey (1984–1985), the most comprehensive study on U.S. lesbians to date. Over half the sample had had thoughts about suicide at some time, and 18% had attempted suicide. Thirty-seven percent had been physically abused

Judith Bradford; Caitlin Ryan; Esther D. Rothblum



Health Care Reform: A Values Debate.  

ERIC Educational Resources Information Center

Addresses the crisis in health care, considering costs, lack of access, and system ineffectiveness. Reviews "Setting Relationships Right," the Catholic Health Association's proposal for health care reform. Advocates educators' awareness of children's health needs and health care reform issues and support for the Every Fifth Child Act of 1992. (DMM)

Popko, Kathleen



Open Access to essential health care information.  


Open Access publishing is a valuable resource for the synthesis and distribution of essential health care information. This article discusses the potential benefits of Open Access, specifically in terms of Low and Middle Income (LAMI) countries in which there is currently a lack of informed health care providers - mainly a consequence of poor availability to information. We propose that without copyright restrictions, Open Access facilitates distribution of the most relevant research and health care information. Furthermore, we suggest that the technology and infrastructure that has been put in place for Open Access could be used to publish download-able manuals, guides or basic handbooks created by healthcare providers in LAMI countries. PMID:15575959

Stokes, Christabel E L; Pandey, Manoj



Finding Low-Cost Mental Health Care  


... Teens > Mind > Mental Health > Finding Low-Cost Mental Health Care Print A A A Text Size What's in ... if you're concerned about paying for mental health care. Lots of people need help and worry that ...


Providing Health Care to Latino Immigrants: Community-Based Efforts in the Rural Midwest  

Microsoft Academic Search

We examined case studies of 3 rural Midwestern communities to as- sess local health care systems' re- sponse to rapidly growing Latino pop- ulations. Currently, clinics provide free or low-cost care, and schools, public health, social services, and re- ligious organizations connect Latinos to the health care system. However, many unmet health care needs result from lack of health insurance,

Michelle M. Casey; Lynn A. Blewett; Kathleen T. Call


Consumerism in health care. Prevalence and predictors.  


Current efforts to contain health care costs include a variety of strategies aimed at the users of health services. These approaches attempt to encourage users to be more cost-conscious and to shop for lower-cost services and more efficient health care plans. The primary method for achieving this is by increasing the consumer's exposure to the cost of health insurance and the cost of care. The assumption is that approaches that increase cost-sensitivity will stimulate greater consumerism among the users of care. This paper presents findings from a study that investigates the extent to which members of insured populations have a consumer approach to health care, identifies factors related to consumer behaviors and attributes, and examines the degree to which consumer cost-sensitivity is associated with other consumer-oriented behaviors. The data used are derived from face-to-face interviews. Only a minority of the respondents engage in the examined consumer behaviors. Both social demographic and attitudinal factors affect the likelihood of engaging in consumer behaviors. Being cost-sensitive appears to be only a minor stimulant to other consumer attributes. Policy implications are discussed. PMID:3320590

Hibbard, J H; Weeks, E C



Health Care Procedure Considerations and Individualized Health Care Plans  

ERIC Educational Resources Information Center

Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

Heller, Kathryn Wolff; Avant, Mary Jane Thompson



Homeless persons and health care.  


Health care is generally unavailable for the homeless. This heterogeneous group of men and women, including long-term street dwellers, residents of shelters, the chronically mentally ill, the economically debased, and alienated youth, are subject to a broad range of acute and chronic diseases, intensified by unsuitable living conditions, stress, and sociopathic behavior. Trauma, pulmonary tuberculosis, infestations, and peripheral vascular disease are common problems among the homeless; incomplete and fragmentary medical care permits exacerbation of chronic disorders. Outreach programs imaginatively constructed by teams of physicians, nurses, and social workers can effectively reestablish and maintain health services for these disenfranchised persons. PMID:3511826

Brickner, P W; Scanlan, B C; Conanan, B; Elvy, A; McAdam, J; Scharer, L K; Vicic, W J



Consumer-driven health care: the future is now.  


Given that managed care seems to have run its course, employers are forced to deal with escalating health care costs by reducing benefits and lowering pay--or are they? Why not bring the power of the responsible, informed consumer to health care? Consumer-driven health care offers a new, economically rational direction that can simultaneously address the needs of both employers and employees. This article reviews the factors leading to the need for consumer-driven health care and describes the characteristics and benefits of its current and next generations of development. PMID:15146749

Bachman, Ronald E



The value of pharmacists in health care.  


The American health care system is concerned about the rise of chronic diseases and related resource challenges. Management of chronic disease traditionally has been provided by physicians and nurses. The growth of the care management industry, in which nurses provide remote telephonic monitoring and coaching, testifies to the increasing need for care management and to the value of nonphysician clinicians. However, this model is challenged by a number of factors, including low enrollment and the growing shortage of nurses. The challenges to the traditional model are causing policy makers and payers to consider innovative models. One such model includes the pharmacist as an essential provider of care. Not only is the number of pharmacists growing, but they are playing an ever broader role in a variety of settings. This article broadly surveys the current state of pharmacist provision of care management services and highlights the increasingly proactive role played by Walgreen Co. toward this trend, using recently conducted research. Pharmacists are making a noticeable impact on and contribution to the care of chronic diseases by improving adherence to medications, a key factor in the improvement of outcomes. Literature also suggests that pharmacies are increasingly encouraging, expanding, and highlighting the role and contributions of their professional pharmacists. Although the role of the pharmacist in chronic care management is still developing, it is likely to grow in the future, given the needs of the health care system and patients. PMID:22313438

Patwardhan, Avinash; Duncan, Ian; Murphy, Patricia; Pegus, Cheryl



Health disparities among health care workers.  


In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field. PMID:19940090

Mawn, Barbara; Siqueira, Eduardo; Koren, Ainat; Slatin, Craig; Devereaux Melillo, Karen; Pearce, Carole; Hoff, Lee Ann



Universal health care in India: Panacea for whom?  


This paper examines the current notion of universal health care (UHC) in key legal and policy documents and argues that the recommendations for UHC in these entail further abdication of the State's responsibility in health care with the emphasis shifting from public provisioning of services to merely ensuring universal access to services. Acts of commission (recommendations for public private partnership [PPPs], definition and provision of an essential health package to vulnerable populations to ensure universal access to care) and omission (silence maintained on tertiary care) will eventually strengthen the private and corporate sector at the cost of the public health care services and access to care for the marginalized. Thus, the current UHC strategy uses equity as a tool for promoting the private sector in medical care rather than health for all. PMID:24351383

Qadeer, Imrana



[About the legal regulation of health care].  


The adoption of the law "About foundations of population health care in the Russian Federation" in absence of concept of health care development determining the major targets and tasks of the sector gives rise in citizen incomprehension and rejection of innovations of health policy. To determine the vector of development of Russian health care as compared with Soviet system of health care the analysis of particular positions of the Federal law "On foundations of population health care" (2011) and the USSR law "On approval of foundations of legislation of USSR and Union republics on health care" (1969) is made. PMID:23634600

Yefremov, D V



take care of What Matters Health Family  

E-print Network

your receipts! Health care account max of $2500; child day care account max of $5000 Convenienttake care of What Matters Health · Family · Finances · Future Medical Coverage Penn State offers plans allow you freedom of choice of health care providers both in and out of network. PPO Blue plan

Lee, Dongwon


Partners HealthCare Center for Connected Health.  


This article reviews the history, current status, and future plans of the Partners HealthCare Center for Connected Health (the Center). Established in 1995 by Harvard Medical School teaching hospitals, the Center develops strategies to move healthcare from the hospital and doctor's office into the day-to-day lives of patients. It leverages information technology to help manage chronic conditions, maintain health and wellness, and improve adherence to prescribed regimen, patient engagement, and clinical outcomes. Since inception, it has served over 30,000 patients. The Center's core functions include videoconference-based real-time virtual visits, home vital sign monitoring, store-and-forward online consultations, social media, mobile technology, and other novel methods of providing care and enabling health and wellness remotely and independently of traditional time and geographic constraints. It offers a wide range of services, programs, and research activities. The Center comprises over 40 professionals with various technical and professional skills. Internally within Partners HealthCare, the role of the Center is to collaborate, guide, advise, and support the experimentation with and the deployment and growth of connected health technologies, programs, and services. Annually, the Center engages in a deliberative planning process to guide its annual research and operational agenda. The Center enjoys a diversified revenue stream. Funding sources include institutional operating budget/research funds from Partners HealthCare, public and private competitive grants and contracts, philanthropic contributions, ad hoc funding arrangements, and longer-term contractual arrangements with third parties. PMID:23330595

Ternullo, Joseph; Jethwani, Kamal; Lane, Susan; Myint-U, Khinlei; Havasy, Robert; Carter, Michael; Kvedar, Joseph



Spirituality, health care, and bioethics  

Microsoft Academic Search

This article explores the relationship of spirituality to health care and bioethics in terms of the need and efforts of people to make sense of their lives in the face of illness, injury, or impending death. Moving beyond earlier associations with specific religious traditions, spirituality has come to designate the way in which people can integrate their experiences with their

Maureen Muldoon; Norman King



Health care insolvency and bankruptcy.  


Bankruptcy is an event that is often considered a business' worst nightmare. Debt, lawyers, and the U.S. government can lead to the eventual destruction of a business. This article shows how declaring bankruptcy can be a helpful instrument in continuing a successful venture in the health care marketplace. PMID:10182242

Handelsman, L; Speiser, M; Maltz, A; Kirpalani, S



Health care and the transcendent  

Microsoft Academic Search

This paper examines the values implicit in health care providers serving dying persons. It studies why providers should form a relationship with the dying person that is more human, less mechanistic, and less directed to that person as an economic unit or as a “case” of this or that disease. Much of the literature on the dying makes such suggestions

Clyde Nabe



Towards an alternative economics of health care.  


It is argued here that an economics centred on subjective utility-maximization is unsuitable for the analysis and policy grounding of health care provision. To some extent, the peculiarities of health care have been recognized by mainstream health economists, who sometimes abandon Paretian welfare considerations to focus on needs instead. This article examines important peculiarities of health care that are relatively neglected in the literature. Some of these concern health care needs: while health itself is a universal need, needs for health care provision are largely involuntary, varied, and idiosyncratic. These issues have important consequences for the planning of health care systems and the extent of transaction costs in any market-based system. These factors, combined with the inherent dynamism of modern health care needs and capabilities, create an opening for alternative approaches to health care economics. PMID:19099619

Hodgson, Geoffrey M



Managed consumerism in health care.  


The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations. PMID:16284020

Robinson, James C



Agent-based health care management An Agent-based Approach to Health Care Management  

E-print Network

Agent-based health care management 1 An Agent-based Approach to Health Care Management Jun Huang1, London WC2A 3PX, UK. Abbreviated title: Agent-based health care management Complete Mailing Address. London E1 4NS UK #12;Agent-based health care management 2 Abstract The provision of medical care

Mascardi, Viviana


Financing the health care Internet.  


Internet-related health care firms have accelerated through the life cycle of capital finance and organizational destiny, including venture capital funding, public stock offerings, and consolidation, in the wake of heightened competition and earnings disappointments. Venture capital flooded into the e-health sector, rising from $3 million in the first quarter of 1998 to $335 million two years later. Twenty-six e-health firms went public in eighteen months, raising $1.53 billion at initial public offering (IPO) and with post-IPO share price appreciation greater than 100 percent for eighteen firms. The technology-sector crash hit the e-health sector especially hard, driving share prices down by more than 80 percent for twenty-one firms. The industry now faces an extended period of consolidation between e-health and conventional firms. PMID:11192423

Robinson, J C



Health care users' satisfaction in Brazil, 2003.  


Evaluation of users' satisfaction with the health system brings back longstanding questions concerning the quality of services provided to the Brazilian population. The current study analyzes satisfaction with outpatient and inpatient care based on the results of the World Health Survey, conducted in Brazil in 2003. To explain satisfaction with various aspects of care through a small number of factors, the factor analysis technique was used, through principal components analysis (PCA). Multiple regression models identified associations between satisfaction scores and different sociodemographic variables. For outpatient care, waiting time showed the lowest degree of satisfaction, and in the case of hospitalization, freedom to choose the physician was the worst evaluated aspect. Three components were extracted from the PCA, related respectively to satisfaction with health professionals, health services, and health problem solution. Multiple regression analysis showed that having experienced some type of discrimination (on the basis of gender, age, poverty, social class, skin color, or type of disease) and being an exclusive user of the public National Health System involved a lower degree of users' satisfaction. PMID:16463002

Gouveia, Giselle Campozana; Souza, Wayner Vieira de; Luna, Carlos F; Souza-Júnior, Paulo Roberto Borges de; Szwarcwald, Célia Landmann



Consumer Attitudes toward Health and Health Care: A Differential Perspective.  

ERIC Educational Resources Information Center

Questionnaires returned by 343 out of 350 subjects measured health attitudes and health status. Results suggest that some consumers take a more scientific approach to health care and prevention. Demographic factors, health status, and health consciousness are partial predictors of consumer attitudes and approach to health care. (SK)

Gould, Stephen J.



[The right to health care services under Quebec law].  


The main goal of the Canada Health Act is to guarantee that Canadian residents have reasonable access to a comprehensive and universal health care plan. However, reduced federal funding for health care and increases in health care costs due to technical and scientific developments have created unprecedented financial pressures on provincial health care systems. The right to health care, once perceived as one of the pillars of Canadian society, may be imperiled. This article will provide a detailed analysis of the nature and scope of the right to health care from mainly a legal, but also from a political, perspective. Based on the premises that the Canada Health Act is basically a financial agreement between the Federal and provincial governments and that it does not enshrine a substantive right on which individuals may claim services, the author explores the nature and scope of this right under Québec legislation. Indeed, the Québec Health and Social Services Act has, since the 1960s, included various provisions that establish a right of access to health care services. This right, however, is fraught with regulatory, organizational and financial limits. The first part of this paper examines relevant regulation from an historical perspective, highlighting the relationships between federal and Québec provincial legislation. In the second part, the author explores exhaustively the principal provisions relevant to the right to health care. This entails the analysis of administrative regulations as well as of the responsibilities of the various provincial, regional, institutional and professional authorities involved. Ultimately, as this study will demonstrate, the availability of health care services depends more on a vague process than on a legal right to health care. This conclusion is further confirmed by the analysis of the adjudication process of patient complaints provided under the Québec Health and Social Services Act and by the limited case law on the right of access to services. Even though judges are generally favorable to patients claims, court interventions remain ad hoc and a posteriori. But if the right of access to health care seems limited, its scope is nonetheless important. The right to health care acts as an obstacle to the current dismantling of health care services and to government withdrawal from this field. It also places limits on abusive, arbitrary and discriminatory decision-making and obliges public authorities to take into closer consideration patients' rights in formulating its health care policy and budgets. This protective role of the right to health care is currently illustrated by the politicians' insistence that the ongoing health care reform is not affecting the quality or quantity of available services. PMID:14746067

Sprumont, D



Synthetic real estate: bringing corporate finance to health care.  


The changing landscape of health care has caused hospitals, health care systems, and other health care organizations to look for ways to finance expansions and acquisitions without "tainting" their balance sheets. This search has led health care executives to a financing technique that has been already embraced by Fortune 500 companies for most of this decade and more recently adopted by high-tech companies: synthetic real estate. Select case studies provide examples of the more creative financial structures currently being employed to meet rapidly growing and increasingly complex funding needs. PMID:9612732

Varwig, D; Smith, J



Cellular Radio Telecommunication for Health Care: Benefits and Risks  

Microsoft Academic Search

Cellular radio telecommunication has increased exponentially with many applications to health care reported. The authors attempt to summarize published applications with demonstrated effect on health care, review briefly the rapid evolution of hardware and software standards, explain current limitations and future potential of data quality and security, and discuss issues of safety.




Cellular Radio Telecommunication for Health Care: Benefits and Risks  

PubMed Central

Cellular radio telecommunication has increased exponentially with many applications to health care reported. The authors attempt to summarize published applications with demonstrated effect on health care, review briefly the rapid evolution of hardware and software standards, explain current limitations and future potential of data quality and security, and discuss issues of safety. PMID:15298996

Sneiderman, Charles A.; Ackerman, Michael J.



Transitions: From Pediatric to Adult Health Care  


... Businesses & Schools > Transitions Transitions From Pediatric to Adult Health Care Transitioning from teenage years to adulthood can be ... management and make more independent judgments about their health care needs. NDEP has assembled the materials below to ...


CDC Vital Signs: Making Health Care Safer  


... About . Vital Signs Share Compartir Making Health Care Safer Stop Infections from Lethal CRE Germs Now ... CRE infections on your state's Notifiable Diseases list. Health Care CEOs/Medical Officers can Require and strictly enforce ...


ARTEMIS: a collaborative framework for health care.  


Patient centered healthcare delivery is an inherently collaborative process. This involves a wide range of individuals and organizations with diverse perspectives: primary care physicians, hospital administrators, labs, clinics, and insurance. The key to cost reduction and quality improvement in health care is effective management of this collaborative process. The use of multi-media collaboration technology can facilitate timely delivery of patient care and reduce cost at the same time. During the last five years, the Concurrent Engineering Research Center (CERC), under the sponsorship of DARPA (Defense Advanced Research Projects Agency, recently renamed ARPA) developed a number of generic key subsystems of a comprehensive collaboration environment. These subsystems are intended to overcome the barriers that inhibit the collaborative process. Three subsystems developed under this program include: MONET (Meeting On the Net)--to provide consultation over a computer network, ISS (Information Sharing Server)--to provide access to multi-media information, and PCB (Project Coordination Board)--to better coordinate focussed activities. These systems have been integrated into an open environment to enable collaborative processes. This environment is being used to create a wide-area (geographically distributed) research testbed under DARPA sponsorship, ARTEMIS (Advance Research Testbed for Medical Informatics) to explore the collaborative health care processes. We believe this technology will play a key role in the current national thrust to reengineer the present health-care delivery system. PMID:8130536

Reddy, R; Jagannathan, V; Srinivas, K; Karinthi, R; Reddy, S M; Gollapudy, C; Friedman, S



New health policies on Primary Health Care in Greece  

Microsoft Academic Search

Introduction. Modern views about health and its medical, sanitary and financial components impose the reorganization of the health care system and its direction towards regional decentralization and primary health care. Political strategies in Greece have been turned towards this direction years ago. Aim. Present review aimed at presenting the importance of Primary Health Care, describing its organizational and functional framework

Theodoula Adamakidou; Athena Kalokerinou



Health and Pre-Med Health care is currently one of the world's fastest-growing and Canada's second-largest, service industry  

E-print Network

-largest, service industry employment sectors. It consumes more than 10 percent of gross domestic product (GDP on their chosen paths to broadly- defined health professions such as medicine, nursing, dentistry, optometry and includes courses in biochemistry, human kinetics, arts and science, environmental science, engineering


Telematics for rural health care practitioners  

NASA Astrophysics Data System (ADS)

The " crisis" in rural health care i. e. the decreasing number of practitioners is partially caused by the increasing use of technology in health care. Health care practitioners in rural Canada are progressively finding their practice more difficult because of their isolation from the population centers housing many of the services and supplies needed in the modern practice of medicine. The centralization of these supplies and services results from the increasing use of technology in medicine. It is uneconomical to place expensive equipment highly trained technicians and consultants and well-stocked and current information sources in rural locations where they are underutilized. Thus over the years the increasing use of technology makes rural practice more difficult and less attractive in comparison to an urban practice that can easily and cheaply employ the benefits of technology and expert consultation. The Saskatchewan situation is examined using data collected by the authors and compared to other rural areas reported in the literature. The ways that computer communications can help alleviate this situation are explained and illustrated through a review of North American telematics activities. Telematic services for physicians are developing in North America. This is in synergy with the increasing ownership of computers by physicians. We contrast the Canadian scene with the American. Telematics is a technological approach that can be employed to reduce the isolation of rural health care practitioners. It can provide

Greenfield, Robert H.; Kardaun, Jan W. P. F.



Mobile Health: The Potential of Mobile Telephony to Bring Health Care to the Majority  

Microsoft Academic Search

This paper examines the current and emerging trends in mobile health, with particular emphasis on lessons learned and on potential opportunities for Latin America to apply mobile services to health care efforts to benefit the majority of people.

Antonio Giuffrida; Shireen El-Wahab; Rafael Anta



Awakening child consumerism in health care.  


Consumer participation, especially among children and their families, is requisite in bargaining assertively for quality care in today's health care industry. The emergence of self-care behaviors must be evoked, cultivated, and embraced during childhood in order to nurture a discriminating attitude toward health care ventures. PMID:1574366

Pittman, K P



Confucian Trust, Market and Health Care Reform  

Microsoft Academic Search

Health care systems in the world are beset by a common problem. The problem to frame a moral basis for health care policy that provides all citizens with basic coverage, encourages innovation, contains costs, and supports commitment to trust and responsibility which can guarantee the reliable function of the market and the ethical behaviour of health care professionals. This paper

Julia Tao


Mental Health Consultation in Child Care and  

E-print Network

Mental Health Consultation in Child Care and Early Childhood Settings Opportunities to Expand-922-1300 · #12;Mental Health Consultation in Child Care and Early Childhood Settings ....................................... 27 Strategies for Implementing Early Childhood Mental Health Consultation in Child Care

McQuade, D. Tyler


Communicating in Multicultural Health Care Organizations.  

ERIC Educational Resources Information Center

This paper investigates the multicultural demands of health care delivery by examining the role of organizational communication in promoting effective multicultural relations in modern health care systems. The paper describes the multicultural make-up of modern health care systems--noting, for example that providers from different professional…

Kreps, Gary L.; Kunimoto, Elizabeth


Competitor analysis in health care marketing.  


Health care providers increasingly are relying upon marketing as a means of overcoming growing competition. Competition-oriented marketing necessitates a comprehensive analysis of the competitive setting, a task which the health care marketing literature has generally given little attention. Herein the concept, perspective and tools of competitor analysis are borrowed from strategic planning and adapted for use in health care marketing. PMID:10299944

Salvatore, T



The Family Therapist as Health Care Consultant  

Microsoft Academic Search

Increasingly therapists are called upon to serve as consultants to health care organizations. The consultant is expected to assess the contribution a family systems therapy perspective can make. Among the areas considered are: the family as a health care agency; the place of direct family therapy treatment in health care; protection of the family at risk; the development of appropriate

Donald A. Bloch



Families, Managed Care, & Children's Mental Health.  

ERIC Educational Resources Information Center

This theme issue of a bulletin on family support and children's mental health focuses on managed care and the impact on children who are in need of mental health services. Articles include: "Private Sector Managed Care and Children's Mental Health" (Ira S. Lourie and others); "Just What Is Managed Care?" (Chris Koyanagi); "Managed Behavioral…

McManus, Marilyn C., Ed.



Catholic health care: future blueprint.  


Every Catholic hospital is influenced by one of two models of behavior, the private-business model and the public-service model. Which model eventually dominates an organization's actions is determined by the behavior of its leaders--sponsors, trustees, executive managers, and physicians. Since these internal forces are more likely than are external forces to determine an organization's course, Catholic health care leaders must consciously decide which value they wish to embrace. They also must improve their ability to forecast and influence the future, beginning with the creation of an independent national commission formed to assess the status of Catholic health care. Religious institutes, seeking collaboration and dialogue among themselves, should play a key role in implementing such a commission's recommendations. The Catholic health care systems that emerge in the future as a result of long-range planning and a value-driven philosophy will be multicongregational rather than owned by a single religious institute, fewer in number and larger in scope, and influential on a regional level. They will be expected to participate in networking with local non-Catholic providers and to integrate finance and delivery. PMID:10279352

Connors, E J



Health and Social Care Is Health and Social Care right for me?  

E-print Network

Health and Social Care Is Health and Social Care right for me? Are you are interested in caring for a specialised degree in medicine, nursing or social work? If yes, then Health and Social Care could be the subject for you. You will need good time management skills as well as a passion for care in order to get

Harman, Neal.A.


Economic evaluation of interventions in health care.  


Economic evaluation is rapidly becoming an invaluable tool for healthcare decision making, especially in light of current pressures on health services to reduce costs and increase expenditure on health care. This article provides an overview of the main methods used for the economic evaluation of healthcare interventions, and their applications and limitations. It is intended as an introduction to the topic for readers with no background in economics, and can be used to review the basic concepts of economic evaluation in healthcare provision. PMID:25370268

McFarland, Agi



Contribution of Primary Care to Health Systems and Health  

PubMed Central

Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary care (in contrast to specialty care) is associated with a more equitable distribution of health in populations, a finding that holds in both cross-national and within-national studies. The means by which primary care improves health have been identified, thus suggesting ways to improve overall health and reduce differences in health across major population subgroups. PMID:16202000

Starfield, Barbara; Shi, Leiyu; Macinko, James



First-class health: amenity wards, health insurance, and normalizing health care inequalities in Tanzania.  


In 2008, a government hospital in southwest Tanzania added a "first-class ward," which, unlike existing inpatient wards defined by sex, age, and ailment, would treat patients according to their wealth. A generation ago, Tanzanians viewed health care as a right of citizenship. In the 1980s and 1990s, structural adjustment programs and user fees reduced people's access to biomedical attention. Tanzania currently promotes "amenity" wards and health insurance to increase health care availability, generate revenue from patients and potential patients, and better integrate for-profit care. In this article, I examine people's discussions of these changes, drawing on ethnographic fieldwork in the 2000s and 1990s. I argue that Tanzanians criticize unequal access to care and health insurance, although the systemic structuring of inequalities is becoming normalized. People transform the language of socialism to frame individualized market-based care as mutual interdependence and moral necessity, articulating a new biomedical citizenship. PMID:24753314

Ellison, James



Health Literacy and Communication Quality in Health Care Organizations  

Microsoft Academic Search

The relationship between limited health literacy and poor health may be due, in part, to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5929 patients. All patients completed seven items assessing

Matthew K. Wynia; Chandra Y. Osborn



Beneficence, justice, and health care.  


This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely "imperfect" duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of "specific" beneficence that should be reflected in a society's health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. PMID:24783323

Kelleher, J Paul



Selectivity within primary health care.  


While great strides have been made in improving socioeconomic conditions in the developing world, prospects for health for all remain remote. Resources are few, and difficult decisions must be made concerning the priorities for their use. This paper addresses several topics involved in making these choices including the methods for determining priorities and ensuring effectiveness of resource use. First, prioritizing. Information is needed concerning the prevalence, mortality, morbidity, feasibility and cost of control for each disease of importance in the area under consideration. Second, the use of technology. In discussion of health care some have denigrated the concentration many programs have placed on specific methods and technologies. Nevertheless, technological advances, while some have had detrimental results, have often led to improved living conditions; for example, improved seed and fertilizer use, improved water pumps, family planning efforts. These technologies required a larger investment in management, financial and communication systems. Health interventions are frequently more various and complex than these and need a similar support system for impact. However there are many shortcomings in health services; the paper looks at some of these learnt through experience, and concludes that the lack of impact on health of large scale health programs that have provided selective interventions is probably related to an inadequate recognition of the importance of community and political involvement and of the necessary social, cultural, financial, management and administrative underpinnings. PMID:3388068

Walsh, J A



Establishment of primary health care in Vietnam.  


Basic demographic and epidemiological data relevant to health problems in Vietnam are described in this paper. Existing health service arrangements are referred to, with particular emphasis on the strategy for development of primary health care. The establishment of the paediatric centre in Ho Chi Minh City is reported, and examples of its valuable work in primary health care development are described. PMID:2121182

Birt, C A



Basic Health Care. Instructor's Teaching Guide.  

ERIC Educational Resources Information Center

The curriculum for the training of the entry level health workers (referred to as nursing aid, assistant, or basic health care worker) is organized with a modular approach and designed within the framework of a humanistic learning growth model. Module 1, The Health Core, provides basic education for any health care worker. Module 2, The Patient…

Miami-Dade Community Coll., FL.


Oral health care for hospitalized children.  


Oral health care may be the greatest unmet health need of children in the U.S. Half of the children in the U.S. suffer from tooth decay by 8 years of age. The consequences of poor oral health are many, including mouth pain, inability to chew and eat, abscess and soft tissue infection, diminished self-esteem, and impaired school performance. Numerous medical conditions, such as asthma and diabetes, and developmental disabilities, such as cerebral palsy and autism, have associated oral health implications. Oral health care is often neglected by nondental health providers. Nurses are in a unique position to contribute to the improvement of this national health problem by promoting oral health care among hospitalized children and their families. A hospital program for oral health care is proposed, including assessment of teeth and gingiva, ensuring oral care for all, as well as oral health education as part of patient education. PMID:22132567

Blevins, Jo Young



Health Care Reform: Opportunities for Improving Adolescent Health.  

ERIC Educational Resources Information Center

Health care reform represents a major step toward achieving the goal of improved preventive and primary care services for all Americans, including children and adolescents. Adolescence is a unique developmental age district from both childhood and adulthood with special vulnerabilities, health concerns, and barriers to accessing health care. It is…

Irwin, Charles E., Jr., Ed.; And Others


Internet and Your Health 1 UC Irvine Health Care Facilitator  

E-print Network

Internet and Your Health 1 UC Irvine Health Care Facilitator Internet and Your Health of diseases, from arthritis to warts as well as information on managed care. The Internet should regulations, advocacy and advice on managed care problems. 4. - The official government web

Burke, Peter


Improving Access to Health Care: School-Based Health Centers.  

ERIC Educational Resources Information Center

This article explores an approach for better serving the complete health care needs of children, specifically, the efficacy of school-based health centers (SBHCs) to provide a service delivery mechanism capable of functioning as a medical home for children, providing primary care for both their physical and behavioral health care needs. The…

Dowden, Shauna L.; Calvert, Richard D.; Davis, Lisa; Gullotta, Thomas P.


New perspectives on health and health care policy  

Microsoft Academic Search

Health care reform has been the primary focus of policymakers for much of the past year, culminating with the Patient Protection and Affordable Care Act that was signed into law by President Obama on March 23, 2010. The vigorous national debate on the act has highlighted the importance of innovative, high-quality research on health and health care policy.

Darren Lubotsky; Bhashkar Mazumder; Zach Seeskin



Health Information Systems for Primary Health Care: Thinking About Participation  

E-print Network

Health Information Systems for Primary Health Care: Thinking About Participation Elaine Byrne in supporting primary health care functioning, the design, development and implementation of these systems care, especially in the context of developing countries, a very challenging task. An important step

Sahay, Sundeep


Challenges for health care development in Croatia.  


The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services. PMID:23213924

Ostoji?, Rajko; Bilas, Vlatka; Franc, Sanja



Quality-of-care challenges for rural health.  


The purpose of this article is to examine the issue of quality of care in rural America and to help others examine this issue in a way that is consistent with the very real challenges faced by rural communities in ensuring the availability of adequate health services. Rural citizens have a right to expect that their local health care meets certain basic standards. Unless rural providers can document that the quality of local health care meets objective external standards, third-party payers might refuse to contract with rural providers, and increasingly sophisticated consumers might leave their communities for basic medical care services. To improve the measurement of health care quality in a rural setting, a number of issues specific to the rural environment must be addressed, including small sample sizes (volume and outcome issues), limited data availability, the ability to define rural health service areas, rural population preferences and the lower priority of formal quality-of-care assessment in shortage areas. Several current health policy initiatives have substantial implications for monitoring and measuring the quality of rural health services. For example, to receive community acceptance and achieve fiscal stability, critical access hospitals (CAHs) must be able to document that the care they provide is at least comparable to that of their predecessor institutions. The expectations for quality assurance activities in CAHs should consider their limited institutional resources and community preferences. As managed care extends from urban areas, there will be an inevitable collision between the ability to provide care and the ability to measure quality. As desirable as it might be to have a national standard for health care quality, this is not an attainable goal. The spectrum and content of rural health care are different from the spectrum and content of care provided in large cities. Accrediting agencies, third-party carriers and health insurance purchasers need to develop rural health care quality standards that are practical, useful and affordable. PMID:10981369

Moscovice, I; Rosenblatt, R



Health care management in workers' compensation.  


A high-performing, effective health care delivery system is critical to the recovery of injured workers within a workers' compensation insurance system. Timely and effective health care has the potential to minimize indemnity costs and therefore contribute to the insurer's financial state. While costs remain a concern to insurers, cost-containment initiatives within the health care arena have evolved from a strict "deep discount" approach to more sophisticated health care strategies that follow managed care-style models. In the future, health care strategies are likely to become more integrated within the business operations of workers' compensation insurance systems. The next evolution of health care strategy within workers' compensation will likely include consensus-based contracts with providers that stipulate the role and function of each party while reinforcing a continuous improvement mindset. It is probable that a component of this evolving system will include shared risk and reimbursement that is based on performance. Insurers who begin to evaluate the true impact of a comprehensive health care strategy will find it necessary and advantageous to modify their business relationship with health care providers. Those who are able to articulate a business strategy that capitalizes on the skills of the health care community are likely to gain a competitive advantage. Most importantly, this bridging of intellectual capacity across the insurance and health care domains will result in a delivery system that is valued by, and contributes to, its key participants--the employers and the injured workers. PMID:9589449

Nikolaj, S; Boon, B



Strengthening of primary health care: key to deliver inclusive health care.  


Inequity and poverty are the root causes of ill health. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. Disparity in health care is interpreted as compromise in 'Right to Life.' It is imperative to define 'essential health care,' which should be made available to all citizens to facilitate inclusivity in health care. The suggested methods for this include optimal utilization of public resources and increasing public spending on health care. Capacity building through training, especially training of paramedical personnel, is proposed as an essential ingredient, to reduce cost, especially in tertiary care. Another aspect which is considered very important is improvement in delivery system of health care. Increasing the role of 'family physician' in health care delivery system will improve preventive care and reduce cost of tertiary care. These observations underlie the relevance and role of Primary health care as a key to deliver inclusive health care. The advantages of a primary health care model for health service delivery are greater access to needed services; better quality of care; a greater focus on prevention; early management of health problems; and cumulative improvements in health and lower morbidity as a result of primary health care delivery. PMID:23873190

Yeravdekar, Rajiv; Yeravdekar, Vidya Rajiv; Tutakne, M A; Bhatia, Neeta P; Tambe, Murlidhar




PubMed Central

Objective: In the health care system, continuing medical education (CME) is concerned with the maintenance, improvement, and promotion of health care provided by physicians. The objectives of this study are: to assess the knowledge, attitude and practice of Primary Health Care (PHC) physicians of CME, and to analyze the utilization of Continuing Medical Education (CME) program. Material and Methods: This is a cross-sectional descriptive study with an analytic component. A two-stage stratified random sampling was done on 189 PHC physicians from 76 PHC centers in the Al Madina, Al Munawarah City. One Hundred Fifteen physicians actually took part in the study. Results: Only 3.5% of the physicians were Saudi, 2% had PHC postgraduate qualification in Primary Health Care and 75% had had basic training during their practice. The study showed that: (1) PHC physicians who worked in a group evaluated Medical Education Center (MEC) better than those who worked alone (p =0.0052). (2)Those who were aware of the presence of the MEC gave MEC contribution a better grade in evaluation than those who were not (p=0.0001). (3) PHC physicians who had more experience in medical practice evaluated CME achievement with a better grade than those who had less experience (p = 0.0173). (4) PHC physicians working in groups evaluated CME achievement with a better grade (p = 0.0330). (5) Those who were attached to the hospitals evaluated CME achievement with a better grade (p = 0.0392). (6) Those who attended activities outside PHC centers evaluated CME achievements better than those who did not (p = 0.0202). Conclusion: From the results it was concluded that: (1) There are many PHC physicians who were unaware of CME activities in their area of work and therefore tend to be unhappy with MEC contribution. (2) PHC physicians were not satisfied with MEC's contribution and with their CME's achievements. (3) PHC physicians felt the need for utilizable CME. (4) PHC physicians were not fully aware of the use of the internet, distance learning, and emails in CME. PMID:23012109

Al-Mosilhi, Ahmed H.; Kurashi, Nabil Y.



Collaborative Partnerships in Health, Medicine & Social Care  

E-print Network

Collaborative Partnerships in Health, Medicine & Social Care Launch Conference Lancaster University and Social Care. By leading the establishment of a Hub partnership approach, involving NHS Trusts and other and globally in Health, Medicine and Social Care. Guest Speakers will include: Dr Louise Wood (Head

Meju, Max


Prospective Medicine: The Next Health Care Transformation  

Microsoft Academic Search

The introduction of science into the practice of medicine in the early 20th century was a transforming event for the profession. Now, breakthroughs in science and know how make it possible to transform care once again and to fix the broken U.S. health care system. To realize this poten- tial, new models of prospective health care must be created and

Ralph Snyderman; R. Sanders Williams



The state of transgender health care: policy, law, and medical frameworks.  


I review the current status of transgender people's access to health care in the United States and analyze federal policies regarding health care services for transgender people and the limitations thereof. I suggest a preliminary outline to enhance health care services and recommend the formulation of explicit federal policies regarding the provision of health care services to transgender people in accordance with recently issued medical care guidelines, allocation of research funding, education of health care workers, and implementation of existing nondiscrimination policies. Current policies denying medical coverage for sex reassignment surgery contradict standards of medical care and must be amended. PMID:24432926

Stroumsa, Daphna



Health Sciences Center Department of Internal Medicine Employee Health Promotion Program Health Care Provider Report  

E-print Network

Health Sciences Center Department of Internal Medicine Employee Health Promotion Program Health Care Provider Report Dear Health Care Provider: Your patient, ______________________________, has applied for enrollment in a fitness program sponsored by the University of New Mexico, Employee Health

New Mexico, University of


Decentralisation of health care and its impact on health outcomes  

Microsoft Academic Search

This paper explores the impact of health care decentralisation on a characteristic of human development: the overall level of a population's health. While much of the literature on decentralisation in health care has stressed the advantages of sub national provision of health services, in the absence of a quantitative measure of the magnitude of the effect of decentralisation, there is

Dolores Jimenez; Peter C. Smith


[Primary health care essential attributes and the family health strategy].  


The essential attributes of Primary Health Care are attention at first contact, longitudinality, completeness and coordination, and the derived attributes are family and community orientation and cultural competence. This paper discusses the presence of such attributes in Family Health Strategy, a political and governmental proposal to change the health care model in the context of the Unified Health System in Brazil. PMID:24092323

Oliveira, Maria Amélia de Campos; Pereira, Iara Cristina



Using appreciative inquiry to transform health care.  


Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context. PMID:24099230

Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra



Sustaining a House of Cards: The Health Care of Undocumented Mexican Immigrants in the United States  

E-print Network

they are often blamed for the increasing costs of health care. I assess current perceptions and misconceptions of undocumented Mexican immigrants' use of health care. I examine how ambiguity in the United States' medical culture and tension from "bare minimum...

Patel, Tejal Sanmukh



"Race" and Community Care. "Race," Health and Social Care Series.  

ERIC Educational Resources Information Center

This collection offers a wide-ranging introduction to contemporary issues surrounding the health care needs of members of minority ethnic communities within the framework of community care in Britain. The following chapters consider state welfare, minority communities, family structures, and social change: (1) "'Race' and Community Care: An…

Ahmad, Waqar I. U., Ed.; Atkin, Karl, Ed.


Assessing business leaders' perspectives on health care issues.  


The survey results reported here shed light on how CEOs perceive various health care issues in general, and factors and proposed solutions regarding uncompensated or indigent care, in specific. The problem of indigent care has reached such dimensions that various legislative remedies are being sought, such as the Indigent Health Care Trust Fund and mandated health insurance coverage. Although the uninsured are not being denied health care, the cost of such care is rising far above that which can continue to be absorbed by hospitals and other providers. Thus, something must be done, legislatively or otherwise. In sponsoring this survey the VHA sought to gather information that would guide and facilitate their response to the problem of financing the cost of indigent health care. The CEO responses: (1) indicate the need for an education program; (2) provide support for legislative proposals; and, (3) highlight areas which need further investigation. Business leaders need to be informed as to the true causes of increasingly high health care costs, with the increasing role of indigent health care cost clearly illustrated, as well as other key areas of concern such as technology, unnecessary medical procedures, and malpractice suits. Hospital associations could develop comparative fact sheets addressing perceptions, misconceptions, and the actual causes of increased health care costs. This informational advertising campaign could eventually be broadened to encompass some of the issues which need further consideration, such as hospital inefficiency and who should pay for indigent health care. The respondent's support for and responsiveness to tax incentives to encourage employers to provide more health care coverage, and CEO support for the Indigent Health Care Trust Fund, should be used to shape legislative proposals. The CEOs' perception of the importance of health care (being third in priority out of eight key current issues) should aid the VHA in their efforts to gain the needed legislative attention to the problems of health care cost. The recognition by the CEOs' of the need for hospital profitability and their desire for limited regulation should also provide support for VHA legislative proposals. Several areas which need further investigation and consideration include: hospital inefficiency, who should pay for indigent care, part-time employees without insurance, cost and availability of health insurance coverage, and equal access to quality care. The widely held belief that hospitals are inefficient needs to be addressed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:10105852

McDermott, D R; Brinkman, L H



Health care of youth aging out of foster care.  


Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met. PMID:23184106



Medical rationing as a health care strategy  

Microsoft Academic Search

Notes the problem of rising health care costs in the USA. Considers a highly controversial solution to this problem, which is to consider health care as a scarce resource and to ration access to it. Whether rationing is done by age, ability to pay, or a cost-benefit analysis, the very concept contradicts the US belief in the right to health

Gay Wayland; Brian H. Kleiner



Special Issue: The Family and Health Care.  

ERIC Educational Resources Information Center

Discusses research and interventions related to family health care. Topics include health promotion; risk behaviors; vulnerability and illness onset; choosing health care systems; stress; caregiving and coping; family counseling; and family responses to Alzheimer's Disease, pediatric cancer, cystic fibrosis, diabetes, and obesity. (JAC)

Doherty, William J., Ed.; McCubbin, Hamilton I., Ed.



Correctional Managed Health Care CMHC ANNUAL REPORT  

E-print Network

The Connecticut Department of Correction (CDOC) historically provided health services to inmates directly, using provide compassionate and clinically appropriate health care to inmates within the DOC correctionalCorrectional Managed Health Care CMHC ANNUAL REPORT July 2011 - June 2012 Introduction Correctional

Oliver, Douglas L.


Work ability in health care workers  

Microsoft Academic Search

Work Ability Index was used as a complementary tool for the periodical health surveillance of health care workers in order to evaluate their functional working capacity and to plan more appropriate preventive and compensatory measures. 867 health care workers of both sexes (337 men, 530 women), aged between 23 and 65 years and with a work experience from 0.5 to

G. Costa; S. Sartori; B. Bertoldo; D. Olivato; G. Antonacci; V. Ciuffa; F. Mauli



Healing, Medical Care, and Health Service Organizations  

Microsoft Academic Search

This paper reviews the reasons for disappointing health results from U.S. medical care, and prescribes val- ues for health service organizations (HSOs) that will provide a foundation for better medicine. Although the United States spends more money that any other country in the world on medical care, it ranks twenty-sixth in major indicators of population health. One reason for this

William E. Lafferty



Brandeis University Health: Science, Society and Policy current number of majors  

E-print Network

) is an inter disciplinary major that focuses on health, health care and health policy. Courses include socialBrandeis University Health: Science, Society and Policy fast facts current number of majors: an interdisciplinary education in health and health care Popular second majors: anthropology, biology, psychology

Fraden, Seth



E-print Network

, Communication Disorders, Dentistry, Nursing, Physician Assistant Studies, Public Health, Radiation Sciences degree of trust between the professional and the individuals he or she serves. Each health profession has"). The health care colleges are: Dentistry, Health Sciences, Medicine, Nursing, Pharmacy, and Public Health

Hayes, Jane E.


Community health centers as primary providers of health care  

Microsoft Academic Search

In their essay, Shelly Raymer Duncan and Cinthia L. Deye examine the experience of community health centers as primary providers\\u000a of health care. These centers provide quality health care for their clientele and operate in an efficient manner. The authors\\u000a argue that community health centers are a viable mechanism for the provision of comprehensive quality primary care for underserved\\u000a persons.

Shelly Raymer Duncan; Cinthia L. Deye



Creating an integrated health care system: the health and human risk management model.  


This article critiques the current health care system and presents a new conceptual model that offers the potential for an integrated health care system in the future. Health care currently consists of parallel care systems based on the competing conceptual frameworks of the medical model and the psychosocial model. It is argued that psychosocial factors must be included in an integrated system. Research literature is reviewed that documents the need for, the therapeutic effectiveness of, and the medical cost-offset benefits of mental and behavioral health interventions. The Health and Human Risk Management Model is described and illustrated with a case example as well as research outcomes from its implementation at United HealthCare Corporation. PMID:10154064

Bergmark, R E; Dell, P; Attridge, M; Parker, M



Health care consolidation and the changing health care marketplace. A review of the literature and issues.  


This Issue Brief examines the academic literature and issues in consolidation of the hospital sector in the context of responses to changes in the competitive environment. It analyzes the motivations for consolidation as well as its effects. Hospital merger activity has increased dramatically in recent years. The current wave of mergers is primarily a reaction to a competitive environment that is placing a greater emphasis on controlling costs and forcing high-cost providers out of the market. The growth of managed care has placed considerable pressure on providers of health care and, in particular, on hospitals. The evolution of insurance companies' behavior helps explain the recent hospital consolidation movement. As managed care has become the dominant type of coverage in the last decade, insurance companies have become more active in trying to control costs--a reversion to their previous practices before the advent of managed care. Insurance companies have placed cost constraints on providers, both in the early years of health insurance and currently, when there are strong competitive forces. Hospitals claim that their primary merger motives are improving efficiency and the quality of care. The empirical evidence on this claim is mixed. Vertical integration (between suppliers and buyers of health care services, such as between hospitals and physicians) has appealed to hospitals because of their need to obtain more patients. More research is needed to explore the effects of vertical integration in the health care sector. In one of the more significant recent legal rulings, the U.S. Justice Department lost a 1997 case challenging the merger of two hospitals in the New York City metropolitan area. This, along with other recent losses by the antitrust authorities, does not bode well for the government's ability to prevent hospital mergers in metropolitan areas. It is difficult to generalize on an appropriate antitrust policy for hospital mergers. Hospital consolidation is likely to continue at a rapid pace. Since some developments may reduce the cost of employee benefits while others may increase the cost of these benefits, the final effect on the provision of health care benefits by employers is uncertain. Employers must pay close attention to the hospital consolidation movement because it will lead to important changes in the provision of health care benefits. PMID:10622866

Goldberg, L G



Empowering patients to direct their health care  

Microsoft Academic Search

The American health care system has changed dramatically during the past 50 years. We no longer live in the days of cradle-to-grave care by a single family practice doctor who knew us and our medical history like the back of his hand. Health care is far more fluid and fast-paced; we often change insurance companies and primary care physicians. We

Rebecca S Busch



Psychology and health: contributions of psychology to the improvement of health and health care  

PubMed Central

Psychology as both a science and a profession has been closely identified with other disciplines in the broad field of health since the turn of the present century. Recent advances in health care have reinforced the growing belief that the promotion of health and the prevention and treatment of illness can be greatly enhanced by incorporating the scientific findings and modern techniques of psychology into everyday practices. This review outlines the contributions of psychology to health care throughout the world; only some of the most timely and relevant issues are mentioned, together with examples of current work in the field. After an introductory overview, special attention is given to each of the major areas within the broad field of health care where psychological applications have been particularly useful. PMID:3325189

Holtzman, W. H.; Evans, R. I.; Kennedy, S.; Iscoe, I.



Consumer Financial Issues in Health Care  

Microsoft Academic Search

While government officials, health care providers, and insurers debate the cause and cure of high and rising health care costs,\\u000a consumers face the daunting task of making critical health care decisions for themselves and family members in a complex market.\\u000a This chapter describes the characteristics of and key players in that market. Reasons given in the academic and popular press

Deanna L. Sharpe


Environmental scanning and the health care manager.  


Health care managers and supervisors work in an environment of major changes and ongoing turbulence. Basic terms and strategic approaches are described to enable managers and supervisors to better understand the process of environmental scanning in the turbulent health care environment. Drawing from multiple disciplines, the information allows health care managers and supervisors to improve their skills as environmental scanners as they develop and implement strategic plans in this environment. PMID:16131929

Layman, Elizabeth J; Bamberg, Richard



Active, Medical Documents in Health Care  

Microsoft Academic Search

Distributed and heterogeneous information systems can be observed in health care. In order to implement the vision of seamless\\u000a health care, the boundaries of institutions need to be closed. Furthermore, information needs to be provided to the members\\u000a of the health care team according to the principle of information logistics for the effective and efficient support of treatment\\u000a processes. Since

Andreas Schweiger; Helmut Krcmar


Barriers to health care for street youth.  


This study investigates the barriers to health care faced by runaway adolescents. A convenience sample of 89 street youth located through community agencies was surveyed to elicit their perceptions of barriers to care. Results indicated that these youth experience a wide range of barriers to health care, both objective and subjective. They also experience fears with regard to receiving health care, many of which seem developmental in nature. The relative isolation of these youth compounds the objective barriers they face, yet many overcame these barriers and received needed care. PMID:9358291

Geber, G M



Health Care-Acquired Viral Respiratory Diseases  

PubMed Central

Health care–associated viral respiratory infections, common among hospitalized children, also occur among adults and institutionalized persons and result in increased patient morbidity, mortality, and health care costs. Approximately 20% of patients with health care–associated pneumonia have viral respiratory infections, with 70% of these infections caused by adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV).1 These infections typically reflect the level of viral activity within the community.1,2 This article focuses on the epidemiology, transmission, and control of health care–associated RSV and influenza virus. PMID:21316002

Goins, William P.; Talbot, H. Keipp; Talbot, Thomas R.



Religion, Spirituality and Your Mental Health Care  


Religion, Spirituality and Your Mental Health Care Quick Links Facts for Families - Numerical List Facts for Families - Keyword (Alphabetical) Facts for Families No. 107; Updated December 2012 Click ...


Attending unintended transformations of health care infrastructure  

PubMed Central

Introduction Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes. PMID:18043725

Wentzer, Helle; Bygholm, Ann



The Health and Social Care Act 2008.  


Several inquiry reports have shown that there is still a need to further improve health and social care and strengthen public confidence in these services. The reports have particularly emphasized the need for stricter regulation of health and adult social care providers and the need to use statutory powers to ensure compliance with quality and safety standards.This article outlines how the provisions of the Health and Social Care Act 2008 aim to address this need to further regulate quality and safety standards in health and social care. PMID:21240085

Griffith, Richard; Tengnah, Cassam



[French national health insurance. The current situation].  


An audit of the French national health insurance system would be justified by economic considerations alone, but this would risk overlooking the notions of solidarity and freedom to which the French are rightly attached. European comparisons suggest, however, that our system could be made more efficient without undermining public health. The national health insurance system allows each member of the population to receive high-quality medical care. Practitioners have near-total freedom of prescription and practice. Medical care contributes to the ongoing increase in life expectancy, which is currently 73 years and second only to Japan. Healthcare is also a source of a million jobs. Macro-economic spending controls have failed, owing to medical progress and population aging, and also to medical consumerism favored by an unprecedented range of examinations and treatments, the increasing reimbursement of medical care, and the extension of direct payment by the insurer. Many ineffective measures have been implemented, such as tarification according to activity, and hospital certification. Health spending is also increased unnecessarily by bureaucratisation of healthcare spending and the transfer of professionals to posts for which they are not qualified. Some controversial medical prescriptions are not adequately controlled by the health service. Many reforms are based on over-optimistic economic predictions that fail to take related overheads into account. Lobbying by special interests groups undermines reform and the public interest. Too many independent administrative bodies have been created, and many are less efficient than the public structures they replaced. In sum, the French national health insurance system has become less and less efficient over the years. PMID:21513139

Huguier, Michel; Lagrave, Michel; Marcelli, Aline; Rossignol, Claude; Tillement, Jean-Paul



Clinical applications of telehealth in mental health care  

Microsoft Academic Search

This article introduces the concept of telehealth and examines how telehealth expands both provider and patient access to health care. Current clinical applications are presented including equipment, research, and examples of direct clinical care. The article focuses on store-and-forward and video teleconferencing technologies providing information about the equipment and research pertaining to the clinical use of the equipment. The status

B. Hudnall Stamm



Organization and financing of mental health care in Poland  

Microsoft Academic Search

Organization of care: Health care is provided to patients with mental disorders by the state health care facilities as well as by social help agencies. Mental health care services are provided mostly by mental health facilities and partly by primary care units. Outpatient clinics, separate for psychiatric patients and substance abusers, are the most numerous mental health care units, amounting

Wanda Langiewicz; Elzbieta Slupczynska-Kossobudzka



Integrating mental health into primary health care in Zambia: a care provider's perspective  

PubMed Central

Background Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget. Most of the mental health services provided are curative in nature and based in tertiary health institutions. At primary health care level, there is either absence of, or fragmented health services. Aims The aim of this paper was to explore health providers' views about mental health integration into primary health care. Methods A mixed methods, structured survey was conducted of 111 health service providers in primary health care centres, drawn from one urban setting (Lusaka) and one rural setting (Mumbwa). Results There is strong support for integrating mental health into primary health care from care providers, as a way of facilitating early detection and intervention for mental health problems. Participants believed that this would contribute to the reduction of stigma and the promotion of human rights for people with mental health problems. However, health providers felt they require basic training in order to enhance their knowledge and skills in providing health care to people with mental health problems. Recommendations It is recommended that health care providers should be provided with basic training in mental health in order to enhance their knowledge and skills to enable them provide mental health care to patients seeking help at primary health care level. Conclusion Integrating mental health services into primary health care is critical to improving and promoting the mental health of the population in Zambia. PMID:20653981



Towards Open Information Management in Health Care  

PubMed Central

The utilization of information technology as tool in health care is increasing. The main benefits stem from the fact that information in electronic form can be transferred to different locations rapidly and from the possibility to automate certain information management tasks. The current technological approach for this automation relies on structured, formally coded representation of information. We discuss the limitations of the current technological approach and present a viewpoint, grounded on previous research and the authors’ own experiences, on how to progress. We present that a bottleneck in the automation of the management of constantly evolving clinical information is caused by the fact that the current technological approach requires the formal coding of information to be static in nature. This inherently hinders the expandability of the information case space to be managed. We present a new paradigm entitled open information management targeting unlimited case spaces. We also present a conceptual example from clinical medicine demonstrating open information management principles and mechanisms. PMID:19415134

Yli-Hietanen, J; Niiranen, S



Justice, welfare and health care.  

PubMed Central

Miss Telfer offers a new analysis, classifying health care into four systems, only one of which, the "laissez-faire" type, is unlikely to be acceptable today. The other three systems are defined here as "liberal humanitarian", "liberal socialist" and "pure socialist." Each is analysed for its content and for the views of its protagonists and antagonists. On these issues no dogma is proclaimed as the author says she has sought to "bring out some of the principles at issue in any discussion of the rights and wrongs of socialized medicine". This journal is surely the proper place for such a discussion as the worlds of the politician, of the economist, of the doctor and of the patient come to a point in the philosophies behind the aspect of medical ethics exemplified in the provision of medical services by the state. Miss Telfer also glances down the byways of the medicine of the market place. PMID:966258

Telfer, E.



Effective health care corporate compliance.  


The pace and intensity of oversight and investigation of health care organizations has greatly increased at all levels. Well run organizations with ethical management committed to following all laws and regulations are still at risk for compliance violations and punitive penalties. Under the Federal Sentencing Guidelines, organizations with an "effective" corporate compliance program may receive reduced penalties. The seven components of an effective program as defined in the guidelines are: (1) Standards and procedures; (2) oversight responsibilities; (3) employee training; (4) monitoring and auditing; (5) reporting systems; (6) enforcement and discipline; and (7) response and prevention. Lack of a compliance program needlessly exposes the organization to an avoidable risk of damage from non-compliance--whether intentional or not. Moreover, an effective program can contribute to the efficient operation of the organization and be a key piece of its corporate culture. PMID:10947465

Saum, T B; Byassee, J



Health care and human rights.  


On April 6, 1995, in New Delhi, India, demonstrators with the group AIDS Bhedbhav Virodhi Andolan (ABVA) protested against the death of an AIDS patient in Calcutta due to medical negligence. They observed two minutes of silence in the memory of Dipak Biswas and carried signs stating Fight AIDS Not AIDS Patients, AIDS Patients Have Human Rights, and Wake Up, National Human Rights Commission. The demonstrators also submitted a memorandum to the Chairman of the National Human Rights Commission and a 26-page report entitled Who's Afraid of AIDS drafted by the Drug Action Forum and the Health Services Association. The report accuses three well-known medical institutions in Calcutta for insensitive treatment of Dipak, and it brings to light the subsequent victimization of his family following his death. Dipak's brother was dismissed from his job. His mother and sister were forced to leave the area. Some important health care questions and human rights issues the report brings up include: despite the commitment of the central and state governments to provide treatment to AIDS patients, AIDS patients tend not to receive care; hospital personnel from top management down are unaware of WHO guidelines on the management of AIDS patients and of the ethical norms concerning confidentiality; and AIDS patients and their families have no one to help them with treatment or with the social stigma. In the case of Dipak, hospital personnel did not tell his family that he had AIDS but told the press and members of the funeral party, who declined to touch his body. ABVA promotes AIDS-related human rights issues, such as the rights of gays, sex workers, prisoners, international travelers, and professional blood donors. The group documents inappropriate practices. For example, some companies practice arbitrary blood testing of employees and prospective recruits without their informed consent. They then fire or refuse to hire persons found to be HIV positive. PMID:12319587

Balasubrahmanyan, V



Health care revival renews, rekindles, and revives.  


In a Black community in Boston, Mass, a community health center developed a faith-based initiative to improve the health of community residents. In partnership with a steering committee composed of community health advocates, church leaders, and community leaders, the community health center planned and implemented annual Health Care Revival meetings at which screening activities and dissemination of health information are integrated with inspirational singing and scripture readings. The success of the Health Care Revival initiative is demonstrated by an increased use of community health center services after each revival meeting, by participants' evaluations, and by an increase in the number of community health improvement projects begun as a direct result of the Health Care Revival initiative. PMID:11818285

Lawson, Erma; Young, Azzie



Health Care Costing: Data, Methods, Future Directions

Health Services and Economics Branch staff have collaborated with colleagues at the Agency for Healthcare Research and Quality (AHRQ), the Department of Veterans Affairs (VA), and Emory University to develop a supplement to the journal Medical Care. The supplement, published in July 2009, examines a broad array of methodologic issues related to health care cost estimation. The supplement's papers are led by experts in health economics, epidemiology, health services research, and biostatistics.


Health care librarians and information literacy: an investigation.  


Until relatively recently, the concept of information literacy, and teaching the skills to enable it, was mainly a concern of academic libraries. Now, it is also seen to be of high importance within the context of health care libraries. Health care libraries and librarians can provide crucial support towards the implementation of evidence-based practice in patient care through both information literacy skills training and by conducting mediated searches on behalf of health care practitioners. This article reports the findings from an investigation conducted by Charlotte Kelham as part of her MA in Librarianship from the University of Sheffield. Her dissertation investigated how health care librarians understand the concept of information literacy, the implications of this for their role and their perceptions around how their role is valued. Charlotte graduated from Sheffield in 2013 and is currently job hunting. AM. PMID:25155981

Kelham, Charlotte



Children with Special Health Care Needs: Impact of Health Care Expenditures on Family Financial Burden  

Microsoft Academic Search

We investigated the relationship between health care expenditures for Special Health Care Needs (SHCN) children and family\\u000a perception of financial burden. Using 2005\\/2006 National Survey of Children with Special Health Care Needs data, a multivariate\\u000a logistic regression model was used to estimate the relationship between the SHCN child’s health care expenditure and perceived\\u000a financial burden, while controlling for family and

Lisa C. Lindley; Barbara A. Mark



Investing in Primary Health Care Achieving better health care in the community  

E-print Network

Investing in Primary Health Care Achieving better health care in the community #12;Images by Nasir of primary care and this investment has been more than matched by considerable national research funding to Oxford of some of the UK's top primary care senior scientists by attracting a large number of junior

Oxford, University of


Bereavement and Bereavement Care in Health and Social Care: Provision and Practice in Scotland  

ERIC Educational Resources Information Center

The interview study described here aimed to explore current views of and practice in bereavement care and identify priorities for service development in Scotland. Fifty-nine participants who worked with the bereaved in some way, or whose interest was in bereavement or bereavement care, were interviewed. They represented National Health Service…

Stephen, Audrey I.; Wimpenny, Peter; Unwin, Rachel; Work, Fiona; Dempster, Paul; MacDuff, Colin; Wilcock, Sylvia E.; Brown, Alison



The Health Care Labor Shortage: Report of the Health Care Labor Shortage Work Group.  

ERIC Educational Resources Information Center

A work group consisting of representatives of public agencies, education, the health care industry, and unions and professional associations was formed to examine education and training issues related to the shortage of health care workers in Washington state. The group concluded that the shortage of available workers in many health care

Washington State Workforce Training and Education Coordinating Board, Olympia.


Health care reform and job satisfaction of primary health care physicians in Lithuania  

Microsoft Academic Search

BACKGROUND: The aim of this research paper is to study job satisfaction of physicians and general practitioners at primary health care institutions during the health care reform in Lithuania. METHODS: Self-administrated anonymous questionnaires were distributed to all physicians and general practitioners (N = 243, response rate – 78.6%), working at Kaunas primary health care level establishments, in October – December

Ilona Buciuniene; Aurelija Blazeviciene; Egle Bliudziute



Learning Health Care Systems: Leading Through Research  

PubMed Central

The Health Maintenance Organization Research Network (HMORN), a consortium of 19 health care delivery systems with integrated research centers, held their 18th annual conference in Seattle, Washington from April 29 to May 2, 2012. Group Health Research Institute hosted the conference, “Learning health care systems: Leading through research”. The 2012 theme was chosen to reflect the critical role of collaboration among researchers, clinicians and health systems to improve health care nationally. Over 500 researchers and health care professionals participated in this conference. Representatives from the NCI, NHLBI, NIMH, and PCORI met with researchers to advance the quality and breadth of public domain research in HMOs. In this article we summarize information about the HMORN and its 18th annual conference. PMID:22904375

Newton, Katherine M.; Larson, Eric B.



The Potential Impact of Health Care Reform on Higher Education.  

ERIC Educational Resources Information Center

A survey of 522 colleges and universities investigated the impact of health care reform proposals. Results provide an overview of typical current medical plan design, including coverage for part- and full-time employees, and give insight into attitudes toward the idea of regional health alliances, a potentially useful reform approach. (MSE)

Reace, Diana



An introduction to China's health care system.  


The Chinese health care system was originally a highly centralized one. It had great success in improving the people's health. The county-township-village three-tier health care system has contributed much to rural primary health care, and has set an example of primary health care to the developing nations. In the 1980s, this system experienced transformations along with the changes of the country's administrative system and economic policy. The transformations are characterized by the disintegration of the rural cooperative medical service, by the decentralization of township hospitals from county to township governments, by official permission for private practice, by the implementation of the personal responsibility system in health institutions, by the health security reform, and by the development of health insurance in rural areas. The long-existing health administrative problems which were aggravated in the last decade are the rural-urban differences in resource allocation and the large proportion of people without health security. With the increase of medical service prices in recent years due to the inflation of the whole economy, it is believed that the cost of health care will create an economic burden to the low-income, fee-for-service paying individuals and will further affect the health of the population. In the process of the national economic reform, it is an important and difficult task for the health administrators to adjust the health care system promptly and properly. Only by continuously carrying forward good traditions, correcting mistakes and consistently persisting in health reform, can China further raise its health care to a new, prosperous stage. PMID:2056096

Liu, X Z; Wang, J L



Many Faces: Addressing Diversity in Health Care  

Microsoft Academic Search

Diversity. The changing demographics and economics of our growing multicultural world, and the long-standing disparities in the health status of people from culturally diverse backgrounds has challenged health care providers and organizations to consider cultural diversity as a priority. The purpose of this article is to present a model that will be helpful in providing culturally competent care. The concept

Josepha Campinha-Bacote


Improving Health Care for Assisted Living Residents  

Microsoft Academic Search

Purpose: The purpose of this article is to explore how medical care is delivered to older people in assisted living (AL) settings and to suggest ways for improving it. Design and Methods: We present a review of the limited research available on health care for older AL residents and on building testable models of better ways to organize primary health

Robert L. Kane; John R. Mach


Segmenting the mental health care market.  


The authors report the results of a segmentation study of the mental health care market. A random sample of 387 residents of a western city were interviewed by telephone. Cluster analysis of the data identified six market segments. Each is described according to the mental health care services to which it is most sensitive. Implications for targeting the segments are discussed. PMID:10104017

Stone, T R; Warren, W E; Stevens, R E



science And society Universal health care, genomic  

E-print Network

medicine. Indian J. Nat. Products 19, 16­23 (2003). 12. Patwardhan, B., Vaidya, A. & Chorghade, M. Ayurvedascience And society Universal health care, genomic medicine and Thailand: investing in today.AmajorfuturechallengewillbeforThailand to integrate genomic medicine in its relatively young universal health-care system. One of Thailand

Cai, Long


Financial management in leading health care systems.  


To understand better the financial management practices and strategies of modern health care organizations, we conducted interviews with chief financial officers (CFOs) of several leading health care systems. In this introduction, we present an overview of the project and summary responses on corporate financial structures and strategic challenges facing CFOs. PMID:10845383

Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L



Teaching Primary Health Care: An Interdisciplinary Approach.  

ERIC Educational Resources Information Center

Nursing and radiology students (n=15) at the University of Malta who completed an interdisciplinary module on primary health care reported they found the theoretical material applicable to practice; the module enabled them to learn about their potential role in primary health care. (SK)

Bezzina, Paul; Keogh, Johann J.; Keogh, Mariana



On Changing Indian Eligibility for Health Care.  

ERIC Educational Resources Information Center

Analyzes empirical data from one service area in Oklahoma as an illustration of the likely effects of proposed restrictions limiting eligibility of Native Americans for Indian Health Service care. Findings indicate dwindling support for Indian health care and negative impact on future Indian population. (PS)

Bashushur, Rashid; And Others



Educating primary care clinicians about health disparities  

Microsoft Academic Search

Racial and ethnic health disparities inarguably exist in the United States. It is important to educate primary care clinicians regarding this topic because they have the ability to have an impact in the reduction of health disparities. This article presents the evidence that disparities exist, how clinicians contribute to these disparities, and what primary care clinicians can do to reduce

Roberto Cardarelli; Ana L Chiapa



Service quality in health care setting  

Microsoft Academic Search

Purpose – This paper attempts to explore the concept of service quality in a health care setting. Design\\/methodology\\/approach – This paper probes the definition of service quality from technical and functional aspects for a better understanding on how consumers evaluate the quality of health care. It adopts the conceptual model of service quality frequently used by the most researchers in

Wan Edura Wan Rashid; Hj. Kamaruzaman Jusoff



Flashpoint in HealthCare Reform  

Microsoft Academic Search

Health care is an explosive flashpoint in U.S. politics this year more than ever. By 2013, Americans will either be headed, however slowly and fitfully, toward virtually universal access to decent health care or most of us will be struggling to use dwindling public vouchers to purchase ever more expensive private insurance. These alternate futures reflect what will happen if

Theda Skocpol



A Guide to Adolescent Health Care EPSDT.  

ERIC Educational Resources Information Center

This document provides guidelines for individuals giving health care to adolescents through the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program. Chapter One briefly indicates needs of adolescents and outlines legal aspects of health care for adolescents such as age of majority, informed consent, confidentiality, disclosure of…

Health Care Financing Administration (DHEW), Washington, DC.


Health Care Provider Physical Activity Prescription Intervention  

ERIC Educational Resources Information Center

Purpose: To examine the feasibility and impact of a health care provider’s (HCP) physical activity (PA) prescription on the PA of patients on preventive care visits. Methods: Consenting adult patients completed health and PA questionnaires and were sequentially assigned to intervention groups. HCPs prescribed PA using a written prescription only…

Josyula, Lakshmi; Lyle, Roseann



Reconstructionist Confucianism and health care: an Asian moral account of health care resource allocation.  


In this article, I offer an abridged reconstruction of the foundational elements of Confucian moral commitments, which, I will argue, still provide the background moral substance for moral reflection in mainland China, Hong Kong, Taiwan, Singapore, and Korea. The essay presents implications of Confucianism for establishing an appropriate health care system and critically assesses the features of current health polices in mainland China, Hong Kong, and Singapore. The goal is to offer a family-oriented, non-individualist account of resource allocation that takes family authority and responsibility seriously. PMID:12607163

Fan, Ruiping



Primary health care in the mental health workplace: insights from the Australian experience.  


In Australia, Primary Health Care and the mental health sector have always shared a philosophy. In 1978, Primary Health Care was first put forward as a strategy to improve "health for all." Recently, the Australian Government included mental health as a national health priority, identifying six strategies consistent with a Primary Health Care approach to address the mental health of all Australians. Throughout this time, Primary Health Care has been highlighted in all models of care. However, in reality, it appears that in mental health services, mental health nurses, despite good intentions, are not delivering care in a planned or systematised way and that much needs to be done to further improve the situation for individuals accessing the health care system. Services currently focus on those identified as seriously mentally unwell; in order to really make an impact it is argued that services should be broader, offered to the population at large and, further, that the emphasis on case work at an individual level should be changed to an approach that considers prevention, maintenance, and follow-up as well as crisis intervention. This article reflects the Australian experience and offers some insights from that experience. PMID:24857527

Cleary, Michelle; Dean, Suzanne; Webster, Sue; Walter, Garry; Escott, Phil; Lopez, Violeta



European priorities for research on health care organizations and service delivery  

Microsoft Academic Search

Objectives: To provide an overview of the principal areas of research on health care organization and service delivery and to identify priority areas from a European comparative perspective. Given the large quantity of articles produced on health care organizations, we focus on primary care and hospital care. Method: A combination of methods was used for describing past and current research:

J. Hansen; W. Schäfer; N. Black; P. P. Groenewegen



Chater 4 Roles of Child Health-Care Providers Roles of Child Health-Care  

E-print Network

screening, as recommended. 4. Provide family lead education. 5. Provide diagnostic and follow-up testing-up care, child health-care providers should per- form blood lead testing when children have unexplained-Care Providers 2. Give anticiator gbidance. During prenatal care and during preventive care at 3-6 months


Catholic health care: rationale for ministry.  


This essay attempts to describe contemporary Catholic sponsored health care in the United States and to describe the purpose and structure of these particular Christian charitable organizations within the broader society. As health care has become more complex, critics claim that there is not a need for Catholic sponsored health care any longer. The author attempts to evaluate critically whether Catholic health care has a place in contemporary society. He reviews some salient biblical, ecclesial, and justice teachings of the Church to demonstrate why religious institutional presence is still needed. The author reviews contemporary health care structures to show how this is accomplished. He also uncovers additional issues which need to be addressed in order for these charitable institutions to carry on the ministry of the Church, to shape social structures, and to proclaim the reign of God. PMID:11657996

Brodeur, Dennis



Children with Special Health Care Needs  

Microsoft Academic Search

The health care model presented in this paper is a non-linear, systems approach to service delivery. The model was a by-product of three ethnic-specific conferences that were convened to discuss strategies for improving access to care and the quality of services provided to children with special health care needs (CSHCN) from diverse cultural backgrounds. The model evolved as insights regarding

Theora Evans; Ann Garwick



Home Health Care: What It Is and What to Expect  


... You are here: Plan of care Share Home health care: what it is and what to expect What is home health care? Home health care is a wide range of ... agency listed. What should you expect from home health care? Doctor’s orders are needed to start care. Once ...


Aboriginal health--current status.  


An analysis of the limited available data confirms that the health status of Australia's Aborigines remains much worse than that of non-Aboriginal Australians. Despite significant improvements over the past decade Aboriginal fetal and infant mortality is still approximately three times that of non-Aborigines. Aboriginal life expectancy remains at least twenty years less than that of the total Australian population. Levels of Aboriginal hospitalisation have declined markedly, but remain well in excess of overall levels, particularly for infants and children. For Aborigines, the reduced overall impact of the communicable diseases has been balanced by a worsening of the "lifestyle" diseases, particularly hypertension, coronary heart disease and diabetes mellitus. Alcohol abuse plays an important role in these diseases, and in the level of accidents and violence amongst Aborigines. The current patterns require a reassessment of Aboriginal health priorities, with more attention being directed at the health problems of Aboriginal adults. Special Aboriginal health programs need to be expanded, and integrated with broad wide-ranging programs aimed at alleviating Aboriginal social inequality. PMID:6397181

Thomson, N



Improving access to oral health care in Florida.  


It is the position of the Florida Dental Association that every Floridian should understand that good oral health is important to overall health and well-being. Good oral health does not just happen; it is the result of both personal responsibility and professional care. The great majority of Floridians (more than 70 percent) receive high quality dental care. Unfortunately, that is not where the story of Florida's oral health ends. For the other approximate 30 percent of Floridians, the system is broken. Only 23.5 percent of Medicaid enrolled children and 11 percent of Medicaid adults receive any dental care annually. This White Paper explains the barriers to accessing dental care in Florida, what is currently being done to address the problem, and what solutions exist that, if implemented in totality, could improve the oral health of millions Floridians. Lack of access to care is the result of many factors, including patients' preceived need for care, lack of oral health literacy, geographic distribution of dentists and dental teams, financial support for care and transportation challenges to name a few. It is important that government, dental professionals, and advocates work together to identify and address the many barriers to access to care. PMID:22856273



Correctional health care: implications for public health policy.  


"Correctional Health Care: Implications for Public Health Policy" is the first in a series of articles that examines the special health care needs of persons who are incarcerated in America's correctional facilities. The intent of the series is to gain a better understanding about the unmet health needs of incarcerated persons, the importance of addressing the health service delivery system in correctional facilities, and the implications that may arise from neglecting to address these health issues on health outcomes for individual detainees and society at-large when detainees transition back into the community. This article provides a descriptive overview of the corrections population, their sociodemographics, health care needs, and health concerns that are in need of improvement. This article also offers recommendations for public policy consideration to improve the overall health of inmates and society at large. PMID:12069208

Adams, Diane L; Leath, Brenda A



Correctional health care: implications for public health policy.  

PubMed Central

"Correctional Health Care: Implications for Public Health Policy" is the first in a series of articles that examines the special health care needs of persons who are incarcerated in America's correctional facilities. The intent of the series is to gain a better understanding about the unmet health needs of incarcerated persons, the importance of addressing the health service delivery system in correctional facilities, and the implications that may arise from neglecting to address these health issues on health outcomes for individual detainees and society at-large when detainees transition back into the community. This article provides a descriptive overview of the corrections population, their sociodemographics, health care needs, and health concerns that are in need of improvement. This article also offers recommendations for public policy consideration to improve the overall health of inmates and society at large. PMID:12069208

Adams, Diane L.; Leath, Brenda A.



Transforming Care Delivery through Health Information Technology  

PubMed Central

The slow but progressive adoption of health information technology (IT) nationwide promises to usher in a new era in health care. Electronic health record systems provide a complete patient record at the point of care and can help to alleviate some of the challenges of a fragmented delivery system, such as drug-drug interactions. Moreover, health IT promotes evidence-based practice by identifying gaps in recommended treatment and providing clinical decision-support tools. In addition, the data collected through digital records can be used to monitor patient outcomes and identify potential improvements in care protocols. Kaiser Permanente continues to advance its capability in each of these areas. PMID:23596377

Wheatley, Benjamin



"Am I Supposed to Understand This Stuff?" Youth with Special Health Care Needs Readiness for Transition  

ERIC Educational Resources Information Center

This study investigated the transition experiences of youth with special health care needs (YSHCN). Fifty-five YSHCN completed a phone survey, which asked about their educational and vocational goals, current health care (e.g., access to adult care providers, health insurance, medications), life experiences (exercise, doing chores, cooking, types…

Bryan, Tanis; Stiles, Nora; Burstein, Karen; Ergul, Cevriye; Chao, Pen-Chiang



Mindfulness-Based Stress Reduction for Health Care Professionals: Results From a Randomized Trial  

Microsoft Academic Search

The literature is replete with evidence that the stress inherent in health care negatively impacts health care professionals, leading to increased depression, decreased job satisfaction, and psychological distress. In an attempt to address this, the current study examined the effects of a short-term stress management program, mindfulness-based stress reduction (MBSR), on health care professionals. Results from this prospective randomized controlled

Shauna L. Shapiro; John A. Astin; Scott R. Bishop; Matthew Cordova



University of California Davis Center for Health Services Research in Primary Care  

E-print Network

University of California Davis Center for Health Services Research in Primary Care THIRD ANNUAL REPORT 1996-1997 The UCD Center for Health Services Research in Primary Care has now completed an initial Administrative Base Although the Center for Health Services Research in Primary Care is currently designated

Carmichael, Owen


Integrating mind and body: Graduate psychology education in primary behavioral health care  

Microsoft Academic Search

Extensive research supports the biopsychosocial model, but the current health care system generally operates according to a model of mind-body dualism. Integrated primary behavioral health care offers an alternative to this dualism. This paper describes the University of Louisville Graduate Psychology Education (GPE) program, a pre-doctoral integrated primary behavioral health care training program. This program emphasizes four shared psychosocial determinants

Tamara L. Newton; Janet Woodruff-Borden; Barbara A. Stetson



Patient Data Confidentiality Issues of the Dutch Electronic Health Care Record  

E-print Network

Patient Data Confidentiality Issues of the Dutch Electronic Health Care Record Perry Groot Ferry.O.Box 9010, 6500GL Nijmegen Abstract Health care is currently in a phase of transition. One of the recent developments that seems to be in- escapable is the introduction of an Electronic Health care Record

Groot, Perry


Investigation of health care waste management in Binzhou District, China  

SciTech Connect

In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed. Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members' knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.

Ruoyan, Gai [Department of Health Policy and Planning, Graduate School of Medicine, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 1130033 (Japan); Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang [Institute of Social Medicine and Health Services Management, School of Public Health, Shandong University, Wen-hua-xi Road, No. 44, Jinan City, Shandong Province 250012 (China); Yoshihisa, Shirayama [Department of Health Policy and Planning, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 1130033 (Japan); Tang Wei [Institute of Social Medicine and Health Services Management, School of Public Health, Shandong University, Wen-hua-xi Road, No. 44, Jinan City, Shandong Province 250012 (China); University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655 (Japan); Chushi, Kuroiwa, E-mail: [Department of Health Policy and Planning, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 1130033 (Japan); Institute of Social Medicine and Health Services Management, School of Public Health, Shandong University, Wen-hua-xi Road, No. 44, Jinan City, Shandong Province 250012 (China)



Health and Ambulatory Care Use Among Native American Veterans  

Microsoft Academic Search

In 1995, the Veterans Health Administration reorganized its health services structure to emphasize ambulatory care. Successful health care planning and improving access to ambulatory care services now depends upon a better understanding of health care needs and outpatient services. Because the veteran population is heterogeneous, it is important to understand the health, access issues, and utilization of ambulatory care services

Valentine M. Villa; Nancy D. Harada; Anh-Luu T. Huynh-Hohnbaum



Migrant farmworker children: Health status, barriers to care, and nursing innovations in health care delivery  

Microsoft Academic Search

Migrant farmworkers are one of the most health care-impoverished populations in the United States. Mobility, hazardous occupations, cultural diversity, and low socioeconomic status place migrants, and particularly migrant children, at high risk for inadequate health care and preventable health problems. This article presents a synthesis of the existing research on migrant demographics, major health risks, and geographic, financial, and cultural

Marni E Gwyther; Melinda Jenkins



Vaccine perceptions among Oregon health care providers.  


Health care providers exert a significant influence on parental pediatric vaccination decisions. We conducted hour-long interviews with traditional and alternative health care providers in which we explored a range of associations between vaccination perceptions and practice. A key finding was that the Health Belief Model constructs of perceived susceptibility to and severity of either an illness or an adverse vaccine event partially explained health care provider (HCP) beliefs about the risks or benefits of vaccination, especially among alternative care providers. Low or high perceived susceptibility to a vaccine-preventable disease (VPD) or of the severity of a given VPD affects whether an HCP will promote or oppose pediatric vaccination recommendations. Beyond these perceptions, health and vaccination beliefs are affected by the contextual factors of personal experience, group norms, immunology beliefs, and beliefs about industry and government. Building powerful affective heuristics might be critical to balancing the forces that defeat good public health practices. PMID:23964059

Bean, Sandra J; Catania, Joseph A



Meeting new health care challenges with a proven innovation: nurse-managed health care clinics.  


Beginning in January 2014, millions of Americans will enroll in health insurance plans under the Affordable Care Act. Some of these individuals were obtaining health care in safety net health clinics, emergency departments, or urgent care centers; many were going without needed care and will be new to the health care system. In addition to these newly insured, the ranks of older Americans and persons in need of chronic disease management will be on the rise. The way in which health care is delivered will have to change in order for the health care workforce to meet the demand for their services without sacrificing quality or access. Nurse practitioners and registered nurses have the education and skills to provide health promotion, disease prevention, and chronic disease management services that will make up a sizable portion of the demand. Amending state practice acts so that the authority to practice matches the ability to practice and opening provider panels to advanced practice nurses will provide opportunities to establish or expand sustainable nurse-led primary care practices in health care shortage areas. Along with these changes, models of health care delivery that incorporate differentiated practice roles and shared interprofessional responsibility for providing care will maximize the capacity of the system to provide the health care that people need. PMID:24569758

Link, Denise G; Perry, Diane; Cesarotti, Evelyn L



Reported lifetime aberrant drug-taking behaviors are predictive of current substance use and mental health problems in primary care patients  

PubMed Central

Background: The aim of this report is to determine the frequency of aberrant drug behaviors and their relationship substance abuse disorders in a large primary sample of patients receiving opioids for chronic pain. Methods: The data utilized for this report was obtained from 904 chronic pain patients receiving opioid therapy from their primary care physician. A questionnaire was developed based on 12 aberrant drug behaviors reported in the clinical literature. The diagnosis of a current substance use disorder was determined using DSM-IV criteria. Results: The average duration of chronic pain in the sample was 16 years, and for opioid therapy 6.4 years. 80.5% of the sample reported one or more lifetime aberrant drug behaviors. The most frequent behaviors reported included early refills (41.7%), increase dose without physician consent (35.7%) and felt intoxicated from opioids (32.2%). Only 1.1% of subjects with 1-3 aberrant behaviors (n=464, 51.2%) met DSM-IV criteria for current opioid dependence compared to 9.9% of patients with 4 or more behaviors (n=264, 29.3%). Persons with a positive urine toxicology tests for cocaine were 14 times more likely to report 4 or more behaviors than no behaviors (14.1% v.s.1.1%). A logistic model found that subjects who reported four or more aberrant behaviors were more likely to have a current substance use disorder (OR 10.14; 3.72, 27.64), a positive test for cocaine (OR 3.01; 1.74, 15.4), an ASI psychiatric composite score >0.5 (OR 2.38; 1.65, 3.44), male gender (OR 2.08: 1.48, 2.92) and older age (OR 0.69; 0.59, 0.81) compared to subjects with three or fewer behaviors. Pain levels, employment status and morphine equivalent dose do not enter the model. Conclusions: Patients who report 4 or more aberrant drug behaviors are associated with a current substance use disorder and illicit drug use, whereas subjects with up to 3 aberrant behaviors have a very low probability of a current substance abuse disorder. Four behaviors - over sedated oneself, felt intoxicated, early refills, increase dose on own – appear useful as a screening questions to predict patients at greatest risk for a current substance use disorders. PMID:18721174

Fleming, Michael F.; Davis, James; Passik, Steven D.



[Renewing primary health care in the Americas].  


At the 2003 meeting of the Directing Council of the Pan American Health Organization (PAHO), the PAHO Member States issued a mandate to strengthen primary health care (Resolution CD44. R6). The mandate led in 2005 to the document "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO [World Health Organization]," and it culminated in the Declaration of Montevideo, an agreement among the governments of the Region of the Americas to renew their commitment to primary health care (PHC). Scientific data have shown that PHC, regarded as the basis of all the health systems in the Region, is a key component of effective health systems and can be adapted to the range of diverse social, cultural, and economic conditions that exist. The new, global health paradigm has given rise to changes in the population's health care needs. Health services and systems must adapt to address these changes. Building on the legacy of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (Kazakhstan, Union of Soviet Socialist Republics), PAHO proposes a group of strategies critical to adopting PHC-based health care systems based on the principles of equity, solidarity, and the right to the highest possible standard of health. The main objective of the strategies is to develop and/or strengthen PHC-based health systems in the entire Region of the Americas. A substantial effort will be required on the part of health professionals, citizens, governments, associations, and agencies. This document explains the strategies that must be employed at the national, subregional, Regional, and global levels. PMID:17565795

Macinko, James; Montenegro, Hernán; Nebot Adell, Carme; Etienne, Carissa



Crises of the uncontrolled and misunderstood numbers of health care costs  

NASA Astrophysics Data System (ADS)

Innovative technologies have dramatically reduced the risk/benefit ratios of health care. These reductions have led to marked growths in health care utilization resulting in the spiraling increases in health care costs. With minimal risk, when health care becomes necessary is not obvious. With innovative technologies, the question regarding health care delivery has changed from `Can it be done?' to `Should it be done?' Physicians do not currently have the information necessary to answer this question. Quality of care issues must replace risk/benefit ratios as the new paradigm for a physician's ordering of health care delivery. Quality of care issues include: medical indication, minimizing risks, cost efficiency and patient satisfaction. Much of health care delivered today lacks the warrantedness and efficacy components of medical indication making it unnecessary. New and, as yet, undeveloped information systems must provide information on all quality of care issues to physicians so appropriate decisions regarding health care delivery can be made. With this information, quality of care will improve and large portions of current health care delivery will be found unnecessary or nonessential. Consequently, information systems can serve to control health care costs and to improve quality of health care.

Davila, Fidel



Managing complaints in health and social care.  


An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur. PMID:20432639

Holmes-Bonney, Kathy



Petroleum and health care: evaluating and managing health care's vulnerability to petroleum supply shifts.  


Petroleum is used widely in health care-primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies-and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473

Hess, Jeremy; Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica



Mental Health under National Health Care Reform: The Empirical Foundations.  

ERIC Educational Resources Information Center

Reviews research pertinent to mental health services under health care reform proposals. Examines redistributional impact of inclusion of outpatient mental health benefits, optimal benefit packages, and findings that mental health services lower medical utilization costs. Argues that extending minimalist model of time-limited benefits to national…

Hudson, Christopher G.; DeVito, Jo Anne



Achieving population health in accountable care organizations.  


Although "population health" is one of the Institute for Healthcare Improvement's Triple Aim goals, its relationship to accountable care organizations (ACOs) remains ill-defined and lacks clarity as to how the clinical delivery system intersects with the public health system. Although defining population health as "panel" management seems to be the default definition, we called for a broader "community health" definition that could improve relationships between clinical delivery and public health systems and health outcomes for communities. We discussed this broader definition and offered recommendations for linking ACOs with the public health system toward improving health for patients and their communities. PMID:23678910

Hacker, Karen; Walker, Deborah Klein



Mobile Health Means Better Health Care for All  

E-print Network

Abstract — Electronic health (eHealth) is an essential tool for improving healthcare delivery and patient care. Although the healthcare industry is information-intensive, it suffers from a high degree of fragmentation which results in inefficiency. There are four key steps in fixing this inefficiency. First, the healthcare industry should adopt Information and Communication Technology (ICT) systems that can allow effective health information management. When used effectively, health ICT systems, such as Electronic Health Record (EHR), Electronic Medical Record (EMR), and Personal Health Record (PHR) can significantly improve health information sharing and patient care. Second, as patients are viewed as partners and participants in their care, PHR systems can enhance the healthcare delivery by engaging patients in their care process. Also, with today’s

Israel R. Kabashiki


eHealth: extending, enhancing, and evolving health care.  


eHealth holds the promise of revolutionizing health care by improving its efficiency; extending and enhancing its reach; energizing and engaging its practitioners and their patients; and in the process, democratizing, decentralizing, and even partially demystifying the practice of medicine. In emerging and developing countries, the use of eHealth and smart health-care planning has the potential to expand access to necessary treatments and prevention services that can serve as underpinnings of rapid economic development. In developed countries, the application of eHealth promises to restructure the business model of health-care delivery, while at the same time improving and personalizing the quality of care received. This article reviews the past, present, and future of eHealth in an effort to illuminate the potential of its impact. PMID:23683088

Meier, Carlos A; Fitzgerald, Maria C; Smith, Joseph M



Medical informatics and health care organizations.  


A dialogue between upper management and operational elements over an organization's informatics policies and procedures could take place in an environment in which both parties could succeed. Excellent patient care practices can exist in organizational settings where upper management is not concerned with the specifics of the medical care process. But as the medical care process itself becomes costly, complex, and part of the purview of upper management, solutions to ambiguous informatics policies and practices need to be found. As the discussion of cost determination suggests, a comprehensive "top-down" solution may not be feasible. Allowing patient care expertise to drive the design and implementation of clinical computing modules without unduly restrictive specifications from above is probably the best way to proceed. But if the organization needs to know the specifics of a treatment episode, then the informatics definitions specific to treatment episodes need to be unambiguous and consistently applied. As the discussion of Social Security numbers suggests, communication of information across various parts of the organization not only requires unambiguous data structure definitions, but also suggests that the communication process not be dependent on the content of the messages. Both ideas--consistent data structure definitions for essential data and open system communication architectures--are current in the medical informatician's vocabulary. The same ideas are relevant to the management and operation of large and diffuse health care enterprises. The lessons we are learning about informatics policy and practice controls in clinical computing need to be applied to the enterprise as a whole. PMID:1921663

Holden, F M



Appendix: Health Care Systems The provision of high-quality health care in the United States and globally will challenge  

E-print Network

policy; and 3) Health care treatment. #12;Health Care Operations Clinics, hospitals, hospital networksAppendix: Health Care Systems The provision of high-quality health care in the United States., 2008). * * First two sentences of "Envisioning the Health Care Initiative at Lehigh" The financial

Napier, Terrence


Health care reform and rural mental health: Severe mental illness  

Microsoft Academic Search

Service needs of rural severely mentally ill and strengths of rural communities are addressed. Health care reform policy development at present appears to neglect the seriously mentally ill in general and rural services specifically. Examples of strategies to meet the needs for health care, psychiatric treatment, psychosocial rehabilitation and appropriate housing are described. The advantages and drawbacks of such efforts

Catherine F. Kane; Jacqueline M. Ennis



Looking Beyond “Affordable” Health Care: Cultural Understanding and Sensitivity—Necessities in Addressing the Health Care Disparities of the U.S. Hispanic Population  

Microsoft Academic Search

Health disparities are pervasive in the United States; but among Hispanics, access to health care is encumbered by poverty, lack of insurance, legal status, and racial or minority status. Research has identified certain aspects of Hispanic culture, values, and traditions contributing to the nature of the Hispanic patient-doctor relationship and the quality of the health care service. Current educational efforts

Mary K. Askim-Lovseth; Adriana Aldana



Health care in systemic lupus erythematosus (SLE): the patient's perspective.  


In order to provide more patient-centered care for patients suffering from systemic lupus erythematosus (SLE), we studied their current satisfaction and preferences regarding future health care delivery. We sent questionnaires to all SLE patients visiting the rheumatology outpatient clinic in Leiden, the Netherlands. The questionnaire comprised three topics: (a) health care needs using a modified version of SLE Needs Questionnaire (range 0-38), (b) satisfaction with care per provider (visual analogue scale, range 0 (not at all)-100 (very satisfied)), and (c) preferences for future healthcare (four items). One hundred and two patients (63 % response) reported an average of 16 (±6) health care needs, with all patients reporting a need in the physical domain. More needs were significantly associated with worse physical functioning and a higher educational level. The average satisfaction score was 73 (±19) with a lower overall satisfaction score being associated with younger age and an educational level higher or lower than average. Regarding preferences for future health care delivery, 75 % of patients showed interest in a yearly standardized medical assessment, 57 % in regular, specialized nurse contacts using internet, 50 % in a yearly inventory on the need for self-management support, and 36 % in an education course. The association of age, education level and physical functioning with health care needs, and/or satisfaction suggest that the delivery of care should be better tailored to the needs of subgroups of patients. PMID:24744153

Zirkzee, E J M; Steup-Beekman, G M; Schouffoer, A A; Henquet, S M; Caljouw, M A A; Huizinga, T W J; Vliet Vlieland, T P M



Health Care Reform: Recommendations and Analysis.  

ERIC Educational Resources Information Center

Health care reform needs to assure coverage to all children regardless of income level or illnesses; address benefits, financing, administration, and delivery systems; provide substantial subsidies to low-income families; be equitable for all people; provide better monitoring of child health; protect and strengthen health providers who assist…

Lewit, Eugene M.; And Others



Home Health and Informal Care Utilization  

E-print Network

and Sano also are supported by the Department of Veterans Affairs, Veterans Health Administration of the Department of Veterans Affairs. Address correspondence to: Carolyn W. Zhu, PhD, Health Economist, GeriatricHome Health and Informal Care Utilization and Costs Over Time in Alzheimer's Disease Carolyn W. Zhu


Space technology in remote health care  

NASA Technical Reports Server (NTRS)

A program for an earth-based remote health service system is discussed as a necessary step for the development and verification of a remote health services spacecraft capability. This demonstration program is described to provide data for developing health care for future manned space missions.

Belasco, N.



Young People's Experiences of Mental Health Care  

ERIC Educational Resources Information Center

Fifteen in-depth interviews were conducted to explore young people's experiences of mental health care in Australia with the aim of informing the headspace National Youth Mental Health Foundation. The interviews revealed that significant numbers of respondents had been aware of their mental health problems for several years before seeking help and…

Cohen, Anjalee; Medlow, Sharon; Kelk, Norm; Hickie, Ian; Whitwell, Bradley



Health Services and Health Care Providers  


... these professionals are familiar with the issues that college students often face, such as stress, chronic health conditions, ... for any illnesses. If for some reason your college doesn't have student health services, an administrator at your school should ...


Reflections on curative health care in Nicaragua.  

PubMed Central

Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a "medicina integral" residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress. PMID:2705603

Slater, R G



Assessing Health Care Needs Among Street Homeless and Transitionally Housed Adults  

Microsoft Academic Search

This study examined the health services received and needed among homeless persons in Hillsborough County, FL (N = 823). Lifetime and current need and receipt of health services were assessed with a cross-sectional survey. Participants reported extensive lifetime and current needs for physical and behavioral health care services. Nearly a third of participants reported current unaddressed health problem(s); an inability

Blake Barrett; Sondra J. Fogel; Jack Garrett; M. Scott Young



Mercy health promoter: A paradigm for just health care  

PubMed Central

The foreign-born population in the United States, according to the “Current Populations Report” published in 2010, is estimated to exceed 39.9 million, or “12.9 percent of the U.S. population.” The increase in foreign-born peoples and their need for health care is a complicated issue facing many cities, health systems and hospitals. Over the course of the past few years Mercy Hospital of Philadelphia has treated increasing numbers of foreign-born African patients. The majority have been presenting in the late stages of disease. The increase of foreign-born documented and undocumented African patients seen by Mercy Hospitals seems to reflect a foreign-born population “boom” in Philadelphia over the past decade. To meet the needs of this growing population, the Mercy Hospital Task Force on African Immigration and the Institute of Catholic Bioethics at Saint Joseph’s University designed a program that centers on the third world concept of “Health Promoters.” This program is intended to serve as one possible solution for hospitals to cost-effectively manage the care of this growing percentage of foreign-born individuals in the population. This notion of a “Health Promoter” program in Philadelphia is unique as one of those rare occasions when a third world concept is being utilized in a first world environment. It is also unique in that it can serve as a paradigm for other hospitals in the United States to meet the growing need of health care for the undocumented population. As of November 2012 the Mercy Hospital of Philadelphia clinic became operative for patients who were referred from the Health Promoter clinics. To date, a total of forty-two patients have actively participated in the screenings, sixteen of which have been referred to Mercy Hospital of Philadelphia clinic for further evaluation. More than 75% of patient referrals were a result of high blood pressure. According to the American Medical Association, readings of 140–159 mmHg and above are indicative of stage 1 hypertension. Among those who presented at the Health Promoter screenings the mean systolic pressure for males was 140 mmHg and for females was 140.48 mmHg. PMID:24084364

Clark, Peter A.; Schadt, Sam



Mercy health promoter: a paradigm for just health care.  


The foreign-born population in the United States, according to the "Current Populations Report" published in 2010, is estimated to exceed 39.9 million, or "12.9 percent of the U.S. population." The increase in foreign-born peoples and their need for health care is a complicated issue facing many cities, health systems and hospitals. Over the course of the past few years Mercy Hospital of Philadelphia has treated increasing numbers of foreign-born African patients. The majority have been presenting in the late stages of disease. The increase of foreign-born documented and undocumented African patients seen by Mercy Hospitals seems to reflect a foreign-born population "boom" in Philadelphia over the past decade. To meet the needs of this growing population, the Mercy Hospital Task Force on African Immigration and the Institute of Catholic Bioethics at Saint Joseph's University designed a program that centers on the third world concept of "Health Promoters." This program is intended to serve as one possible solution for hospitals to cost-effectively manage the care of this growing percentage of foreign-born individuals in the population. This notion of a "Health Promoter" program in Philadelphia is unique as one of those rare occasions when a third world concept is being utilized in a first world environment. It is also unique in that it can serve as a paradigm for other hospitals in the United States to meet the growing need of health care for the undocumented population. As of November 2012 the Mercy Hospital of Philadelphia clinic became operative for patients who were referred from the Health Promoter clinics. To date, a total of forty-two patients have actively participated in the screenings, sixteen of which have been referred to Mercy Hospital of Philadelphia clinic for further evaluation. More than 75% of patient referrals were a result of high blood pressure. According to the American Medical Association, readings of 140-159 mmHg and above are indicative of stage 1 hypertension. Among those who presented at the Health Promoter screenings the mean systolic pressure for males was 140 mmHg and for females was 140.48 mmHg. PMID:24084364

Clark, Peter A; Schadt, Sam



The Current State of Quality of Care Measurement in the California Department of Corrections and Rehabilitation  

Microsoft Academic Search

The quality of health care in prisons is lacking in many states. In particular, the California Department of Corrections and Rehabilitation (CDCR) is in the midst of an extreme legal remedy to address problems related to access to and quality of care; it now operates under the direction of a federally appointed receiver for medical care. To understand the current

Stephanie S. Teleki; Cheryl L. Damberg; Rebecca Shaw; Liisa Hiatt; Brie Williams; Terry E. Hill; Steven M. Asch



Giving Teens a Voice in Health Care Decisions  


Giving Teens a Voice in Health Care Decisions KidsHealth > Parents > Doctors & Hospitals > Caring for a Seriously or Chronically Ill Child > Giving Teens a Voice in Health Care Decisions Print A A A ...


20 CFR 402.65 - Health care information.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Health care information. 402...Employees' Benefits SOCIAL SECURITY ADMINISTRATION... § 402.65 Health care information. We have...information about health care programs under titles...and Medicaid) of the Social Security Act. We...



20 CFR 402.65 - Health care information.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Health care information. 402...Employees' Benefits SOCIAL SECURITY ADMINISTRATION... § 402.65 Health care information. We have...information about health care programs under titles...and Medicaid) of the Social Security Act. We...



20 CFR 402.65 - Health care information.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false Health care information. 402...Employees' Benefits SOCIAL SECURITY ADMINISTRATION... § 402.65 Health care information. We have...information about health care programs under titles...and Medicaid) of the Social Security Act. We...



20 CFR 402.65 - Health care information.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Health care information. 402...Employees' Benefits SOCIAL SECURITY ADMINISTRATION... § 402.65 Health care information. We have...information about health care programs under titles...and Medicaid) of the Social Security Act. We...



38 CFR 17.901 - Provision of health care.  

... 2014-07-01 false Provision of health care. 17.901 Section 17.901...DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children...Birth Defects § 17.901 Provision of health care. (a) Spina bifida....



76 FR 37307 - Rural Health Care Support Mechanism  

Federal Register 2010, 2011, 2012, 2013

...02-60; FCC 11-101] Rural Health Care Support Mechanism AGENCY: Federal...discounted services under the rural health care program. Grandfathered providers...but play a key role in delivering health care services to surrounding...



77 FR 42185 - Rural Health Care Support Mechanism  

Federal Register 2010, 2011, 2012, 2013

...02-60; FCC 12-74] Rural Health Care Support Mechanism AGENCY: Federal...responsible basis for specific Rural Health Care Pilot Program participants that...connectivity and the resulting health care benefits that patients...



76 FR 57637 - TRICARE; Continued Health Care Benefit Program Expansion  

Federal Register 2010, 2011, 2012, 2013

...0720-AB30 TRICARE; Continued Health Care Benefit Program Expansion AGENCY...eligible to purchase Continued Health Care Benefit Program (CHCBP) coverage...program that provides continued health care coverage for eligible...



Analysis of Assembly Bill 213: Health Care Coverage for Lymphedema  

E-print Network

Division of Health Care Finance and Policy, July 26). Thishealth care services plans licensed by Knox-Keene 1 and to health insurance policieshealth care services plans licensed by Knox-Keene 5 and to health insurance policies

California Health Benefits Review Program (CHBRP)



Future developments in health care performance management  

PubMed Central

This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. PMID:24255600

Crema, Maria; Verbano, Chiara



The link between health care spending and health outcomes for the new English Primary Care Trusts  

Microsoft Academic Search

English programme budgeting data have yielded major new insights into the link between health care spending and health outcomes. This paper updates two recent studies that have used programme budgeting data for 295 Primary Care Trusts (PCTs) in England to examine the link between spending and outcomes for several programmes of care. We use the same economic model employed in

Stephen Martin; Nigel Rice; Peter C Smith



Health care coalitions: from joint purchasing to local health reform.  


For several decades, business and health coalitions have played an important role in representing the interests of business in the health care arena. During the 1990s, these coalitions focused their efforts on supporting purchasing activities related to health insurance benefits and direct health care. Based on a national survey conducted in 2006, and prior similar surveys, we find that business and health coalitions have invested in pooling regional health care data, promoting public reporting of quality and cost information, and coordinating pay-for-performance initiatives. In addition, many business and health coalitions are broadening their membership to include other stakeholders and to support community health reform efforts with far-reaching benefits. Through this work, coalitions increasingly are recognizing and embracing their role as catalysts for local market reform. PMID:18767380

Camillus, Joseph A; Rosenthal, Meredith B



A Model for Implementing Integrative Practice in Health Care Agencies  

PubMed Central

Over the last few years, there has been increased awareness and use of complementary/alternative therapies (CAM) in many countries without the health care infrastructure to support it. The National Centre for Complementary and Alternative Medicine referred to the combining of mainstream medical therapies and CAM as integrative medicine. The creation of integrative health care teams will definitely result in redefining roles, but more importantly in a change in how services are delivered. The purpose of this paper is to describe a model of the necessary health care agency resources to support an integrative practice model. A logic model is used to depict the findings of a review of current evidence. Logic models are designed to show relationships between the goals of a program or initiative, the resources to achieve desired outputs and the activities that lead to outcomes. The four major resource categories necessary for implementing integrative care are within the domains of a) professional and research development, b) health human resource planning, c) regulation and legislation and d) practice and management in clinical areas. It was concluded that the system outcomes from activities within these resource categories should lead to freedom of choice in health care; a culturally sensitive health care system and a broader spectrum of services for achieving public health goals. PMID:21614155

Patterson, Chris; Arthur, Heather M.



Electronic health record functionality needed to better support primary care.  


Electronic health records (EHRs) must support primary care clinicians and patients, yet many clinicians remain dissatisfied with their system. This article presents a consensus statement about gaps in current EHR functionality and needed enhancements to support primary care. The Institute of Medicine primary care attributes were used to define needs and meaningful use (MU) objectives to define EHR functionality. Current objectives remain focused on disease rather than the whole person, ignoring factors such as personal risks, behaviors, family structure, and occupational and environmental influences. Primary care needs EHRs to move beyond documentation to interpreting and tracking information over time, as well as patient-partnering activities, support for team-based care, population-management tools that deliver care, and reduced documentation burden. While stage 3 MU's focus on outcomes is laudable, enhanced functionality is still needed, including EHR modifications, expanded use of patient portals, seamless integration with external applications, and advancement of national infrastructure and policies. PMID:24431335

Krist, Alex H; Beasley, John W; Crosson, Jesse C; Kibbe, David C; Klinkman, Michael S; Lehmann, Christoph U; Fox, Chester H; Mitchell, Jason M; Mold, James W; Pace, Wilson D; Peterson, Kevin A; Phillips, Robert L; Post, Robert; Puro, Jon; Raddock, Michael; Simkus, Ray; Waldren, Steven E



Primary care and the maelstrom of health care reform in the United States of America.  

PubMed Central

Recent reform in the National Health Service has moved general practice towards a more intense market and competition structure. Meanwhile in the United States of America there has been an attempt to modify the free enterprise approach to medical care towards a more socially responsive system. This discussion paper provides a family doctor's perspective of primary care and the maelstrom of health care reform in the USA. The cultural, economic and organizational issues underlying the need for reform are considered in turn, and the current situation with regard to health care provision, medical research, medical education and primary care are outlined. General practitioners in the United Kingdom would do well to pay attention to the effects of market reform occurring in general practice among their American counterparts. PMID:7576850

Curtis, P



The Shifting Landscape of Health Care: Toward a Model of Health Care Empowerment  

PubMed Central

In a rapidly changing world of health care information access and patients’ rights, there is limited conceptual infrastructure available to understand how people approach and engage in treatment of medical conditions. The construct of health care empowerment is defined as the process and state of being engaged, informed, collaborative, committed, and tolerant of uncertainty regarding health care. I present a model in which health care empowerment is influenced by an interplay of cultural, social, and environmental factors; personal resources; and intrapersonal factors. The model offers a framework to understand patient and provider roles in facilitating health care empowerment and presents opportunities for investigation into the role of health care empowerment in multiple outcomes across populations and settings, including inquiries into the sources and consequences of health disparities. PMID:21164096



Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research.  


Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Health-care providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant-feeding counseling. However, rates of EBF at 6 months of age are suboptimal. HCPs are uniquely positioned to educate HIV-positive mothers and provide support by addressing known barriers to EBF. However, limited evidence exists on the experiences faced by HCPs in providing counseling on infant feeding to HIV-positive women. Our objective is to describe experiences faced by HCPs when delivering infant-feeding counseling in the context of HIV in program settings in sSA. We searched a range of electronic databases, including PubMed, CINAHL, and PsycINFO from January 1990 to February 2013, in addition to hand-searching, cross-reference searching, and personal communications. The search was limited to publications in English. Empirical studies of HCP experiences providing infant-feeding counseling in the prevention of mother-to-child transmission (PMTCT) of HIV programs in sSA were selected. We identified 10 peer-reviewed articles reporting HCP challenges in infant-feeding counseling that met inclusion criteria. Articles included qualitative, cross-sectional and mixed-method studies, and cumulatively reported 31 challenges faced by HCPs. Among the challenges identified, the most commonly reported were personal beliefs held by the HCPs toward infant feeding in the context of HIV, contradictory messages, staff workload, directive counseling styles, and a lack of practical strategies to offer mothers, often leading to improvised counseling approaches. Counseling strategies need to be developed that are relevant, meaningful, and responsive to the needs of both HCPs and mothers. PMID:25208096

Tuthill, Emily L; Chan, Jessica; Butler, Lisa M



The ORIGINS of Primary Health Care and SELECTIVE Primary Health Care  

PubMed Central

I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations’ political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care. These debates led to the development of an alternative, more restricted approach, known as selective primary health care. My study examined library and archival sources; I cite examples from Latin America. PMID:15514221

Cueto, Marcos



Satisfaction with Health Care of Dually Eligible Older Beneficiaries  

PubMed Central

Satisfaction with health care was compared for dually eligible older beneficiaries receiving care in three settings: a managed care organization (MCO) that is at risk for providing Medicare and Medicaid benefits (n=200); the fee-for-service (FFS) sector in the same ZIP Code (n=201); and respondents to the national Medicare Current Beneficiary Survey (MCBS) (n=531). Patients in the MCO were more likely to be highly satisfied in three domains—global quality, access to care, and technical skills—compared with patients in the local and national FFS study groups but fewer were highly satisfied with the interpersonal manner of their providers. PMID:12378765

Burton, Lynda C.; Weiner, Jonathan P.; Folkemer, John; Kasper, Judith; German, Pearl S.; Stevens, Gregory D.



Challenges to Native American health care.  

PubMed Central

Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment. Images p[23]-a p27-a p28-a p30-a PMID:9885525

Noren, J; Kindig, D; Sprenger, A



Challenges to Native American health care.  


Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment. PMID:9885525

Noren, J; Kindig, D; Sprenger, A



The Rehabilitation Nurse in the Home Health Care Setting  

Microsoft Academic Search

The primary goals of home health care nursing and rehabilitation nursing are strikingly similar. Rehabilitation nursing principles should guide home health care nurses as they formulate and deliver quality patient care. Home health care agencies eager to keep up with the emerging trends in health care delivery are encouraged to recruit and hire rehabilitation nurses. This article discusses the principles

Leslie Jean Neal



Health care and health promotion in southern Italian communities.  


Health promotion projects may be regarded as responses to insufficient health care in Europe, where modern health problems, consumer needs, participation and life quality are neglected. In Southern Italy and especially in Naples the situation is particularly difficult (poverty, poor accessibility of health care, high infant mortality, epidemics etc.); nevertheless there exist elements of everyday life which are advantageous for health promotion. The health projects described started around Naples in the 'seventies. They focused on the psychosocial problems of marginalized people (elderly people, women, mentally and physically handicapped men, big families etc.). Different elements of health care (prevention, primary health care, health education), social work and political and cultural activation were linked together in the local centres of social medicine. Thus the accessibility of health care was improved, social distance between suppliers and users reduced, and poor and disadvantaged people better integrated into the social life of the community. One important step in the realization of such aims was the stimulation of politically and socially defined homogeneous target groups with similar interests and needs. The specific measures, organizational structures and the personal staff are directed to these target groups in an integrated way. They are based on the teamwork of different professions and cooperation with other related organizations, and they include explicitly political, social and cultural activities, different from the self-help activities related only to health in most of Central Europe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10286860

Füller, A



The Medicaid Managed Care Program. In To Improve Health and Health Care, vol. IX  

Microsoft Academic Search

In the 1990s, insurance companies and employers began to rely on managed care to control costs, and state governments followed suit by adopting managed care in Medicaid programs. To deal with the challenges associated with developing effective state Medicaid managed care programs, the Robert Wood Johnson Foundation developed the Medicaid Managed Care Initiative in 1995 to help states, health plans,

Marsha R. Gold; Justin S. White; Erin Fries Taylor



Adolescent health care maintenance in a teen-friendly clinic.  


Adolescence is marked by complex physical, cognitive, social, and emotional development, which can be stressful for families and adolescents. Before the onset of puberty, providers should clearly lay the groundwork for clinical care and office visits during the adolescent years. This article addresses the guidelines and current legal standards for confidentiality in adolescent care, the most frequently used psychosocial screening tools, and current recommendations for preventive health services and immunizations. Through the creation of teen-friendly clinics, primary care providers are well positioned to offer guidance and support to teens and their parents during this time of transition and growth. PMID:25124200

Chaisson, Nicole; Shore, William B



Long-Term Care, Formal Home Health Care, and Informal Care  

Microsoft Academic Search

We use the 1993 wave of the AHEAD data set to estimate a game- theoretic model of families' decisions concerning time spent caring for elderly individuals and Ţnancial transfers for home health care. The out- come is a Nash equilibrium where each family member jointly determines his or her consumption, transfers for formal care, and time allocation — informal care,

David Byrne; Michelle S. Goeree; Bridget Hiedemann; Steven Stern


African-American elders. Implications for health care providers.  


With the demographic projections that are expected in the next century, health care professionals of all disciplines will be caring for a large group of older African Americans. Most will be women with multiple chronic illnesses that are, and will continue to be, influenced by a number of factors, including race, gender, and socioeconomic status. Although the data we have on older African Americans have increased significantly over the past several years, a great need for studies that examine the complexities of race, health risks, and disease course still exists. Health-care providers will begin to avoid stereotypes as they begin to appreciate the diversity of this group, which will become especially important as the characteristics of the current cohort of elders changes in the coming years. It is clear that more and more African Americans are living longer and are in better health. An examination of those determinants of successful aging that might be applied to elders of all racial and ethnic backgrounds must occur. It will be imperative that all facets of the established medical system begin to provide and plan for culturally sensitive health care and services, which will require data, both quantitative and qualitative, that defines the characteristics of older African Americans along with their health-service needs. Health professional schools will have to adapt curricula to include issues of ethnogeriatrics to ensure that all providers are prepared to meet the challenge of providing culturally sensitive health care.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7720018

Brangman, S A



Health and Health Care Disparities among Homeless Women  

PubMed Central

While disparities in health and health care between vulnerable (e.g., minorities, low income) and majority populations are well documented, less is known about disparities within these special populations that are large and diverse. Such knowledge is essential to determine the most needy within these generally needy populations and to plan interventions to reduce their health and health care disparities. With data from 1,331 women residing in Los Angeles County, in one of the largest, most comprehensive studies of the health of homeless women to date, we examined the health and health care disparities among homeless African American, Latina and white women. We further explored if race/ethnicity and other factors that predispose homeless women to poor health or enable them to obtain better health care were associated with their unmet need for medical care. We found that white, non-Latina women were more likely to report unmet need than African Americans and Latinas, and women suffering from drug abuse, violence, or depression were most in need of care. These findings should be considered in targeting and addressing the special needs of homeless women of different racial/ethnic groups. PMID:21170815

Teruya, Cheryl; Longshore, Douglas; Andersen, Ronald M.; Arangua, Lisa; Nyamathi, Adeline; Leake, Barbara; Gelberg, Lillian



Benchmarking HIV health care: from individual patient care to health care evaluation. An example from the EuroSIDA study  

PubMed Central

Background State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV patients based on four key indicators. Methods Four indicators of health care were assessed: Compliance with current guidelines on initiation of: 1) combination antiretroviral therapy (cART); 2) chemoprophylaxis; 3) frequency of laboratory monitoring; and 4) virological response to cART (proportion of patients with HIV-RNA < 500copies/ml for >90% of time on cART). Results 7097 EuroSIDA patients were included from Northern (n = 923), Southern (n = 1059), West Central (n = 1290) East Central (n = 1366), Eastern (n = 1964) Europe, and Argentina (n = 495). Patients in Eastern Europe with a CD4 < 200cells/mm3 were less likely to initiate cART and Pneumocystis jiroveci-chemoprophylaxis compared to patients from all other regions, and less frequently had a laboratory assessment of their disease status. The proportion of patients with virological response was highest in Northern, 89% vs. 84%, 78%, 78%, 61%, 55% in West Central, Southern, East Central Europe, Argentina and Eastern Europe, respectively (p < 0.0001). Compared to Northern, patients from other regions had significantly lower odds of virological response; the difference was most pronounced for Eastern Europe and Argentina (adjusted OR 0.16 [95%CI 0.11-0.23, p < 0.0001]; 0.20[0.14-0.28, p < 0.0001] respectively). Conclusions This assessment of HIV health care utilization revealed pronounced regional differences in adherence to guidelines and can help to identify gaps and direct target interventions. It may serve as a tool for the assessment and benchmarking of the clinical management of HIV patients in any setting worldwide. PMID:23009317



Public health care in balance : exploring popular support for health care systems in the European Union  

Microsoft Academic Search

Health care systems are important elements of western European welfare states. Earlier research indicates that public health care has always been warmly welcomed and supported by the public, even in periods of retreat of the welfare state due to retrenchment policies. Using data from 1973, Ardigó (1995) reviewed comparative evidence on the public opinion concerning health services in seven European

J. M. P. Gevers; J. P. T. M. Gelissen; W. A. Arts; R. J. A. Muffels



Lactose Intolerance: Information for Health Care Providers  

E-print Network

't traditionally include dairy products in their diets.3 There are three main types of lactose intolerance patients with lactose intolerance may believe they are allergic to milk or milk products. A milk allergy Lactose Intolerance: Information for Health Care

Rau, Don C.


Primary health care consumerism amongst elderly Australians.  


Despite acceptance of many of the principles justifying government intervention in health care provision and financing, much recent market-based policy in Australia, the USA and the UK has been based on the assumption that patients have the potential to behave as 'good consumers'. Good consumers are patients with the ability and desire to seek out health care of good quality and reasonable cost. In this paper, an exploratory survey of general practice attenders in Western and Northern Sydney is reported. The aim of the survey was to assess the extent to which patients critically select and evaluate their general practitioner, as a good consumer may be expected to do. The results demonstrate a lack of consumer-oriented behaviour both in general and amongst older respondents in particular. If such results hold true, market-based health care policies relying on consumers to judge quality of care are likely to be detrimental to the health of older people. PMID:1927736

Donaldson, C; Lloyd, P; Lupton, D



Essays on health care delivery and financing  

E-print Network

This thesis contains essays on health care delivery and financing. Chapter 1 studies the effect of organizational structure on physician behavior. I investigate this by studying emergency department (ED) physicians who ...

Chan, David C. (David Cchimin)



Defense Health Care: DOD Chiropractor Wage Rates.  

National Technical Information Service (NTIS)

In response to congressional direction in House Report 112-479, the enclosed briefing provides information on the wage rates of the Department of Defense s (DOD) federal civilian chiropractors compared with the wages of other federal civilian health care ...

B. S. Farrell, G. Coleman, J. E. Anderson, L. Atkinson, T. Carr



Health Care System and Policy Factors Influencing Engagement in HIV Medical Care: Piecing Together the Fragments of a Fractured Health Care Delivery System  

PubMed Central

Grounded in a socio-ecological framework, we describe salient health care system and policy factors that influence engagement in human immunodeficiency virus (HIV) clinical care. The discussion emphasizes successful programs and models of service delivery and highlights the limitations of current, fragmented health care system components in supporting effective, efficient, and sustained patient engagement across a continuum of care. A fundamental need exists for improved synergies between funding and service agencies that provide HIV testing, prevention, treatment, and supportive services. We propose a feedback loop whereby actionable, patient-level surveillance of HIV testing and engagement in care activities inform educational outreach and resource allocation to support integrated “testing and linkage to care plus” service delivery. Ongoing surveillance of programmatic performance in achieving defined benchmarks for linkage of patients who have newly diagnosed HIV infection and retention of those patients in care is imperative to iteratively inform further educational efforts, resource allocation, and refinement of service delivery. PMID:21342913

Norton, Wynne E.; Saag, Michael S.



Emerging trends in health care finance.  


Access to capital will become more difficult. Capital access is dependent on ability to repay debt, which, in turn, is dependent on internally generated cash flows. Under any health care reform proposal, revenue inflows will be slowed. The use of corporate finance techniques to limit financial risk and lower cost will be a permanent response to fundamental changes to the health care system. These changes will result in greater balance sheet management, centralized capital allocation, and alternative sources of capital. PMID:7614219

Sterns, J B



Health care costs and personal bankruptcy.  


In response to published but unconfirmed reports that health care costs were a leading cause of personal bankruptcy in the U.S., court records of all bankruptcy petitioners in one judicial district were examined. The records were analyzed by income, employment, debt categories and amounts. Within the limitations of the study, health care costs seem not to have played a significant role in the financial lives of this population. PMID:6765745

Gold, B A; Donahue, E A



Can we have universal health care?  

Microsoft Academic Search

Barack Obama aspires to be a “transformative” president, with his hopes particularly fixed on America’s finally achieving a universal health care system. But would his health plan go far enough to transform a system that has been dominated and distorted by for-profit insurers who maximize profit by rationing care to patients, restricting doctors' choice of treatments, and raising premiums? Of

Roger Bybee



Health care fraud: a critical challenge.  


Fraud is defined as an international deception or misrepresentation that the individual or entity makes knowing that the misrepresentation could result in some unauthorized benefit to the individual, the entity, or some other party. This article focuses on acts committed by health care providers but it is important to note that health care fraud also encompasses those fraudulent acts perpetrated by employer groups, members or insureds, and employees. PMID:10154068

Leonardo, J A



Gender, social roles and health care utilization  

E-print Network

GENDER, SOCIAL ROLES AND HEALTH CARE UTILIZATION A Thesis by JENNIFER LOUISE DAVID Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE December... 1992 Major Subject: Sociology GENDER, SOCIAL ROLES AND HEALTH CARE UTILIZATION A Thesis by JENNIFER LOUISE DAVID Approved as to style and content by: Howard B. Kaplan (Chair of Committee) m. Alex Mclntosh (Member) J oehr (Member) 0 0N...

David, Jennifer Louise



Workplace flexibility, self-reported health, and health care utilization  

Microsoft Academic Search

Flexible work arrangements, or organizational practises that permit employees to adjust their work schedule or location to better manage demands outside of work, are a popular family-friendly benefit. There is relatively little research examining the health outcomes associated with flexibility and no published studies examining associations with health care utilization. We analyzed responses to self-administered Health Risk Appraisals (HRAs) completed

Adam B. Butler; Joseph G. Grzywacz; Susan L. Ettner; Bo Liu



Model Child Care Health Policies. Fourth Edition.  

ERIC Educational Resources Information Center

Drawn from a review of policies at over 100 child care programs nationwide, this document compiles model health policies intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the document presents model policy forms with blanks for adding individualized information for the following areas: (1)…

Aronson, Susan S.


Future health care technology and the hospital.  


The past decades have been a time of rapid technological change in health care, but technological change will probably accelerate during the next decade or so. This will bring problems, but it will also present certain opportunities. In particular, the health care system is faced with the need to spend its limited resources more effectively. The number of hospital beds is being reduced, and lengths of stay are falling. In the future, the health care system will have to care for an increasing number of elderly people, both with chronic disease and also with dependency because of frailty and functional problems. The hospital of the future will probably be smaller and more intensive in the nature of its care. In part, this is because many present and future clinical technologies can be delivered outside of the hospital setting. And communication technologies offer the possibility of tying the various parts of the health care system into one true system. This would mean that the future hospital would have a more active role in supervising technical care outside of the hospital, and in making specialized knowledge accessible in all parts of the health system. PMID:10104535

Banta, H D



Contextualizing an expanded definition of health literacy among adolescents in the health care setting  

PubMed Central

The current emphasis on preventive health care and wellness services suggests that measures of skills and competencies needed to effectively navigate the health care system need to be better defined. We take an expanded perspective of health literacy and define it as a set of skills used to organize and apply health knowledge, attitudes and practices relevant when managing one’s health environment. It is an emerging area of inquiry especially among adults and those with chronic conditions; however, it has been less studied among adolescent populations. To begin operationalizing this concept in a manner appropriate for teens in a health systems context, we explored knowledge, attitudes and practices related to health and preventive health care in 12 focus groups with publicly insured adolescents (N?=?137), aged 13–17 years, as well as eight key informant interviews with physicians who serve publicly insured teens. Five dimensions emerged that provide a preliminary framework for an expanded definition of health literacy among adolescents. These include: (i) navigating the system, (ii) rights and responsibilities, (iii) preventive care, (iv) information seeking and (v) patient–provider relationship. This robust definition of health literacy contextualizes the concept in a health environment where individuals must be informed and skilled health care consumers. PMID:22623619

Massey, Philip M.; Prelip, Michael; Calimlim, Brian M.; Quiter, Elaine S.; Glik, Deborah C.



The Impact of Disasters on Populations With Health and Health Care Disparities  

PubMed Central

Context A disaster is indiscriminate in whom it affects. Limited research has shown that the poor and medically underserved, especially in rural areas, bear an inequitable amount of the burden. Objective To review the literature on the combined effects of a disaster and living in an area with existing health or health care disparities on a community’s health, access to health resources, and quality of life. Methods We performed a systematic literature review using the following search terms: disaster, health disparities, health care disparities, medically underserved, and rural. Our inclusion criteria were peer-reviewed, US studies that discussed the delayed or persistent health effects of disasters in medically underserved areas. Results There has been extensive research published on disasters, health disparities, health care disparities, and medically underserved populations individually, but not collectively. Conclusions The current literature does not capture the strain of health and health care disparities before and after a disaster in medically underserved communities. Future disaster studies and policies should account for differences in health profiles and access to care before and after a disaster. PMID:20389193

Davis, Jennifer R.; Wilson, Sacoby; Brock-Martin, Amy; Glover, Saundra; Svendsen, Erik R.



Assuring Equity Through Health and Health Care Reform Conference Registration Information (Type or Print)  

E-print Network

Research in Clinical and Translational Science Immigrant Health Caring for Veterans Children's HealthAssuring Equity Through Health and Health Care Reform Conference Registration Information (Type of Health Reform in the Pharmaceutical Industry Sustaining Community Health Workers Comparative

Brown, Lucy L.


Mental health stigma and primary health care decisions.  


People with serious mental illness have higher rates of mortality and morbidity due to physical illness. In part, this occurs because primary care and other health providers sometimes make decisions contrary to typical care standards. This might occur because providers endorse mental illness stigma, which seems inversely related to prior personal experience with mental illness and mental health care. In this study, 166 health care providers (42.2% primary care, 57.8% mental health practice) from the Veteran?s Affairs (VA) medical system completed measures of stigma characteristics, expected adherence, and subsequent health decisions (referral to a specialist and refill pain prescription) about a male patient with schizophrenia who was seeking help for low back pain due to arthritis. Research participants reported comfort with previous mental health interventions. Path analyses showed participants who endorsed stigmatizing characteristics of the patient were more likely to believe he would not adhere to treatment and hence, less likely to refer to a specialist or refill his prescription. Endorsement of stigmatizing characteristics was inversely related to comfort with one?s previous mental health care. Implications of these findings will inform a program meant to enhance VA provider attitudes about people with mental illness, as well as their health decisions. PMID:24774076

Corrigan, Patrick W; Mittal, Dinesh; Reaves, Christina M; Haynes, Tiffany F; Han, Xiaotong; Morris, Scott; Sullivan, Greer



Latino Adults’ Access to Mental Health Care  

PubMed Central

Since the early 1980s, epidemiological studies using state-of-the-art methodologies have documented the unmet mental health needs of Latinos adults in the U.S. and Puerto Rico. This paper reviews 16 articles based on seven epidemiological studies, examines studies methodologies, and summarizes findings about how Latino adults access mental health services. Studies consistently report that, compared to non-Latino Whites, Latinos underutilize mental health services, are less likely to receive guideline congruent care, and rely more often on primary care for services. Structural, economic, psychiatric, and cultural factors influence Latinos’ service access. In spite of the valuable information these studies provide, methodological limitations (e.g., reliance on cross-sectional designs, scarcity of mixed Latino group samples) constrict knowledge about Latinos access to mental health services. Areas for future research and development needed to improve Latinos’ access and quality of mental health care are discussed. PMID:16598658

Cabassa, Leopoldo J.; Zayas, Luis H.; Hansen, Marissa C.



Public health implications of substandard correctional health care.  


US citizens face a growing threat of contracting communicable diseases owing to the high recidivism rate in state and federal prisons, poor screening and treatment of prisoners, and inferior follow-up health care upon their release. Insufficient education about communicable diseases--for prisoners and citizens alike--and other problems, such as prejudice against prisoners, escalating costs, and an unreliable correctional health care delivery system for inmates, all contribute to a public health problem that requires careful examination and correction for the protection of everyone involved. PMID:16186448

Restum, Zulficar Gregory



Health practices of critical care nurses.  


Little is known about the health practices of critical care nurses (CCNs). Because their health behaviors may influence their inclinations to counsel patients, it is important that CCNs engage in a healthy lifestyle and serve as health exemplars. The purpose of this survey was to describe the health practices of 499 CCNs. Data were gathered by questionnaires that elicited information regarding smoking habits, oral health and dietary practices, energy expenditure, seat belt use, alcohol consumption, and health surveillance behaviors. This article is a sequel to a previous manuscript that reported findings relative to the smoking practices of CCNs. Results of the study suggest that the CCNs surveyed were not fulfilling their roles as health exemplars. Although some reported favorable health practices, many indicated habits that were less than desirable. These data document the need to develop strategies for improving the health behaviors of CCNs, thereby protecting their future health. Ultimately, these strategies may benefit their patients. PMID:1592608

Haughey, B P; Kuhn, M A; Dittmar, S S; Wu, Y W



78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...  

Federal Register 2010, 2011, 2012, 2013

...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 professional shortages. The Health Care Safety Net Amendments of 2002...



77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...  

Federal Register 2010, 2011, 2012, 2013

...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 professional shortages. The Health Care Safety Net Amendments of 2002...



76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...  

Federal Register 2010, 2011, 2012, 2013

...designated as a result of the Health Care Safety Net Amendments of 2002...definition of such Tribes in the Indian Health Care Improvement Act of 1976, 25 professional shortages. The Health Care Safety Net Amendments of 2002...



Role of Primary Health Care in Ensuring Access to Medicines  

PubMed Central

To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization. PMID:20564760

Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L



Issues in mental health care benefits: the costs of mental health parity.  


This Issue Brief discusses issues in mental health care benefits. It describes the current state of employment-based mental health benefits and discusses studies and issues regarding full mental health parity. It also includes an analysis of the effect of full mental parity on the uninsured population and the effects of the limited mental health parity provision contained in the VA-HUD appropriations bill. The final section discusses the implications of mental health parity for health plans and health insurers. When employers began to provide health insurance benefits to their employees and their families, they extended coverage to include mental health benefits under the same terms as other health care services. Many employers continued to add mental health benefits through the 1970s and early 1980s until cost pressures required employers to re-examine all health care benefits that were offered. They quickly found that, while only a small proportion of the beneficiaries used mental health care services, the costs associated with this care were very high. As a result, employers placed limits on mental health benefits in an attempt to make the insurance risk more manageable. The general strategies employers have used to manage their health care costs are cost sharing, utilization review, managed care, and the packaging of provider services. Employers' cost management strategies may be restricted, however. Five states have mental health parity laws, but three of the states--Rhode Island, Maine, and New Hampshire--apply these laws only to the seriously mentally ill. In addition, 31 states mandate that mental health benefits be provided. However, state mandates apply only to insured plans, not to self-insured employer plans, which are exempt from state regulation of health plans under the Employee Retirement Income Security Act of 1974 (ERISA). A number of recent studies have examined the effect of mental health parity on health insurance premiums in a "typical" preferred provider organization and on the uninsured. In general, the studies concluded that mental health parity could increase health insurance premiums, decrease health insurance coverage for non-mental health related illnesses, and increase the number of uninsured individuals. All studies of mental health parity, and mandated benefits in general, assume that there is a strong likelihood that increased health benefit costs would be passed along to workers in the form of higher cost sharing for health insurance, lower wage growth, or lower growth in other employee benefits. PMID:10164993

Fronstin, P



Managed Care and Provider Satisfaction in Mental Health Settings  

Microsoft Academic Search

We assess the satisfaction of mental health providers using four dimensions from the medical practice literature—degree of\\u000a autonomy, relationship with patients, compensation, and administrative burden—and extend current work on professional satisfaction\\u000a to include frontline service providers rather than only psychiatrists or other physicians. In contrast to results reported\\u000a for primary care settings, we find that the impact of managed care

Kimberley R. Isett; Alan R. Ellis; Sharon Topping; Joseph P. Morrissey



Health care consumerism movement takes a step forward.  


One of the contributing factors to both the increase in health care costs and the backlash to managed care was the lack of consumer awareness of the cost of health care service, the effect of health care costs on profits and wages, and the need to engage consumers more actively as consumers in health care decisions. This article reviews the birth of the health care consumerism movement and identifies gaps in health care consumerism today. The authors reveal some of the keys to building a sustainable health care consumerism framework, which involves enlisting consumers as well as other stakeholders. PMID:20608112

Thompson, Michael; Cutler, Charles M



Humanitarian and civic assistance health care training and cultural awareness promoting health care pluralism.  


Integration between traditional and contemporary health care in a host nation can be beneficial to nation- and capacity-building and, subsequently, to the overall health of the society. "Traditional" health care in this sense refers to the indigenous health care system in the host nation, which includes characteristic religious or cultural practices, whereas "contemporary" health care is also known as "conventional" or "Westernized"; integration is a synchronization of these two health care forms. However, the choice of integration depends on the political and cultural situation of the nation in which the Department of Defense health care personnel are intervening. Thus, cultural awareness training is essential to ensure the success of missions related to global health and in promoting a health care system that is most beneficial to the society. The present study attempts to show the benefits of both cultural training and health care integration, and how adequately evaluating their efficacy has been problematic. The author proposes that determinants of this efficacy are better documentation collection, extensive predeployment cultural awareness and sensitivity training, and extensive after-action reports for future development. PMID:23756013

Facchini, Rose E



Health care technology as a policy issue  

Microsoft Academic Search

he rapidly rising costs of health care became the most im- portant health policy issue in many countries during the 1980s and early 1990s. These costs are now threatening the prospects for providing higher quality services to broader population groups, especially in the United States. The reasons for rising costs clearly include the aging of the popula- tion, with associated

H. David Banta



Poverty, Ethnic Identity, and Health Care.  

ERIC Educational Resources Information Center

This book tries to present the health care problems of the major ethnic minority groups in perspective. Although poverty is probably the most crucial variable in the genesis of these problems, there are still many subtle and not so subtle forms of discrimination operating in the health field. Unfortunately, discrimination in other aspects of…

Bullough, Bonnie; Bullough, Vern L.


Health Care Spending: Context and Policy  

Microsoft Academic Search

[Excerpt] The United States spends a large and growing share of national income on health care. In 2007, health spending is expected to approach $2.3 trillion and account for more than 16% of gross domestic product (GDP). We spend substantially more than other developed countries, both per capita and as a share of GDP. However, given our wealth, such spending

Jennifer Jenson



Business risk and the health care entrepreneur.  


This article addresses issues of business risk in the home health care industry. General concepts of risk are discussed, and the unique attributes affecting risk in the home health industry are identified and reviewed particularly as they affect market entry strategies, differentiation, innovation, and regulation. PMID:8263081

Woerner, L



Ethics and Culture in Mental Health Care  

Microsoft Academic Search

This article examines the complex relationship between culture, values, and ethics in mental health care. Cultural competence is a practical, concrete demonstration of the ethical principles of respect for persons, beneficence (doing good), nonmaleficence (not doing harm), and justice (treating people fairly)—the cornerstones of modern ethical codes for the health professions. Five clinical cases are presented to illustrate the range

Jinger G. Hoop; Tony DiPasquale; Juan M. Hernandez; Laura Weiss Roberts



Your Guide to Health Care Coverage  

E-print Network

link community service and learning objectives for youth from kindergarten through college as well, the covered services you are entitled to are called "your benefits." This guide is an overview of your health into training or service. Your health care benefits will terminate automatically on the date your service ends


Computers, Health Care, and Medical Information Science.  

ERIC Educational Resources Information Center

Discusses the new discipline of medical information science (MIS) and examines some problem-solving approaches used in its application in the clinical laboratory, emphasizing automation by computer technology. The health care field is viewed as one having overlapping domains of clinical medicine, health management and statistics, and fundamental…

Lincoln, Thomas L.; Korpman, Ralph A.



Tax Options for Financing Health Care Reform  

Microsoft Academic Search

Summary Several tax options have been proposed to provide financing for health care reform. President Obama has proposed restricting itemized deductions for high income taxpayers, along with some narrower provisions. The Senate Finance Committee has provided a list of options for health- related tax provisions. Individuals testifying at a round-table discussion have also proposed a number of other options, including

Jane G. Gravelle


Twenty-first century health care.  


A dynamic, proactive health-care environment is beckoning. Fueled by consumer-led awareness, digital television, the Internet and a preoccupation with preventative health maintenance, it will define a new genre of products. In a series of provocative statements, this visionary article explores what the future may hold for diagnostics and medical devices. PMID:10387620

Pearson, M



Physician migration, education, and health care.  


Physician migration is a complex and multifaceted phenomenon that is intimately intertwined with medical education. Imbalances in the production of physicians lead to workforce shortages and surpluses that compromise the ability to deliver adequate and equitable health care to large parts of the world's population. In this overview, we address a special section of the journal and briefly describe the current state of affairs in physician migration and its effects on donor and recipient countries. Global forms of practice and education, based on initiatives such as telemedicine and the International Virtual Medical School, hold promise of redressing some of these imbalances without requiring physicians to leave their countries. Other initiatives, such as those to raise the standards of medical education across the continuum, will improve the quality of care locally and permit the movement of physicians, resulting in better distribution of the workforce. All of these actions require a uniquely global perspective that places a premium on the long-term benefits to humankind while respecting the rights of patients and physicians. PMID:16078796

Norcini, John J; Mazmanian, Paul E



The Effect of Medicaid Managed Care on Mental Health Care for Children: A Review of the Literature  

Microsoft Academic Search

Despite its widespread adoption, little is known about the effect of Medicaid managed care (MMC) on children using mental health services. To assess the state of current research, we reviewed the literature on MMC and synthesized findings regarding access to care, expenditures, utilization, cost-shifting, and quality of care. A literature search was conducted and updated in November 2001. Studies were

Angela Blair Hutchinson; E. Michael Foster



Do Healthy People Worry? Modern Health Worries, Subjective Health Complaints, Perceived Health, and Health Care Utilization  

Microsoft Academic Search

Background  Modern health worries (MHW) are concerns related to modern or technological features of daily life (e.g., air pollution, x-rays,\\u000a food additives, etc.), and have been associated with subjective health complaints (SHC) and health care use.\\u000a \\u000a \\u000a \\u000a \\u000a Purpose  The MHW scale was expected to predict aspects of health status in healthy individuals (e.g., health care visits, health perceptions,\\u000a and medication use). SHC was

Kelly B. Filipkowski; Joshua M. Smyth; Abraham M. Rutchick; Alecia M. Santuzzi; Meera Adya; Keith J. Petrie; Ad A. Kaptein



Boards of directors under fire: an examination of nonprofit board duties in the health care environment.  


Attorney Ono presents a detailed discussion of fiduciary duty principles as applied to the directors of nonprofit health care corporations in the current health care environment. The article reviews general corporate responsibilities, the implication of the taxpayer's Bill of Rights 2, the care of In re Caremark International Inc. Derivative Litigation and particular issues faced by boards in nonprofit conversions. PMID:10187376

Ono, N



Commentary: Health care reform and primary care: training physicians for tomorrow's challenges.  


Although Congress recently passed health insurance reform legislation, the real catalyst for change in the health care delivery system, the author's argue, will be changes to the reimbursement model. To rein in increasing costs, the Centers for Medicare and Medicaid aims to move Medicare from the current fee-for-service model to a reimbursement approach that shifts the risk to providers and encourages greater accountability both for the cost and the quality of care. This level of increased accountability can only be achieved by clinical integration among health care providers. Central to this reorganized delivery model are primary care providers who coordinate and organize the care of their patients, using best practices and evidence-based medicine while respecting the patient's values, wishes, and dictates. Thus, the authors ask whether primary care physicians will be available in sufficient numbers and if they will be adequately and appropriately trained to take on this role. Most workforce researchers report inadequate numbers of primary care doctors today, a shortage that will only be exacerbated in the future. Even more ominously, the authors argue that primary care physicians being trained today will not have the requisite skills to fulfill their contemplated responsibilities because of a variety of factors that encourage fragmentation of care. If this training issue is not debated vigorously to determine new and appropriate training approaches, the future workforce may eventually have the appropriate number of physicians but inadequately trained individuals, a situation that would doom any effort at system reform. PMID:21270552

Caudill, T Shawn; Lofgren, Richard; Jennings, C Darrell; Karpf, Michael



Who pays for health care in Ghana?  

PubMed Central

Background Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Methods Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. Results Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. Conclusion For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues affecting the expansion of the National Health Insurance. Furthermore, the pre-payment funding pool for health care needs to grow so budgetary allocation to the health sector can be enhanced. PMID:21708026



National Lesbian Health Care Survey Mental Health Implications,  

National Technical Information Service (NTIS)

The results of a survey of lesbians to determine their health care needs are reported. The survey was conducted in 1984-85. Responses were received from 1,917 lesbians who resided in all fifty states.

J. B. Bradford, C. C. Ryan



Making better use of health care information.  


Effective use of health care information holds the promise of improved care and reduced health costs. A number of challenges must, however, be met. Incentives for using information must be introduced. A code of practice for using patient data to allay confidentiality concerns is needed. An institution is needed to accelerate the development of health information standards. Awareness must be raised about the opportunities provided by more effective use of information. Champions are needed to create the required information-intensive infrastructures. PMID:10131593

Aspden, P



Health care financing: recent experience in Africa.  


The economic realities of health sector development in Africa has been analyzed in this paper. Both the global and national macroeconomic context has been defined. Given the available data, it is clear that most African countries face increasingly serious economic realities, such as slow or even declining economic growth (per capita), a depressed food production situation, severe balance of payments crises, and increasing dependence on external financial assistance. Given the limited but increasingly available 1981 and 1982 data, the economic situation in many countries is more constrained than those indicated by the data contained in this paper. In this context, the potential competitive situation facing governmental health care systems was reviewed. In addition, the diversity in the sources of health expenditures between countries in Africa was highlighted. These data provide clear evidence that governments clearly do not finance the entire health care system and that individual payment for service in many countries represent an important source of revenue for many care providers in various health care systems operating in any given country. The potential for governments to finance either an expansion of or improvements to the government component of their health care systems is then reviewed. The highlights of this analysis include the following points. First, the tax structure in many African countries is highly dependent on export and import duties, which in turn creates dependency on sustained foreign demand for exports.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6422557

Dunlop, D W



Children with Special Health Care Needs: How Immigrant Status is Related to Health Care Access, Health Care Utilization, and Health Status  

Microsoft Academic Search

To compare health care access, utilization, and perceived health status for children with SHCN in immigrant and nonimmigrant\\u000a families. This cross-sectional study used data from the 2003 California Health Interview Survey to identify 1404 children\\u000a (ages 0–11) with a special health care need. Chi-square and logistic regression analyses were used to examine relations between\\u000a immigrant status and health access, utilization,

Joyce R. Javier; Lynne C. Huffman; Fernando S. Mendoza; Paul H. Wise



The impact of racism on the delivery of health care and mental health services.  


This article presents research findings useful in formulating a Best Practices Model for the delivery of mental health services to underserved minority populations. Aspects of the role of racism in health care delivery and public health planning are explored. An argument is made for inclusion of the legacy of the slavery experience and the history of racism in America in understanding the current health care crisis in the African-American population. The development of an outline in APA DSM IV for the use of cultural formulations in psychiatric diagnosis is discussed. PMID:11525081

Hollar, M C



[Health care expenditures and the aging population].  


The impact of a longer life on future health care expenditures will be quite moderate because of the high costs of dying and the compression of mortality in old age. If not age per se but proximity to death determines the bulk of expenditures, a shift in the mortality risk to higher ages will not significantly affect lifetime health care expenditures, as death occurs only once in every life. A calculation of the demographic effect on health care expenditures in Germany up until 2050 that explicitly accounts for costs in the last years of life leads to a significantly lower demographic impact on per-capita expenditures than a calculation based on crude age-specific health expenditures. PMID:22526849

Felder, S



The health care market: can hospitals survive?  


Does it sound familiar? Resources are scarce, competition is tough, and government regulations and a balanced budget are increasingly hard to meet at the same time. This is not the automobile or oil industry but the health care industry, and hospital managers are facing the same problems. And, maintains the author of this article, they must borrow some proven marketing techniques from business to survive in the new health care market. He first describes the features of the new market (the increasing economic power of physicians, new forms of health care delivery, prepaid health plans, and the changing regulatory environment) and then the possible marketing strategies for dealing with them (competing hard for physicians who control the patient flow and diversifying and promoting the mix of services). He also describes various planning solutions that make the most of a community's hospital facilities and affiliations. PMID:10247957

Goldsmith, J C



Translational Research Overview Health Policy and Primary Care Research Center  

E-print Network

Translational Research Overview Health Policy and Primary Care Research Center Effective and timely findings that leads to the improvement of care and the revi- sion of health care policy. #12;REFERENCES translation of research into health care practice is essential to the delivery of high quality care. Despite

Oliver, Douglas L.


Providing Safe Health Care: The Role of Educational Support Personnel.  

ERIC Educational Resources Information Center

This handbook is written for the educational support person (ESP) who may or may not be a trained or licensed health care provider, but whose job has come to include caring for students with disabilities with special health care needs. Section 1, "The Laws Governing the ESP and the Care of the Student with Special Health Care Needs," discusses the…

Weiss, Julie


of Health Care National Institutes of Health  

E-print Network

sound science to the study of cam would yield dividends­new therapies to benefit health, prevent disease made clear that there would be no equivocation in the face of negative findings. The evidence would built a significant communications program operations. This outreach effort, along with the all

Bandettini, Peter A.


Cultural competence in health care: an emerging theory.  


This study examined the current state of cultural competence in health care using a qualitative descriptive design. Interviews were conducted with 20 multidisciplinary experts in culture and cultural competence from the United States and abroad. Findings identified 3 themes; awareness, engagement, and application that crossed 4 domains of cultural competence; intrapersonal, interpersonal, system/organization, and global. PMID:24469088

Soulé, Isabelle



Perspective: A New Model of Leadership Performance in Health Care  

E-print Network

are correlated with the way in which the leadership situation we are dealing with occurs for us, and (2Leadership Perspective: A New Model of Leadership Performance in Health Care Wiley Souba, MD, ScD, MBA Abstract Current leadership models are based largely on concepts and explanations, which provide

Myers, Lawrence C.


Building the national health information infrastructure for personal health, health care services, public health, and research  

PubMed Central

Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

Detmer, Don E



Environmental Health Data in Europe: Current Approaches.  

ERIC Educational Resources Information Center

These papers presented at a World Health Organization Regional Office for Europe (WHO/EURO) Consultation explore current approaches to environmental health data in Europe. Topics discussed include unified environmental health databases, the use of national hospital registers, health statistics in small areas, expert systems, chemical databases,…

Elias, A. W., Ed.



Care Coordination: A Case Study Linking Primary Health Care  

Microsoft Academic Search

The purpose of this project is to demonstrate, through a case study, how York Community Services (YCS) is a leader in the delivery ofprimary health care through its integration ofhealth, legal and social services. YCS is located in Toronto, Ontario, Canada. YCS's mandate is to serve populations that have traditionally been on the margins ofsociety and therefore have had difficulty

Monica M. Lancaster; David P. Thow



Health Care Autonomy in Children with Chronic Conditions: Implications for Self Care and Family Management  

PubMed Central

Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. PMID:23659815

Beacham, Barbara L.; Deatrick, Janet A.



Palliative health care: ancient wisdom.  


An ancient story from Bhagavata Purana may be relevant to the psychology and spirituality of palliative care in modern medicine. This article brings an ancient Indian story that people still use during the grieving process. Symbolism of the old story is explained in a modern perspective. PMID:22811211

Mehta, Jay



Health Care Basics: Choosing the  

E-print Network

Obstructive Pulmonary Disease (COPD) · Coronary Artery Disease (CAD) · Hypertension(integratedwithCAD/CHF) #12(adult/pediatric) · Diabetes · Cardiovascular Disease · Chronic Heart Failure (CHF) · Chronic Kidney Disease · Chronic help members with chronic or acute conditions by supporting them in adhering to their physicians' care

Hutcheon, James M.


HealtH Care BasiCs Health Care Basics  

E-print Network

-785-0006 Kaiser: 404-365-0966 (Metro Atlanta) 800-611-1811 (outside Atlanta) · Health support programs at 404-261-2590 in Atlanta or 888-865-5813 outside of Atlanta. Comparison guide To assist you in making

Hutcheon, James M.


Health Care for the International Student: Asia and the Pacific.  

ERIC Educational Resources Information Center

This handbook consists of 24 papers addressing various aspects on health care and health care systems and services for foreign students from the Asia Pacific Region. The papers are: "Providing Health Care for International Students" (Donald F. B. Char); "Major Health Care Systems in Asia and the Pacific: Mainland China, Taiwan, Hong Kong" (Julia…

Naughton, June C., Ed.; And Others


Rapid Business Transformations in Health Care: A Systems Approach  

ERIC Educational Resources Information Center

The top two priorities of health care business leaders are to constantly improve the quality of health care while striving to contain and reduce the high cost of health care. The Health Care industry, similar to all businesses, is motivated to deliver innovative solutions that accelerate business transformation and increase business capabilities. …

Shulaiba, Refaat A.



Health Care Delivery in Athletics.  

ERIC Educational Resources Information Center

A structural framework is provided for a responsive athletic injury control program, the Health Supervision Loop in Sport. The use of certified athletic trainers is recommended to lessen the risk of sport-related injuries. (FG)

Clarke, Kenneth S.



Mental Health Care: Who's Who  


... with a master’s degree or doctoral degree in psychology (Psy.D.), philosophy (Ph.D.) or education (Ed. ... work experience. Licensed Professional Counselor: Master’s degree in psychology, counseling or a related field. Mental Health Counselor: ...


Health Care Systems in Transition  

Microsoft Academic Search

This document may be freely reviewed or abstracted, but not for commercial purposes. For rights of reproduction,in part or in whole, application should b e made to the Secretariat of the European Observatory on Health Systems and Policies, WHO Regional Office for Europe, Scherfigsvej 8, DK-2100 Copenhagen Ř, Denmark. The European Observatory on Health Systems and Policies welcomes,such applications. The

John Holley; Oktay Akhundov; Ellen Nolte; Laura MacLehose; Martin McKee


Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities  

ERIC Educational Resources Information Center

A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William



Prevention of health care-associated infections.  


Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. Prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic technique when inserting, and device removal when no longer necessary. Specific recommendations for preventing central line-associated bloodstream infections include use of chlorhexidine for skin preparation, as a component of dressings, and for daily bathing of patients in intensive care units. Catheter-associated urinary tract infections are the most common device-related health care-associated infection. Maintaining a closed drainage system below the patient reduces the risk of infection. To prevent ventilator-associated pneumonia, which is associated with high mortality, mechanically ventilated patients should be placed in the semirecumbent position and receive antiseptic oral care. Prevention of surgical site infections includes hair removal using clippers, glucose control, and preoperative antibiotic prophylaxis. Reducing transmission of Clostridium difficile and multidrug-resistant organisms in the hospital setting begins with hand hygiene and contact precautions. Institutional efforts to reduce unnecessary antibiotic prescribing are also strongly recommended. Reducing rates of methicillin-resistant Staphylococcus aureus infection can be achieved through active surveillance cultures and decolonization therapy with mupirocin. PMID:25251230

Hsu, Vincent



Staying alive: strategies for accountable health care.  


The Patient Protection and Affordable Care Act signed into law in March 2010, has led to sweeping changes to the US health care system. The ensuing pace of change in health care regulation is unparalleled and difficult for physicians to keep up with. Because of the extraordinary challenges that have arisen, the public policy committee of the Society for Surgery of the Alimentary tract conducted a symposium at their 52nd Annual Meeting in May 2011 to educate participants on the myriad of public policy changes occurring in order to best prepare them for their future. Expert speakers presented their views on policy changes affecting diverse areas including patient safety, patient experience, hospital and provider fiscal challenges, and the life of the practicing surgeon. In all areas, surgical leadership was felt to be critical to successfully navigate the new health care landscape as surgeons have a long history of providing safe, high quality, low cost care. The recognition of shared values among the diverse constituents affected by health care policy changes will best prepare surgeons to control their own destiny and successfully manage new challenges as they emerge. PMID:22399268

Marcus, Stuart G; Reid-Lombardo, Kaye M; Halverson, Amy L; Maker, Vijay; Demetriou, Achilles; Fischer, Josef E; Bentrem, David; Rudnicki, Marek; Hiatt, Jonathan R; Jones, Daniel



Unmanaged care: towards moral fairness in health care coverage.  


Health insurers are generally guided by the principle of "actuarial fairness," according to which they distinguish among various risks on the basis of cost-related factors. Thus, insurers often limit or deny coverage for vision care, hearing aids, mental health care, and even AIDS treatment based on actuarial justifications. Furthermore, approximately forty-two million Americans have no health insurance at all, because most of these individuals cannot afford the cost of insurance. This Article argues that Americans have come to demand more than actuarial fairness from health insurers and are increasingly concerned by what I call "moral fairness." This is evidenced by the hundreds of laws that have been passed to constrain insurers' discretion with respect to particular coverage decisions. Legislative mandates are frequent, but seemingly haphazard, following no systematic methodology. This Article suggests an analytical framework that can be utilized to determine which interventions are appropriate and evaluates a variety of means by which moral fairness could be promoted in the arena of health care coverage. PMID:15214342

Hoffman, Sharona



A Health Care Planner: Teaching Low-Income Consumers about Health Care Alternatives.  

ERIC Educational Resources Information Center

This module, one of six on teaching consumer matters to low-income groups, focuses on health care alternatives. It provides helpers of low-income people in Virginia with a composite of information in the areas of traditional health care, alternatives to the traditional methods, insurance, medications, and fraudulent practices. At the end of each…

Fitch, Sandra F.


Child Care Health Connections, 2001: A Health and Safety Newsletter for California Child Care Professionals.  

ERIC Educational Resources Information Center

This document is comprised of the six 2001 issues of a bimonthly newsletter providing information on young children's health and safety for California's child care professionals. Regular features include a column on infant/toddler concerns, a question-answer column regarding medical and health issues, and resources for child care providers.…

Walery, Nancy, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Zamani, Rahman, Ed.; Guralnick, Eva, Ed.



Just health care (I): Is beneficence enough?  


Few in our society believe that access to health care should be determined primarily by ability to pay. We believe instead that society has an obligation to assure access to adequate health care for all. This is the view explicitly endorsed in the President's Commission Report Securing Access to Health Care. But there is an important moral ambiguity here, for this obligation may be construed as being either beneficence-based or justice-based. A beneficence-based construal would yield a much weaker obligation with respect to the distribution of health care. In the first section of this paper I argue that the President's Commission is committed only to this weaker construal of this obligation. In the second section I argue that such a beneficence-based obligation is really rooted in a libertarian conception of justice, similar to that recently articulated by Engelhardt, and that this conception is seriously flawed when it comes to effecting a just distribution of health care. PMID:2675374

Fleck, L M



Essays on the Evolution of Health Care Technology  

E-print Network

Human Services, Health Resources and Services Administration [database online]. Health Care ProfessionsHuman Services, 2008; lnterStudy Publications, 2008). The ARF contains data on health professions,

Hodgson, Ashley Renee



Health Care Reform Tracking Project: Tracking State Health Care Reforms as They Affect Children and Adolescents with Emotional Disorders and Their Families.  

ERIC Educational Resources Information Center

The Health Care Reform Tracking Project is a 5-year national project to track and analyze state health care reform initiatives as they affect children and adolescents with emotional/behavioral disorders and their families. The study's first phase was a baseline survey of all 50 states to describe current state reforms as of 1995. Among findings of…

Pires, Sheila A.; Stroul, Beth A.


The Social Implications of Health Care Reform: Reducing Access Barriers to Health Care Services for Uninsured Hispanic and Latino Americans in the United States  

ERIC Educational Resources Information Center

The U.S. health care system is currently facing one of its most significant social challenges in decades in terms of its ability to provide access to primary care services to the millions of Americans who have lost their health insurance coverage in the recent economic recession. National statistics compiled by the U.S. Census Bureau for 2009…

Kaplan, Mitchell A.; Inguanzo, Marian M.



Racial and Ethnic Disparities in Access to Health Insurance and Health Care  

E-print Network

health, Latino and AAPI men and women experience disparities compared to whites and AfricanDisparities In Access to Health Insurance and Health Care AfricanDisparities In Access to Health Insurance and Health Care Among African-

Brown, E. Richard; Ojeda, Victoria D.; Wyn, Roberta; Levan, Rebecca



Perceived Impacts of Health Care Reform on Large Urban Health Departments  

PubMed Central

Context: The Patient Protection and Affordable Care Act (ACA) is changing the landscape of health systems across the United States, as well as the functioning of governmental public health departments. As a result, local health departments are reevaluating their roles, objectives, and the services they provide. Objective: We gathered perspectives on the current and future impact of the ACA on governmental public health departments from leaders of local health departments in the Big Cities Health Coalition, which represents some of the largest local health departments in the country. Design: We conducted interviews with 45 public health officials in 16 participating Big Cities Health Coalition departments. We analyzed data reflecting participants' perspectives on potential changes in programs and services, as well as on challenges and opportunities created by the ACA. Results: Respondents uniformly indicated that they expected ACA to have a positive impact on population health. Most participants expected to conduct more population-oriented activities because of the ACA, but there was no consensus about how the ACA would impact the clinical services that their departments could offer. Local health department leaders suggested that the ACA might create a broad range of opportunities that would support public health as a whole, including expanded insurance coverage for the community, greater opportunity to collaborate with Accountable Care Organizations, increased focus on core public health issues, and increased integration with health care and social services. Conclusions: Leaders of some of the largest health departments in the United States uniformly acknowledged that realignments in funding prompted by the ACA are changing the roles that their offices can play in controlling infectious diseases, providing robust maternal and child health services, and more generally providing a social safety net for health care services in their communities. Health departments will continue to need strong leaders to strengthen and maintain their critical role in protecting and promoting the health of the public they serve. PMID:25423059

Leider, Jonathon P.; Castrucci, Brian C.; Russo, Pamela; Hearne, Shelley



Green politics in Germany: what is Green health care policy?  


For the first time ever, a Green party has governed in Germany. From September 1998 to January 2001 the German Green party, Bündnis 90/Die Grünen, held the Federal Ministry of Health. Little has been said so far about Bündnis 90/Die Grünen and its relation to health policy. This article is intended to fill that void. An analysis of the health policy program of the Greens reveals that it centers around moving the health sector toward more comprehensiveness and decentralization, strengthened patients' rights, increased use of preventive and alternative medicine, and a critique of the German cost-containment debate and policy. The current health policy program of the Greens is closest to that of the Party of Democratic Socialism, and to a lesser extent it has affinities to the program of the Social Democratic Party. The health policy program of Bündnis 90/Die Grünen is furthest from those of the Christian Democratic Union and the Free Democratic Party. The health care reforms passed in 1998 and 1999 were not a shift toward a "Green paradigm" of health care policy, because they included no fundamental changes. In addition, cost-containment is still a major political goal in German health care policy. PMID:11809012

Wörz, M; Wismar, M



Community health services and health care utilization in rural Bangladesh  

Microsoft Academic Search

The study, which is based on data from two household level health surveys conducted in 1976 and 1987 in the Companiganj area of rural Bangladesh, examines the premise that the utilization of public health care services can be increased by increasing the availability and accessability of effective medicines to the public and by improving the disease recognition and management by

Ruhul Amin; Shifiq A. Chowdhury; G. M. Kamal; J. Chowdhury



Pediatric Mental Health Emergencies and Special Health Care Needs  

PubMed Central

SYNOPSIS Children with mental health problems are increasingly being evaluated and treated by both pediatric primary care and pediatric emergency physicians. This article focuses on the epidemiology, evaluation, and management of the two most common pediatric mental health emergencies, suicidal and homicidal/aggressive patients, as well as the equally challenging population of children with autism or other developmental disabilities. PMID:24093903

Chun, Thomas H.; Katz, Emily R.; Duffy, Susan J.



Confronting AIDS. Directions for Public Health, Health Care, and Research.  

ERIC Educational Resources Information Center

This book is addressed to anyone involved with or affected by the Acquired Immune Deficiency Syndrome (AIDS) epidemic, including legislators, researchers, health care personnel, insurance providers, educators, health officials, executives in the pharmaceutical industry, blood bank administrators, and other concerned individuals. The following…

Institute of Medicine (NAS), Washington, DC.


[Health care systems and impossibility theorems].  


Health care systems, amongst the most complicated systems that serve mankind, have been in turmoil for many years. They are characterized by widespread dissatisfaction, repeated reforms and a general perception of failure. Is it possible that this abominable situation derives from underlying causes, which are inherent to the most basic elements of these systems? Those elements compromise the use of words and definitions in the formulation of their principles and their way of action, in their logical structure as well as in the social order in which they exist. An in-depth investigation of these elements raises findings that may negate the basic feasibility of the success of such complex systems, as currently known in the western world. One of the main elements of the democratic regime is its system of decision/choice making, i.e. the majority vote. But, already in the nineteenth century, it was discovered that a majority was an intransitive ordering and did not produce a consistent definition of a preference. The Marquis of Condorcet in his famous 1785 "Essai sur l'application de l'analyse a la probabilite des decisions rendues a la plurite des voix", clearly demonstrated that majority decisions might lead to intransitivity and an indeterminancy in social choices. On the basis of his discoveries, it was later shown that legislative rules may lead to the choice of a proposal that is actually opposed by the majority, or to a deadlock and therefore, to socially undesirable implications. Subsequent to these theories of Condorcet, which became known as "The Paradox of Condorcet", many papers were published in the 19th and 20th centuries regarding the issue of problems dealing with individual preferences leading to social order--a complex procedure of, amongst others, aggregation in a defined axiomatic framework. During the twentieth century it became astoundingly manifest that certain issues, although correctly attacked logically, could not be resolved. Two such famous results are Kurt Godel's seminal paper in 1931: "Ueber formal unentscheidbare Saetze der Principia Mathematica and verwandter System I" and Arrow's Nobel Prize winning "Impossibility Theorem" (Social Choice and Individual Values, 1951). Godel showed, unequivocally, that there is an enormous gap between what is being perceived as truth and what in fact can be proven as such. Arrow showed that the translation of individual preferences into a social order is impossible--except in a dictatorship. The unsolved controversies concerning the desirable or ideal structure of health care systems are impinged upon by these findings generally, and, in the case of the impossibility theorem, also directly. There is the impossibility of aggregating preferences and, at a deeper level, the impossibility of defining certain fundamental values, coupled with the problematic use of certain words, the absence of the possibility of creating, on a logically defined base, a complex system, complete and comprehensive in its own right. This is added to the fact that according to the elaboration by Stephen Wolfram in "A New Kind of Science", it is not easy to reduce complicated systems to simple components and to predict the continuation of their development even from simple basic laws without complicated calculations. All of these factors impede the construction of satisfying health care systems and leave obvious problems which overshadow the structure and the operation of health care systems. PMID:15143703

Penchas, Shmuel



Sustainability and the health care manager: Part II.  


Are there additional costs associated with achieving goals of sustainable health care? Will going green enhance or impede financial performance? These are questions that all health care managers should confront, yet there is little evidence to show that health care sustainability is affordable or profitable. This article considers what is presently known and suggests that health care managers use an assessment framework to determine whether they are ready to achieve health care sustainability. PMID:21808179

Ramirez, Bernardo; Oetjen, Reid M; Malvey, Donna



Health Care System Reform in China: Issues, Challenges and Options  

Microsoft Academic Search

This paper examines health care reform in urban and rural China. Before health care reform, Chinese health service facilities were run entirely by the state and basically they performed a social welfare function. This health care system greatly improved the population health conditions but many problems started to emerge in 1980s when the economic reform started. Since then, the government

Rong Hu; Chunli Shen; Heng-fu Zou



Health Literacy and Health Care Spending and Utilization in a Consumer-Driven Health Plan  

Microsoft Academic Search

We examined health literacy and health care spending and utilization by linking responses of three health literacy questions to 2006 claims data of enrollees new to consumer-driven health plans (n = 4,130). Better health literacy on all four health literacy measures (three item responses and their sum) was associated with lower total health care spending, specifically, lower emergency department and inpatient admission

Nancy A. Hardie; Kelly Kyanko; Susan Busch; Anthony T. LoSasso; Regina A. Levin



Health Care Policies for Children in Out-of-Home Care.  

ERIC Educational Resources Information Center

Examined health care policies and services for children under 46 state welfare agencies. Found that most states had written policies regarding health care for foster children, but half had no management system to record health care data. Most states did not meet standards set by the Child Welfare League of America for health care of these…

Risley-Curtiss, Christina; Kronenfeld, Jennie Jacobs



Out of Place: Mediating Health and Social Care in Ontario's Long-Term Care Sector  

ERIC Educational Resources Information Center

The paper discusses two reforms in Ontario's long-term care. The first is the commercialization of home care as a result of the implementation of a "managed competition" delivery model. The second is the Ministry of Health and Long-Term Care's privileging of "health care" over "social care" through changes to which types of home care and home…

Daly, Tamara



Can We Talk? Priorities for Patient Care Differed Among Health Care Providers  

Microsoft Academic Search

Objective: Poor communication and collaboration between members of a patient's health care team can result in medical errors and poor quality of care. The purpose of this study was to assess communication and consensus regarding patient care goals between members of the health care team (physicians, registered nurses (RNs), and patient care technicians (PCTs)) caring for the same patient on

Bradley Evanoff; Patricia Potter; Laurie Wolf; Deborah Grayson; Clay Dunagan; Stuart Boxerman


Health Care Issues in Southern Rural Black America.  

ERIC Educational Resources Information Center

High infant and maternal mortality, poverty, isolation, a shortage of health professionals, inadequate health care facilities, and difficult geographic access to care are some of the health-related problems that plague Black rural southerners. (GC)

Turner, Henrie M.



Second Health Care Worker in Dallas Tests Positive for Ebola  


... features on this page, please enable JavaScript. Second Health Care Worker in Dallas Tests Positive for Ebola Nurse ... WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- A second health care worker who helped treat a patient who died ...


Talking with Your Health Care Professionals about Kidney Disease  


... Kidney Disease Additional Kidney Information Talking with Your Health Care Professionals The most important person on your health ... if you already have it. Tips for Your Health Care Visits Be prepared. The more you plan for ...


Health Education in Child Care: Opportunities and Challenges.  

ERIC Educational Resources Information Center

This article addresses the health and safety risks associated with child care facilities, including injuries and infectious diseases. Related health education needs for child care providers, parents, and children are examined, and recommendations for health educators are provided. (SM)

Nalle, Maureen A.



Health Care Costs Workshop Agenda

Skip to Main Content at the National Institutes of Health | Print Page E-mail Page Search: Please wait while this form is being loaded.... Home Browse by Resource Type Browse by Area of Research Research Networks Funding Information About


How to solve the cost crisis in health care.  


U.S. health care costs currently exceed 17% of GDP and continue to rise. One fundamental reason that providers are unable to reverse the trend is that they don't understand what it costs to deliver patient care or how those costs compare with outcomes. To put it bluntly, few health care providers measure the actual costs for treating a given patient with a given medical condition over a full cycle of care, or compare the costs they incur with the outcomes they achieve. What isn't measured cannot be managed or improved, and this is all too true in health care, where poor costing systems mean that effective and efficient providers go unrewarded, and inefficient ones have little incentive to improve. But all this can be remedied by exploring the concept of value in health care and carefully measuring costs. This article describes a new way to analyze costs that uses patients and their conditions--not organizational units or narrow diagnostic treatment groups--as the fundamental unit of analysis for measuring costs and outcomes. The new approach, called time-driven activity-cased costing, is currently being implemented in pilots at the Head and Neck Center at MD Anderson, the Cleft Lip and Palate Program at Children's Hospital in Boston, and units performing knee replacements at Schön Klinik in Germany and Brigham & Women's Hospital in Boston. As providers and payors better understand costs, they will be positioned to achieve a true "bending of the cost curve" from within the system, not in response to top-down mandates. Accurate costing also unlocks a whole cascade of opportunities, such as process improvement, better organization of care, and new reimbursement approaches that will accelerate the pace of innovation and value creation. PMID:21939127

Kaplan, Robert S; Porter, Michael E



Mapping the literature of health care chaplaincy  

PubMed Central

Objective: This study examined citation patterns and indexing coverage from 2008 to 2010 to determine (1) the core literature of health care chaplaincy and (2) the resources providing optimum coverage for the literature. Methods: Citations from three source journals (2008–2010 inclusive) were collected and analyzed according to the protocol created for the Mapping the Literature of Allied Health Professions Project. An analysis of indexing coverage by five databases was conducted. A secondary analysis of self-citations by source journals was also conducted. Results: The 3 source journals—Chaplaincy Today, the Journal of Health Care Chaplaincy, and the Journal of Pastoral Care and Counseling—ranked as the top 3 journals in Zone 1 and provided the highest number of most frequently cited articles for health care chaplaincy. Additional journals that appeared in this highly productive zone covered the disciplines of medicine, psychology, nursing, and religion, which were also represented in the Zones 2 and 3 journals. None of the databases provided complete coverage for the core journals; however, MEDLINE provided the most comprehensive coverage for journals in Zones 1 and 2, followed by Academic Search Complete, CINAHL, PsycINFO, and ATLA. Self-citations for the source journals ranged from 9% to 16%. Conclusions: Health care chaplaincy draws from a diverse body of inter-professional literature. Libraries wishing to provide access to journal literature to support health care chaplaincy at their institutions will be best able to do this by subscribing to databases and journals that cover medical, psychological, nursing, and religion- or spirituality-focused disciplines. PMID:23930090

Johnson, Emily; Dodd-McCue, Diane; Tartaglia, Alexander; McDaniel, Jennifer



Health care policy and cancer survivorship.  


The United States and the European Union (EU) vary widely in approaches to ensuring affordable health care coverage for our respective populations. Such variations stem from differences in the political systems and beliefs regarding social welfare. These variations are also reflected in past and future initiatives to provide high quality cancer survivorship care. The United States spends considerably more on health care compared to most European countries, often with no proven benefit. In the United States, individuals with chronic illnesses, such as cancer survivors, often experience difficulties affording insurance and maintaining coverage, a problem unknown to EU countries with national health insurance. This article reviews health policy development over time for the United States and EU and the impact for cancer survivors. For the United States, the impact of the Affordable Care Act on improving access to affordable care for cancer survivors is highlighted. For the EU, the importance of multiple-morbidity disease management, cancer plan development, and pan-European data collection for monitoring cancer outcomes is addressed. Given predicted workforce shortages and ever-increasing numbers of aging cancer survivors on both sides of the Atlantic, sharing lessons learned will be critical. PMID:23695931

Virgo, Katherine S; Bromberek, Julia L; Glaser, Adam; Horgan, Denis; Maher, Jane; Brawley, Otis W



Thinking about equity in health care.  


Public health care systems such as the British National Health Service typically profess two principal objectives: to improve the health of the whole population; and to reduce inequalities in health within it. Given scarce resources, these objectives are often in conflict. Much attention has justifiably been paid, by health economists, to addressing the former objective with methods of economic appraisal. My intention is to focus on the more difficult issue of the pursuit of 'equity' in health care, specifically the desire to reduce inequalities in health. This raises philosophical and policy questions about what makes some people more deserving of care than others, and whether or not society should adopt a forgiving stance towards those who have compromised their health status in some way, and offer access to treatment. Also, decision-makers may need to distinguish between the goal of raising the level of those worse-off and reducing inequality across society as a whole. Moreover, it is important to clarify what we wish to be made less unequal within the realm of health care provision. Tough decisions like these are based on value judgements and trading off one priority against another. In the interests of equity, such decisions need to be transparent and based on the preferences of society as a whole rather than covert and capricious. No manager needs reminding that resources are limited or that if more favourable treatment is accorded to some, inevitably less favourable treatment is accorded to others. Policy-making for a whole unit requires a nurse manager to offer a perspective on multidisciplinary matters and engage in wider public policy issues facing the team. As circumstances change, existing practice may be challenged as unfair, inefficient, or failing to account for important patient characteristics which make them different. Here, thinking clearly about equity is very important, and nurse managers are important as clarifiers of the thinking about what should be considered when making these difficult decisions. PMID:16108777

Williams, Alan



Orphan care in Malawi: current practices.  


HIV and AIDS has moved rapidly throughout sub-Saharan Africa, dramatically adding to the crisis of orphaned children on the continent. Knowledge of African responses to their problem is needed so that interventions from the global community are culturally appropriate. An assessment of 73 programs caring for over 100,000 vulnerable and orphaned children in Malawi was conducted. A cross section of programs throughout the country was visited. Three primary care strategies were found: community-based orphan care, institutional and residential care, and self-care. The model of care preferred by Africans is community based because this keeps a child in a family environment in their own village and tribe. By listening to the people of Africa, the worldwide community can learn how to work with them as they care for millions of orphaned children. PMID:15877539

Beard, Betty J



The Ethical Self-Fashioning of Physicians and Health Care Systems in Culturally Appropriate Health Care  

Microsoft Academic Search

Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities\\u000a in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims\\u000a on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office

Susan J. Shaw; Julie Armin



Arab culture and mental health care.  


This selective review describes recent literature and the author's experience with mental illness and mental health care, and the impact of cultural transformation on mental health in some Arab Islamic cultures, particularly in Egypt, Qatar and Kuwait. Traditional extended Arab families provide a structure for their members that may sometimes prevent and or compensate for the effects of parental loss and mental disability. The role of traditional families in the care of members and in medical decision-making is discussed. The impact of cultural change on Arab culture is also examined, as is the effect of intergenerational conflict in traditional families. PMID:19091731

Fakhr El-Islam, M



Improving Health Care Quality Reporting: Lessons from the California HealthCare Foundation. Oakland, CA: California HealthCare Foundation  

Microsoft Academic Search

The California HealthCare Foundation has devoted substantial resources to promoting public reporting on the quality of California hospitals, physician groups, and nursing homes. Mathematica conducted an evaluation of the foundation's work from 1998 through 2005, identifying lessons from its experience in fostering quality information and exploring avenues for future foundation involvement in the field. This brief looks at the measurement

Beth Stevens; Tim Lake; Erin Fries Taylor



Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis  

NASA Astrophysics Data System (ADS)

This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to develop a socio-physical model of systemic seismic vulnerability that enhances the further understanding of societal seismic risk by taking into account social vulnerability impacts for health and health-care system, shelter, and transportation.

Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.



Health care of homeless veterans  

Microsoft Academic Search

It is important to understand the needs of those veterans who are homeless. We describe characteristics of homeless male veterans\\u000a and factors associated with needing VA benefits from a two-city, community survey of 531 homeless adults. Overall, 425 were\\u000a male, of whom 127 were veterans (29.9%). Significantly more veterans had a chronic medical condition and two or more mental\\u000a health

Thomas P. O’Toole; Alicia Conde-Martel; Jeanette L. Gibbon; Barbara H. Hanusa; Michael J. Fine



Poverty Status, Health Behaviours, and Health: Implications for Social Assistance and Health Care Policy  

Microsoft Academic Search

This study investigated the relationships among poverty status, health behaviours, and the health of 130 Albertans living in poor families. For the purposes of this study, poverty status indicated whether poor families were receiving social assistance along with comprehensive health care benefits or whether they were working poor without comprehensive health care benefits. Findings from seven separate path analyses indicate

Deanna L. Williamson; Janet E. Fast



Leaders: are you ready for change? The clinical nurse as care coordinator in the new health care system.  


Care coordination is an integral piece for the success of health care reform. Nurses are positioned to be able to bring a strong perspective for assisting individual's health needs across the continuum from illness to wellness. Currently, nurses are not consistently being fully prepared to provide care coordination. In order for clinical nurses in acute care, clinics, and across the care continuum to be able to perform this integral and emerging role, nurse leaders will need to restructure, engage with these nursing roles, and plan to provide resources for a new educational curriculum for their continuing professional development. PMID:24317034

George, Victoria M; Shocksnider, Julie



Organizational economics and health care markets.  

PubMed Central

As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership. PMID:11327173

Robinson, J C



Successful Reentry: The Perspective of Private Correctional Health Care Providers  

PubMed Central

Due to public health and safety concerns, discharge planning is increasingly prioritized by correctional systems when preparing prisoners for their reintegration into the community. Annually, private correctional health care vendors provide $3 billion of health care services to inmates in correctional facilities throughout the U.S., but rarely are contracted to provide transitional health care. A discussion with 12 people representing five private nationwide correctional health care providers highlighted the barriers they face when implementing transitional health care and what templates of services health care companies could provide to state and counties to enhance the reentry process. PMID:17131191

Greifinger, Robert B.



The Contribution of Health Services Research to Improved Dermatologic Care  

PubMed Central

To translate scientific discovery into improved health, we must study health care itself: ie, how people access health care, costs or other barriers to the provision of good care, and what happens to patients as a result of this care. Health services research (HSR) is the interdisciplinary field that studies health care and its effects. This paper reviews different types of HSR and highlights some dermatologic examples that have resulted in improved health care systems or have helped us understand access to existing systems. The paper also addresses some of the political and systematic challenges for health services research overall, and for individual investigators and program leaders. PMID:22071474

Chren, Mary-Margaret



Social Learning Theory and Behavioral Health Care  

Microsoft Academic Search

Health costs in the US have risen at astronomic rates, rising from 4.6% of the GNP in 1950 to 8.3% in 1975. Yet, despite the compounding costs of medical care, the health of the population has not improved significantly since 1950, when viewed from the standpoint of increased longevity or decrease in the incidence of the major causes of death

Kenton L. Burns



Health insurance in India: need for managed care expertise.  


Health insurers in India currently face many challenges, including poor consumer awareness, strict regulations, and inefficient business practices. They operate under a combination of stifling administrative costs and high medical expense ratios which have ensured that insurers operate under steep losses. External factors (eg, onerous regulations, lack of standards, high claims payouts) and internal factors (eg, high administrative costs, dependence on indemnity models that cover inpatient treatment costs only) have forced the health insurance industry into a regressive spiral. To overcome these challenges, health insurers need to innovate in their product offerings and tighten their existing processes and cost structures. But as a long-term strategy, it is imperative that health insurers deploy managed care concepts, which will go a long way toward addressing the systemic issues in the current operational models of health plans. PMID:21473657

Thomas, Thomas K



Distraction: an assessment of smartphone usage in health care work settings  

PubMed Central

Smartphone use in health care work settings presents both opportunities and challenges. The benefits could be severely undermined if abuse and overuse are not kept in check. This practice-focused research paper examines the current panorama of health software applications. Findings from existing research are consolidated to elucidate the level and effects of distraction in health care work settings due to smartphone use. A conceptual framework for crafting guidelines to regulate the use of smartphones in health care work settings is then presented. Finally, specific guidelines are delineated to assist in creating policies for the use of smartphones in a health care workplace. PMID:22969308

Gill, Preetinder S; Kamath, Ashwini; Gill, Tejkaran S



Health Care Reform: How Will It Impact You?  

ERIC Educational Resources Information Center

Discusses the impact of health care reform on child-care centers and child-care employees. Topics covered include requirements to provide health insurance for all employees; subsidies for businesses with fewer than 50 employees; subsidies for low income employees; family coverage; health are costs for 2 working parents; and costs to day-care

Lukaszewski, Thomas



Cancer care--A stress for health professionals  

Microsoft Academic Search

Literature related to health care professionals dealing with stress of cancer care is still in its infancy. The authors distinguish papers of general interest (the most frequent), papers identifying stressors, and papers about stress consequences. Most of them recognize death of the patients as a major stressor for health care professionals. There are also additional stressors specific to health care

Nicole Delvaux; Darius Razavi; Christine Farvacques



Reason for Visit: Is Migrant Health Care that Different?  

ERIC Educational Resources Information Center

Purpose: The purpose of this pilot study was to determine the reasons for which migrant agricultural workers in Pennsylvania seek health care. Methods: Participants were individuals 14 years of age and over, actively involved in agricultural labor and presenting for medical care at 6 migrant health care centers. Bilingual health care providers…

Henning, George F.; Graybill, Marie; George, John



The Role of Informatics in Health Care Reform  

E-print Network

reducing cost has become a high priority. There has been a push for Accountable Care Organizations, whichThe Role of Informatics in Health Care Reform Yueyi I. Liu, MD, PhD, Daniel L. Rubin, MD, MS Improving health care quality while simultaneously reducing cost has become a high priority of health care

Rubin, Daniel L.


[Continuous nursing education to improve the quality of health care].  


Health care and today's medical and technical achievements and approved standards of treatment provide comprehensive quality, safety and traceability of medical procedures respecting the principles of health protection. Continuous education improves the quality of nursing health care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety. Patient health problems impose the need of appropriate, planned and timely nursing care and treatment. In providing quality nursing care, attention is focused on the patient and his/her needs in order to maintain and increase their safety, satisfaction, independence and recovery or peaceful death, so the health and nursing practices must be systematized, planned and based on knowledge and experience. Health and nursing care of patients at risk of developing acute and chronic wounds or already suffering from some form of this imply preventive measures that are provided through patient education, motivation, monitoring, early recognition of risk factors and causes, and reducing or removing them through the prescribed necessary medical treatment which is safe depending on the patient health status. Except for preventive measures, nursing care of patients who already suffer from some form of acute or chronic wounds is focused on the care and treatment of damaged tissue by providing appropriate and timely diagnosis, timely and proper evaluation of the wound and patient general status, knowledge and understanding of the wide range of local, oral and parenteral therapy and treatment, aiming to increase patient safety by preventing progression of the patient general condition and local wound status and reducing the possibility of developing infection or other complications of the underlying disease. In the overall patient management, through nursing process, medical interventions are implemented and aimed to maintain and optimize health status, prevent complications of existing diseases and conditions, provide appropriate wound treatment, increase satisfaction, reduce pain, increase mobility, reduce and eliminate aggravating factors, and achieve a satisfactory functional and aesthetic outcome. Many scientific researches and knowledge about the pathophysiological processes of wound formation and healing are currently available. Modern achievements can accelerate independence, reduce pain and encourage faster wound healing, thus it is important to continuously develop awareness, knowledge and experience, along with the treatment to achieve, maintain and enhance the quality of health care and patient safety. PMID:25326985

Fumi?, Nera; Marinovi?, Marin; Brajan, Dolores



""The current U.S. healthcare system is ailing. To treat its significant problems, we need a fundamental shift in how health care is paid for and delivered.  

E-print Network

as a thought leader in healthcare innovation · Gain recognition through all print and social media""The current U.S. healthcare system is ailing. To treat its significant problems, we need in Healthcare Innovation, Stanford GSB I nformation technology has the potential to be a lightning rod

Li, Fei-Fei


Exposure of health workers in primary health care to glutaraldehyde  

PubMed Central

Background In order to avoid proliferation of microorganisms, cleaning, disinfection and sterilisation in health centres is of utmost importance hence reducing exposure of workers to biological agents and of clients that attend these health centres to potential infections. One of the most commonly-used chemical is glutaraldehyde. The effects of its exposure are well known in the hospital setting; however there is very little information available with regards to the primary health care domain. Objective To determine and measure the exposure of health workers in Primary Health Care Centres. Environmental to glutaraldehyde and staff concentration will be measured and compared with regulated Occupational Exposure Limits. Methods/Design Observational, cross-sectional and multi-centre study. The study population will be composed of any health professionals in contact with the chemical substance that work in the Primary Health Care Centres in the areas of Barcelončs Nord, Maresme, and Barcelona city belonging to the Catalan Institute of Health. Data will be collected from 1) Glutaraldhyde consumption from the previous 4 years in the health centres under study. 2) Semi-structured interviews and key informants to gather information related to glutaraldehyde exposure. 3) Sampling of the substance in the processes considered to be high exposure. Discussion Although glutaraldehyde is extensively used in health centres, scientific literature only deals with certain occupational hazards in the hospital setting. This study attempts to take an in-depth look into the risk factors and environmental conditions that exist in the primary care workplace with exposure to glutaraldehyde. PMID:24180250



Associations Between Older Adults' Spoken Interactive Health Literacy and Selected Health Care and Health Communication Outcomes  

Microsoft Academic Search

Recent trends in the conceptualization of health literacy lead toward expansive notions of health literacy as social practice, rather than as a narrower cognitive capacity to understand health-related texts and materials. These expansive and complex constructions of health literacy demand tools for assessing individuals’ propensities to actively seek information in their interactions with health care professionals and other health information

Donald L. Rubin; John Parmer; Vicki Freimuth; Terry Kaley; Mumbi Okundaye



Value-based health care: a surgical oncologist's perspective.  


There is ongoing debate on how to reform the health care system. Value-based systems have been proposed to account for both quality and cost. The primary goal of value-based health care is to achieve good health outcomes for patients with consideration of dollars spent. To do so, it is imperative that health care providers define meaningful outcome metrics for specific medical conditions and consider the full cycle of care as well as multiple dimensions of care. PMID:22583997

Cormier, Janice N; Cromwell, Kate D; Pollock, Raphael E



Religion, aging, and health: exploring new frontiers in medical care.  


The purpose of this review article is to selectively examine research that was designed to evaluate the relation between religious involvement and health among older people. Four facets of religion are examined in detail: church-based social support, religious coping, forgiveness, and prayer. In addition, potential negative effects of religion on health are discussed. Negative interaction in the church as well as religious doubt are evaluated in this respect. Throughout, an effort is made to show how current research on religion and health may be used to provide more comprehensive care for our aging population. PMID:15646760

Krause, Neal



Online Simulation of Health Care Reform: Helping Health Educators Learn and Participate  

ERIC Educational Resources Information Center

Young and healthy undergraduates in health education were not predisposed to learn the complex sprawl of topics in a required course on U.S. Health Care. An online simulation of health care reform was used to encourage student learning about health care and participating in health care reform. Students applied their understanding of high costs,…

Jecklin, Robert



Health care's most wired. A wired exchange.  


There was a time when innovation in health care information technology meant being at the cutting edge of managerial systems. Hospitals made significant investments in financially oriented technology. In the past five years, the investment in clinical IT appears to have outstripped the investment in managerial systems, including enterprise resource planning aimed at improving the supply chain. PMID:15453607

Solovy, Alden



Unleashing the health care border guards.  


A fervent anti-immigrant sentiment is picking up momentum, and it is reflected in state and federal legislative proposals, including those addressing health reform. If these bills become law, including a California initiative, doctors and nurses could be turned into border patrol guards, and as many as one million legal immigrants could be denied non-emergency medical care. PMID:10142812

Reynoso, C



General practitioners' perceptions of effective health care  

Microsoft Academic Search

Objectives To explore general practitioners' perceptions of effective health care and its application in their own practice; to examine how these perceptions relate to assumptions about clinicians' values and behaviour implicit in the evidence based medicine approach. Design A qualitative study using semistructured interviews. Setting Eight general practices in North Thames region that were part of the Medical Research Council

Zelda Tomlin; Charlotte Humphrey; Stephen Rogers



How Stigma Interferes with Mental Health Care  

ERIC Educational Resources Information Center

Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care. Stigma yields 2 kinds of harm that may…

Corrigan, Patrick



German health care system in transition  

Microsoft Academic Search

As is the case with all other health care systems, the German one is in constant transition. The reasons—such as costly medical innovations, aging population, and lack of overall economic growth—are well known, widely discussed, and not unique to Germany. Although the problems are not unique to Germany, there are some trends in each country which may be of interest

J.-Matthias Graf von der Schulenburg



Primary health care in the Pacific  

Microsoft Academic Search

It is widely accepted that a Primary Health Care (PHC) response needs to be separately designed for each individual country, but less emphasis has been given to the need to consider different objectives under different circumtances. During the 1970s and 1980s the island States of the Pacific are facing their era of major movement towards political independence and self-sufficiency, which

Kenneth W. Newell



Erythema Migrans in Primary Health Care  

Microsoft Academic Search

Abstract Lyme borreliosis (LB) is the most ,common ,vector-borne disease in the ,northern hemisphere, and southern Sweden is a highly endemic area. In over 70% of the cases, LBis represented by the ,non-disseminated cutaneous ,form erythema ,migrans (EM). This thesis has its focus on EM from ,a primary ,health care perspective ,in southern

Louise Bennet


Online Collaborative Learning in Health Care Education  

ERIC Educational Resources Information Center

At our University, the Faculty of Health, Social Care and Education has delivered a variety of undergraduate and postgraduate courses via flexible distance learning for many years. Distance learning can be a lonely experience for students who may feel isolated and unsupported. However e-learning provides an opportunity to use technology to…

Westbrook, Catherine



Comparability of Health Care Responsiveness in Europe  

ERIC Educational Resources Information Center

The aim of this paper is to measure and to correct for the potential incomparability of responses to the SHARE survey on health care responsiveness. A parametric approach based on the use of anchoring vignettes is applied to cross-sectional data (2006-2007) in eleven European countries. More than 7,000 respondents aged 50 years old and over were…

Sirven, Nicolas; Santos-Eggimann, Brigitte; Spagnoli, Jacques



Health Care Assistant Core. Instructor Manual.  

ERIC Educational Resources Information Center

This document contains the core curriculum for a basic high school course for health care assistants. It is designed as a 1-semester course of study, after which students can take a course in an emphasis area, such as veterinary, nursing, pharmacology, or physical therapy, in which they learn skills for specific entry-level jobs. The curriculum…

Feilner, Veronica; Robling, Jeannine


HEALTH CARE CLAIM FORM Yale University (05102)  

E-print Network

drugs, remember to submit the receipt that the pharmacist has attached to the prescription, instead $ * Over-the-counter medicine requires a prescription from an authorized health care provider to be eli REQUESTED AMOUNT PATIENT NAME $ * Over-the-counter medicine requires a prescription from an authorized


Raich, Health Care, and the Commerce Clause  

Microsoft Academic Search

This article considers to what extent health care may be viewed as a traditional area of state concern in the context of the Supreme Court’s revival of federalism principles, in particular limits on Congress’ Commerce Clause power, and what effect Raich v. Ashcroft, heard by the Court in the fall 2004 term, might have on these issues. Addressing these questions

Alex Kreit; Aaron Marcus



Equine Health Care Equine Field Service  

E-print Network

;Equine Health Care What vaccines are available? · Tetanus toxoid · Eastern Equine Encephalitis · Western Equine Encephalitis · Influenza · Rhinopneumonitis · Rabies · West Nile · Tetanus antitoxin Core Vaccines · Eastern and Western Encephalitis · West Nile · Tetanus · Rabies http

Buehrer, R. Michael


Hospital mergers and reproductive health care.  


In the US, when one of the two hospitals involved in a merger is a Catholic hospital, comprehensive reproductive health care tends to suffer. The Catholic Church forbids its hospitals from providing and making direct referrals for many reproductive health services (i.e., reversible contraception, infertility treatments, male and female sterilization, abortion, condoms for HIV prevention, and emergency contraception). These mergers are especially severe in small towns and rural areas. Several groups have formed to address this hidden crisis. In Troy, New York, a settlement was reached about 12 months after a law suit was filed against the conditions of a merger between a Catholic hospital and a nonsectarian hospital. After a long fight, the settlement essentially guaranteed that patients who are dependent on religious institutions obtain the contraceptive and sterilization services they need and want, but abortion services and referrals continued to be denied. The state of Montana considered the impact of a merger of a Catholic institution and a nonsectarian institution, yet continued availability of all reproductive health services was not guaranteed. The American Civil Liberties Union asked the Federal Trade Commission (FTC) to investigate the merger's impact on reproductive health care, since the merger created a monopoly on acute care in Great Falls. FTC took no action. Key factors to provision of reproductive health services other than abortion in cases of mergers between a Catholic hospital and a nonsectarian hospital include the type of association the two hospitals enter into, the local bishop's willingness to accept a creative solution, and the willingness