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Sample records for health care current

  1. A blessing in disguise? Empowering Catholic health care institutions in the current health care environment.

    PubMed

    Zimbelman, J

    2000-01-01

    Health care institutions, including Roman Catholic institutions, are in a time of crisis. This crisis may provide an important opportunity to reinvigorate Roman Catholic health care. The current health care crisis offers Roman Catholic health care institutions a special opportunity to rethink their fundamental commitments and to plan for the future. The author argues that what Catholic health care institutions must first do is articulate the nature of their identity and their commitments. By a renewed commitment to the praxis of health care on their own distinctive terms, Roman Catholic health care institutions may reestablish a vision of human nature and human service in an increasingly secular society. Health care could then reclaim its place as a powerful setting for the expression of Roman Catholic faith, life and witness. PMID:17209253

  2. The US health care system: Part 1: Our current system.

    PubMed

    Nuwer, M R; Esper, G J; Donofrio, P D; Szaflarski, J P; Barkley, G L; Swift, T R

    2008-12-01

    The US health care crisis is of great concern to American neurologists. The United States has the world's most expensive health care system yet one-sixth of Americans are uninsured. The cost and volume of procedures is expanding, while reimbursement for office visits is declining. Pharmaceutical costs, durable goods, and home health care are growing disproportionately to other services. Carriers spend more for their own administration and profit than on payments to physicians. This first article on the US health care system identifies problems and proposes solutions, many of which are championed by the American Academy of Neurology through its legislative and regulatory committees. PMID:18971443

  3. The Current State of Health Care for People with Disabilities

    ERIC Educational Resources Information Center

    Breslin, Mary Lou; Yee, Silvia

    2009-01-01

    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…

  4. Infant oral health is the current standard of care.

    PubMed

    Sacheti, Anubha; Ng, Man Wai; Ramos-Gomez, Francisco

    2012-01-01

    Despite professional recommendations calling for earlier first dental visits, Massachusetts children, on average, have their first dental visit at 3 years of age. This article will discuss the age-one dental visit and early establishment of a dental home. The components of an infant oral health visit will be outlined, including how to efficiently and effectively perform a caries risk assessment and a successful knee-to-knee exam. All dentists are challenged to improve their collective standard of care by incorporating infant oral health into their practices. PMID:23311041

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

    PubMed

    Hanser, Suzanne B

    2014-01-01

    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

  6. Current Allergic Rhinitis Experiences Survey (CARES): Health-care practitioners' awareness, attitudes and practices.

    PubMed

    Blaiss, Michael S; Fromer, Leonard M; Jacob-Nara, Juby A; Long, Randall M; Mannion, Karen M; Lauersen, Lori A

    2014-01-01

    Allergic rhinitis (AR) is a common health problem in the United States, with significant comorbidities and impairment of quality of life despite the availability of many prescription (Rx) and over-the-counter (OTC) medications. The health-care practitioners (HCPs) arm of the Current Allergic Rhinitis Experiences Survey (CARES) assessed HCPs' perceptions about the current management of AR. This U.S.-based national survey included 375 primary care physicians and 375 nurse practitioners/physician assistants. Participants were screened to ensure that they treat ≥15 AR sufferers per month during allergy season. The majority of HCPs (86%) agreed that AR patients can easily recognize allergy symptoms after diagnosis and that 57% of their patients come to them self-recognizing their symptoms. A total of 82% strongly agreed that AR sufferers are primarily diagnosed via history and physical and do not typically undergo diagnostic testing until after pharmacologic intervention. HCPs reported that 63-77% of AR sufferers can easily manage AR once treatment is established. According to surveyed HCPs, OTC medication should precede an Rx medication for AR management. A total of 82% HCPs considered intranasal steroids (INSs) to be the gold standard AR treatment and have minimal safety concerns about INS use. HCPs perceive that patients can easily recognize and self-manage their AR symptoms. Patient history/symptoms and physical examination are the primary methods of AR diagnosis. INSs are considered the gold standard for treatment of AR. However, most HCPs feel OTC medication should be tried before Rx medication for AR management. PMID:24992551

  7. [The academization of health care. An interim report in the context of current developments and challenges].

    PubMed

    Kälble, K

    2013-08-01

    In the last two decades, the educational landscape for health-care training has been seen in a new light as a result of complex social changes. Against this background, the present report offers an interim appraisal and assessment of the process of making health care more academic in view of current developments and challenges. The report begins with a short description and examination of the present training situation at a pre-academic level; several reform ideas are also presented. Following this, the report reconstructs the first phase of the academization of health care in the 1990s before the advent of the Bachelor's and Master's university degrees, which were created in the framework of the Bologna Reforms, and in which it first became possible to academicize to a limited extent certain areas of the large spectrum of health-care practices. The central part of the report is a discussion of the present situation and the newest developments in the field of academic health care within the context of the Bologna process and further changing conditions. In the conclusion, the report discusses the future prerequisites that could promote a sustainable and qualitative development of the academization of health care. PMID:23884529

  8. The current state of health care in the former Soviet Union: implications for health care policy and reform.

    PubMed Central

    Barr, D A; Field, M G

    1996-01-01

    OBJECTIVES. Given the many profound health care problems facing Russia and the other former Soviet republics, there are a number of fundamental policy questions that deserve close attention as part of the reform process. METHODS. Summary data regarding Soviet health care issues were drawn from government agency reports, scholarly books and journals, recent press reports, and the authors' personal research. RESULTS. Smoking, alcohol, accidents, poor sanitation, inadequate nutrition, and extensive environmental pollution contribute to illness and premature mortality in Russia and the other newly independent states. Hospitals and clinics are poorly maintained and equipped; most physicians are poorly trained and inadequately paid; and there is essentially no system of quality management. While efforts at reform, which emphasize shifting to a system of "insurance medicine," have been largely unsuccessful, they have raised several important policy issues that warrant extensive research and discussion. CONCLUSIONS. Without considering the implications and consequences of alternative policy directions, Russia and the other states face the very real possibility of developing health care systems that improve the overall level of care but also incorporate limited access and escalating costs. Russian health care reform leaders can learn from the health care successes in the West and avoid repeating our mistakes. PMID:8604753

  9. Health care agents

    MedlinePlus

    Durable power of attorney for health care; Health care proxy; End-of-life - health care agent; Life support treatment - ... Respirator - health care agent; Ventilator - health care agent; Power of attorney - health care agent; POA - health care ...

  10. Continuing Trends in Health and Health Care

    ERIC Educational Resources Information Center

    Wilson, Ronald W.; And Others

    1978-01-01

    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)

  11. Video-based telehealth in Australian primary health care: current use and future potential.

    PubMed

    Raven, Melissa; Butler, Caryn; Bywood, Petra

    2013-01-01

    Many Australians have limited access to health-care services due to a range of barriers, including geographic distance and restricted mobility, which telehealth can potentially address. This paper reviews the current and potential use of video consultation in primary health care in Australia, drawing on international literature. There is substantial evidence of high patient satisfaction, but many studies have methodological limitations. Overall, evidence of effectiveness and cost-effectiveness is weak. There is reasonable evidence for diagnosis, home care and specialist consultations by GPs with patients present. Two telehealth initiatives using video consultation are briefly presented. Both provide evidence that video consultation has a valuable role to play, but does not obviate the need for face-to-face consultations. Video consultation challenges traditional professional roles, particularly those of nurses, and can improve health workers' skills and job satisfaction. More fundamentally, telehealth challenges the traditional distinction between primary and secondary care. This can be a source of resistance but may ultimately be one of its strengths. Appropriately targeted video consultation has much potential to improve the delivery of primary health care in Australia, particularly in rural and remote regions. PMID:24134865

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

    PubMed Central

    Linder, Regina

    2012-01-01

    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

  13. Patient and citizen participation in German health care--current state and future perspectives.

    PubMed

    Loh, Andreas; Simon, Daniela; Bieber, Christiane; Eich, Wolfgang; Härter, Martin

    2007-01-01

    Patient participation within the German healthcare system is described at three different levels: the macro level as active patient influence on the regulation of medical care, the meso level in terms of institutions enhancing patient information and counselling, and the micro level focusing on the actual treatment decision-making process in the medical encounter. The main focus of the present publication is on the health care system-specific influences on patient participation in medical decision-making and on the current state of research and implementation of shared decision-making in Germany. We describe institutions promoting patient involvement, their aims and initiatives as well as recent changes in German legislation. Against the background of German health politics' endorsement of patient participation the German Ministry of Health funded a research consortium with shared decision-making intervention projects in various disease areas. The present state of the intervention projects' results is outlined as well as subsequently funded transfer projects and future perspectives of research grants. Supported by health politics and the utilisation of scientific evidence shared decision-making's transfer into practice is considered to be relevant to the German health care system. PMID:17601177

  14. Health care informatics.

    PubMed

    Siau, Keng

    2003-03-01

    The health care industry is currently experiencing a fundamental change. Health care organizations are reorganizing their processes to reduce costs, be more competitive, and provide better and more personalized customer care. This new business strategy requires health care organizations to implement new technologies, such as Internet applications, enterprise systems, and mobile technologies in order to achieve their desired business changes. This article offers a conceptual model for implementing new information systems, integrating internal data, and linking suppliers and patients. PMID:12670013

  15. Mental health services for children placed in foster care: an overview of current challenges.

    PubMed

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

    2009-01-01

    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

  16. A current look at the key performance measures considered critical by health care leaders.

    PubMed

    Love, Dianne; Revere, Lee; Black, Ken

    2008-01-01

    The increased focus on health care quality is changing the face of performance measures. Traditional measures of financial performance are being complemented by indicators of satisfaction, medical error rates, infection control ,and more. This study surveyed health care executives to determine the performance indicators considered critical for organizational assessment and improvement. The findings suggest financial measures such as operating profit margin, days cash on hand, charity care, net profit margin, bad dept expense, and days in accounts receivable A/R continue to be critical for health care decision makers. These measures are complemented by non-financial indicators such as physician and employee satisfaction, hospital-acquired infection rates, surgical site infection rates, inpatient mortality, infection control outcomes, and medication error rates. The results of this study underscore the notion that health care administrators are concerned about delivering high-quality effective health care in which both customers and providers are satisfied and which is done in a strong financial environment. PMID:18468376

  17. [The role of caregivers in health care. Historical backgrounds and current conflict situations].

    PubMed

    Hofmann, I

    2012-09-01

    As a result of recent demographic developments, there has been an increased demand for high-quality health care. Among the various health professions, caregiving represents the largest professional group, numbering approximately 820,000 caregivers. Despite its size, this group is failing to meet basic conditions in line with international standards that secure adequate care. This failing is primarily due to the special path that Germany took regarding healthcare at the end of the nineteenth century and on which it continues to this day. It manifests itself in a heteronomy to which the professional group is permanently subjected by lobbies and policies that view health care from a perspective whose primary aim is to reduce unemployment. The present lack of organization of caregivers has frustrated their political assertiveness; and not least because of this, many caregivers leave the profession early. The profession itself is grappling with its professional identity. The development of expert standards, research into care, ethical reflections, as well as the struggle for common professional training are positive signs in this ongoing debate and are reflected in the positive feedback received from patients. The interdisciplinary dialogue between caregivers and physicians is in need of improvement. The first signs of progress are evident within the framework of health care ethics committees. This dialogue would certainly benefit both the professional group as well as the patients. PMID:22936484

  18. Defining quality in health care.

    PubMed

    Buck, A S

    1992-05-01

    The difficulty and importance of developing and implementing a definition of quality in health care is discussed. Some current definitions are considered, and a recommended definition of quality health care is presented. PMID:1630660

  19. Focus group reflections on the current and future state of cognitive assessment tools in geriatric health care

    PubMed Central

    Whitehead, Jocelyne C; Gambino, Sara A; Richter, Jeffrey D; Ryan, Jennifer D

    2015-01-01

    Objective This study provides insight into the thoughts and opinions of geriatric health-care professionals toward cognitive assessments and the use of emerging technologies, such as eye-tracking, to supplement current tools. Methods Two focus group sessions were conducted with nurses and physicians who routinely administer neurocognitive assessments to geriatric populations. Video recordings of the focus group sessions were transcribed and a thematic analysis was performed. Results Participants reported the need for assessment and diagnostic tools that are accessible and efficient, and that are capable of accommodating the rapid growth in the aging population. The prevalence of more complex ailments experienced by older adults has had repercussions in the quality of care that the clients receive, and has contributed to lengthy wait times and resource shortages. Health-care professionals stated that they are hampered by the disjointed structure of the health-care system and that they would benefit from a more efficient allocation of responsibilities made possible through tools that did not require extensive training or certification. Eyetracking-based cognitive assessments were thought to strongly complement this system, yet it was thought that difficulty would be faced in gaining the support and increased uptake by health-care professionals due to the nonintuitive relationship between eyetracking and cognition. Conclusion The findings suggest that health-care professionals are receptive to the use of eyetracking technology to assess for cognitive health as it would conserve resources by allowing frontline staff to administer assessments with minimal training. PMID:26109860

  20. Home Health Care

    MedlinePlus

    ... Page Resize Text Printer Friendly Online Chat Home Health Care Home health care helps older adults live independently for as long ... need for long-term nursing home care. Home health care may include occupational and physical therapy, speech therapy, ...

  1. Child Care Health Connections, 2002.

    ERIC Educational Resources Information Center

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

    2002-01-01

    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…

  2. [Quality of health care].

    PubMed

    Medina, J L; De Melo, P C

    2000-01-01

    Quality assurance is a relatively recent concern but already plays a major role in health care management and provision. Quality involves the definition of a comprehensive programme tailored by realistic and effective objectives and norms that include the structured review of procedures (namely clinical audits) and the use of up-to-date protocols. The involvement and motivation of health professionals, together with an adequate internal and external communication strategy, play a key role in the planning and application of these programmes. The use of programmed assessment, based on a solid knowledge of current practice, should have practical implications, optimising procedures in order to improve the quality of care. This commitment towards quality in health care should go far beyond governmental policy and should have clear support from health professionals. PMID:11234496

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

    NASA Technical Reports Server (NTRS)

    Jemison, Mae C.; Thomas, J. Segun

    1992-01-01

    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, enhance optimized resource distribution and build a framework for telecommunications for the entire country.

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

    NASA Technical Reports Server (NTRS)

    Jemison, Mae C.; Thomas, J. S.

    1992-01-01

    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 provides timely epidemiologic information, sharing of medical expertise through telemedical consultations, enhances optimized resource distribution and builds a framework for telecommunications for the entire country.

  5. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

    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.

  6. Home health care

    MedlinePlus

    ... 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. ... ...

  7. Respiratory Home Health Care

    MedlinePlus

    ... Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources Immunizations Pollution Nutrition ... Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at home can contribute to improved ...

  8. Current situation of health care in India and corporation in emerging economies--what is the way forward?

    PubMed

    Surendra, Kumar; Amit, Sengupta; Kumar, Agarwal Vishnu

    2012-01-01

    In this study, we examine the management and operational problems faced by different categories of health care delivery platforms such as corporate hospitals, medium level private hospitals and public hospitals in Mumbai. Some suggestions are made and we believe many of the short falls or limitations that exist in the current set up can be removed and a way forward can be made in alleviating the suffering of vast majority of humankind living in our mega cities. Three major issues emerged as far as a public health system is concerned--that is shifting of trained health manpower from the public system to private or corporate hospitals, severe strain on the public health system's infrastructure and support services compounded by lack of accountability as far as management and governance are concerned. PMID:23342758

  9. Primary Health Care.

    ERIC Educational Resources Information Center

    Lauffer, Sandra, Ed.

    1979-01-01

    This report contains 13 articles and book/film reviews on various topics related to the diffusion of health care information in developing countries; beginning with two articles which define primary health care, and suggest principles related to the community, communication, and the health practitioner upon which primary health care should be…

  10. [Scarcity in health care, age as selection criterion and the value of old age. Current discussion].

    PubMed

    Naafs, J

    1993-06-01

    There is a growing attention for setting limits in health care. Contemporary medical scarcity makes choices necessary, but what are the arguments? Only medical criteria for selection are accepted in the Netherlands, but that does not mean at all that age is an unimportant criterion. In this article the discussion on age as criterion for selection is reviewed. It seems that arguments are based on different basic (moral) assumptions and that age and aging can be appreciated from different points of view. There is among other things the principle of justice and the idea of a natural life-span (Daniels), the norm of a worthwhile life-time (the fair-innings argument of Harris) and the idea of old age as a period of its own (Callahan). The different starting points can lead to the same way of thinking about age as a criterion for selection. Daniels, Harris, and Callahan justify this kind of selection. The Dunning-committee however does not accept it, from the point of a fundamental equality of people, the protection of life and the principle of solidarity in our society. It seems that not only the different arguments lead towards different conclusions but also the different views on the value of old age by different groups or by society as a whole. PMID:8328008

  11. The changing health care marketplace: current industry trends, new provider organizational structures, and effects on plastic surgeons.

    PubMed

    Krieger, L M

    1998-09-01

    Current market forces are driving the health care industry in new directions. The managed care industry is currently undergoing a market shakeout, as manifested by consolidation, increased competition, and lower profits. Medicare is fighting to remain solvent by lowering fees paid to providers, driving patients into managed care plans, and cracking down on billing irregularities. For providers, the combined effect of these trends is lower fees, increased risk-sharing, and increased overhead. Plastic surgeons face new demands in this environment. They must increase their efficiency and form new alliances with other providers. These alliances allow plastic surgeons to maintain a steady stream of patients, to manage risk, to negotiate more lucrative contracts with managed care organizations, and to increase efficiency. To achieve these alliances, plastic surgeons must alter the organizational structure of their practices. Several corporate practice models are becoming more prevalent; these include large group practices, physician practice management companies, and integrated delivery systems. Each structure has advantages for plastic surgeons, but each also requires plastic surgeons to trade varying degrees of financial and professional autonomy for market strength. PMID:9727464

  12. Migrant health care: creativity in primary care.

    PubMed

    Artemis, L

    1996-01-01

    Historically, migrant health care services have always been in a precarious position for funding. The government currently proposes major cuts in federally and state-funded programs for indigent and underserved populations, making this state of precariousness the rule, rather than the exception. The primary care practitioner, therefore, must provide quality, cost-effective care with minimal resources. Case studies illustrate how services can be provided using creativity and community resources. PMID:9447073

  13. Vacation health care

    MedlinePlus

    ... 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 ...

  14. Vacation health care

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001937.htm Vacation health care To use the sharing features on this page, ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 to ...

  15. American Health Care Association

    MedlinePlus

    ... Resources Affordable Care Act Clinical Practice Emergency Preparedness Finance Health Information Technology ICD-10 Integrity Medicaid Medicare ... Facility Operations Affordable Care Act Clinical Emergency Preparedness Finance Health Information Technology Integrity Medicaid Medicare Patient Privacy ...

  16. National Health Care Survey

    Cancer.gov

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  17. Improving Educational Preparation for Transcultural Health Care.

    ERIC Educational Resources Information Center

    Le Var, Rita M. H.

    1998-01-01

    Nurses and health care professionals must be prepared for transcultural health care because society is becoming increasingly multicultural and current health services are not meeting the needs of minority ethnic groups in Britain. (SK)

  18. Herbal extracts in oral health care - A review of the current scenario and its future needs

    PubMed Central

    Chandra Shekar, Byalakere Rudraiah; Nagarajappa, Ramesh; Suma, Shankarappa; Thakur, Rupesh

    2015-01-01

    Background: Oral diseases are among the major public health problems and the commonest of chronic diseases that affect mankind. The application of natural products for the control of oral diseases is considered as an interesting alternative to synthetic antimicrobials due to their lower negative impact, and for the effort to overcome primary or secondary resistance to the drug during therapy. Objective: To review the current evidence on the antimicrobial efficacy of 10 plant extracts on dental caries and plaque microorganisms. Materials and Methods: A comprehensive literature search was made by one of the authors for 2 months in PubMed, PubMed Central, MEDLINE, LILACS/BBO, Cochrane database of systematic reviews, SCIENCE DIRECT, and Google scholar databases. The results from the relevant published literatures are discussed. Summary and Conclusion: The extracts of Azadirachta Indica, Ocimum sanctum, Murraya koenigii L., Acacia nilotica, Eucalyptus camaldulensis, Hibiscus sabdariffa, Mangifera indica, Psidium guajava, Rosa indica, and Aloe barbadensis Miller have all been found to inhibit certain dental caries and periodontal pathogens. The current evidence is on individual plant extracts against bacteria involved in either caries or periodontitis. “Herbal shotgun” or “synergistic multitarget effects” are the terms used for the strategy of combining different extracts. The research assessing the antimicrobial efficacy of a combination of these plant extracts against dental caries and periodontal pathogens is the need of the hour, and such research will aid in the development of a novel, innovative method that can simultaneously inhibit two of the most common dental diseases of mankind, besides slowing the development of drug resistance. PMID:26392704

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

    ERIC Educational Resources Information Center

    Halfon, Neal; And Others

    1994-01-01

    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.…

  20. Physician payment 2008 for interventionalists: current state of health care policy.

    PubMed

    Manchikanti, Laxmaiah; Giordano, James

    2007-09-01

    Physicians in the United States have been affected by significant changes in the pattern(s) of medical practice evolving over the last several decades. These changes include new measures to 1) curb increasing costs, 2) increase access to patient care, 3) improve quality of healthcare, and 4) pay for prescription drugs. Escalating healthcare costs have focused concerns about the financial solvency of Medicare and this in turn has fostered a renewed interest in the economic basis of interventional pain management practices. The provision and systemization of healthcare in North America and several European countries are difficult enterprises to manage irrespective of whether these provisions and systems are privatized (as in the United States) or nationalized or seminationalized (as in Great Britain, Canada, Australia and France). Consequently, while many management options have been put forth, none seem to be optimally geared toward affording healthcare as a maximized individual and social good, and none have been completely enacted. The current physician fee schedule (released on July 12, 2007) includes a 9.9% cut in payment rate. Since the Medicare program was created in 1965, several methods have been used to determine physicians' rate(s) for each covered service. The sustained growth rate (SGR) system, established in 1998, has evoked negative consequences on physician payment(s). Based on the current Medicare expenditure index, practice expenses are projected to increase by 34.5% from 2002 to 2016, whereas, if actual practice inflation is considered, this increase will be 90%. This is in contrast to projected physician payment cuts that are depicted to be 51%. No doubt, this scenario will be devastating to many practices and the US medical community at large. Resolutions to this problem have been offered by MedPAC, the Government Accountability Office, physician organizations, economists, and various other interested groups. In the past, temporary measures have

  1. The strategic genius of Jonathan Letterman: the relevancy of the American Civil War to current health care policy makers.

    PubMed

    Place, Ronald J

    2015-03-01

    With expanding health insurance coverage, innovative technologies, improved diagnostic acumen, and pharmaceutical additions combining to increase life expectancy, quality of life, and concomitant costs, the American health care system is under significant stress. However, it pales in comparison to the challenges faced by health care leaders during the American Civil War. As we approach the 150th anniversary of the conclusion of that war, it is appropriate to review key strategic health care decisions faced by military leaders during the Civil War and how their resultant outcomes may provide an appropriate perspective for today's leaders. PMID:25735014

  2. Smokers' rights to health care.

    PubMed Central

    Persaud, R

    1995-01-01

    The question whether rights to health care should be altered by smoking behaviour involves wideranging implications for all who indulge in hazardous behaviours, and involves complex economic utilitarian arguments. This paper examines current debate in the UK and suggest the major significance of the controversy has been ignored. That this discussion exists at all implies increasing division over the scope and purpose of a nationalised health service, bestowing health rights on all. When individuals bear the cost of their own health care, they appear to take responsibility for health implications of personal behaviour, but when the state bears the cost, moral obligations of the community and its doctors to care for those who do not value health are called into question. The debate has far-reaching implications as ethical problems of smokers' rights to health care are common to situations where health as a value comes into conflict with other values, such as pleasure or wealth. PMID:8558542

  3. Health Care Indicators

    PubMed Central

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

    1993-01-01

    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:25372246

  4. Health Care Indicators

    PubMed Central

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

    1991-01-01

    This regular feature of the journal includes a section on 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 provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10114933

  5. Health Care Indicators

    PubMed Central

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

    1991-01-01

    This regular feature of the journal includes a section on 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 provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10122365

  6. Health Care Indicators

    PubMed Central

    Cowan, Cathy A.; Donham, Carolyn S.; Letsch, Suzanne W.; Maple, Brenda T.; Lazenby, Helen C.

    1992-01-01

    This regular feature of the journal includes a section on 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 provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10120177

  7. Health Care Indicators

    PubMed Central

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

    1993-01-01

    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

  8. Health care in Brazil.

    PubMed Central

    Haines, A

    1993-01-01

    Brazil has great geopolitical importance because of its size, environmental resources, and potential economic power. The organisation of its health care system reflects the schisms within Brazilian society. High technology private care is available to the rich and inadequate public care to the poor. Limited financial resources have been overconcentrated on health care in the hospital sector and health professionals are generally inappropriately trained to meet the needs of the community. However, recent changes in the organisation of health care are taking power away from federal government to state and local authorities. This should help the process of reform, but many vested interests remain to be overcome. A link programme between Britain and Brazil focusing on primary care has resulted in exchange of ideas and staff between the two countries. If primary care in Brazil can be improved it could help to narrow the health divide between rich and poor. Images p503-a p504-a p505-a PMID:8448465

  9. Efficacy of misoprostol for the treatment of postpartum hemorrhage: current knowledge and implications for health care planning

    PubMed Central

    Prata, Ndola; Weidert, Karen

    2016-01-01

    Background A myriad of interventions exist to treat postpartum hemorrhage (PPH), ranging from uterotonics and hemostatics to surgical and aortic compression devices. Nonetheless, PPH remains the leading cause of maternal mortality worldwide. The purpose of this article is to review the available evidence on the efficacy of misoprostol for the treatment of primary PPH and discuss implications for health care planning. Data and methods Using PubMed, Web of Science, and GoogleScholar, we reviewed the literature on randomized controlled trials of interventions to treat PPH with misoprostol and non-randomized field trials with controls. We discuss the current knowledge and implications for health care planning, especially in resource-poor settings. Results The treatment of PPH with 800 μg of misoprostol is equivalent to 40 IU of intravenous oxytocin in women who have received oxytocin for the prevention of PPH. The same dose might be an option for the treatment of PPH in women who did not receive oxytocin for the prevention of PPH and do not have access to oxytocin for treatment. Adding misoprostol to standard uterotonics has no additional benefits to women being treated for PPH, but the beneficial adjunctive role of misoprostol to conventional uterotonics is important in reducing intra- and postoperative hemorrhage during cesarean section. Conclusion Misoprostol is an effective uterotonic agent in the treatment of PPH. Clinical guidelines and treatment protocols should be updated to reflect the current knowledge on the efficacy of misoprostol for the treatment of PPH with 800 μg sublingually. PMID:27536161

  10. Health Care Reform and the Academic Health Center.

    ERIC Educational Resources Information Center

    Kimmey, James R.

    1994-01-01

    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…

  11. HealthCare.gov

    MedlinePlus

    ... ask for more info Site Search Search Need health insurance? See if you qualify You can enroll in ... September 01 Start the school year strong with health insurance See More Footer Resources About the Affordable Care ...

  12. Disinfection and Sterilization in Health Care Facilities: An Overview and Current Issues.

    PubMed

    Rutala, William A; Weber, David J

    2016-09-01

    When properly used, disinfection and sterilization can ensure the safe use of invasive and noninvasive medical devices. The method of disinfection and sterilization depends on the intended use of the medical device: critical items (contact sterile tissue) must be sterilized before use; semicritical items (contact mucous membranes or nonintact skin) must be high-level disinfected; and noncritical items (contact intact skin) should receive low-level disinfection. Cleaning should always precede high-level disinfection and sterilization. Current disinfection and sterilization guidelines must be strictly followed. PMID:27515140

  13. Reproductive health care delivery.

    PubMed

    Lindgren, Mark C; Ross, Lawrence S

    2014-02-01

    Most patients in the United States with reproductive health disorders are not covered by their health insurance for these problems. Health insurance plans consider reproductive care as a lifestyle choice not as a disease. If coverage is provided it is, most often, directed to female factor infertility and advanced reproductive techniques, ignoring male factor reproductive disorders. This article reviews the history of reproductive health care delivery and its present state, and considers its possible future direction. PMID:24286778

  14. Health care for children in foster care.

    PubMed

    Bean, Andrea; Gamino, Laura; Pierce, Priscilla; Shropshire, Deborah; Wallace, Kristina

    2004-09-01

    Every month 6,600 children in Oklahoma live under the custody of the state, most as result of being abused or neglected by their own families. The state provides medical care to these children via the Medicaid program. The American Academy of Pediatrics(AAP) has set forth a guideline for optimal care of these children. We discuss the current Oklahoma health care system for foster children and suggest changes that may move Oklahoma in the direction of the AAP recommendations. A more uniform, organized medical system may not only meet a foster child's medical needs but may also provide a degree of continuity to an otherwise discontinuous process. PMID:15540570

  15. Achieving health care affordability.

    PubMed

    Payson, Norman C

    2002-10-01

    Not all plans are jumping headlong into the consumer-centric arena. In this article, the CEO of Oxford Health Plans discusses how advanced managed care can achieve what other consumer-centric programs seek to do--provide affordable, quality health care. PMID:12391815

  16. Health Care System Accessibility

    PubMed Central

    Steinberg, Annie G; Barnett, Steven; Meador, Helen E; Wiggins, Erin A; Zazove, Philip

    2006-01-01

    BACKGROUND People who are deaf use health care services differently than the general population; little research has been carried out to understand the reasons. OBJECTIVE To better understand the health care experiences of deaf people who communicate in American Sign Language. DESIGN Qualitative analyses of focus group discussions in 3 U.S. cities. PARTICIPANTS Ninety-one deaf adults who communicate primarily in American Sign Language. MEASUREMENTS We collected information about health care communication and perceptions of clinicians' attitudes. We elicited stories of both positive and negative encounters, as well as recommendations for improving health care. RESULTS Communication difficulties were ubiquitous. Fear, mistrust, and frustration were prominent in participants' descriptions of health care encounters. Positive experiences were characterized by the presence of medically experienced certified interpreters, health care practitioners with sign language skills, and practitioners who made an effort to improve communication. Many participants acknowledged limited knowledge of their legal rights and did not advocate for themselves. Some participants believed that health care practitioners should learn more about sociocultural aspects of deafness. CONCLUSIONS Deaf people report difficulties using health care services. Physicians can facilitate change to improve this. Future research should explore the perspective of clinicians when working with deaf people, ways to improve communication, and the impact of programs that teach deaf people self-advocacy skills and about their legal rights. PMID:16499543

  17. Lean health care.

    PubMed

    Hawthorne, Henry C; Masterson, David J

    2013-01-01

    Principles of Lean management are being adopted more widely in health care as a way of improving quality and safety while controlling costs. The authors, who are chief executive officers of rural North Carolina hospitals, explain how their organizations are using Lean principles to improve quality and safety of health care delivery. PMID:23802475

  18. Developing primary health care.

    PubMed Central

    Jarman, B; Cumberlege, J

    1987-01-01

    Primary health care is best provided by a primary health care team of general practitioners, community nurses, and other staff working together from good premises and looking after the population registered with the practice. It encourages personal and continuing care of patients and good communication among the members of the team. Efforts should be made to foster this model of primary care where possible and also to evaluate its effectiveness. Community services that are not provided by primary care teams should be organised on a defined geographical basis, and the boundaries of these services should coincide as much as possible. Such arrangements would facilitate effective community care and health promotion and can be organised to work well with primary care teams. The patient's right to freedom of choice of a doctor, however, should be retained, as it adds flexibility to the rigidity of fixed geographically based services. PMID:3119003

  19. Soviet health care and perestroika.

    PubMed Central

    Schultz, D S; Rafferty, M P

    1990-01-01

    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

  20. Soviet health care and perestroika.

    PubMed

    Schultz, D S; Rafferty, M P

    1990-02-01

    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

  1. Health Care Indicators

    PubMed Central

    Donham, Carolyn S.; Letsch, Suzanne W.; Maple, Brenda T.; Singer, Naphtale; Cowan, Cathy A.

    1991-01-01

    Contained in this regular feature of the journal is a section on each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; 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 provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10112766

  2. Health Care Indicators

    PubMed Central

    Cowan, Cathy A.; Letsch, Suzanne W.; Levit, Katharine R.; Maple, Brenda T.; Stewart, Madie W.

    1991-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; 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 provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10110874

  3. What is the health care product?

    PubMed

    France, K R; Grover, R

    1992-06-01

    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

  4. Health-Care Hub

    ERIC Educational Resources Information Center

    Bowman, Darcia Harris

    2004-01-01

    The Broad Acres clinic is one of 1,500 school-based health centers nationwide that bring a wide range of medical, nutritional, and mental-health care to millions of students and their families. The centers provide an important safety net for children and adolescents--particularly the more than 10 million today who lack health insurance, according…

  5. Health care in Africa.

    PubMed

    Brown, M S

    1984-07-01

    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

  6. E-medicine and health care consumers: recognizing current problems and possible resolutions for a safer environment.

    PubMed

    Brann, Maria; Anderson, James G

    2002-01-01

    Millions of Americans access the Internet for health information, which is changing the way patients seek information about, and often treat, certain medical conditions. It is estimated that there may be as many as 100,000 health-related Web sites. The availability of so much health information permits consumers to assume more responsibility for their own health care. At the same time, it raises a number of issues that need to be addressed. The health information available to Internet users may be inaccurate or out-of-date. Potential conflicts of interest result from the blurring of the distinction between advertising and professional health information. Also, potential threats to privacy may result from data mining. Health care consumers need to be able to evaluate the quality of the information provided on the Internet. Various evaluative mechanisms such as codes of ethics, rating systems, and seals of approval have been developed to aid in this process. The effectiveness of these solutions is evaluated in this paper. Finally, the paper addresses the importance of including patients in developing standardized quality assurance systems for online health information. PMID:12814287

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

    ERIC Educational Resources Information Center

    Mouton, Lauren; Bruce, Jacklyn

    2013-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    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…

  9. Managed health care.

    PubMed

    Curtiss, F R

    1989-04-01

    The fundamental components of managed-care plans are described; the development of managed-care programs is discussed; and the impact of managed care on pharmacy services and the price, quality, and accessibility of health care are reviewed. Health care can be considered to be managed when at least one of the following fundamental components is present: prospective pricing, "UCR" (usual, customary, and reasonable) pricing of services, peer review, mandatory use review, benefit redesign, capitation payments, channeling, quality criteria, and health promotion. The managed-care industry consists of health maintenance organizations (HMOs), preferred provider organizations (PPOs), and managed fee-for-service plans. Managed-care reimbursement principles involve transferring some or all of the impetus for controlling use of services to the health-care provider. Means by which this is done include prospective pricing, services bundling, price discounts and negotiated fees, and capitation financing and reimbursement. Financial risk-sharing arrangements with providers--including hospitals, physicians, pharmacies, and home-care companies--are necessary for any managed-care plan to attain true control over its service costs. Use-review and use-management services are also fundamental to containing health-care spending. These include retrospective, concurrent, and prospective reviews of the necessity and appropriateness of medical services. Use management, like services bundling and prospective pricing, has been more effective in reducing costs of hospital inpatient services than costs associated with ambulatory care. Per case payments and services bundling have made individual charges for items irrelevant to hospital revenue. This has forced hospital pharmacy managers to become more sensitive to cost management. Drug formularies, improved productivity, and use of prescribing protocols are means by which hospital pharmacies have controlled costs. However, since shorter hospital

  10. The concept of "intercultural opening": the development of an assessment tool for the appraisal of its current implementation in the mental health care system.

    PubMed

    Penka, S; Kluge, U; Vardar, A; Borde, T; Ingleby, D

    2012-06-01

    The German concept of "intercultural opening" is an approach to facilitating migrants' access to the health care system and improving the care they receive. No data exist concerning the current status of the implementation of this approach in Germany, and the concept has never been analysed in practice. To assess the status of "intercultural opening" in the German mental health care system and to further analyse the concept, we developed a tool by combining pre-existing instruments. In order to review the preliminary tool we combined experts' knowledge by carrying out a consensusoriented, expert-based Delphi process with actual practice by piloting the instrument in each type of institution to be assessed. The assessment tool thus developed(1) is the first one to evaluate the current status of "intercultural opening" in the community mental health care system in Germany from a broad perspective. This paper is intended to present the development process of our assessment tool for demonstrating the benefits of this approach and as a model for future studies, as well as to increase transparency in relation to the current German approach to health care structures in dealing with migrants. PMID:22863253

  11. Health care automation companies.

    PubMed

    1995-12-01

    Health care automation companies: card transaction processing/EFT/EDI-capable banks; claims auditing/analysis; claims processors/clearinghouses; coding products/services; computer hardware; computer networking/LAN/WAN; consultants; data processing/outsourcing; digital dictation/transcription; document imaging/optical disk storage; executive information systems; health information networks; hospital/health care information systems; interface engines; laboratory information systems; managed care information systems; patient identification/credit cards; pharmacy information systems; POS terminals; radiology information systems; software--claims related/computer-based patient records/home health care/materials management/supply ordering/physician practice management/translation/utilization review/outcomes; telecommunications products/services; telemedicine/teleradiology; value-added networks. PMID:10153839

  12. Home health care

    MedlinePlus

    ... Skilled nursing - home health; Skilled nursing - home care; Physical therapy - at home; Occupational therapy - at home; Discharge - home ... being in the hospital, skilled nursing center, or rehabilitation facility. You should probably be able to go ...

  13. Health Insurance Coverage and Use of Family Planning Services among Current and Former Foster Youth: Implications of the Health Care Reform Law

    PubMed Central

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-01-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population. PMID:23262773

  14. Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

    PubMed

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-04-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population. PMID:23262773

  15. Problems and the potential direction of reforms for the current individual medical savings accounts in the Chinese health care system.

    PubMed

    Kong, Xiangjin; Yang, Yang; Gong, Fuqing; Zhao, Mingjie

    2012-12-01

    Individual health savings accounts are an important part of the current basic medical insurance system for urban workers in China. Since 1998 when the system of personal medical insurance accounts was first implemented, there has been considerable controversy over its function and significance within different social communities. This paper analyzes the main problems in the practical implementation of individual medical insurance accounts and discusses the social and cultural foundations for the establishment of family health savings accounts from the perspective of Chinese Confucian familism. Accordingly, it addresses the direction of the reform and the development of the current system of individual health insurance accounts in China. PMID:23192456

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    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…

  17. Controlling Health Care Costs

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2009-01-01

    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…

  18. Health care and AIDS.

    PubMed

    Peck, J; Bezold, C

    1992-07-01

    The acquired immune deficiency syndrome (AIDS) is a harbinger for change in health care. There are many powerful forces poised to transform the industrialized health care structure of the twentieth century, and AIDS may act as either a catalyst or an amplifier for these forces. AIDS could, for example, swamp local resources and thereby help trigger national reform in a health care system that has already lost public confidence. AIDS can also hasten the paradigm shift that is occurring throughout health care. Many of the choices society will confront when dealing with AIDS carry implications beyond health care. Information about who has the disease, for example, already pits traditional individual rights against group interests. Future information systems could make discrimination based upon medical records a nightmare for a growing number of individuals. Yet these systems also offer the hope of accelerated progress against not only AIDS but other major health threats as well. The policy choices that will define society's response to AIDS can best be made in the context of a clearly articulated vision of a society that reflects our deepest values. PMID:10119289

  19. Enhancing transgender health care.

    PubMed Central

    Lombardi, E

    2001-01-01

    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

  20. [A Long Way Home: The Current State of Care Provided by Family Caregivers and Public Health Nurses to Persons With Mental Illness in the Community].

    PubMed

    Huang, Yu-Chu; Wang, Yu-Hui

    2015-08-01

    According to Taiwan's Health and Welfare Ministry statistics, Taiwan had a total of 122,538 people who were officially registered as mentally disabled at the end of December 2013. Worldwide, schizophrenia ranks as the sixth most burdensome disease in terms of total expenditures. The present paper uses the two actual care stories of the families of mental illness patients and compares and contrasts these with the community mental illness care models used in other countries. The hospital-based psychiatric and community-based mental illness care that is practiced in Taiwan presents dilemmas and has long focused on "disease-orientated care" rather than holistic care. The gap between institutional and community mental rehabilitation services in Taiwan are examined. We recommend that policy makers create an open space for mental illness family caregivers and public health nurses to engage in dialogue in order to effectively integrate the care resources available to community mental illness patients and to break down the care barriers that currently separate community mental illness patients, family caregivers, and public health nurses. PMID:26242433

  1. Containing Health Care Costs

    PubMed Central

    Derzon, Robert A.

    1980-01-01

    As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or “gap-filling” role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is expected to average $950, triple for the aged. Hospital costs vary considerably and inexplicably among states; California residents, for example, spend 50 percent more per year for hospital care than do state of Washington residents. The failure of each sector to understand the other is potentially damaging to the parties and to patients. First, and most important, differences can and must be moderated through definite changes in the attitudes of the protagonists. PMID:6770551

  2. Health care in Armenia today.

    PubMed Central

    Farmer, R G; Chobanian, A V

    1994-01-01

    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

  3. Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

    PubMed

    Lasair, Simon

    2016-03-01

    Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer. PMID:26956752

  4. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care

    PubMed Central

    Peat, G; McCarney, R; Croft, P

    2001-01-01

    BACKGROUND—Osteoarthritis is the single most common cause of disability in older adults, and most patients with the condition will be managed in the community and primary care.
AIM—To discuss case definition of knee osteoarthritis for primary care and to summarise the burden of the condition in the community and related use of primary health care in the United Kingdom.
DESIGN—Narrative review.
METHOD—A literature search identified studies of incidence and prevalence of knee pain, disability, and radiographic osteoarthritis in the general population, and data related to primary care consultations. Findings from UK studies were summarised with reference to European and international studies.
RESULTS—During a one year period 25% of people over 55 years have a persistent episode of knee pain, of whom about one in six in the UK and the Netherlands consult their general practitioner about it in the same time period. The prevalence of painful disabling knee osteoarthritis in people over 55 years is 10%, of whom one quarter are severely disabled.
CONCLUSION—Knee osteoarthritis sufficiently severe to consider joint replacement represents a minority of all knee pain and disability suffered by older people. Healthcare provision in primary care needs to focus on this broader group to impact on community levels of pain and disability.

 PMID:11156538

  5. Spurious claims for health-care products: an experimental approach to evaluating current UK legislation and its implementation.

    PubMed

    Rose, Leslie B; Posadzki, Paul; Ernst, Edzard

    2012-01-01

    The lay media, and especially the Internet, contain many misleading claims for health products which have previously been inadequately regulated by consumer law. This was an experimental interventional survey within a consumer health-care setting. Three health products were chosen on the basis of being widely available on the UK market and having no available evidence of effectiveness. Twelve volunteers submitted 39 complaints to Consumer Direct (UK portal for the regulator Trading Standards) regarding false health claims, and 36 complaints were followed up for a maximum of 4.8 months. The mean time from submission of complaints to Consumer Direct to acknowledgement by the relevant Trading Standards office was 13 days. There were no responses from Trading Standards for 22% of complaints. At the end of the study one supplier had amended their website following Trading Standards advice, but did not stop all health claims. Another stopped advertising their product on the Internet and the third continued the health claims unchanged. EU directive 2005/29/EC is largely ineffective in preventing misleading health claims for consumer products in the UK. PMID:22403120

  6. Primary care and health reform.

    PubMed

    Calman, Neil S; Golub, Maxine; Shuman, Saskia

    2012-01-01

    Skyrocketing health care costs are burdening our people and our economy, yet health care indicators show how little we are achieving with the money we spend. Federal and state governments, along with public-health experts and policymakers, are proposing a host of new initiatives to find solutions. The Patient Protection and Affordable Care Act is designed to address both the quality and accessibility of health care, while reducing its cost. This article provides an overview of models supported by the Affordable Care Act that address one or more goals of the "Triple Aim": better health care for individuals, better health outcomes in the community, and lower health care costs. The models described below rely on the core principles of primary care: comprehensive, coordinated and continuous primary care; preventive care; and the sophisticated implementation of health information technology designed to promote communication between health care providers, enhance coordination of care, minimize duplication of services, and permit reporting on quality. These models will support better health care and reduced costs for people who access health care services but will not address health outcomes in the community at large. Health care professionals, working in concert with community-based organizations and advocates, must also address conditions that influence health in the broadest sense to truly improve the health of our communities and reduce health care costs. PMID:22976358

  7. Health care interactional suffering in palliative care.

    PubMed

    Beng, Tan Seng; Guan, Ng Chong; Jane, Lim Ee; Chin, Loh Ee

    2014-05-01

    A secondary analysis of 2 qualitative studies was conducted to explore the experiences of suffering caused by interactions with health care providers in the hospital setting. Interview transcripts from 20 palliative care patients and 15 palliative care informal caregivers in University Malaya Medical Centre were thematically analyzed. The results of health care interactional suffering were associated with themes of attention, understanding, communication, competence, and limitation. These 5 themes may serve as a framework for the improvement in interaction skills of health care providers in palliative care. PMID:23689367

  8. Values in health care.

    PubMed

    Gish, O

    1984-01-01

    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

  9. Genetic competencies essential for health care professionals in primary care.

    PubMed

    Engstrom, Janet L; Sefton, Marlene G S; Matheson, Jolie Kim; Healy, Kristine M

    2005-01-01

    The completion of the sequencing of the human genome in 2003 signaled the onset of the genomic era in health care. The knowledge gleaned from the Human Genome Project has led to the understanding that every health problem has a genetic component and that clinicians should include the application of genetic information in all aspects of health care. This article describes the genetic competencies essential for all health care professionals in primary care. Health care professionals should augment their current practice by obtaining a multigenerational genetic family history for each patient, assessing all patients for potentially heritable conditions, providing referrals to genetic health professionals as needed, offering genetic testing when indicated, and considering an individual's genetic makeup in the selection of medications and treatments for that person. Finally, all health care professionals ought to be prepared to address the complex personal, cultural, theological, ethical, legal, and social issues associated with genetic testing and other genetic issues commonly encountered in clinical practice. PMID:15894994

  10. Understanding your health care costs

    MedlinePlus

    ... as X-rays or MRIs Rehab, physical or occupational therapy, or chiropractic care Mental health, behavioral health, or substance abuse care Hospice, home health, skilled nursing, or durable medical equipment Prescription drugs Dental and ...

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

    PubMed

    Dawson, Angela; Jackson, Debra

    2013-04-01

    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

  12. Funding Rural Health Care.

    ERIC Educational Resources Information Center

    Moore, Kim

    This paper provides first-time grant writers with suggestions on how to approach a private funding source. While intended for rural health care advocates, the remarks are equally applicable for educators and others. The rural crisis has produced many heart-rending stories about medically indigent people, but there is a lack of reliable statistics…

  13. Education for primary health care.

    PubMed

    Smith, M; Drickey, R

    1985-07-01

    Postrevolutionary Nicaragua has developed a new health system in which primary health care is a central component. Great progress has been made in correcting the poor health conditions that existed prior to the revolution. As part of an interdisciplinary health team that emphasizes prevention and community service, physicians in the new system play a different role than they did previously. Training for health workers of all types has been expanded. However, scarce teaching and curricular resources have restrained progress in this area. The U.S. based Committee for Health Rights in Central America (CHRICA) has collaborated with the Nicaraguan Ministry of Health to organize two Colloquia on Health in Nicaragua in the past two years. These Colloquia brought together North American participants who provided current medical training and Nicaraguan participants who provided information about the new health system. The Colloquia, whose participants were eligible to receive CME credit from the UCSF School of Medicine, have led to continuing educational exchanges between health care personnel in the two countries. PMID:10272498

  14. Pediatric provider's perspectives on the transition to adult health care for youth with autism spectrum disorder: current strategies and promising new directions.

    PubMed

    Kuhlthau, Karen A; Warfield, Marji E; Hurson, Jill; Delahaye, Jennifer; Crossman, Morgan K

    2015-04-01

    Few youth with autism spectrum disorder (ASD) nationally report receiving services to help them transition from the pediatric health care system to the adult health care system. For example, only one-fifth (21.1%) of youth with ASD receive any transition planning services. To better understand why the transition from pediatric to adult health care is so difficult, we interviewed pediatric health care providers with extensive experience serving youth with ASD. We gathered information about the strategies and interventions they use to transition their patients with ASD to an adult provider. Five interventions or strategies are currently being used. These include providing families with written medical summaries to give to adult providers, compiling lists of available adult providers or community resources, coordinating care and communication between individual pediatric and adult providers, making transition-specific appointments, and using checklists to track transition progress. Other interventions or strategies were identified as needed but not currently in practice, and these focused on education and training. For example, informational workshops were suggested to train families and youth about transition. Training adult providers and medical students was also seen as important. Several respondents additionally identified the need for a transition center where all services could be coordinated in one place. With large numbers of youth with ASD becoming young adults, it seems that pediatric practices might want to consider some of the activities described here. Some of these activities, such as family educational seminars and written medical summaries, are likely relatively easy for a practice to implement. PMID:24497626

  15. Health care: a brave new world.

    PubMed

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

    2015-03-01

    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

  16. [Reembursing health-care service provider networks].

    PubMed

    Binder, A; Braun, G E

    2015-03-01

    Health-care service provider networks are regarded as an important instrument to overcome the widely criticised fragmentation and sectoral partition of the German health-care system. The first part of this paper incorporates health-care service provider networks in the field of health-care research. The system theoretical model and basic functions of health-care research are used for this purpose. Furthermore already established areas of health-care research with strong relations to health-care service provider networks are listed. The second part of this paper introduces some innovative options for reimbursing health-care service provider networks which can be regarded as some results of network-oriented health-care research. The origins are virtual budgets currently used in part to reimburse integrated care according to §§ 140a ff. SGB V. Describing and evaluating this model leads to real budgets (capitation) - a reimbursement scheme repeatedly demanded by SVR-Gesundheit (German governmental health-care advisory board), for example, however barely implemented. As a final step a direct reimbursement of networks by the German sickness fund is discussed. Advantages and challenges are shown. The development of the different reimbursement schemes is partially based on models from the USA. PMID:25625796

  17. The current situation in education and training of health-care professionals across Africa to optimise the delivery of palliative care for cancer patients

    PubMed Central

    Rawlinson, FM; Gwyther, L; Kiyange, F; Luyirika, E; Meiring, M; Downing, J

    2014-01-01

    The need for palliative care education remains vital to contribute to the quality of life of patients, both adults and children, with cancer in Africa. The number of patients with cancer continues to rise, and with them the burden of palliative care needs. Palliative care has been present in Africa for nearly four decades, and a number of services are developing in response to the HIV/AIDS epidemic. However, the needs of cancer patients remain a challenge. Education and training initiatives have developed throughout this time, using a combination of educational methods, including, more recently, e-learning initiatives. The role of international and national organisations in supporting education has been pivotal in developing models of education and training that are robust, sustainable, and affordable. Developing a material for education and professional development needs to continue in close collaboration with that already in production in order to optimise available resources. Seeking ways to evaluate programmes in terms of their impact on patient care remains an important part of programme delivery. This article reviews the current situation. PMID:25624873

  18. [Current Care Guideline: Eating disorders].

    PubMed

    Suokas, Jaana; Alenius, Heidi; Ebeling, Hanna; Haapasalo-Pesu, Kirsi-Maria; Järvi, Leea; Koskinen, Minna; Laukkanen, Eila; Meskanen, Katarina; Morin-Papunen, Laure; Ryöppönen, Anita; Salonen, Ulla; Tossavainen, Päivi; Vuorela, Piia

    2015-01-01

    Early diagnosis with intervention is linked to better outcome. In primary care patients in risk for eating disorder should be screened and actively asked about eating disorder symptoms. Treatment is mainly out-patient care and should first be focused on gaining a normal nutritional status. It is important to involve the patient's family in the treatment. A confidential relationship between health care professionals and the patient is important. The patient's own motivation and readiness for recuperation are essential. Different therapeutic and psychosocial approaches are central in the treatment, as the disorders are psychiatric. Medical treatment may bring additional help in treating binge-eating disorder or bulimia nervosa, but it is seldom of help in treating anorexia nervosa. PMID:26245050

  19. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-01-01

    One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile.The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992-2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index.Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly. PMID:23937894

  20. Equity in health care utilization in Chile

    PubMed Central

    2013-01-01

    One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile. The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992–2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index. Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly. PMID:23937894

  1. Care for the Health Care Provider.

    PubMed

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

    Pretravel care for the health care provider begins with an inventory, including the destination, length of stay, logistical arrangements, type of lodging, food and water supply, team members, personal medical needs, and the needs of the community to be treated. This inventory should be created and processed well in advance of the planned medical excursion. The key thing to remember in one's planning is to be a health care provider during one's global health care travel and not to become a patient oneself. This article will help demonstrate the medical requirements and recommendations for such planning. PMID:26900113

  2. The constitutionality of current legal barriers to telemedicine in the United States: analysis and future directions of its relationship to national and international health care reform.

    PubMed

    Gupta, Amar; Sao, Deth

    2011-01-01

    The current health care crisis in the United States compels a consideration of the crucial role that telemedicine could play towards deploying a pragmatic solution. The nation faces rising costs and difficulties in access to and quality of medical services. Telemedicine can potentially help to overcome these challenges, as it can provide new cost-effective and efficient methods of delivering health care across geographic distances. The full benefits and future potential of telemedicine, however, are constrained by overlapping, inconsistent, and inadequate legal and regulatory frameworks, as well as the repertoire of standards imposed by state governments and professional organizations. Proponents of these barriers claim that they are necessary to protect public health and safety, and that the U.S. Constitution gives states exclusive authority over health and safety concerns. This Article argues that such barriers not only fail to advance these public policy goals, but are unconstitutional when they restrict the practice of telemedicine across state and national borders. Furthermore, the interstate and international nature of telemedicine calls for increasing the centralized authority of the federal government; this position is consistent with the U.S. Constitution and other governing principles. Finally, this Article observes that the U.S. experience bears some similarities to that of other nations, and represents a microcosm of the international community's need and struggle to develop a uniform telemedicine regime. Just as with state governments in the U.S., nations are no longer able to view health care as a traditional domestic concern and must consider nontraditional options to resolve the dilemmas of rising costs and discontent in the delivery of health care to their people. PMID:22145522

  3. Understanding your health care costs

    MedlinePlus

    ... This is the payment you make for certain health care provider visits and prescriptions. It is a set ... about lower-cost facilities and medicines. Understanding your health care costs can help you save money when managing ...

  4. An eHealth Application in Head and Neck Cancer Survivorship Care: Health Care Professionals' Perspectives

    PubMed Central

    van Uden-Kraan, Cornelia F; Peek, Niels; Cuijpers, Pim; Leemans, C René; Verdonck-de Leeuw, Irma M

    2015-01-01

    Background Although many cancer survivors could benefit from supportive care, they often do not utilize such services. Previous studies have shown that patient-reported outcomes (PROs) could be a solution to meet cancer survivors’ needs, for example through an eHealth application that monitors quality of life and provides personalized advice and supportive care options. In order to develop an effective application that can successfully be implemented in current health care, it is important to include health care professionals in the development process. Objective The aim of this study was to investigate health care professionals’ perspectives toward follow-up care and an eHealth application, OncoKompas, in follow-up cancer care that monitors quality of life via PROs, followed by automatically generated tailored feedback and personalized advice on supportive care. Methods Health care professionals involved in head and neck cancer care (N=11) were interviewed on current follow-up care and the anticipated value of the proposed eHealth application (Step 1). A prototype of the eHealth application, OncoKompas, was developed (Step 2). Cognitive walkthroughs were conducted among health care professionals (N=21) to investigate perceived usability (Step 3). Interviews were recorded, transcribed verbatim, and analyzed by 2 coders. Results Health care professionals indicated several barriers in current follow-up care including difficulties in detecting symptoms, patients’ perceived need for supportive care, and a lack of time to encourage survivors to obtain supportive care. Health care professionals expected the eHealth application to be of added value. The cognitive walkthroughs demonstrated that health care professionals emphasized the importance of tailoring care. They considered the navigation structure of OncoKompas to be complex. Health care professionals differed in their opinion toward the best strategy to implement the application in clinical practice but

  5. Environmental Health: Health Care Reform's Missing Pieces.

    ERIC Educational Resources Information Center

    Fadope, Cece Modupe; And Others

    1994-01-01

    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…

  6. Health care reforms in Poland.

    PubMed

    Baginska, Ewa

    2004-01-01

    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

  7. Redirecting health care spending: consumer-directed health care.

    PubMed

    Nolin, JoAnn; Killackey, Janet

    2004-01-01

    In an environment of rising health care costs, defined contribution plans and closely related consumer-directed health plans are emerging as a possible next phase in health plan development and offer new opportunities for the nursing profession. PMID:15586479

  8. Public health care provisions: access and equity.

    PubMed

    Bin Juni, M H

    1996-09-01

    Within the current exercise of reforming the health care system, underlying all issues, is the reassessment of the role of government. It is a government's responsibility and concern that the health sector be accessible and equitable to the population, and more important that the health sector be more efficient and affordable. Many governments in the world attempt to provide universal health care services to their population through public health care provisions. This paper reviews and analyses the experience of the Malaysian health system, focusing on the performance of the system in relation to access and equity. The performance of the Malaysian health system has been impressive. At minimum cost it has achieved virtually accessible and equitable health care to the entire population. This is evident by analysing almost all the commonly used indicators. These clearly show that when matched to comparable countries, health outcome is even better than predicted value. PMID:8870140

  9. Outbreaks in Health Care Settings.

    PubMed

    Sood, Geeta; Perl, Trish M

    2016-09-01

    Outbreaks and pseudo-outbreaks in health care settings can be complex and should be evaluated systematically using epidemiologic tools. Laboratory testing is an important part of an outbreak evaluation. Health care personnel, equipment, supplies, water, ventilation systems, and the hospital environment have been associated with health care outbreaks. Settings including the neonatal intensive care unit, endoscopy, oncology, and transplant units are areas that have specific issues which impact the approach to outbreak investigation and control. Certain organisms have a predilection for health care settings because of the illnesses of patients, the procedures performed, and the care provided. PMID:27515142

  10. Psychology's Role in Health Care.

    ERIC Educational Resources Information Center

    American Psychological Association, Washington, DC.

    This information packet contains eight two- to three-page publications from the American Psychological Association series "Psychological Services for the 21st Century, Psychology's Role in Health Care: Studying Human Behavior; Promoting Health; Saving Health Care Dollars; Providing Mental Health Services." The focus of the series is the connection…

  11. Pediatric Provider's Perspectives on the Transition to Adult Health Care for Youth with Autism Spectrum Disorder: Current Strategies and Promising New Directions

    ERIC Educational Resources Information Center

    Kuhlthau, Karen A.; Warfield, Marji E.; Hurson, Jill; Delahaye, Jennifer; Crossman, Morgan K.

    2015-01-01

    Few youth with autism spectrum disorder (ASD) nationally report receiving services to help them transition from the pediatric health care system to the adult health care system. For example, only one-fifth (21.1%) of youth with ASD receive any transition planning services. To better understand why the transition from pediatric to adult health care…

  12. Leadership models in health care - a case for servant leadership.

    PubMed

    Trastek, Victor F; Hamilton, Neil W; Niles, Emily E

    2014-03-01

    Our current health care system is broken and unsustainable. Patients desire the highest quality care, and it needs to cost less. To regain public trust, the health care system must change and adapt to the current needs of patients. The diverse group of stakeholders in the health care system creates challenges for improving the value of care. Health care providers are in the best position to determine effective ways of improving the value of care. To create change, health care providers must learn how to effectively lead patients, those within health care organizations, and other stakeholders. This article presents servant leadership as the best model for health care organizations because it focuses on the strength of the team, developing trust and serving the needs of patients. As servant leaders, health care providers may be best equipped to make changes in the organization and in the provider-patient relationship to improve the value of care for patients. PMID:24486078

  13. Betting against health care.

    PubMed

    Appleby, C

    1996-06-20

    Health care firms of all types helped fuel the biggest short-selling frenzy in the New York Stock Exchange's history, recently hitting a record 2.2 billion shares. While some analysts say this means nothing, the fact is that many investors are "shorting" the stock; in other words, they're betting against it. What appears as a lack of confidence may be nothing more than a simple quirk of Wall Street. Good, bad or indifferent, selling short is no tall tale. PMID:8640268

  14. Integrating Children's Mental Health into Primary Care.

    PubMed

    Wissow, Lawrence S; van Ginneken, Nadja; Chandna, Jaya; Rahman, Atif

    2016-02-01

    Children's mental health problems are among global health advocates' highest priorities. Nearly three-quarters of adult disorders have their onset or origins during childhood, becoming progressively harder to treat over time. Integrating mental health with primary care and other more widely available health services has the potential to increase treatment access during childhood, but requires re-design of currently-available evidence-based practices to fit the context of primary care and place a greater emphasis on promoting positive mental health. While some of this re-design has yet to be accomplished, several components are currently well-defined and show promise of effectiveness and practicality. PMID:26613691

  15. Access to health care

    PubMed Central

    Fortin, Martin; Maltais, Danielle; Hudon, Catherine; Lapointe, Lise; Ntetu, Antoine Lutumba

    2005-01-01

    OBJECTIVE To explore access to health care for patients presenting with multiple chronic conditions and to identify barriers and factors conducive to access. DESIGN Qualitative study with focus groups. SETTING Family practice unit in Chicoutimi (Saguenay), Que. PARTICIPANTS Twenty-five male and female adult patients with at least four chronic conditions but no cognitive disorders or decompensating conditions. METHODS For this pilot study, only three focus group discussions were held. MAIN FINDINGS The main barriers to accessing follow-up appointments included long waits on the telephone, automated telephone-answering systems, and needing to attend at specific times to obtain appointments. The main barriers to specialized care were long waiting times and the need to get prescriptions and referrals from family physicians. Factors reported conducive to access included systematic callbacks and the personal involvement of family physicians. Good communication between family physicians and specialists was also perceived to be an important factor in access. CONCLUSION Systematic callbacks, family physicians’ personal efforts to obtain follow-up visits, and better physician-specialist communication were all suggested as ways to improve access to care for patients with multiple chronic conditions. PMID:16926944

  16. The future of health care.

    PubMed

    Grossman, J H

    1992-10-01

    Future changes in patient care to curb costs and refocus on health versus medical care are discussed, and efforts at the New England Medical Center (NEMC) to measure patient outcomes and reorganize the delivery of care are described. Medical care is not the only determinant of an individual's health; lifestyle choices and the community also play important roles. The rate of increase in the cost of medical care must be contained. The future of health-care reform will be predicated on packages for the administration of care; for any given condition, all of the elements of medical care would be combined so that clinical and functional outcomes are achieved at a given price (episode-of-illness pricing). The success of medical care should be determined on the basis of the patient's ability to function, not on clinical indicators alone. Also, the prices for new generations of drugs should be determined on whether the new drugs improve patients' quality of life. Health-care professionals in hospitals should not be divided according to their specialties; instead, they should compose multidisciplinary teams that can care for patients over time. NEMC is developing a process and structure in which various health-care professionals work together to design health-care plans that cover a full episode of illness. The future of health care will also be influenced by global trends, including international medical-care inflation, standardization of process and outcome measurements, and a shift in emphasis from medicine to health. The health-care industry is in transition as this country searches for the best way to improve the health and functioning of each citizen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1442820

  17. Nurses cut health care costs.

    PubMed

    Dunham-Taylor, J; Oldaker, J; DeCapua, T; Manley, N K; Oprian, B; Wrestler, J

    1993-12-01

    Nurses are a value-added and cost-savings component of health care, yet others frequently impede nurse efforts. Nurses, coupled with business, can contribute to cutting health care costs by (a) increasing dialogue with business leaders on effective cost-cutting measures across health care, (b) supporting nurse leaders who are capable of administering key community positions, (c) involving whole communities in wellness/health promotion and/or disease prevention programs, (d) encouraging more home health care alternatives; and (e) supporting nurse-related entrepreneurial efforts. PMID:8228142

  18. Improving mental health through primary care.

    PubMed Central

    Dowrick, C

    1992-01-01

    The government white paper Health of the nation has highlighted mental health as a key issue for the next decade. Primary care is being encouraged to take a leading role in developing effective services for people with mental health problems. This paper reviews current research on key aspects of mental health in adults: the prevalence of mental health problems, improving detection and management of mental health problems, the role of counselling, and communication between primary and secondary care. Recommendations are made for initiatives in both research and service development. PMID:1457175

  19. Current Awareness in Health Education.

    ERIC Educational Resources Information Center

    Center for Disease Control (DHEW/PHS), Atlanta, GA.

    Included in this annotated bibliography on health education are journal articles, monographs, and government reports. Topics covered are patient education, community health education, school health education, sex education, lifestyle, general health education, research and evaluation, smoking, self-care, and other miscellaneous areas. It contains…

  20. Transformational leadership in health care.

    PubMed

    Trofino, J

    1995-08-01

    One of the most important evolutionary forces in transforming health care is the shift from management to leadership in nursing. The transformational leader will be the catalyst for expanding a holistic perspective, empowering nursing personnel at all levels and maximizing use of technology in the movement beyond even patient-centered health care to patient-directed health outcomes. PMID:7630599

  1. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    National Consortium on Health Science and Technology Education, Okemos, MI.

    This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

  2. Information Technology Outside Health Care

    PubMed Central

    Tuttle, Mark S.

    1999-01-01

    Non-health-care uses of information technology (IT) provide important lessons for health care informatics that are often overlooked because of the focus on the ways in which health care is different from other domains. Eight examples of IT use outside health care provide a context in which to examine the content and potential relevance of these lessons. Drawn from personal experience, five books, and two interviews, the examples deal with the role of leadership, academia, the private sector, the government, and individuals working in large organizations. The interviews focus on the need to manage technologic change. The lessons shed light on how to manage complexity, create and deploy standards, empower individuals, and overcome the occasional “wrongness” of conventional wisdom. One conclusion is that any health care informatics self-examination should be outward-looking and focus on the role of health care IT in the larger context of the evolving uses of IT in all domains. PMID:10495095

  3. The health care learning organization.

    PubMed

    Hult, G T; Lukas, B A; Hult, A M

    1996-01-01

    To many health care executives, emphasis on marketing strategy has become a means of survival in the threatening new environment of cost attainment, intense competition, and prospective payment. This paper develops a positive model of the health care organization based on organizational learning theory and the concept of the health care offering. It is proposed that the typical health care organization represents the prototype of the learning organization. Thus, commitment to a shared vision is proposed to be an integral part of the health care organization and its diagnosis, treatment, and delivery of the health care offering, which is based on the exchange relationship, including its communicative environment. Based on the model, strategic marketing implications are discussed. PMID:10158798

  4. Gypsies and health care.

    PubMed Central

    Sutherland, A

    1992-01-01

    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

  5. The promise of Lean in health care.

    PubMed

    Toussaint, John S; Berry, Leonard L

    2013-01-01

    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

  6. Flourishing in Health Care.

    PubMed

    Edgar, Andrew; Pattison, Stephen

    2016-06-01

    The purpose of this paper is to offer an account of 'flourishing' that is relevant to health care provision, both in terms of the flourishing of the individual patient and carer, and in terms of the flourishing of the caring institution. It is argued that, unlike related concepts such as 'happiness', 'well-being' or 'quality of life', 'flourishing' uniquely has the power to capture the importance of the vulnerability of human being. Drawing on the likes of Heidegger and Nussbaum, it is argued that humans are at once beings who are autonomous and thereby capable of making sense of their lives, but also subject to the contingencies of their bodies and environments. To flourish requires that one engages, imaginatively and creatively, with those contingencies. The experience of illness, highlighting the vulnerability of the human being, thereby becomes an important experience, stimulating reflection in order to make sense of one's life as a narrative. To flourish, it is argued, is to tell a story of one's life, realistically engaging with vulnerability and suffering, and thus creating a framework through which one can meaningful and constructively go on with one's life. PMID:26846370

  7. "Cloud" health-care workers.

    PubMed Central

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

    2001-01-01

    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

  8. [Health care research to improve the quality of health care provision for older people].

    PubMed

    Kuhlmey, A

    2011-08-01

    This article addresses the contribution that health care research can make to facilitating appropriate health care provision for older adults. First, the major risks in this age group are described. These include multiple illnesses, the increasing need for nursing care with age, but also the growing numbers of older adults with psychological disorders, primarily dementia. The second section of the article presents a critical assessment of the current health care situation in light of the risks identified. On this basis, the third section specifies the areas of health care research that can contribute to improving the quality of the health care provision for this population. The article is based on a presentation made by the author at the 2010 Berlin Talks on Social Medicine: "The New Old--Health Care Research for a Changed Society." PMID:21800238

  9. Child Care Currents: A Briefing Paper for Constructing Care Roundtable.

    ERIC Educational Resources Information Center

    Child Care Action Campaign, New York, NY.

    This paper presents an overview of the current status of child care in the United States. It provides a framework for discussing strategies to expand the supply of child care, improve its quality, and make it accessible to all families. Child care is defined, and factors that influence the quality of care are listed. The demand for child care is…

  10. Health and Disability: Partnerships in Health Care

    ERIC Educational Resources Information Center

    Tracy, Jane; McDonald, Rachael

    2015-01-01

    Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…

  11. [External and internal financing in health care].

    PubMed

    Henke, Klaus-Dirk

    2007-05-15

    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

  12. Health Care System Responses to Children Exposed to Domestic Violence.

    ERIC Educational Resources Information Center

    Culross, Patti L.

    1999-01-01

    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)

  13. Managed care and reproductive health.

    PubMed

    Cohen, S S; Williams, D R

    1998-01-01

    Managed care poses special challenges to midwives providing reproductive health care. This is owing to the sensitive nature of issues surrounding reproductive health and aspects of managed care that may impede a woman's ability to obtain continuous, confidential, and comprehensive care from the provider of her choice. Variations across payers (ie, Medicare, Medicaid, and commercial insurers) regarding covered benefits and reimbursement of midwifery services also may create obstacles. Furthermore, some physicians and managed care organizations are embracing policies that threaten the ability of midwives to function as primary health care providers for women. Despite these hurdles, midwives have the potential to remain competitive in the new marketplace. This article underscores the importance of being knowledgeable about legislation and policy issues surrounding the financing of midwifery services, quality performance measurement for HMOs as they pertain to reproductive health, and discussions regarding which clinicians should be defined as primary care providers. PMID:9674347

  14. The current status of the Korean student health examination

    PubMed Central

    2013-01-01

    Recent trends place an emphasis on school health care, the ultimate goal of which is to protect, maintain, and promote students' health. School health care is a program that integrates health care services, health education, health counseling, and local social health services. The student health examination (SHE) system is a part of school health care and schools and communities must be available to provide professional health services. Pediatricians also have important roles as experts in both school health care and the SHE system. In this article, the history of school health care, its legal basis, and the current status of the SHE system in Korea are reviewed. Furthermore, sample surveys from the past few years are reviewed. Through this holistic approach, future directions are proposed for the improvement of SHE and school health care. PMID:24019840

  15. Space age health care delivery

    NASA Technical Reports Server (NTRS)

    Jones, W. L.

    1977-01-01

    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.

  16. Late presentation to HIV care despite good access to health services: current epidemiological trends and how to do better.

    PubMed

    Darling, Katharine Ea; Hachfeld, Anna; Cavassini, Matthias; Kirk, Ole; Furrer, Hansjakob; Wandeler, Gilles

    2016-01-01

    In 2014, there were 36.9 million people worldwide living with human immunodeficiency virus (PLWH), of whom 17.1 million did not know they were infected. Whilst the number of new human immunodeficiency virus (HIV) infections has declined globally since 2000, there are still regions where new infection rates are rising, and diagnosing HIV early in the course of infection remains a challenge. Late presentation to care in HIV refers to individuals newly presenting for HIV care with a CD4 count below 350 cells/µl or with an acquired immune deficiency syndrome (AIDS)-defining event. Late presentation is associated with increased patient morbidity and mortality, healthcare costs and risk of onward transmission by individuals unaware of their status. Further, late presentation limits the effectiveness of all subsequent steps in the cascade of HIV care. Recent figures from 34 countries in Europe show that late presentation occurs in 38.3% to 49.8% of patients newly presenting for care, depending on region. In Switzerland, data from patients enrolled in the Swiss HIV Cohort Study put the rate of late presentation at 49.8% and show that patients outside established HIV risk groups are most likely to be late presenters. Provider-initiated testing needs to be improved to reach these groups, which include heterosexual men and women and older patients. The aim of this review is to describe the scale and implications of late presentation using cohort data from Switzerland and elsewhere in Europe, and to highlight initiatives to improve early HIV diagnosis. The importance of recognising indicator conditions and the potential for missed opportunities for HIV testing is illustrated in three clinical case studies. PMID:27544642

  17. Congress enacts health care reform.

    PubMed

    2010-03-01

    Health care reform at last: After nearly a century of effort by Presidents from Theodore Roosevelt on down, the Congress finally agreed on and President Barack Obama signed into law a system that covers most Americans, regulates sharp insurance practices, and embraces a paradigm shift from acute institutionally focused care to chronic disease management based on home and community-based care. PMID:20465039

  18. Foster Care and Child Health.

    PubMed

    McDavid, Lolita M

    2015-10-01

    Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care. PMID:26318955

  19. Prospects for Health Care Reform.

    ERIC Educational Resources Information Center

    Kastner, Theodore

    1992-01-01

    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)

  20. Contagious Ideas from Health Care

    ERIC Educational Resources Information Center

    Chaffee, Ellen

    2009-01-01

    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…

  1. The foundation for future health care.

    PubMed

    Marcarelli, J L

    1987-01-01

    In the March-April issue of Physician Executive, Thomas Ainsworth, MD, provided his view of the current status of health promotion within the health care delivery system. The potential, he wrote, is far greater than the realization to date, and physicians can have a significant role in the development of health promotion programs. In this article, the theory is posited that the prime factor in the failure of health promotion to achieve a more significant position in the health care field is inertia. The forces for the status quo have simply been too great to be overcome. However, consumers, providers, and payers are almost certain to be involved in a health promotion strategy that will revolutionize the health care industry. PMID:10312136

  2. Women Veterans Health Care: Frequently Asked Questions

    MedlinePlus

    ... Program Overview » Outreach Materials » FAQs Women Veterans Health Care Menu Menu Womens Health Women Veterans Health Care ... can I call for more help? What health care services are available to women Veterans? A full ...

  3. Health care's service fanatics.

    PubMed

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life. PMID:23898737

  4. Academic Health Centers and Health Care Reform.

    ERIC Educational Resources Information Center

    Miles, Stephen H.; And Others

    1993-01-01

    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…

  5. Cohort effects on the need for health care and implications for health care planning in Canada.

    PubMed

    Whittaker, William; Birch, Stephen; MacKenzie, Adrian; Murphy, Gail Tomblin

    2016-01-01

    The sustainability of publicly funded health care systems is an issue for governments around the world. The economic climate limits governments' fiscal capacity to continue to devote an increasing share of public funds to health care. Meanwhile the demands for health care within populations continue to increase. Planning the future requirements for health care is typically based on applying current levels of health service use by age to demographic projections of the population. But changes in age-specific levels of health over time would undermine this 'constant use by age' assumption. We use representative Canadian survey data (Canadian Community Health Survey) covering the period 2001-2012, to identify the separate trends in demography (population ageing) and epidemiology (population health) on self-reported health. We propose an approach to estimating future health care requirements that incorporates cohort trends in health. Overall health care requirements for the population increase as the size and mean age of the population increase, but these effects are mitigated by cohort trends in health-we find the estimated need for health care is lower when models account for cohort effects in addition to age effects. PMID:26586614

  6. [Female migrants in the health care system. Health care utilisation, access barriers and health promotion strategies].

    PubMed

    Wimmer-Puchinger, B; Wolf, H; Engleder, A

    2006-09-01

    Due to the evident interaction between social factors and health, migrants are exposed to specific risk factors and access barriers to health services. Some examples are the lower education level, the low social position and/or the insufficient language skills. This concept is further elaborated in the multi-factorial impacts of health literacy. Female migrants often experience additional discrimination because of their gender. Despite the lack of representative data, consistent studies show that female migrants do not regularly take advantage of health care prevention and present themselves with higher degrees of stress. The current "inadequate health care" manifests itself in a lack of care in the areas of prevention and health education and an abundance in the context of medication and diagnostic procedures. To meet these demands and to further reduce barriers, in particular language barriers, specific strategies for this target group involving both politics and the health care system have to be developed. Besides the employment of interpreters with a native cultural background and the distribution of information booklets, it is an important strategy to reduce structural obstacles such as cultural diversity. To contact these women in their living environment should help to increase their self-determined health promotion. Selected models of good practice in Austria with regard to the themes of FGM (female genital mutilation), violence, heart disease and breast cancer are presented to highlight the specific health situation and risk factors of female migrants as well as successful strategies to confront them. PMID:16927035

  7. Reforming the Israeli health care market.

    PubMed

    Chinitz, D P

    1994-11-01

    Israel's experience in attempting to implement a health system reform based in large measure on managed competition should provide important data to other countries considering reliance on competitive mechanisms for third-party purchase of health care. In this paper, current proposals for reform of the Israeli market for third-party purchase of health care are examined in light of ideal market structures, particularly the theory of managed competition. The relationship between the theory, the notion of a 'purchaser-provider split' and the Israeli case are explored. The current Israeli health care market, which features enrollment of 96% of the population in competing sick funds, is presented. The changes necessary to base third-party purchase of health-care on managed competition are discussed. Special conditions of the Israeli health care system likely to influence implementation of a managed competition strategy are considered. Beyond a 'purchaser-provider' split, the proposals call for other restructurings, such as a split between finance and insurance functions, which the standard theory of managed competition does not take into account. The implications of these proposals for smooth functioning of the health care market must be weighed against political and ethical considerations unique to the Israeli environment. PMID:7863357

  8. Transition Care for Children With Special Health Care Needs

    PubMed Central

    Davis, Alaina M.; Brown, Rebekah F.; Taylor, Julie Lounds; Epstein, Richard A.

    2014-01-01

    BACKGROUND: Approximately 750 000 children in the United States with special health care needs will transition from pediatric to adult care annually. Fewer than half receive adequate transition care. METHODS: We had conversations with key informants representing clinicians who provide transition care, pediatric and adult providers of services for individuals with special health care needs, policy experts, and researchers; searched online sources for information about currently available programs and resources; and conducted a literature search to identify research on the effectiveness of transition programs. RESULTS: We identified 25 studies evaluating transition care programs. Most (n = 8) were conducted in populations with diabetes, with a smaller literature (n = 5) on transplant patients. We identified an additional 12 studies on a range of conditions, with no more than 2 studies on the same condition. Common components of care included use of a transition coordinator, a special clinic for young adults in transition, and provision of educational materials. CONCLUSIONS: The issue of how to provide transition care for children with special health care needs warrants further attention. Research needs are wide ranging, including both substantive and methodologic concerns. Although there is widespread agreement on the need for adequate transition programs, there is no accepted way to measure transition success. It will be essential to establish consistent goals to build an adequate body of literature to affect practice. PMID:25287460

  9. Current Health Problems.

    ERIC Educational Resources Information Center

    Gay, John; And Others

    The basic premise of this text is that, in addition to the presentation of basic cognitive and affective information, health education should go one step further by assisting student in developing decision-making skills. The text begins by offering the student a basic foundation of what is meant by health and how this meaning applies to the world,…

  10. Integrating Biopsychosocial Intervention Research in a Changing Health Care Landscape

    ERIC Educational Resources Information Center

    Ell, Kathleen; Oh, Hyunsung; Wu, Shinyi

    2016-01-01

    Objective: Safety net care systems are experiencing unprecedented change from the "Affordable Care Act," Patient-Centered Medical Home (PCMH) uptake, health information technology application, and growing of mental health care integration within primary care. This article provides a review of previous and current efforts in which social…

  11. A national survey of health professionals and volunteers working in voluntary hospice services in the UK. I. Attitudes to current issues affecting hospices and palliative care.

    PubMed

    Addington-Hall, Julia M; Karlsen, Saffron

    2005-01-01

    This paper reports results from a national survey in 1999 of voluntary hospice services in the UK. It focuses on volunteer and staff views of the purposes of hospice care, and on current debates within palliative care. Twenty-five hospice services, stratified by region, services provided (inpatient care, day care and/or home care) and number of beds were randomly sampled from amongst 175 voluntary hospices in the UK. Nineteen participated. Seventy per cent of a random sample of professional and voluntary staff within these hospices returned a postal questionnaire. Both volunteers and professionals considered care of the whole person, pain and symptom control, quality of life and dying peacefully to be important aspects of hospice care. Most doctors chose care of the whole person as the most important aspect, and they were more likely to choose this option than other staff. Hospice volunteers were less positive than hospice staff (particularly doctors and nurses) in their attitudes to extending hospice care to noncancer patients (where many volunteers held no strong view), to restricting care to patients with specialist palliative care needs, and less negative about euthanasia. These findings illustrate the importance of including hospice volunteers and the general public, as well as hospice staff, in debates about the future of hospice and palliative care in the UK. Further research is needed into lay and professional views of the role of hospices and palliative care services. PMID:15690867

  12. [A Maternal Health Care System Based on Mobile Health Care].

    PubMed

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals. PMID:27382731

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

    SciTech Connect

    Al-Khatib, Issam A. Sato, Chikashi

    2009-08-15

    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.

  14. Health-care market robust.

    PubMed

    Merkel, Jayne

    2004-01-01

    Construction of health care facilities hit an all-time high in 2002 totalling about $16 billion of work. As baby boomers age health care construction will soar, because seniors are the largest consumers of health care The top five firms--Perkins & Will, HDR, HKS, NBBJ, and Ellerbe Becket--monopolize about 20 percent of the work. H.R. 1 increases Medicare payments to rural hospitals by $25 billion over 10 years--so help is on the way for facilities that are languishing. PMID:15077503

  15. Home health care in France.

    PubMed

    Charles, B

    1990-02-23

    Home health care in France has a long tradition, but is limited in its development. Since 1970 hospitals are by law permitted to extend services at home. Apart from this, patient associations are a driving force in the organization of home health care. There is a trend to more home health care, but this is hampered by splitting of responsibilities of local, departmental or central authorities. The hospital pharmacist is recommended to focus on his scientific and technical competence. Improved relations between community pharmacists and hospital pharmacists are advocated. PMID:2314994

  16. Nurses in the United States with a practice doctorate: implications for leading in the current context of health care.

    PubMed

    Redman, Richard W; Pressler, Susan J; Furspan, Philip; Potempa, Kathleen

    2015-01-01

    The Institute of Medicine has recommended doubling the number of nurses with doctorates by 2020. The National Research Council has recommended a clearer distinction between doctoral preparation for a practice profession and that for the preparation of scientists. To support the central premise that both the research-oriented doctorate (PhD) and the practice-oriented doctorate, the doctor of nursing practice (DNP), are critical to achieve and expand doctoral education, we present current information regarding the impact of DNP programs, including enrollments, scholarly productivity of DNP graduates, and the employment setting of DNP scholars. Scholarly productivity was estimated by searching publication databases between 2005 and 2012 using three strategies to estimate the publication record of nurses who had earned a DNP degree. The large numbers of nurses receiving the DNP are helping to fulfill the Institute of Medicine's recommendation and are increasingly contributing to the scholarly output in the field, especially related to clinical practice. PMID:25241137

  17. Rural health care: redefining access.

    PubMed

    Collins, Chris

    2015-01-01

    The population and demographics of rural America are shifting once again. As our nation's unprecedented health care reform unfolds, it is becoming clear that rural communities have unique strengths, and capitalizing on these strengths can position them well for this health care transformation. Equally important are the distinct challenges that--with careful planning, attention, and resources--can be transformed into opportunities to thrive in the new health care environment. The North Carolina Institute of Medicine's Task Force on Rural Health recently published a report that highlights the strengths and challenges of rural communities [1]. In order to fully leverage these opportunities, we must continue to acknowledge the fundamental importance of access to basic health care, while also broadening our discussion to collectively tackle the additional components necessary to create healthy, thriving rural communities. As we reexamine the needs of rural communities, we should broaden our discussions to include an expansion of the types of access that are necessary for strengthening rural health. Collaboration, successful recruitment and retention, availability of specialty services, quality care, and cost effectiveness are some of the issues that must come into discussions about access to services. With this in mind, this issue of the NCMJ explores opportunities to strengthen the health of North Carolina's rural communities. PMID:25621473

  18. Five Steps to Safer Health Care

    MedlinePlus

    ... to Safer Health Care Five Steps to Safer Health Care: Patient Fact Sheet This information is for reference ... safety is one of the Nation's most pressing health care challenges. A 1999 report by the Institute of ...

  19. Measuring the quality of care: reforming the health care system.

    PubMed

    Longo, D R; Daugird, A J

    1994-01-01

    Elements of meaningful health care reform must include the ability of patients, providers, and payers to select services offering quality care at an affordable price. To achieve this goal, an appropriate definition of quality needs to be articulated and adopted; data capturing the definition needs to be collected; and appropriate measures need to be selected to analyze that data. Results need to be publically available to assist in making informed choices. The health professions need to fulfill their social contract. And, government needs to ensure that public safety and accountability are maintained and preserved. While the goals and strategies of the different players in the health care arena may be different, there is one thing in common--the needs of citizens must be met through the provision of available, accessible, quality, equitable, and cost-effective health care. These values need to be incorporated into a reform plan. Currently, our ability to comprehensively, consistently, and uniformly perform these tasks is severely limited. While many diverse factors, such as the limitation of financial support and the lack of uniform information systems, contribute to this situation, we believe it is possible through the implementation of a series of recommendations to achieve these goals. This paper outlines the current situation, reviews insights derived from the literature and past and current experiences. Recommendations are made that apply equally to health reform efforts at the state and/or federal levels. PMID:7950482

  20. [Supply and demand in home health care].

    PubMed

    Braga, Patrícia Pinto; de Sena, Roseni Rosângela; Seixas, Clarissa Terenzi; de Castro, Edna Aparecida Barbosa; Andrade, Angélica Mônica; Silva, Yara Cardoso

    2016-03-01

    The changes in the demographic and epidemiologic profiles of the Brazilian population and the need to rethink the health care model have led many countries like Brazil to consider Home Care (HC) as a care strategy. However, there is a gap between the supply of HC services, the demand for care and the health needs manifested by the population. Thus, this article analyzes scientific output regarding the status of the relation between supply, demand and the needs related to home health care. This work is based on an integrative review of the literature in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin America and the Caribbean Literature on Health and Science (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) and Web of Science. Despite the fact that few articles refer to the issue in question, there is evidence indicating that health demands and needs are seldom taken into account either in a quantitative or qualitative approach when developing the organization of HC services. The analysis would indicate that there is a national and international deficit in the supply of HC services considering the demand for health care and needs currently prevailing. PMID:26960102

  1. Will Boeing Change Health Care?

    PubMed

    Stempniak, Marty

    2015-12-01

    Big employers like Boeing and Intel are directly contracting with hospitals in an effort to control health care prices. Some hospital CEOs see direct contracting as the future, while others wonder how they can participate. PMID:26837134

  2. Health in Day Care: A Guide for Day Care Providers in Massachusetts.

    ERIC Educational Resources Information Center

    Kendrick, Abby Shapiro, Ed.; Messenger, Katherine P., Ed.

    This reference manual and resource guide describes high standards for health policies and day care procedures that reflect current research and recommendations of experts. Chapters 1 and 2, which concern day care's role in health, cover health education in day care and the basics relating to policies, providers, and records. Chapters 3-5 concern…

  3. Czechoslovakia's changing health care system.

    PubMed Central

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services. PMID:1454975

  4. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

    PubMed Central

    2013-01-01

    Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices

  5. New developments in a consolidating health care industry.

    PubMed

    Taylor, D; Kleiner, B H

    1998-01-01

    The current health care industry has recently seen a great deal of consolidation in the form of mergers and acquisitions. These mergers and acquisitions invariably result in a loss of jobs. This paper focuses on two strategies that health care companies use to reduce workforce under these circumstances. Specifically, the paper will focus on the mergers between SmithKline Beckman and Beecham plc in the late 1980s, FHP Health Care and TakeCare Health Plans, and PacifiCare's recent acquisition of FHP Health-care. It will compare and contrast theory, strategy and practices of these six companies as they endeavoured to merge or acquire each other. PMID:10346310

  6. Model Child Care Health Policies.

    ERIC Educational Resources Information Center

    Aronson, Susan; Smith, Herberta

    Drawn from a review of policies at over 100 child care programs nationwide, the model health policies presented in this report are intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the report presents model policy forms with blanks for adding individualized information for the following…

  7. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions. PMID:26016214

  8. The priority of health care.

    PubMed

    Green, R M

    1983-11-01

    The economic recession, the mounting costs of medical technology, and the weakening of public support for welfare state ideals have led to philosophical qualification of the right of equal access to health care by writers like Norman Daniels and Lawrence Stern. Green rejects their arguments and reiterates the claim that a Rawlsian theory of justice provides an appropriate way of thinking about the right to health care, which should be treated on a par with basic civil liberties. PMID:6655385

  9. 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

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

    1999-01-01

    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)

  10. Health care utilisation in India.

    PubMed

    Duggal, R

    1994-02-01

    India has a plurality of health care systems as well as different systems of medicine. The government and local administrations provide public health care in hospitals and clinics. Public health care in rural areas is concentrated on prevention and promotion services to the detriment of curative services. The rural primary health centers are woefully underutilized because they fail to provide their clients with the desired amount of attention and medication and because they have inconvenient locations and long waiting times. Public hospitals provide 60% of all hospitalizations, while the private sector provides 75% of all routine care. The private sector is composed of an equal number of qualified doctors and unqualified practitioners, with a greater ratio of unqualified to qualified existing in less developed states. In rural areas, qualified doctors are clustered in areas where government services are available. With a population barely able to meet its nutritional needs, India needs universalization of health care provision to assure equity in health care access and availability instead of a large number of doctors who are profiting from the sicknesses of the poor. PMID:12288588

  11. Helping You Choose Quality Behavioral Health Care

    MedlinePlus

    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 ...

  12. Universal health care: the changing international discourse.

    PubMed

    Bisht, Ramila

    2013-01-01

    Nearly 34 years ago, in 1978 in the face of a looming crisis in the health of the world's populations and rising health inequality, 134 countries came together to sign the historic Alma Ata Declaration where the idea of primary health care as the chosen path to "Health for All" was formulated. However even before the declaration and more so since, countries have diverse interpretations of Universalism, each setting it in the context of its own health care model. These have ranged from the minimalist to the more comprehensive welfare state. Today, as health statistics reveal, the crisis has deepened, not only in the developing world but also in the developed world. It is important to debate the nature of the crisis and understand current policy initiatives and their ideological legitimations. The paper attempts to trace, clarify and account for the shifts in international discourse on universal health care (UHC). It argues that the idea of UHC is still with us, but there have occurred substantial shifts in discourse and meaning, shaped by changing international and national contexts and social forces impinging on health systems. The current concept of universal health coverage has only a notional allusion to universality of Alma Ata and disregards its fundamental principles. It concludes that the shifts are detrimental and its value in promoting health for all is likely to be severely limited. PMID:24351385

  13. Health care entrepreneurship: financing innovation.

    PubMed

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

    Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects. PMID:16583848

  14. Agents of Change for Health Care Reform

    ERIC Educational Resources Information Center

    Buchanan, Larry M.

    2007-01-01

    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…

  15. [Calculation of workers' health care costs].

    PubMed

    Rydlewska-Liszkowska, Izabela

    2006-01-01

    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

  16. The outcomes of health care process in Iran's rural society

    PubMed Central

    Eskandari, Manije; Abbaszadeh, Abbas; Borhani, Fariba

    2013-01-01

    Background: Health care systems in rural areas face numerous challenges in meeting the community's needs and adequate attention has not been paid to this problem. The aim of this study was to describe the outcomes of health care process in rural society. Materials and Methods: Twenty-six participants including twenty-one rural health care providers and five clients were selected according to purposive sampling. The data were collected via semi-structured individual interviews and a mini focus group. Data were analyzed by using qualitative content analysis based on methods described by Granheme and Landman. Results: Data analysis eventually led to formation of one category of inefficiency in health care process in rural society including subcategories such as arbitrary self-therapy, slow care process, dissatisfaction with the care process, superficial caring, job stress and burn out of caregivers, and ineffective caring relationship. Conclusion: Outcomes in health care in rural society of Iran represents inefficiency of the current health care process. These outcomes are related to the cultural and social context of rural communities and the structure of the health system. These outcomes in health care in the rural society of Iran represent impairment of the current health care process. The necessity of modifying the existing care trend with new models designed to improve the health care process is felt. PMID:24403941

  17. Health Care Becomes an Industry

    PubMed Central

    Rastegar, Darius A.

    2004-01-01

    The delivery of health care is in the process of “industrialization” in that it is undergoing changes in the organization of work which mirror those that began in other industries a century ago. This process is characterized by an increasing division of labor, standardization of roles and tasks, the rise of a managerial superstructure, and the degradation (or de-skilling) of work. The consolidation of the health care industry, the fragmentation of physician roles, and the increasing numbers of nonphysician clinicians will likely accelerate this process. Although these changes hold the promise of more efficient and effective health care, physicians should be concerned about the resultant loss of autonomy, disruption of continuity of care, and the potential erosion of professional values. PMID:15053287

  18. Health care's 100 most wired.

    PubMed

    Solovy, A; Serb, C

    1999-02-01

    They're wired all right, and America's 100 most techno-savvy hospitals and health systems share one more thing: a commitment to using technology to link with employees, patients, suppliers, and insurers. "We want to be a health care travel agency for our community," says one chief information officer. "And we see Internet technology as a key." PMID:10081454

  19. Help Yourself to Health Care.

    ERIC Educational Resources Information Center

    Snyder, Sarah

    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…

  20. Advanced practice nursing in performing arts health care.

    PubMed

    Weslin, Anna T; Silva-Smith, Amy

    2010-06-01

    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

  1. Use of "serious health games" in health care: a review.

    PubMed

    Adams, Samantha A

    2010-01-01

    This inter-disciplinary literature review examines current and potential uses of so-called "Serious Games" in health care. Based on a core body of 51 articles about Serious Games (12 pertaining specifically to health care), it briefly examines examples of use for training professionals, but focuses mostly on how games are used for patient treatment or education and how they can be used for disease prevention and health promotion. This article highlights considerations that must be made when designing and implementing Serious Games for these purposes. PMID:20543383

  2. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  3. Mental health care roles of non-medical primary health and social care services.

    PubMed

    Mitchell, Penny

    2009-02-01

    Changes in patterns of delivery of mental health care over several decades are putting pressure on primary health and social care services to increase their involvement. Mental health policy in countries like the UK, Australia and New Zealand recognises the need for these services to make a greater contribution and calls for increased intersectoral collaboration. In Australia, most investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain, however, in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Very little research has examined the nature of the roles that non-medical primary health and social care services actually or potentially play in mental health care. Lack of information about these roles could have inhibited development of service improvement initiatives targeting these services. The present paper reports the results of an exploratory study that examined the mental health care roles of 41 diverse non-medical primary health and social care services in the state of Victoria, Australia. Data were collected in 2004 using a purposive sampling strategy. A novel method of surveying providers was employed whereby respondents within each agency worked as a group to complete a structured survey that collected quantitative and qualitative data simultaneously. This paper reports results of quantitative analyses including a tentative principal components analysis that examined the structure of roles. Non-medical primary health and social care services are currently performing a wide variety of mental health care roles and they aspire to increase their involvement in this work. However, these providers do not favour approaches involving selective targeting of clients with mental disorders. PMID

  4. Patient care outcomes: implications for the Military Health Services System.

    PubMed

    Jennings, B M

    1993-05-01

    Policy makers are targeting patient outcomes and the effectiveness of interventions as possible ways to curb spiraling health care costs. Quality assurance/improvement programs are focusing on patient outcomes as a way to evaluate and improve care delivery. Consequently, members of the Military Health Services System need a solid understanding of the current emphasis on the outcomes of care to be knowledgeable participants in the health care changes precipitated by highlighting patient outcomes. PMID:8502389

  5. Counseling and Mental Health Care in Palestine

    ERIC Educational Resources Information Center

    Shawahin, Lamise; Ciftci, Ayse

    2012-01-01

    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.

  6. Training Health Care Paraprofessionals

    ERIC Educational Resources Information Center

    Linton, Corinne B.

    1977-01-01

    This review of the allied health occupations training programs offered by Brevard Community College (Cocoa, Florida) covers organization of the division, objectives, selection and admission process, instructional delivery system, clinical facilities, advisory committees, high school relations, continuing education programs, and program success.…

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

    PubMed

    Cuellar, Alison Evans; Cheema, Jehanzeb

    2014-10-01

    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

  8. reDefined contribution health care.

    PubMed

    Lair, Tamra

    2004-01-01

    To combat rising health care costs and a society increasingly unsatisfied with employer-sponsored health care services, reDefined Contribution Health Care suggests a process to create a more consumer-driven health care market. To create this value-sensitive market requires a planned, staged approach that will include immediate actions and work toward fundamental, long-term changes. PMID:15146751

  9. A right to health care.

    PubMed

    Eleftheriadis, Pavlos

    2012-01-01

    What does it mean to say that there is a right to health care? Health care is part of a cooperative project that organizes finite resources. How are these resources to be distributed? This essay discusses three rival theories. The first two, a utilitarian theory and an interst theory, are both instrumental, in that they collapse rights to good states of affairs. A third theory, offered by Thomas Pogge, locates the question within an institutional legal context and distinguishes between a right to health care that results in claimable duties and other dimensions of health policy that do not. Pogge's argument relies on a list of "basic needs," which itself, however, relies on some kind of instrumental reasoning. The essay offers a reconstruction of Pogge's argument to bring it in line with a political conception of a right to health care. Health is a matter of equal liberty and equal citizenship, given our common human vulnerability. If we are to live as equal members in a political community, then our institutions need to create processes by which we are protected from the kinds of suffering that would make it impossible for us to live as equal members. PMID:22789045

  10. Primary care: can it solve employers' health care dilemma?

    PubMed

    Sepulveda, Martin-J; Bodenheimer, Thomas; Grundy, Paul

    2008-01-01

    Employers are beginning to recognize that investing in the primary care foundation of the health care system may help address their problems of rising health care costs and uneven quality. Primary care faces a crisis as a growing number of U.S. medical graduates are avoiding primary care careers because of relatively low reimbursement and an unsatisfying work life. Yet a strong primary care sector has been associated with reduced health care costs and improved quality. Through the Patient-Centered Primary Care Collaborative and other efforts, some large employers are engaged in initiatives to strengthen primary care. PMID:18180490

  11. Informal care and health care use of older adults.

    PubMed

    Van Houtven, Courtney Harold; Norton, Edward C

    2004-11-01

    Informal care by adult children is a common form of long-term care for older adults and can reduce medical expenditures if it substitutes for formal care. We address how informal care by all children affects formal care, which is critically important given demographic trends and the many policies proposed to promote informal care. We examine the 1998 Health and Retirement Survey (HRS) and 1995 Asset and Health Dynamics Among the Oldest-Old Panel Survey (AHEAD) using two-part utilization models. Instrumental variables (IV) estimation controls for the simultaneity of informal and formal care. Informal care reduces home health care use and delays nursing home entry. PMID:15556241

  12. Health care coalitions: continuity and change.

    PubMed

    Mullner, R M; Young, G W; Andersen, R M

    1988-01-01

    The purpose of this study has been to investigate how coalitions have changed during 1983-1986, to describe the current characteristics of coalitions, and to speculate about their future roles and likely evolution. Several insights emerge from the empirical findings of this study. First, the number of operational health care coalitions has greatly expanded over the last several years to the point where almost every state and metropolitan area of the country has at least one. Second, the service area of most coalitions is generally county-wide, although there has been significant growth in the number of coalitions that serve states. Third, coalitions are expanding their membership composition and including not only business members but also hospitals, physicians, insurance companies, and labor organizations. Fourth, coalitions are becoming more financially secure; most have annual cash budgets, and most rely on dues. Fifth, coalitions are increasingly hiring and using paid professional staff. Last, coalitions are expanding their agendas beyond investigating direct health care costs to examine some of the underlying issues (such as hospital and medical professional liability issues, the financing of uncompensated care, and ethical issues) and are developing programs to address them. For the near future, the extension of recent trends suggests how coalitions will look and function. Further down the road, health care coalitions may evolve into health care public/private policy forums or associations of health benefits managers and/or associations for managed care purchasers. In conclusion, the trends we documented and the projections of the future of coalitions appear to be in keeping with the summary perspective of John T. Dunlop (1987) who indicates: Coalitions provide a continuing forum in which parties become more interested and informed about health care costs, utilization and the problems and operations of the other participants. The discourse encourages a more

  13. Knowledge management in health care.

    PubMed

    Guptill, Janet

    2005-01-01

    It is a long-term, sustainable commitment to changing the culture of health care to become more collaborative, more transparent, and more proactive. Knowledge management, implemented well, will transform the health care delivery system over the next few decades, into a more cost-effective, error-averse, and accountable public resource. For the sake of simplicity, this article will limit the application of knowledge management principles to the context of hospitals, hospital systems or associations, or other groupings of hospitals based on a common interest or focus. The field of knowledge management has tremendous application and value to the health care industry, particularly for hospitals and hospital systems. For many who have invested in a knowledge management infrastructure, it has become the measure of value of belonging to a hospital system or membership organization. PMID:16080410

  14. Promoting environmentally responsible health care.

    PubMed

    Gaudry, Jacqueline; Skiehar, Kimberly

    2007-01-01

    Dioxins, polyvinyl chloride and di(2-ethylhexyl) phthalate are the three main toxins interfering with the goal to maintain a healthy environment, according to the international organization Health Care Without Harm (2004). Exposure to these chemicals has been linked to cancer, as well as reproductive, cardiac, hepatic and developmental disorders (Tickner, Schettler, Guidotti, McCally, and Rossi, 2001). Health-care clients are potentially exposed to these toxins every day: polyvinyl chloride equipment, such as i.v. bags and tubing, is widely used in hospitals, and medical incineration practices emit dioxins into the air (Chlorine Chemistry Council, 2006). Nurses are uniquely positioned to play an active role in environmentally responsible health care through education, advocacy and the implementation of measures to reduce medical wastage and exposure to these chemical toxins (Canadian Nurses Association, 2005). PMID:17269580

  15. [Accreditation in health care].

    PubMed

    Fügedi, Gergely; Lám, Judit; Belicza, Éva

    2016-01-24

    Besides the rapid development of healing procedures and healthcare, efficiency of care, institutional performance and safe treatment are receiving more and more attention in the 21st century. Accreditation, a scientifically proven tool for improving patient safety, has been used effectively in healthcare for nearly a hundred years, but only started to spread worldwide since the 1990s. The support and active participation of medical staff are determining factors in operating and getting accross the nationally developed, upcoming Hungarian accreditation system. However, this active assistance cannot be expected without the participants' understanding of the basic goals and features of the system. The presence of the ISO certification in Hungary, well-known by healthcare professionals, further complicates the understanding and orientation among quality management and improvement systems. This paper aims to provide an overview of the history, goals, function and importance of healthcare accreditation, and its similarities and differences regarding ISO certification. PMID:26772826

  16. The Future of Mental Health Care Delivery: Ideals and Realities.

    ERIC Educational Resources Information Center

    Gottlieb, Michael C.; Cooper, Caren C.

    2000-01-01

    Gives a response to the reactants of the authors' article (this issue), "Ethical Issues with Managed Care: Challenges Facing Counseling Psychology." Anticipates trends in the managed care movement and predicts numerous models of health care delivery as the current system of managed care diminishes. (Author/GCP)

  17. Health care clinics in Cambodia.

    PubMed

    Wollschlaeger, K

    1995-04-01

    Under the Pol Pot Khmer Rouge regime, most physicians with clinical experience were either killed or fled the country. The few practitioners who managed to survive were forced to hide their knowledge; much of that knowledge and experience is now lost. As part of a general process of national rehabilitation, Cambodia has trained since the 1980s hundreds of physicians and physician assistants. There were 700 physicians, 1300 physician assistants, and 4000 nurses in the country by 1992. Problems do, however, remain with medical education in Cambodia. In particular, the medical texts and lectures are in French, a language which very few of the younger generation speak; instructional texts are designed to meet the needs of developing nations, not a rehabilitating one like Cambodia; emphasis is upon curative health care, hospitals, and vertical programs instead of primary and preventive health care; Cambodian physicians are used to a system based upon the division of patients by ability to pay instead of by age, disease, or need; corruption has grown as the cost of living has outstripped the level of official salaries; and there is neither professional contact, feedback, nor program evaluation within health care programs. The authors is a resident in obstetrics and gynecology at the University of Chicago who worked at two clinics during a stay in Phnom Penh. She recommends that instead of simply training more doctors, these training-related problems should be addressed, including a revision of the curriculum to include both primary health care medicine and psychiatry. Moreover, people in Cambodia need to be taught the importance of preventive health care, which should then reduce the number of visits to physicians. This process will be accomplished more effectively with the cooperation of physicians, the government, nongovernmental organizations, and international organizations associated with health care. PMID:7787486

  18. Phytotherapy in primary health care

    PubMed Central

    Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  19. Phytotherapy in primary health care.

    PubMed

    Antonio, Gisele Damian; Tesser, Charles Dalcanele; Moretti-Pires, Rodrigo Otavio

    2014-06-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  20. Pharmacy and the health-care environment.

    PubMed

    Oddis, J A

    1986-06-01

    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

  1. Health Care Procedure Considerations and Individualized Health Care Plans

    ERIC Educational Resources Information Center

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

    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…

  2. Health Care Reform: Lessons From Canada

    PubMed Central

    Deber, Raisa Berlin

    2003-01-01

    Although Canadian health care seems to be perennially in crisis, access, quality, and satisfaction in Canada are relatively high, and spending is relatively well controlled. The Canadian model is built on a recognition of the limits of markets in distributing medically necessary care. Current issues in financing and delivering health care in Canada deserve attention. Key dilemmas include intergovernmental disputes between the federal and provincial levels of government and determining how to organize care, what to pay for (comprehensiveness), and what incentive structures to put in place for payment. Lessons for the United States include the importance of universal coverage, the advantages of a single payer, and the fact that systems can be organized on a subnational basis. PMID:12511378

  3. Sustainable health care for Canada.

    PubMed

    Maxwell, J; Angus, D; Albert, T

    1995-01-01

    Sustainable Health Care For Canada is a synthesis of the research findings of the Cost-Effectiveness of the Canadian Health Care System Project initiated by the Economic Council of Canada. Upon the council's closing, the team moved to become part of the Queen's-University of Ottawa Economic Projects to complete the research. During the project, 18 working papers were produced, in addition to the research report and the synthesis report. In this article, the authors provide an overview of this large-scale research program and highlight some of its key findings. PMID:10140965

  4. A systems view of health care for the poor.

    PubMed Central

    Prasad, N.

    1989-01-01

    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

  5. Measuring competition in health care markets.

    PubMed Central

    Baker, L C

    2001-01-01

    OBJECTIVE: Measuring competition is increasingly important for analysis of health care markets and policies. Measurement of competition in health care is made complex by the breadth of potential issues under study, by the lack of necessary data, and by rapid changes in health care financing and delivery. This study reviews key issues in the measurement of competition and is designed to familiarize researchers and policymakers interested in competition measurement, but not steeped in its practice, with key concepts, data sources, and ways of adapting measures to fit ongoing changes in health care markets. PRINCIPAL FINDINGS: Attention to several key issues will strengthen measurement. Important components of successful measurement are: careful identification of the products and market areas for study; selection of Herfindahl-Hirschman or other indices to fit the issues being considered; consideration of econometric problems, like endogeneity, with common measures; and attention to the ways that current marketplace changes, like growth in managed care, affect the performance of classic measures. Data needed for constructing measures are also frequently scarce, insufficient, or both. Measurement could be improved with access to better data. PMID:11327175

  6. Health disparities among health care workers.

    PubMed

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

    2010-01-01

    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

  7. Health Care Reform: A Values Debate.

    ERIC Educational Resources Information Center

    Popko, Kathleen

    1992-01-01

    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)

  8. Analyzing health care operations using ABC.

    PubMed

    Ross, Thomas K

    2004-01-01

    The evolution of health care created a climate in which cost was subordinate to medical treatment. Current reimbursement constraints have increased the need for providers to be cost conscious, but they have discovered that current accounting practices do not provide the appropriate information to determine the cost of service or make decisions. This article argues that activity-based costing (ABC) can bridge the gap between the medical and financial communities and provide a foundation for performance improvement. PMID:15151193

  9. Communication security in open health care networks.

    PubMed

    Blobel, B; Pharow, P; Engel, K; Spiegel, V; Krohn, R

    1999-01-01

    Fulfilling the shared care paradigm, health care networks providing open systems' interoperability in health care are needed. Such communicating and co-operating health information systems, dealing with sensitive personal medical information across organisational, regional, national or even international boundaries, require appropriate security solutions. Based on the generic security model, within the European MEDSEC project an open approach for secure EDI like HL7, EDIFACT, XDT or XML has been developed. The consideration includes both securing the message in an unsecure network and the transport of the unprotected information via secure channels (SSL, TLS etc.). Regarding EDI, an open and widely usable security solution has been specified and practically implemented for the examples of secure mailing and secure file transfer (FTP) via wrapping the sensitive information expressed by the corresponding protocols. The results are currently prepared for standardisation. PMID:10724890

  10. Pediatric palliative care online: the views of health care professionals.

    PubMed

    Ens, Carla D L; Chochinov, Harvey M; Bérard, Josette L M; Harlos, Mike S; Stenekes, Simone J; Wowchuk, Suzanne M

    2008-01-01

    The purpose of the study was to evaluate the role of an online resource for dying children, their family members, and health care providers from the perspective of pediatric palliative care experts. Semistructured interviews with 12 leaders in pediatric palliative care in North America were conducted, exploring their perceptions and attitudes towards various aspects of Web-based resources for dying children and their care providers. Informants felt that an online resource may allow for a different form of expression, a connection between people undergoing a rare event, and an increase in education and support. Major challenges, such as accessibility, monitoring, and remaining current, would be ongoing. Other key themes included access, information, and anonymity. The data suggest that developing Web-based resources for dying young patients and their families may have merit. Should this take place, a feasibility study will be necessary to further determine the value of such a Web site for these vulnerable populations. PMID:18459596

  11. School Readiness Goal Begins with Health Care Reform.

    ERIC Educational Resources Information Center

    Penning, Nick

    1992-01-01

    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,…

  12. Transforming Health Care Delivery Through Consumer Engagement, Health Data Transparency, and Patient-Generated Health Information

    PubMed Central

    Wald, J. S.

    2014-01-01

    Summary Objectives Address current topics in consumer health informatics. Methods Literature review. Results Current health care delivery systems need to be more effective in the management of chronic conditions as the population turns older and experiences escalating chronic illness that threatens to consume more health care resources than countries can afford. Most health care systems are positioned poorly to accommodate this. Meanwhile, the availability of ever more powerful and cheaper information and communication technology, both for professionals and consumers, has raised the capacity to gather and process information, communicate more effectively, and monitor the quality of care processes. Conclusions Adapting health care systems to serve current and future needs requires new streams of data to enable better self-management, improve shared decision making, and provide more virtual care. Changes in reimbursement for health care services, increased adoption of relevant technologies, patient engagement, and calls for data transparency raise the importance of patient-generated health information, remote monitoring, non-visit based care, and other innovative care approaches that foster more frequent contact with patients and better management of chronic conditions. PMID:25123739

  13. Good Health Before Pregnancy: Preconception Care

    MedlinePlus

    ... Login Join Pay Dues Follow us: Women's Health Care Physicians Contact Us My ACOG ACOG Departments Donate ... Patients About ACOG Good Health Before Pregnancy: Preconception Care Home For Patients Search FAQs Good Health Before ...

  14. Oral health care in residential aged care services: barriers to engaging health-care providers.

    PubMed

    Hearn, Lydia; Slack-Smith, Linda

    2015-01-01

    The oral health of older people living in residential aged care facilities has been widely recognised as inadequate. The aim of this paper is to identify barriers to effective engagement of health-care providers in oral care in residential aged care facilities. A literature review was conducted using MEDline, CINAHL, Web of Science, Academic Search Complete and PsychInfo between 2000 and 2013, with a grey literature search of government and non-government organisation policy papers, conference proceedings and theses. Keywords included: dental/oral care, residential aged care, health-care providers, barriers, constraints, and limitations. A thematic framework was used to synthesise the literature according to a series of oral health-care provision barriers, health-care provider barriers, and cross-sector collaborative barriers. A range of system, service and practitioner level barriers were identified that could impede effective communication/collaboration between different health-care providers, residents and carers regarding oral care, and these were further impeded by internal barriers at each level. Findings indicated several areas for investigation and consideration regarding policy and practice improvements. While further research is required, some key areas should be addressed if oral health care in residential aged care services is to be improved. PMID:25155109

  15. The value of pharmacists in health care.

    PubMed

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

    2012-06-01

    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

  16. Small area variations in health care delivery.

    PubMed

    Wennberg, J; Gittelsohn

    1973-12-14

    Health information about total populations is a prerequisite for sound decision-making and planning in the health care field. Experience with a population-based health data system in Vermont reveals that there are wide variations in resource input, utilization of services, and expenditures among neighboring communities. Results show prima facie inequalities in the input of resources that are associated with income transfer from areas of lower expenditure to areas of higher expenditure. Variations in utilization indicate that there is considerable uncertainty about the effectiveness of different levels of aggregate, as well as specific kinds of, health services. Informed choices in the public regulation of the health care sector require knowledge of the relation between medical care systems and the population groups being served, and they should take into account the effect of regulation on equality and effectiveness. When population-based data on small areas are available, decisions to expand hospitals, currently based on institutional pressures, can take into account a community's regional ranking in regard to bed input and utilization rates. Proposals by hospitals for unit price increases and the regulation of the actuarial rate of insurance programs can be evaluated in terms of per capita expenditures and income transfer between geographically defined populations. The PSRO's can evaluate the wide variations in level of services among residents of different communities. Coordinated exercise of the authority vested in these regulatory programs may lead to explicit strategies to deal directly with inequality and uncertainty concerning the effectiveness of health care delivery. Population-based health information systems, because they can provide information on the performance of health care systems and regulatory agencies, are an important step in the development of rational public policy for health. PMID:4750608

  17. Health care insolvency and bankruptcy.

    PubMed

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

    1998-08-01

    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

  18. Mental health care in Cambodia.

    PubMed Central

    Somasundaram, D. J.; van de Put, W. A.

    1999-01-01

    An effort is being made in Cambodia to involve grass-roots personnel in the integration of the care of the mentally ill into a broad framework of health services. This undertaking is examined with particular reference to the work of the Transcultural Psychosocial Organization. PMID:10212521

  19. Reengineering health care materials management.

    PubMed

    Connor, L R

    1998-01-01

    Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management. PMID:9785300

  20. Where Is Health Care Headed?

    PubMed

    Bland, Jeffrey

    2016-06-01

    Looking at the trends, developments, and discoveries points us toward the future, but it is only when we consider these in the context of our understanding about the origins of disease that we can truly gain a clearer view of where health care is headed. This is the view that moves us from a focus on the diagnosis and treatment of a disease to an understanding of the origin of the alteration in function in the individual. This change in both perspective and understanding of the origin of disease is what will lead us to a systems approach to health care that delivers personalized and precision care that is based on the inherent rehabilitative power that resides within the genome. PMID:27547161

  1. Managed consumerism in health care.

    PubMed

    Robinson, James C

    2005-01-01

    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

  2. Partners HealthCare Center for Connected Health.

    PubMed

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

    2013-05-01

    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

  3. Universal health care in India: Panacea for whom?

    PubMed

    Qadeer, Imrana

    2013-01-01

    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

  4. Preserving community in health care.

    PubMed

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  5. Contextualizing an Expanded Definition of Health Literacy among Adolescents in the Health Care Setting

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

  6. Health care needs of Hispanic Americans and the responsiveness of the health care system.

    PubMed

    De la Rosa, M

    1989-05-01

    The Hispanic population in the United States is growing rapidly but this population has many health care needs that are not being met. The findings from recent research on the current health status of Hispanic people who live in the United States are presented. An assessment of how accessible and available medical care services are to Hispanic people is made. Serious gaps exist in the delivery of medical care services to this group. Human service providers, particularly social workers, can help make the current health care system more responsive to the needs of this group by helping Hispanic individuals who have no health insurance coverage to find employment that includes health insurance benefits or some other form of insurance, by establishing community-based health care centers in Hispanic communities, by developing counseling programs tailored to the alcohol and drug abuse problems of the Hispanic population, and by advocating for government agencies to improve existing sources of data on the health of this group. PMID:2714702

  7. Consumer-directed health care: understanding its value in health care reform.

    PubMed

    Guo, Kristina L

    2010-01-01

    The purpose of this article is to describe the importance of consumer-directed health care as the essential strategy needed to lower health care costs and support its widespread adoption for making significant strides in health care reform. The pros and cons of health care consumerism are discussed. The intent is to show that the viability of the US health care system depends on the application of appropriate consumer-directed health care strategies. PMID:20145464

  8. Integrating Health Information Technology to Achieve Seamless Care Transitions.

    PubMed

    Marcotte, Leah; Kirtane, Janhavi; Lynn, Joanne; McKethan, Aaron

    2015-12-01

    Improving care transitions, or "handoffs" as patients migrate from one care setting to another, is a priority across stakeholder groups and health-care settings and additionally is included in national health-care goals set forth in the National Quality Strategy. Although many demonstrations of improved care transitions have succeeded, particularly for hospital discharges, ensuring consistent, high-quality, and safe transitions of care remains challenging. This paper highlights the potential for health information technology to become an increasing part of effective transitional care interventions, with the potential to reduce the resource burden currently associated with effective care transitions, the ability to spread improved practices to larger numbers of patients and providers efficiently and at scale, and, as health technology interoperability increases, the potential to facilitate critical information flow and feedback loops to clinicians, patients, and caregivers across disparate information systems and care settings. PMID:24522208

  9. Reduction of catastrophic health care expenditures by a community-based health insurance scheme in Gujarat, India: current experiences and challenges.

    PubMed Central

    Ranson, Michael Kent

    2002-01-01

    OBJECTIVE: To assess the Self Employed Women's Association's Medical Insurance Fund in Gujarat in terms of insurance coverage according to income groups, protection of claimants from costs of hospitalization, time between discharge and reimbursement, and frequency of use. METHODS: One thousand nine hundred and thirty claims submitted over six years were analysed. FINDINGS: Two hundred and fifteen (11%) of 1927 claims were rejected. The mean household income of claimants was significantly lower than that of the general population. The percentage of households below the poverty line was similar for claimants and the general population. One thousand seven hundred and twelve (1712) claims were reimbursed: 805 (47%) fully and 907 (53%) at a mean reimbursement rate of 55.6%. Reimbursement more than halved the percentage of catastrophic hospitalizations (>10% of annual household income) and hospitalizations resulting in impoverishment. The average time between discharge and reimbursement was four months. The frequency of submission of claims was low (18.0/1000 members per year: 22-37% of the estimated frequency of hospitalization). CONCLUSIONS: The findings have implications for community-based health insurance schemes in India and elsewhere. Such schemes can protect poor households against the uncertain risk of medical expenses. They can be implemented in areas where institutional capacity is too weak to organize nationwide risk-pooling. Such schemes can cover poor people, including people and households below the poverty line. A trade off exists between maintaining the scheme's financial viability and protecting members against catastrophic expenditures. To facilitate reimbursement, administration, particularly processing of claims, should happen near claimants. Fine-tuning the design of a scheme is an ongoing process - a system of monitoring and evaluation is vital. PMID:12219151

  10. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  11. [A theoretical analysis of coordination in the field of health care: application to coordinated care systems].

    PubMed

    Sebai, Jihane

    2016-01-01

    Various organizational, functional or structural issues have led to a review of the foundations of the former health care system based on a traditional market segmentation between general practice and hospital medicine, and between health and social sectors and marked by competition between private and public sectors. The current reconfiguration of the health care system has resulted in “new” levers explained by the development of a new organizational reconfiguration of the primary health care model. Coordinated care structures (SSC) have been developed in this context by making coordination the cornerstone of relations between professionals to ensure global, continuous and quality health care. This article highlights the contributions of various theoretical approaches to the understanding of the concept of coordination in the analysis of the current specificity of health care. PMID:27392057

  12. Health care in remote areas.

    PubMed

    Padeken, D; Sotiriou, D; Boddy, K; Gerzer, R

    1995-02-01

    Migration from space medicine toward telemedicine services is described by potential application areas in highly populated and remote areas of Europe. Special emphasis is laid upon links between mobile patient monitoring and health care in remote areas. Pilot projects are described for home (mobile) monitoring of newborn infants endangered by sudden infant death (SID) and adults suffering from sleep apnoea. Health care in remote areas is described by the "TeleClinic-project" which will link national nodes for telemedicine services in several European states for the mobile European citizen. Another project describes the future potential of robotics for semiautonomous ultrasound diagnostics and for realtime interaction of remote experts with diagnostics and therapy. PMID:7790809

  13. ARTEMIS: a collaborative framework for health care.

    PubMed

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

    1993-01-01

    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

  14. Many Manly Men Avoid Needed Health Care

    MedlinePlus

    ... fullstory_158551.html Many Manly Men Avoid Needed Health Care Gender stereotypes can have dangerous consequences, research suggests ... traditional masculine ideals were less likely to seek health care, more likely to downplay symptoms, and had worse ...

  15. Savings account for health care costs

    MedlinePlus

    ... can set aside tax-exempt money for your health care expenses. This means you will pay no or ... offers reimbursement for those expenses when you use health care. HRAs can be set up for any type ...

  16. Passion in today's health care leaders.

    PubMed

    Piper, Llewellyn E

    2005-01-01

    Passion in today's health care leaders is essential as health care organizations face increasing demands for survival. Leaders in health care have been educated, selected, promoted, and retained based on their analytical and creativity skills. Today's health care leaders must also have emotional intelligence. Emotional intelligence is primal for passion. Emotional intelligence, which leads to passion, is crucial to the survivability of today's health care organizations. In order for health care organizations to go from good to great, the leader must inspire followers through passion. This article encourages health care leaders to gain awareness of emotional intelligence and to use emotional intelligence as part of their leadership to inspire passion. Through passion, leaders and followers become more motivated to accomplish the health care mission of serving others. PMID:15825818

  17. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose endometriosis? Skip sharing on social media ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...

  18. 8 ways to cut health care costs

    MedlinePlus

    ... ency/patientinstructions/000870.htm 8 ways to cut health care costs To use the sharing features on this page, please enable JavaScript. The cost of health care continues to rise. That is why it helps ...

  19. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose pheochromocytoma? Skip sharing on social media links Share this: Page Content A health care provider uses blood and urine tests that measure ...

  20. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose hypoparathyroidism? Skip sharing on social media links Share this: Page Content A health care provider will order a blood test to determine ...

  1. Job satisfaction in health-care organizations

    PubMed Central

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

    Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations. PMID:23766585

  2. The Cultural Geography of Health Care Delivery.

    ERIC Educational Resources Information Center

    Gesler, Wilbert M.

    1987-01-01

    This article shows how health care delivery is related to cultural or human geography. This is accomplished by describing health care delivery in terms of 12 popular themes of cultural geography. (JDH)

  3. Accreditation Association for Ambulatory Health Care

    MedlinePlus

    ... Press Release Archives learn more » For Patients Your health care choices matter. Whether you're anticipating a surgical ... certificate of accreditation is a sign that a health care organization meets or exceeds nationally-recognized Standards. Learn ...

  4. Mental health-related stigma in health care and mental health-care settings.

    PubMed

    Henderson, Claire; Noblett, Jo; Parke, Hannah; Clement, Sarah; Caffrey, Alison; Gale-Grant, Oliver; Schulze, Beate; Druss, Benjamin; Thornicroft, Graham

    2014-11-01

    This Review considers the evidence for mental-health-related stigma in health-care and mental-health-care settings. Do mental-health-care and other health-care professionals stigmatise people using their services? If so, what are the effects on quality of mental and physical health care? How can stigma and discrimination in the context of health care be reduced? We show that the contact mental-health-care professionals have with people with mental illness is associated with positive attitudes about civil rights, but does not reduce stigma as does social contact such as with friends or family members with mental illness. Some evidence suggests educational interventions are effective in decreasing stigma especially for general health-care professionals with little or no formal mental health training. Intervention studies are needed to underpin policy; for instance, to decrease disparity in mortality associated with poor access to physical health care for people with mental illness compared with people without mental illness. PMID:26361202

  5. How to Pay for Health Care.

    PubMed

    Porter, Michael E; Kaplan, Robert S

    2016-01-01

    The United States stands at a crossroads in how to pay for health care. Fee for service, the dominant payment model in the U.S. and many other countries, is now widely recognized as perhaps the single biggest obstacle to improving health care delivery. A battle is currently raging, outside of the public eye, between the advocates of two radically different payment approaches: capitation and bundled payments. The stakes are high, and the outcome will define the shape of the health care system for many years to come, for better or for worse. In this article, the authors argue that although capitation may deliver modest savings in the short run, it brings significant risks and will fail to fundamentally change the trajectory of a broken system. The bundled payment model, in contrast, triggers competition between providers to create value where it matters--at the individual patient level--and puts health care on the right path. The authors provide robust proof-of-concept examples of bundled payment initiatives in the U.S. and abroad, address the challenges of transitioning to bundled payments, and respond to critics' concerns about obstacles to implementation. PMID:27526565

  6. The right to preventive health care.

    PubMed

    Conly, Sarah

    2016-08-01

    The right to health care is a right to care that (a) is not too costly to the provider, considering the benefits it conveys, and (b) is effective in bringing about the level of health needed for a good human life, not necessarily the best health possible. These considerations suggest that, where possible, society has an obligation to provide preventive health care, which is both low cost and effective, and that health care regulations should promote citizens' engagement in reasonable preventive health care practices. PMID:27491748

  7. Synthetic real estate: bringing corporate finance to health care.

    PubMed

    Varwig, D; Smith, J

    1998-01-01

    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

  8. Cellular Radio Telecommunication for Health Care: Benefits and Risks

    PubMed Central

    Sneiderman, Charles A.; Ackerman, Michael J.

    2004-01-01

    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

  9. Health Care Resources for Children and Pregnant Women.

    ERIC Educational Resources Information Center

    Perloff, Janet D.

    1992-01-01

    Reviews evidence about health care resources currently available to children and pregnant women in the United States. Evidence suggests that the maldistribution of resources remains a serious threat to health care access for women and children at greatest risk of adverse pregnancy outcomes and child morbidity and mortality. (SLD)

  10. Nursing Titles and Health Care Plans.

    ERIC Educational Resources Information Center

    Erceg, Linda

    1996-01-01

    Recommends choosing appropriate health care providers for camp, and referring to them by the title their credentials warrant. Explains distinctions among nursing titles and that they vary by state. Discusses developing a health care plan suited to camp's population, program, and location. Presents guidelines required of a health care plan by…

  11. Communicating in Multicultural Health Care Organizations.

    ERIC Educational Resources Information Center

    Kreps, Gary L.; Kunimoto, Elizabeth

    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…

  12. Health Care Delivery to Southeast Asian Refugees.

    ERIC Educational Resources Information Center

    Mattson, Susan

    1989-01-01

    Discusses the problems of providing sufficient health care for Southeast Asian refugees. Describes their unique languages and dialects, religious backgrounds, cultural behaviors, and health and illness beliefs so that health care professionals will be able to accommodate their needs and provide effective medical care for them. (JS)

  13. Health care expenditure in Sweden--an international comparison.

    PubMed

    Gerdtham, U G; Jönsson, B

    1991-01-01

    This paper analyses health care expenditure in Sweden and compares this with the corresponding expenditure in OECD countries. The definition and measurement problems of health care expenditure are discussed, new figures for the development of health care expenditure are presented and different measures of health care expenditure are provided. We found that health care expenditure has increased by about 20% in constant prices for Sweden between 1980 and 1988, but that health care expenditure as a share of the GDP has dropped during the same period in current prices. Health care expenditure disaggregated on different age groups show for Sweden that in the age group 15-64 years, health care expenditure has not increased in constant prices between 1976 and 1985, but in the oldest age group, health care expenditure has increased considerable during this period. Health care expenditure in Sweden is as high as would be expected, taking into account the degree of economic development and the growth of expenditure during the 80s, and has followed that in comparable OECD countries. However, the relative price is lower, which means that the input of real resources are greater than in other countries. PMID:10115993

  14. On reducing information asymmetry in U.S. health care.

    PubMed

    Mascarenhas, Oswald A J; Kesavan, Ram; Bernacchi, Michael D

    2013-01-01

    Information asymmetry is a significant issue facing the U.S. health care system. In this article, we investigate some methods of reducing this asymmetry. We trace the information asymmetry using the "wicked problem" of the health care distribution system. An information asymmetry reduction method requiring joint responsibilities among health care stakeholders is developed. It is argued that information asymmetry is a contributor to enormous health care inflation. Hence, any reduction in such asymmetry will reduce health care costs. Concepts from both signaling and corrective justice theories are integrated in this article to help reduce the information asymmetry that exists in the U.S. health care system. Getting health care costs in line with other "advanced" nations, is the long-term solution to the wicked problem that currently exists in the U.S. health care system. There is an immediate need for a centralized health care database with adequate provisions for individual privacy. Both processes as well as an outcome-based control system are essential for reducing information asymmetries in the U.S. health care system. PMID:24308415

  15. Community financing of health care.

    PubMed

    Carrin, G

    1988-01-01

    This article discusses ways to lesson the restrictions on health development in sub-Saharan Africa caused by limited public health budgets. Health improvements can be funded by the implementation of health insurance, the use of foreign aid, the raising of taxes, the reallocation of public money, and direct contributions by users or households either in the form of charges for services received or prepayments for future services. Community financing, i.e. the direct financing of health care by households in villages or distinct urban communities, is seen as preferable to a national or regional plan. When community financing is chosen, a choice must then be made between direct payment, fee-for-service, and prepayment (insurance) systems. The 3 systems, using the example of an essential drugs program, are described. Theoretically, with direct payment the government receives full cost recovery, and the patients receive the drugs they need, thereby improving their health. Of course the poor may not be able to purchase the drugs, therefore a subsidy system must be worked out at the community level. Fee-for-service means charging for a consultation or course of treatment, including drugs. A sliding scale of fees or discounts for certain types of consultations (e.g. pre-and post natal) can be used. In fee-for-service the risk is shared; because the cost of drugs is financed by the fees, those who receive costly treatments are subsidized by those whose treatments are relatively inexpensive. With prepayment or health insurance the risk of illness is shifted from the patient to the insurance firm or state. 2 issues make insurance plans hard to implement. When patients are covered by insurance, they may demand "too much" medical care (moral hazard) and thus premiums may be too small to cover treatment costs. On the other hand, people in low-risk groups may be unwilling to pay a higher premium, thus leading to adverse selection. Eventually, premiums may rise to the point where

  16. The risks of innovation in health care.

    PubMed

    Enzmann, Dieter R

    2015-04-01

    Innovation in health care creates risks that are unevenly distributed. An evolutionary analogy using species to represent business models helps categorize innovation experiments and their risks. This classification reveals two qualitative categories: early and late diversification experiments. Early diversification has prolific innovations with high risk because they encounter a "decimation" stage, during which most experiments disappear. Participants face high risk. The few decimation survivors can be sustaining or disruptive according to Christensen's criteria. Survivors enter late diversification, during which they again expand, but within a design range limited to variations of the previous surviving designs. Late diversifications carry lower risk. The exception is when disruptive survivors "diversify," which amplifies their disruption. Health care and radiology will experience both early and late diversifications, often simultaneously. Although oversimplifying Christensen's concepts, early diversifications are likely to deliver disruptive innovation, whereas late diversifications tend to produce sustaining innovations. Current health care consolidation is a manifestation of late diversification. Early diversifications will appear outside traditional care models and physical health care sites, as well as with new science such as molecular diagnostics. They warrant attention because decimation survivors will present both disruptive and sustaining opportunities to radiology. Radiology must participate in late diversification by incorporating sustaining innovations to its value chain. Given the likelihood of disruptive survivors, radiology should seriously consider disrupting itself rather than waiting for others to do so. Disruption entails significant modifications of its value chain, hence, its business model, for which lessons may become available from the pharmaceutical industry's current simultaneous experience with early and late diversifications. PMID

  17. mHealth in Cardiovascular Health Care.

    PubMed

    Chow, Clara K; Ariyarathna, Nilshan; Islam, Sheikh Mohammed Shariful; Thiagalingam, Aravinda; Redfern, Julie

    2016-08-01

    Mobile health (mHealth) has been defined as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices and personal digital assistants. Cardiovascular mHealth is, arguably, leading the mHealth space, through innovation, research and implementation, and especially in the areas of prevention, cardiac rehabilitation and education. mHealth includes simple strategies, such as the use of short message service (SMS) or text messages in successful short-term smoking-cessation, weight loss and diabetes management programs. The recent Australian Tobacco, Exercise and Diet Messages (TEXT ME) randomised clinical trial addressed multiple cardiovascular risk factors. mHealth can also involve more complex strategies, such as smart phone applications (apps), global positioning systems (GPS) and Bluetooth technologies. Although many apps could be considered suitable for primary prevention, they are largely unregulated and most are not evidence-based. Some have been well-developed, such as the Food Switch app and an iPhone electrocardiogram (ECG) system. The "explosion" of apps has driven initiatives such as the Mobile Applications Rating Scale (MARS). More recently, the use of sensors to monitor and provide feedback to patients and healthcare providers is being explored. With almost two billion people currently owning a Smartphone, and 50% of adults (globally) predicted to own one by 2018, mHealth provides the prospect of delivering efficient, affordable healthcare services to widespread populations both locally and globally. In particular, it has the potential to reduce socioeconomic disparity and alleviate the burden of cardiovascular disease. There is now a need to rethink traditional health service structures and bioengineering capacity, to ensure mHealth systems are also safe, secure and robust. PMID:27262389

  18. Health care under the Taliban.

    PubMed

    Faiz, A

    1997-04-26

    When the Taliban swept into Kabul, Afghanistan in September 1996, they began a reign of terror over the people of that city, especially the women. Adhering to a fundamentalist interpretation of Islamic law, the group has severely restricted women's freedom of movement and access to health care, education, and employment. Some female physicians and nurses have been able to continue working because the Taliban has decreed that male doctors can not treat women patients unless they are their relatives. Female physicians and nurses have been subjected to beatings by armed Taliban guards who enforce "morals." Male and female doctors are viewed with suspicion by the Taliban and are routinely ridiculed in public. Women are attacked when they venture into the streets to seek medical care for themselves or their children, and a pregnant woman recently delivered her baby in the street while her husband was being beaten for trying to take her to the hospital. This interference with the delivery of health care has occurred at a time when many people require treatment for injuries inflicted in connection with the war and when the public utility system has collapsed. Few physicians are willing to discuss the patients they treat for injuries inflicted by the torturous Taliban, especially since some physicians have collaborated with the Taliban in order to avoid reprisals. PMID:9130961

  19. Wholistic Health Care: Evolutionary Conceptual Analysis.

    PubMed

    Ziebarth, Deborah Jean

    2016-10-01

    While performing a data search to define "wholistic health care", it was evident that a definite gap existed in published literature. In addition, there are different definitions and several similar terms (whole person care, wholistic health, whole person health, wholism, etc.), which may cause confusion. The purpose of this paper was to present the analysis of "wholistic health care" using Rodgers' Evolutionary Method. The method allows for the historical and social nature of "wholistic health care" and how it changes over time. Attributes, antecedents, and consequences of wholistic health care were reduced using a descriptive matrix. In addition, attributes that consistently occurred in wholistic health care were presented as essential attributes. Definitions of Wholistic Health Care Provider(s), Wholistic Health, Wholistic Illness, Wholistic Healing, and Patient were created from the analysis of the literature review of attributes, antecedents, and consequences of wholistic health care. Wholistic Health Care is defined as the assessment, diagnosis, treatment and prevention of wholistic illness in human beings to maintain wholistic health or enhance wholistic healing. Identified wholistic health needs are addressed simultaneously by one or a team of allied health professionals in the provision of primary care, secondary care, and tertiary care. Wholistic health care is patient centered and considers the totality of the person (e.g., human development at a given age, genetic endowments, disease processes, environment, culture, experiences, relationships, communication, assets, attitudes, beliefs, and lifestyle behaviors). Patient centered refers to the patient as active participant in deciding the course of care. Essential attributes of wholistic health care are faith (spiritual) integrating, health promoting, disease managing, coordinating, empowering, and accessing health care. Wholistic health care may occur in collaboration with a faith-based organization to

  20. Health Care Marketing: Role Evolution of the Community Health Educator.

    ERIC Educational Resources Information Center

    Syre, Thomas R.; Wilson, Richard W.

    1990-01-01

    This article discusses role delineation in the health education profession, defines and presents principles of health care marketing, describes marketing plan development, and examines major ethical issues associated with health care marketing when utilized by community health educators. A marketing plan format for community health education is…

  1. Spinal pain: current understanding, trends, and the future of care

    PubMed Central

    Parkin-Smith, Gregory F; Amorin-Woods, Lyndon G; Davies, Stephanie J; Losco, Barrett E; Adams, Jon

    2015-01-01

    This commissioned review paper offers a summary of our current understanding of nonmalignant spinal pain, particularly persistent pain. Spinal pain can be a complex problem, requiring management that addresses both the physical and psychosocial components of the pain experience. We propose a model of care that includes the necessary components of care services that would address the multidimensional nature of spinal pain. Emerging care services that tailor care to the individual person with pain seems to achieve better outcomes and greater consumer satisfaction with care, while most likely containing costs. However, we recommend that any model of care and care framework should be developed on the basis of a multidisciplinary approach to care, with the scaffold being the principles of evidence-based practice. Importantly, we propose that any care services recommended in new models or frameworks be matched with available resources and services – this matching we promote as the fourth principle of evidence-based practice. Ongoing research will be necessary to offer insight into clinical outcomes of complex interventions, while practice-based research would uncover consumer needs and workforce capacity. This kind of research data is essential to inform health care policy and practice. PMID:26604815

  2. [French national health insurance. The current situation].

    PubMed

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

    2010-06-01

    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

  3. Transformation of health care in China.

    PubMed

    Hsiao, W C

    1984-04-01

    The evolving Chinese cooperative medical system is examined in an effort to gain some valuable knowledge for both the 3rd world and developed countries. The changes occurring in the Chinese health system are the unintended consequences of economic reforms that have exerted direct and indirect effects on the organization, financing, and delivery of health care. As China does not publish complete or current information on its health care system, the discussion draws on limited published information. China, an agrarian nation, has a population of 1 billion with 80% of the people living in rural areas. A gross national product of US$300/person in 1981 places China in the bottom 1/3 of the developing countries. In 1981 China had 2 hospital beds/1000 people. There are 516,000 senior doctors trained in Western medicine and 290,000 senior doctors trained in traditional Chinese medicine, yielding a ratio of 0.8 senior doctors/1000 people. China also has 436,000 assistant doctors in Western medicine, but most of the primary health care is provided by "barefoot doctors." Hospital beds and health personnel are unevenly distributed between the urban and rural areas. Health personnel, health stations, and hospitals are organized on a 3-tier system. In 1980 China inaugurated major economic reforms in agricultural production and public financing. Alterations in the rural economic structure brought about major changes in the Chinese cooperative medical system. The most influential reform provided financial incentives to peasants, who now receive direct rewards for individual output. Because of economic reform, collective financing and public support for the cooperative medical system diminished. The proportion of the rural population protected by the system has been reduced by 50%. The rapid, continuing decline in the cooperative medical system has affected several important elements of health care: the number of barefoot doctors per capita has diminished; most barefoot doctors

  4. Primary Health Care Needs of Immigrants.

    ERIC Educational Resources Information Center

    Department of Health, Education, and Welfare, Washington, DC.

    This report constitutes the response by the Department of Health, Education, and Welfare (DHEW) to 1977 and 1978 Congressional directives to assess immigrants' access to health care and the impact of immigrants on public health services and resources. Areas covered in the report are: (1) the primary health care needs of immigrants, including…

  5. Establishment of primary health care in Vietnam.

    PubMed Central

    Birt, C A

    1990-01-01

    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

  6. Rural Youth and the Health Care System

    ERIC Educational Resources Information Center

    McGruk, Lois F.

    1978-01-01

    Presenting a documentary statement regarding the background of rural youth health needs, this article includes definitions, barriers to health care for the rural poor (poverty, culture, isolation, immobility, and low priority for health services), and some alternatives (self-care, a wider view of health determinants, living patterns, etc.). (JC)

  7. Integrated health care in California's managed care capital.

    PubMed

    Terry, D

    1994-01-01

    Sacramento, California's capital, represents the nation's most competitive managed care marketplace. The Sutter Health organization represents a significant force in this marketplace and surrounding regions of Northern California. Sutter has created an integrated regional health care network capable of delivering a full continuum of care through appropriate community-based facilities, a variety of physician relationships, and both owned and aligned managed care structures. The overall Sutter Health strategy that incorporates facilities, physician partnerships, and patient care financing is described. The article identifies six key lessons learned during this period of growth. PMID:10138791

  8. Preventive Health Care for the Elderly

    PubMed Central

    Stults, Barry M.

    1984-01-01

    Demographic, economic and humanitarian considerations dictate that effective preventive health care be provided to the elderly. A disease-specific approach to geriatric preventive health care will not suffice; measures to enhance or maintain physical, mental and social function must also be emphasized. Unfortunately, the effectiveness of many preventive care procedures has not been adequately investigated in the elderly. Research is urgently needed to determine the efficacy of and appropriate target population for various geriatric preventive health care measures. PMID:6395498

  9. The changing face of health care consumers.

    PubMed

    2001-01-01

    Caring for a diverse pool of patients is an ongoing challenge for health care practitioners and marketers. Communication difficulties and cultural misunderstandings still stand in the way and keep members of some minority populations from getting the health care they need. To better serve these groups, it's crucial to learn more about patients' values, needs, and expectations. Fortunately, opportunities abound for health care marketers to learn about and effectively target these still largely underserved populations. PMID:11763652

  10. Health Care Reform: Opportunities for Improving Adolescent Health.

    ERIC Educational Resources Information Center

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

    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…

  11. [Control of health care by the economist?].

    PubMed

    Henke, K D

    2000-12-01

    Although the health care system has to deal with huge financial problems one cannot neglect that this labour-intensive service branch creates the most jobs with social security obligations. Corrective strategies will have to increase the orientation of health care to patients' needs which requires better information and more decision-making autonomy for the insured people as well as a maximising of efficiency. Competition needs to be strengthened in order to improve quality and reduce costs. This requires more contractual freedom for insurance funds and a dismantling of the current monopolistic structures. Finally, adequate remuneration schedules and patients' individual responsibility play a major role to meet the future challenges in the European internal market. PMID:11190916

  12. [Update on Current Care Guideline: Headache (children)].

    PubMed

    HämäläInen, Mirja; Katri, Laimi; Laukkala, Tanja; Nokelainen, Pekka; Raisio, Mikael; Rantala, Heikki; Aanttila, Pirjo; Sätilä, Heli

    2016-01-01

    The majority of children with recurrent headaches can be effectively treated in the primary health care. Paracetamol and ibuprofen are the recommended first-line pain medications. Limited evidence is available on the effectiveness of triptans in children and adolescents. However, nasal sumatriptan and possibly oral rizatriptan and nasal zolmitriptan can be considered for children and adolescents, as well as oral almotriptan for adolescents. Propranolol is the first-line prophylactic medication for migraine. PMID:26939493

  13. Controversies in faith and health care.

    PubMed

    Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. PMID:26159392

  14. Challenges for health care development in Croatia.

    PubMed

    Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja

    2012-09-01

    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

  15. Creating a high-value delivery system for health care.

    PubMed

    Teisberg, Elizabeth O; Wallace, Scott

    2009-01-01

    Health care reform that focuses on improving value enhances both the well-being of patients and the professional satisfaction of physicians. Value in health care is the improvement in health outcomes achieved for patients relative to the money spent. Dramatic and ongoing improvement in the value of health care delivered will require fundamental restructuring of the system. Current efforts to improve safety and reduce waste are truly important but not sufficient. The following three structural changes will drive simultaneous improvement in outcomes and efficiency: (1) reorganizing care delivery into clinically integrated teams defined by patient needs over the full cycle of care; (2) measuring and reporting patient outcomes by clinical teams, across the cycle of care and for identified clusters of medical circumstances; and (3) enabling reimbursement tied to value rather than to quantity of services. Many of these changes require physician leadership. We discuss steps on the journey to value-based care delivery. PMID:19632561

  16. Optimizing Health Care Coalitions: Conceptual Frameworks and a Research Agenda.

    PubMed

    Hupert, Nathaniel; Biala, Karen; Holland, Tara; Baehr, Avi; Hasan, Aisha; Harvey, Melissa

    2015-12-01

    The US health care system has maintained an objective of preparedness for natural or manmade catastrophic events as part of its larger charge to deliver health services for the American population. In 2002, support for hospital-based preparedness activities was bolstered by the creation of the National Bioterrorism Hospital Preparedness Program, now called the Hospital Preparedness Program, in the US Department of Health and Human Services. Since 2012, this program has promoted linking health care facilities into health care coalitions that build key preparedness and emergency response capabilities. Recognizing that well-functioning health care coalitions can have a positive impact on the health outcomes of the populations they serve, this article informs efforts to optimize health care coalition activity. We first review the landscape of health care coalitions in the United States. Then, using principles from supply chain management and high-reliability organization theory, we present 2 frameworks extending beyond the Office of the Assistant Secretary for Preparedness and Response's current guidance in a way that may help health care coalition leaders gain conceptual insight into how different enterprises achieve similar ends relevant to emergency response. We conclude with a proposed research agenda to advance understanding of how coalitions can contribute to the day-to-day functioning of health care systems and disaster preparedness. PMID:26545194

  17. [Motivational interviewing in health care].

    PubMed

    Lev-Ran, Shaul; Nitzan, Uri

    2011-09-01

    Harmful behaviors and low adherence to medical treatment significantly contribute to an increased rate of hospitalizations, mortality and morbidity. Leading health organizations worldwide are making great efforts to find and develop efficient strategies in order to recruit patients to adhere to medical treatment and adopt a healthier lifestyle. Motivational interviewing is an evidence-based approach that the physician can apply in numerous health care situations in order to increase patients' adherence to treatment. It is a patient-centered approach, based on principles of collaboration, autonomy and evocation. Research indicates that the patient's verbal commitment towards change is directly correlated to future behavioral change. Therefore, the approach includes learnable techniques which assist in allowing the patient to speak about the advantages of behavioral change and treatment. Thus, motivational interviewing helps patients adopt a healthier lifestyle while contributing to the professionalism of physicians and their sense of satisfaction from work. PMID:22026060

  18. Achieving better health care outcomes for children in foster care.

    PubMed

    Mekonnen, Robin; Noonan, Kathleen; Rubin, David

    2009-04-01

    This article reviews the challenges health care systems face as they attempt to improve health care outcomes for children in foster care. It discusses several of the promising health care strategies occurring outside the perimeter of child welfare and identifies some of the key impasses in working alongside efforts in child welfare reform. The authors posit that the greatest impasse in establishing a reasonable quality of health care for these children is placement instability, in which children move frequently among multiple homes and in and out of the child welfare system. The authors propose potential strategies in which efforts to improve placement stability can serve as a vehicle for multidisciplinary reform across the health care system. PMID:19358924

  19. [Information security in health care].

    PubMed

    Ködmön, József; Csajbók, Zoltán Ernő

    2015-07-01

    Doctors, nurses and other medical professionals are spending more and more time in front of the computer, using applications developed for general practitioners, specialized care, or perhaps an integrated hospital system. The data they handle during healing and patient care are mostly sensitive data and, therefore, their management is strictly regulated. Finding our way in the jungle of laws, regulations and policies is not simple. Notwithstanding, our lack of information does not waive our responsibility. This study summarizes the most important points of international recommendations, standards and legal regulations of the field, as well as giving practical advices for managing medical and patient data securely and in compliance with the current legal regulations. PMID:26122901

  20. Skin Diseases: Questions for Your Health Care Provider

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Questions for Your Health Care Provider Past ... dermatitis worse? What are the most common irritants? Skin cancer What type of skin cancer do I ...

  1. America's health care safety net: revisiting the 2000 IOM report.

    PubMed

    Lewin, Marion E; Baxter, Raymond J

    2007-01-01

    The committee that wrote the 2000 Institute of Medicine report on the health care safety net reconvened in 2006 to reflect on the safety net from the perspective of rising numbers of uninsured and underinsured people, the aftermath of Hurricane Katrina, high immigration levels, and new fiscal and policy pressures on care for vulnerable populations. Safety-net providers now participate in Medicaid managed care but find it difficult to meet growing needs for specialty services, particularly mental health care and affordable prescription drugs. How current state reforms and coverage expansions will affect care for the poor and uninsured is a critical issue. PMID:17848461

  2. Prioritizing health-care funding.

    PubMed

    O'Donnell, J L; Smyth, D; Frampton, C

    2005-07-01

    In the face of limited resources, on what basis should we prioritize health-care funding? The most influential consideration should be the knowledge that an intervention does something beneficial for the person who receives it. Rather than using imposed knowledge or knowledge obtained by grace, modern medicine uses knowledge obtained by rational thought. Traditionally, two philosophical schools of rational thought support medical interventions: empiricism and rationalism. Empiricist knowledge underpins the treatment of risk, while rationalist knowledge underpins the treatment of disease. To introduce reasoned order into the rationing process we must understand the limitations inherent in the application of these two forms of knowledge. Why are screening programmes for breast and uterine cervical cancer supported while severe restrictions are placed on treatments for chronic arthritis? Can the benefits of cholesterol-lowering drugs be measured? Empiricism has achieved an unchallenged ascendancy in modern health-care delivery. Is this ascendancy justified? There is a need for reference criteria to compare the benefits of competing interventions across disciplines. As a starting point for debate we propose that interventions should be given a priority based on how closely they fulfil five criteria: knowledge of disease pathophysiology, measurability of short-term and long-term benefits, incidence of serious adverse effects and affordability. It is only by using and refining such funding criteria that better public understanding of the rationing process will be achieved and political interference minimized. PMID:15958111

  3. Beware the Managed Health-Care Companies.

    ERIC Educational Resources Information Center

    Ashbaugh, John; Smith, Gary

    1996-01-01

    This article discusses implications of the movement toward managed health care models for long-term health care services for people with disabilities, especially people with developmental disabilities. It notes possible advantages of managed care but raises issues concerning consumer choice, management and financial capacity of managed care…

  4. The health care response to pandemic influenza.

    PubMed

    Barnitz, Laura; Berkwits, Michael

    2006-07-18

    The threat of an H5N1 influenza virus (avian flu) pandemic is substantial. The success of the current U.S. influenza pandemic response plan depends on effective coordination among state and local public health authorities and individual health care providers. This article is a summary of a public policy paper developed by the American College of Physicians to address issues in the U.S. Department of Health and Human Services Pandemic Influenza Plan that involve physicians. The College's positions call for the following: 1) development of local public health task forces that include physicians representing all specialties and practice settings; 2) physician access to 2-way communication with public health authorities and to information technology tools for diagnosis and syndrome surveillance; 3) clear identification and authorization of agencies to process licensing and registration of volunteer physicians; 4) clear guidelines for overriding standard procedures for confidentiality and consent in the interest of the public's health; 5) clear and fair infection control measures that do not create barriers to care; 6) analysis of and solutions to current problems with seasonal influenza vaccination programs as a way of developing a maximally efficient pandemic flu vaccine program; 7) federal funding to provide pandemic flu vaccine for the entire U.S. population and antiviral drugs for 25% of the population; and 8) planning for health care in alternative, nonhospital settings to prevent a surge in demand for hospital care that exceeds supply. *This paper is an abridged version of a full-text position paper (available at http://www.acponline.org/college/pressroom/as06/pandemic_policy.pdf) written by Laura Barnitz, BJ, MA, and updated and adapted for publication in Annals of Internal Medicine by Michael Berkwits, MD, MSCE. The original position paper was developed for the Health and Public Policy Committee of the American College of Physicians: Jeffrey P. Harris, MD

  5. Consumer-directed health care: implications for health care organizations and managers.

    PubMed

    Guo, Kristina L

    2010-01-01

    This article uses a pyramid model to illustrate the key components of consumer-directed health care. Consumer-directed health care is considered the essential strategy needed to lower health care costs and is valuable for making significant strides in health care reform. Consumer-directed health care presents new challenges and opportunities for all health care stakeholders and their managers. The viability of the health system depends on the success of managers to respond rapidly and with precision to changes in the system; thus, new and modified roles of managers are necessary to successfully sustain consumerism efforts to control costs while maintaining access and quality. PMID:20436329

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

    PubMed

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

    2013-01-01

    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

  7. The Impacts of Electronic Health Record Implementation on the Health Care Workforce.

    PubMed

    Zeng, Xiaoming

    2016-01-01

    Health care organizations at various levels are transitioning into the new electronic era by implementing and adopting electronic health record systems. New job roles will be needed for this transition, and some current job roles will inevitably become obsolete due to the change. In addition to training new personnel to fill these new roles, the focus should also be on equipping the current health care workforce with knowledge and skills in health information technology and health informatics that will support their work and improve quality of care. PMID:26961833

  8. Primary Health Care and Narrative Medicine.

    PubMed

    Murphy, John W

    2015-01-01

    Primary health care has received a lot of attention since the Alma Ata Conference, convened by the World Health Organization in 1978. Key to the strategy to improve health care outlined at the Alma Ata conference is citizen participation in every phase of service delivery. Although the goals of primary health care have not been achieved, the addition of narrative medicine may facilitate these ends. But a new epistemology is necessary, one that is compatible with narrative medicine, so that local knowledge is elevated in importance and incorporated into the planning, implementation, and evaluation of health programs. In this way, relevant, sustainable, and affordable care can be provided. The aim of this article is to discuss how primary health care might be improved through the introduction of narrative medicine into planning primary health care delivery. PMID:26222094

  9. Primary Health Care and Narrative Medicine

    PubMed Central

    Murphy, John W

    2015-01-01

    Primary health care has received a lot of attention since the Alma Ata Conference, convened by the World Health Organization in 1978. Key to the strategy to improve health care outlined at the Alma Ata conference is citizen participation in every phase of service delivery. Although the goals of primary health care have not been achieved, the addition of narrative medicine may facilitate these ends. But a new epistemology is necessary, one that is compatible with narrative medicine, so that local knowledge is elevated in importance and incorporated into the planning, implementation, and evaluation of health programs. In this way, relevant, sustainable, and affordable care can be provided. The aim of this article is to discuss how primary health care might be improved through the introduction of narrative medicine into planning primary health care delivery. PMID:26222094

  10. Ethics and geographical equity in health care.

    PubMed

    Rice, N; Smith, P C

    2001-08-01

    Important variations in access to health care and health outcomes are associated with geography, giving rise to profound ethical concerns. This paper discusses the consequences of such concerns for the allocation of health care finance to geographical regions. Specifically, it examines the ethical drivers underlying capitation systems, which have become the principal method of allocating health care finance to regions in most countries. Although most capitation systems are based on empirical models of health care expenditure, there is much debate about which needs factors to include in (or exclude from) such models. This concern with legitimate and illegitimate drivers of health care expenditure reflects the ethical concerns underlying the geographical distribution of health care finance. PMID:11479357

  11. Is home health care a substitute for hospital care?

    PubMed

    Lichtenberg, Frank R

    2012-01-01

    A previous study used aggregate (region-level) data to investigate whether home health care serves as a substitute for inpatient hospital care and concluded that "there is no evidence that services provided at home replace hospital services." However, that study was based on a cross-section of regions observed at a single point of time and did not control for unobserved regional heterogeneity. In this article, state-level employment data are used to reexamine whether home health care serves as a substitute for inpatient hospital care. This analysis is based on longitudinal (panel) data--observations on states in two time periods--which enable the reduction or elimination of biases that arise from use of cross-sectional data. This study finds that states that had higher home health care employment growth during the period 1998-2008 tended to have lower hospital employment growth, controlling for changes in population. Moreover, states that had higher home health care payroll growth tended to have lower hospital payroll growth. The estimates indicate that the reduction in hospital payroll associated with a $1,000 increase in home health payroll is not less than $1,542, and may be as high as $2,315. This study does not find a significant relationship between growth in utilization of home health care and growth in utilization of nursing and residential care facilities. An important reason why home health care may serve as a substitute for hospital care is that the availability of home health care may allow patients to be discharged from the hospital earlier. Hospital discharge data from the Healthcare Cost and Utilization Project are used to test the hypothesis that use of home health care reduces the length of hospital stays. Major Diagnostic Categories with larger increases in the fraction of patients discharged to home health care tended to have larger declines in mean length of stay (LOS). Between 1998 and 2008, mean LOS declined by 4.1%, from 4.78 to 4.59 days

  12. An Overview of Oral Health Status, Resources, and Care Delivery.

    ERIC Educational Resources Information Center

    White, B. Alex

    1994-01-01

    An overview of the current oral health status of Americans looks at the epidemiology of oral/dental diseases, rates of use of dental services, and expenditures for dental health care. Substantial progress in improving oral health is seen as are particular challenges resulting from the aging and ethnic diversification of the population. (MSE)

  13. College and University Health Care Professionals: An Expanding Team.

    ERIC Educational Resources Information Center

    Grier, Phillip M.

    1980-01-01

    An historical perspective of the American College Health Association emphasizes the importance of teamwork among health personnel. The current trend in litigation toward health care professionals and the regulatory role of government has resulted in an apparent increase in legal activity, and necessitates teamwork between doctors and lawyers. (JN)

  14. Current research funding methods dumb down health care and rehabilitation for disabled people and aging population: a call for a change.

    PubMed

    Negrini, S; Padua, L; Kiekens, C; Michail, X; Boldrini, P

    2014-12-01

    Health care systems in Western societies are faced with two major challenges: aging populations and the growing burden of chronic conditions. This translates into more persons with disabilities and the need for more Physical and Rehabilitation Medicine (PRM) services. We raise the point of how these emerging needs are faced by the actual research funding. We briefly present the results of an analysis we made about research funding by the Italian National Health Service as an interesting case study, since it relates to Italy (the financer) and the United States, where National Institutes of Health (NIH) reviewers were identified according to their classification of research topics. The topics of potentially greatest interest for aging Western societies, like chronicity, disability and rehabilitation, were among those least often funded and considered in the traditional method of financing research projects. These results could be based on those PRM peculiarities that make the specialty different from all other classical biomedical specialties, namely the bio-psycho-social approach and its specific research methodologies. Moreover, PRM researchers are spread among the different topics as usually classified, and it is probable that PRM projects are judged by non-PRM reviewers. There are at least two possible ways in which research can be better placed to meet the emerging needs of Western societies (chronicity, disability and consequently also rehabilitation). One is to create specific keywords on these topics so as to improve the match between researchers and reviewers; the second is to allocate specific funds to research in these areas. In fact, the not coherence between emerging needs and research priorities have already been periodically addressed in the past with specific "political" and/or "social" initiatives, when researchers were forced to respond to new emergencies: some historical examples include cancer or HIV and viral diseases or the recent Ebola

  15. Dual loyalty in prison health care.

    PubMed

    Pont, Jörg; Stöver, Heino; Wolff, Hans

    2012-03-01

    Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners. PMID:22390510

  16. Cost-effective health care: new data.

    PubMed

    Kalies, R F

    1997-06-01

    The key to health care programs that meet their goals is to integrate data, coordinate care and ensure a patient-centered not cost-centered, focus. Then the purchaser can achieve the desired decrease in cost of care, increase in quality of care, improvement in quality of life, improvement in job performance, decrease in disability and decrease in absenteeism. PMID:10168421

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

    ERIC Educational Resources Information Center

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

    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…

  18. Financial Health of Child Care Facilities Affects Quality of Care.

    ERIC Educational Resources Information Center

    Brower, Mary R.; Sull, Theresa M.

    2003-01-01

    Contends that child care facility owners, boards of directors, staff, and parents need to focus on financial management, as poor financial health compromises the quality of care for children. Specifically addresses the issues of: (1) concern for providing high quality child care; (2) the connection between quality and money; and (3) strengthening…

  19. Current status of neonatal intensive care in India.

    PubMed

    Karthik Nagesh, N; Razak, Abdul

    2016-05-01

    Globally, newborn health is now considered as high-level national priority. The current neonatal and infant mortality rate in India is 29 per 1000 live births and 42 per 1000 live births, respectively. The last decade has seen a tremendous growth of neonatal intensive care in India. The proliferation of neonatal intensive care units, as also the infusion of newer technologies with availability of well-trained medical and nursing manpower, has led to good survival and intact outcomes. There is good care available for neonates whose parents can afford the high-end healthcare, but unfortunately, there is a deep divide and the poor rural population is still underserved with lack of even basic newborn care in few areas! There is increasing disparity where the 'well to do' and the 'increasingly affordable middle class' is able to get the most advanced care for their sick neonates. The underserved urban poor and those in rural areas still contribute to the overall high neonatal morbidity and mortality in India. The recent government initiative, the India Newborn Action Plan, is the step in the right direction to bridge this gap. A strong public-private partnership and prioritisation is needed to achieve this goal. This review highlights the current situation of neonatal intensive care in India with a suggested plan for the way forward to achieve better neonatal care. PMID:26944066

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

    PubMed

    Al-Khatib, Issam A; Sato, Chikashi

    2009-08-01

    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(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. PMID:19398317

  1. Can managed care plans control health care costs?

    PubMed

    Zwanziger, J; Melnick, G A

    1996-01-01

    The health insurance sector has been transformed in the past fifteen years, with managed care replacing indemnity insurance as the norm. This transformation was intended to change the nature of competition in the health care system so that market forces could be used to control costs. Empirical studies have shown that this objective has been met, as areas with high managed care penetration have tended to have much lower rates of increase in their costs. Creating a more efficient health care system will require additional efforts to produce useful measures of quality and to maintain competitive markets. PMID:8690375

  2. Toward a 21st-century health care system: recommendations for health care reform.

    PubMed

    Arrow, Kenneth; Auerbach, Alan; Bertko, John; Brownlee, Shannon; Casalino, Lawrence P; Cooper, Jim; Crosson, Francis J; Enthoven, Alain; Falcone, Elizabeth; Feldman, Robert C; Fuchs, Victor R; Garber, Alan M; Gold, Marthe R; Goldman, Dana; Hadfield, Gillian K; Hall, Mark A; Horwitz, Ralph I; Hooven, Michael; Jacobson, Peter D; Jost, Timothy Stoltzfus; Kotlikoff, Lawrence J; Levin, Jonathan; Levine, Sharon; Levy, Richard; Linscott, Karen; Luft, Harold S; Mashal, Robert; McFadden, Daniel; Mechanic, David; Meltzer, David; Newhouse, Joseph P; Noll, Roger G; Pietzsch, Jan B; Pizzo, Philip; Reischauer, Robert D; Rosenbaum, Sara; Sage, William; Schaeffer, Leonard D; Sheen, Edward; Silber, B Michael; Skinner, Jonathan; Shortell, Stephen M; Thier, Samuel O; Tunis, Sean; Wulsin, Lucien; Yock, Paul; Nun, Gabi Bin; Bryan, Stirling; Luxenburg, Osnat; van de Ven, Wynand P M M

    2009-04-01

    The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform: 1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment. 2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions. 3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions. 4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange. 5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make de-identified information from this database on clinical interventions, patient outcomes, and costs available to researchers. 6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans. 7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges

  3. Prospects for Flourishing in Contemporary Health Care.

    PubMed

    Pattison, Stephen; Edgar, Andrew

    2016-06-01

    This special issue of Health Care Analysis originated in an conference, held in Birmingham in 2014, and organised by the group Think about Health. We introduce the issue by briefly reviewing the understandings of the concept of 'flourishing', and introducing the contributory papers, before offering some reflections on the remaining issues that reflection on flourishing poses for health care provision. PMID:26857468

  4. Rx for Rising Health Care Premiums.

    ERIC Educational Resources Information Center

    Younger, Sandra Millers

    1990-01-01

    Strategies for containing the cost of providing health insurance for college employees include cost sharing with employees, cost reduction through options such and managed care, incentives for use of health maintenance organizations, offering health care alternatives, and entering into multiple-employer purchasing groups. (MSE)

  5. Health Care Access among Deaf People

    ERIC Educational Resources Information Center

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  6. Predictors of Adolescent Health Care Utilization

    ERIC Educational Resources Information Center

    Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

    2007-01-01

    This study, using Andersen's health care utilization model, examined how predisposing characteristics, enabling resources, need, personal health practices, and psychological factors influence health care utilization using a nationally representative, longitudinal sample of Canadian adolescents. Second, this study examined whether this process…

  7. The Participatory Imperative in Primary Health Care.

    ERIC Educational Resources Information Center

    Hollnsteiner, Mary Racelis

    1982-01-01

    This article presents the major issues, trends, interpretations, and difficulties facing Primary Health Care (PHC) personnel in taking the drastic steps required to reform the health care system. The author argues that PHC aims to enable people to take responsibility for their own health and further the redistribution of resources. (SSH)

  8. The recovery of Bay State Health Care.

    PubMed

    Maltz, D L

    1994-03-01

    Blue Cross and Blue Shield of Massachusetts acquired Bay State Health Care after the HMO's tumultuous downturn. The case study described herein provides a useful lesson in the moves that must be made, particularly in an era of health care consolidation and intensive competition, to maintain health plan stability and reinforce its position in the marketplace. PMID:10133054

  9. Special Issue: The Family and Health Care.

    ERIC Educational Resources Information Center

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

    1985-01-01

    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)

  10. Quality of health care: the responsibility of health care professionals in delivering high quality services.

    PubMed

    Giangrande, A

    1998-11-01

    According to a recent definition, quality of care consists of the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge; a definition that introduces both requirements of outcomes and the appropriateness of the process used. Clearly many different figures are interested in quality assessment initiatives in the health care field and these include patients, administrators and doctors each having different perspective. Doctors obviously pay greater attention to technical quality and results, giving greater emphasis to the health of the individual patient, tending to give priority to technical excellence and interaction between patient and doctor. Although the perspective of health care professionals is widely acknowledged to be important and useful, other perspectives on quality have been emphasised in recent years. The most important of these is the recognition that care must be responsive to the preferences and values of the consumers of health care services. In complete harmony with one's own professional commitment, the attention to the perspectives of patients must give physician the chance to identify methods of measuring and verifying quality which take account of the expectations of the many groups with an interest in improving the functioning of the health system. A global approach in the health field is needed the more specialization advances. The quality of medicine lies in its capacity to integrate what science says is appropriate and to be recommended, what can be reconciled with human rights and the self determination of the patient and what can be achieved by optimising available resources. In this complex context, the doctor could take on both the role of the person who decides on the use of resources and the one of social mediator. PMID:9894749

  11. Mental Health in Long Term Care Settings.

    ERIC Educational Resources Information Center

    Shore, Herbert

    1978-01-01

    There are many ways in which long-term care facilities attempt to cope with the mental health problems of the elderly. The author reviews five factors crucial to effective care for the aged in these facilities. (Author/RK)

  12. Health care law versus constitutional law.

    PubMed

    Hall, Mark A

    2013-04-01

    National Federation of Independent Business v. Sebelius, the Supreme Court's ruling on the Patient Protection and Affordable Care Act, is a landmark decision - both for constitutional law and for health care law and policy. Others will study its implications for constitutional limits on a range of federal powers beyond health care. This article considers to what extent the decision is also about health care law, properly conceived. Under one view, health care law is the subdiscipline that inquires how courts and government actors take account of the special features of medicine that make legal or policy issues especially problematic - rather than regarding health care delivery and finance more generically, like most any other economic or social enterprise. Viewed this way, the opinions from the Court's conservative justices are mainly about general constitutional law principles. In contrast, Justice Ruth Bader Ginsburg's dissenting opinion for the four more liberal justices is just as much about health care law as it is about constitutional law. Her opinion gives detailed attention to the unique features of health care finance and delivery in order to inform her analysis of constitutional precedents and principles. Thus, the Court's multiple opinions give a vivid depiction of the compelling contrasts between communal versus individualistic conceptions of caring for those in need, and between health care and health insurance as ordinary commodities versus ones that merit special economic, social, and legal status. PMID:23262771

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

    PubMed Central

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

    2009-01-01

    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

  14. Health care reform: informing difficult choices.

    PubMed

    Maynard, A; Bloor, K

    1995-01-01

    During the last decade, policy makers in a large number of countries have attempted various reforms of their health care systems. Health care reform has been described as a 'global epidemic' (Klein, 1993). All health care reforms consist of very complex policy choices, some of which are examined in this article. After an introductory exploration of ideological issues, the objectives of health care reformers are considered. Three major policy objectives of health care reform are examined: cost containment; efficiency; and, equity. Three types of reform which have been advocated are also considered: public planning; market regulation; and provider-advocated reforms such as a 'basic package' with copayments and alternative means of finance. Finally, appropriate features of efficient health care reform are suggested, addressing explicit policy goals. PMID:10154305

  15. Americans' Views of Health Care Costs, Access, and Quality

    PubMed Central

    Blendon, Robert J; Brodie, Mollyann; Benson, John M; Altman, Drew E; Buhr, Tami

    2006-01-01

    For more than two decades, polls have shown that Americans are dissatisfied with their current health care system. However, the public's views on how to change the current system are more conflicted than often suggested by individual poll results. At the same time, Americans are both dissatisfied with the current health care system and relatively satisfied with their own health care arrangements. As a result of the conflict between these views and the public's distrust of government, there often is a wide gap between the public's support for a set of principles concerning what needs to be done about the overall problems facing the nation's health care system and their support for specific policies designed to achieve those goals. PMID:17096637

  16. Health care: economic impact of caring for geriatric patients.

    PubMed

    Rich, Preston B; Adams, Sasha D

    2015-02-01

    National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. PMID:25459539

  17. The State of Transgender Health Care: Policy, Law, and Medical Frameworks

    PubMed Central

    2014-01-01

    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

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

    PubMed

    Stroumsa, Daphna

    2014-03-01

    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

  19. Spirulina in health care management.

    PubMed

    Kulshreshtha, Archana; Zacharia, Anish J; Jarouliya, Urmila; Bhadauriya, Pratiksha; Prasad, G B K S; Bisen, P S

    2008-10-01

    Spirulina is a photosynthetic, filamentous, spiral-shaped and multicellular edible microbe. It is the nature's richest and most complete source of nutrition. Spirulina has a unique blend of nutrients that no single source can offer. The alga contains a wide spectrum of prophylactic and therapeutic nutrients that include B-complex vitamins, minerals, proteins, gamma-linolenic acid and the super anti-oxidants such as beta-carotene, vitamin E, trace elements and a number of unexplored bioactive compounds. Because of its apparent ability to stimulate whole human physiology, Spirulina exhibits therapeutic functions such as antioxidant, anti-bacterial, antiviral, anticancer, anti-inflammatory, anti-allergic and anti-diabetic and plethora of beneficial functions. Spirulina consumption appears to promote the growth of intestinal micro flora as well. The review discusses the potential of Spirulina in health care management. PMID:18855693

  20. [Development and current utility of infobases in Czech cancer care].

    PubMed

    2014-01-01

    Evaluation of the quality and effectiveness of health care is an integral part of modern health care. It can only be performed with sufficiently detailed data sources describing each segment of care. In case of significant heterogeneity and lack of standardization of hospital information systems it is necessary to fully exploit existing parametric data sources. The valid systems for Czech cancer care: the National Cancer Registry, clinical registries of Czech Society for Oncology of the Czech Medical Association of J.E. Purkyne, registries of screening programs and administrative data form healthcare payers. From these registries we can obtain a very complex and detailed view on prevention, diagnosis and cancer treatment in the Czech Republic. To achieve this goal, which means more integrated and comprehensive utilization of national registries, surveys and administrative data, it is necessary to fully utilize and apply the current legislative framework, in particular provision of the Act no. 372/2011 Sb.Key words: clinical registry - evaluation of health care - information system - legislation - malignant tumor - population. PMID:25389092

  1. School Health Services for Children with Special Health Care Needs in California

    ERIC Educational Resources Information Center

    Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S.; Knauer, Heather

    2015-01-01

    Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study…

  2. The liberty principle and universal health care.

    PubMed

    Sachs, Benjamin

    2008-06-01

    A universal entitlement to health care can be grounded in the liberty principle. A detailed examination of Rawls's discussion of health care in Justice as Fairness shows that Rawls himself recognized that illness is a threat to the basic liberties, yet failed to recognize the implications of this fact for health resource allocation. The problem is that one cannot know how to allocate health care dollars until one knows which basic liberties one seeks to protect, and yet one cannot know which basic liberties to protect until one knows how health care dollars will be allocated. The solution is to design the list of basic liberties and the health care system in tandem so as to fit each other, such that every citizen is guaranteed a set of basic liberties and access to the health services needed to secure them. PMID:18610783

  3. [Physiotherapeutic care marketing research: current state-of-the art].

    PubMed

    Babaskin, D V

    2011-01-01

    Successful introduction of modern technologies into the national health care systems strongly depends on the current pharmaceutical market situation. The present article is focused on the peculiarities of marketing research with special reference to physiotherapeutic services and commodities. Analysis of the structure and sequence of marketing research processes is described along with the methods applied for the purpose including their support by the use of Internet resources and technologies. PMID:21574299

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

    PubMed Central

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

    1987-01-01

    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

  5. Attending unintended transformations of health care infrastructure

    PubMed Central

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

    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

  6. Towards Open Information Management in Health Care

    PubMed Central

    Yli-Hietanen, J; Niiranen, S

    2008-01-01

    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

  7. Health Care Austerity Measures in Times of Crisis: The Perspectives of Primary Health Care Physicians in Madrid, Spain.

    PubMed

    Heras-Mosteiro, Julio; Sanz-Barbero, Belén; Otero-Garcia, Laura

    2016-01-01

    The current financial crisis has seen severe austerity measures imposed on the Spanish health care system, including reduced public spending, copayments, salary reductions, and reduced services for undocumented migrants. However, the impacts have not been well-documented. We present findings from a qualitative study that explores the perceptions of primary health care physicians in Madrid, Spain. This article discusses the effects of austerity measures implemented in the public health care system and their potential impacts on access and utilization of primary health care services. This is the first study, to our knowledge, exploring the health care experiences during the financial crisis of general practitioners in Madrid, Spain. The majority of participating physicians disapproved of austerity measures implemented in Spain. The findings of this study suggest that undocumented migrants should regain access to health care services; copayments should be minimized and removed for patients with low incomes; and health care professionals should receive additional help to avoid burnout. Failure to implement these measures could result in the quality of health care further deteriorating and could potentially have long-term negative consequences on population health. PMID:26825100

  8. In health care reform, who cares for the community?

    PubMed

    Sigmond, R; Seay, J D

    1994-01-01

    Health care reform has again focused the issues of ownership and mission of organizations in the health care field. Some believe that universal entitlement will eventually make both charitable patient care and the nonprofit form of organization obsolete. Others believe that special treatment of nonprofit organizations does not depend on charity at all; rather that the nonprofit form has social value in and of itself. The authors reflect a different point of view. They suggest that with reform, community benefit as the modern expression of a charitable mission will become ever more important in achieving the nation's health care goals. They believe that nonprofit organizations will continue to be entitled to special treatment only if their missions and programs extend beyond care of patients and entitled populations to focus also on care of communities. Any health organization's investment in disciplined community initiatives encompasses all the people in targeted communities, including those served by competing organizations. Without tax exemption, an organization committed to community care initiatives will be at a competitive disadvantage under the proposed community rated capitation payment system. Rather than abandoning the community benefit standard for tax exemption, health care reform calls for more systematic management of community care initiatives by nonprofit organizations and also of tax-exemption eligibility by the IRS. PMID:10135183

  9. Ode to Healing Music in Health Care.

    PubMed

    Powell, Suzanne K

    2016-01-01

    Music therapy has been around since the 1940s when physicians notice a positive effect that music had on the soldiers with "shell shock" (now more commonly known as posttraumatic stress disorder). For decades, veterans were the primary patients worked with by music therapists. In the 1970s, the hospice movement started to enter the health care continuum, largely due to Dr Elisabeth Kübler-Ross, who advocated for home care and patient choice for the terminally ill. Two decades later, it became apparent that hospice patients could benefit from music. And currently, there are not enough people certified to work with music in hospice patients, veterans, or patients with dementia/Alzheimer's disease. No, music does not prolong life, but it does add life to the time left. PMID:26618264

  10. Health policy and craniofacial care: issues in resource allocation.

    PubMed

    Strauss, R P

    1994-01-01

    The distribution of health care services, including craniofacial services in the United States, is examined. The U.S. has a unique health care financing and organizational system in which persons are most commonly covered by health insurance as a benefit of their employment. Current estimates are that nearly 40 million Americans have no health insurance (Himmelstein et al., 1992). Approximately half of the uninsured persons are in low-wage employment that does not provide health insurance benefits nor allow them to qualify for Medicaid (Pepper Commission, 1990). Personal health care costs now exceed 11% of the U.S. gross domestic product, a significantly higher percentage than that found in other industrialized nations (Consumer Reports, 1990b). Within the current system, is health care distributed in a fair or moral manner? What are the effects of the allocation scheme? Possible changes in health care financing and delivery are examined and basic ethical and social issues associated with a changing U.S. health care delivery system are explored. PMID:8130247

  11. Coming Together To Cut Health Care Costs.

    ERIC Educational Resources Information Center

    Heron, W. David; Donatelli, Ben

    2003-01-01

    Describes how, through a shared plan, the Health Insurance Initiative of the Independent Colleges and Universities in Florida (ICUF) is saving participating institutions millions in costs associated with providing employee health care. (EV)

  12. Hazardous waste compliance in health care settings.

    PubMed

    Marcoux, Rita M; Vogenberg, F Randy

    2015-02-01

    Pharmaceutical waste has become an urgent public health and environmental protection issue in recent years, leading to a variety of sometimes-conflicting federal and state legislation and regulations that health care entities must take seriously. PMID:25673960

  13. Health care 2020: reengineering health care delivery to combat chronic disease.

    PubMed

    Milani, Richard V; Lavie, Carl J

    2015-04-01

    Chronic disease has become the great epidemic of our times, responsible for 75% of total health care costs and the majority of deaths in the US. Our current delivery model is poorly constructed to manage chronic disease, as evidenced by low adherence to quality indicators and poor control of treatable conditions. New technologies have emerged that can engage patients and offer additional modalities in the treatment of chronic disease. Modifying our delivery model to include team-based care in concert with patient-centered technologies offers great promise in managing the chronic disease epidemic. PMID:25460529

  14. Health Care Revival Renews, Rekindles, and Revives

    PubMed Central

    Lawson, Erma; Young, Azzie

    2002-01-01

    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

  15. Community Health Workers as Support for Sickle Cell Care.

    PubMed

    Hsu, Lewis L; Green, Nancy S; Donnell Ivy, E; Neunert, Cindy E; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R; Martin, Molly

    2016-07-01

    Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care. PMID:27320471

  16. The informatics of health care reform.

    PubMed

    Masys, D R

    1996-01-01

    Health care in the United States has entered a period of economic upheaval. Episodic, fee-for-service care financed by indemnity insurance is being replaced by managed care financed by fixed-price, capitated health plans. The resulting focus on reducing costs, especially in areas where there is competition fueled by oversupply of health services providers and facilities, poses new threats to the livelihood of medical libraries and medical librarians but also offers new opportunities. Internet services, consumer health education, and health services research will grow in importance, and organizational mergers will provide librarians with opportunities to assume new roles within their organizations. PMID:8938325

  17. Health care in the Yemen Arab Republic.

    PubMed

    Lambeth, S

    1988-01-01

    The Yemen Arab Republic has health-care problems similar to other developing countries yet lacks the abundant oil reserves of its Arabian peninsula neighbors to address these problems. An ambitious 5 year health plan developed in 1977 has been impeded by a lack of material and human resources. The infant mortality rate remains one of the highest in the world, schistosomiasis drains the energy of the people, and tuberculosis and malaria remain endemic. Progress is, however, being made in health-care educational programs within Sanaa University and the Health Manpower Institutes to develop the resources of the Yemeni people to meet the health-care needs of their country. PMID:3225123

  18. Health reform in Finland: current proposals and unresolved challenges.

    PubMed

    Saltman, Richard B; Teperi, Juha

    2016-07-01

    The Finnish health care system is widely respected for its pilot role in creating primary-care-led health systems. In the early 1990s, however, a severe economic downturn in Finland reduced public funding and weakened the Finnish system's deeply decentralized model of health care administration. Recent Bank of Finland projections forecasting several decades of slow economic growth, combined with the impact of an aging population, appear to make major reform of the existing public system inevitable. Over the last several years, political attention has focused mostly on administrative consolidation inside the public sector, particularly integration of health and social services. Current proposals call for a reformed health sector governance structure based on a new meso-level configuration of public administration. In addition, Finland's national government has proposed replacing the current multi-channel public funding structure (which includes health insurance subsidies for occupational health services) with a single-channel public funding structure. This commentary examines several key issues involved in reforming the delivery structure of the Finnish health care system. It also explores possible alternative strategies to reform current funding arrangements. The article concludes with a brief discussion of implications from this Finnish experience for the wider health reform debate. PMID:26865494

  19. Physician leadership: a health-care system's investment in the future of quality care.

    PubMed

    Orlando, Rocco; Haytaian, Marcia

    2012-08-01

    The current state of health care and its reform will require physician leaders to take on greater management responsibilities, which will require a set of organizational and leadership competencies that traditional medical education does not provide. Physician leaders can form a bridge between the clinical and administrative sides of a health-care organization, serving to further the organization's strategy for growth and success. Recognizing that the health-care industry is rapidly changing and physician leaders will play a key role in that transformation, Hartford HealthCare has established a Physician Leadership Development Institute that provides advanced leadership skills and management education to select physicians practicing within the health-care system. PMID:23248866

  20. The authoritarian reign in American health care.

    PubMed

    Ballou, Kathryn A; Landreneau, Kandace J

    2010-02-01

    The aim of this article is to increase understanding of the mechanisms of the continuation of elite hegemonic control of a highly valued social system--American health care. White, male physicians and administrators achieved control of the health care industry and its workers, including nurses, at the start of the 20th century. Using critical theorists' work on authoritarianism and incorporating gender analysis, the authors describe the health care system from a critical social- psychological perspective. The authors discuss the meaning and presence of authoritarian hierarchy and gender effects in today's health system through a critical analysis of the profession of medicine, the profession of nursing, corporate and bureaucratic health care, and patients or consumers. It is concluded that the social-psychological behavior of the American health care system has profound implications that must be taken into account in any recommendations for change. PMID:20628179

  1. Challenges for the German Health Care System.

    PubMed

    Dietrich, C F; Riemer-Hommel, P

    2012-06-01

    The German Health Care System (GHCS) faces many challenges among which an aging population and economic problems are just a few. The GHCS traditionally emphasised equity, universal coverage, ready access, free choice, high numbers of providers and technological equipment; however, real competition among health-care providers and insurance companies is lacking. Mainly in response to demographic changes and economic challenges, health-care reforms have focused on cost containment and to a lesser degree also quality issues. In contrast, generational accounting, priorisation and rationing issues have thus far been completely neglected. The paper discusses three important areas of health care in Germany, namely the funding process, hospital management and ambulatory care, with a focus on cost control mechanisms and quality improving measures as the variables of interest. Health Information Technology (HIT) has been identified as an important quality improvement tool. Health Indicators have been introduced as possible instruments for the priorisation debate. PMID:22660990

  2. Health Care: Lessons from China and Cuba

    PubMed Central

    Younge, Richard G.

    1982-01-01

    Health has improved in Cuba and China during the past quarter of a century. Some of the improvements in health occurred as economic conditions improved in both countries, but there are other similarities of health care delivery in China and Cuba. Collective activity plays an important role in health care in both nations; both do health planning centrally, but local communities control the daily activities of the health services that they use. Techniques that have improved health in underdeveloped nations might be applied in underserved areas of the United States. PMID:7120476

  3. Measuring the quality of health care.

    PubMed

    Custer, W

    1995-03-01

    This Issue Brief examines some of the issues involved in defining and measuring the quality of health care and in implementing quality measures. It discusses the importance of measures of health care quality in the evolving health care delivery system, examines some of the conceptual issues involved in defining quality of care, and discusses some of the measures of health care quality and how these measures have been implemented in the health care delivery system. The major impetus for quality assurance programs is cost management: it is an attempt to allocate scarce health care resources efficiently. This requires making choices among alternatives, which may mean that maximizing quality of care for whole populations may not maximize the quality of care for individuals. Quality, in terms of any single good or service, has a number of dimensions. Health care is a complex bundle of services, and each component service within an episode of care affects the other components and the patients differently. Moreover, patients differ in numerous ways, which means that similar symptoms may require different services if care is to be effective. Measuring quality of health care services requires accounting for all of these factors. In attempting to manage health care costs, employers and other private health plans have begun to employ process measures of quality, i.e., evaluating caregivers' activities, the decisions made at each step in an episode of illness, and the appropriateness of the care provided. Process is an important component of quality measures because it focuses directly on the uncertainty in the efficacy of treatment. Given this uncertainty, the logic of medical decision making is an important determinant of quality and cost effectiveness. Examining the process of care involves assembling a panel of physicians who review medical records to determine the appropriateness of the care received. Providers have increasingly found that their medical decision making

  4. Pivoting: leveraging opportunities in a turbulent health care environment*

    PubMed Central

    Bandy, Margaret Moylan

    2015-01-01

    Purpose: The purpose of this lecture is to challenge librarians in clinical settings to leverage the opportunities presented by the current health care environment and to develop collaborative relationships with health care practitioners to provide relevant services. Discussion: Health care organizations are under financial and regulatory pressures, and many hospital librarians have been downsized or have had their positions eliminated. The lecture briefly reviews hospital librarians' roles in the past but focuses primarily on our current challenges. This environment requires librarians to be opportunity focused and pivot to a new vision that directs their actions. Many librarians are already doing this, and colleagues are encouraging us to embrace these opportunities. Evidence from publications, websites, discussion lists, personal communications, and the author's experience is explored. Conclusion: Developing interdisciplinary and collaborative relationships in our institutions and providing relevant services will mark our progress as vital, contributing members of our health care organizations. PMID:25552938

  5. [Health care levels and minimum recommendations for neonatal care].

    PubMed

    Rite Gracia, S; Fernández Lorenzo, J R; Echániz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Moreno Hernando, J; Salguero García, E; Sánchez Luna, M

    2013-07-01

    A policy statement on the levels of care and minimum recommendations for neonatal healthcare was first proposed by the Standards Committee and the Board of the Spanish Society of Neonatology in 2004. This allowed us to define the level of care of each center in our country, as well as the health and technical requirements by levels of care to be defined. This review takes into account changes in neonatal care in the last few years and to optimize the location of resources. Facilities that provide care for newborn infants should be organized within a regionalized system of perinatal care. The functional capabilities of each level of care should be defined clearly and uniformly, including requirements for equipment, facilities, personnel, ancillary services, training, and the organization of services (including transport) needed to cover each level of care. PMID:23266243

  6. Health Care and the Search for Wholeness.

    ERIC Educational Resources Information Center

    Connell, David B.; And Others

    1979-01-01

    Doctors, nurses, and counselors from residential schools got together to share ideas on counseling and the school infirmary. From this meeting, the Independent School Health Society was formed, dedicated to achieving good health within a school by teamwork among those involved in health care and health education. (KC)

  7. A Conversation on Rural Health Care.

    ERIC Educational Resources Information Center

    Myers, Wayne; Russell, Jack; Baldwin, Fred D.

    1999-01-01

    Wayne Myers, director of the Office of Rural Health Policy, discusses Appalachian rural health and access to health care. The health manpower shortage in Central Appalachia still exists but is less severe than 10 years ago. The needs of underserved areas could be address by training local people in the community and through telemedicine and…

  8. Insights From Health Care in Germany

    PubMed Central

    Altenstetter, Christa

    2003-01-01

    German Statutory Health Insurance (national health insurance) has remained relatively intact over the past century, even in the face of governmental change and recent reforms. The overall story of German national health insurance is one of political compromise and successful implementation of communitarian values. Several key lessons from the German experience can be applied to the American health care system. PMID:12511381

  9. Health care allocation, public consultation and the concept of 'health'.

    PubMed

    Edgar, A

    1998-09-01

    By comparing models of market-based allocation with state-controlled national health care systems, it will be suggested that the way in which different communities deal with the allocation of health care is central to their expression of what might be called a moral self-understanding. That is to say that the provision of health care may be expected to be a focus of communal debate, not simply about morally acceptable and unacceptable actions, but also about the community's understanding of what it is that makes for a worthwhile and morally defensible human life. This moral self-understanding is seen to be entwined with the different concepts of 'health' that are implicit in different systems of allocation. In conclusion, it will be suggested that decisions concerning health care allocation must be made in response to a continuing, public and open debate about what health and health care mean to a particular community. PMID:10185170

  10. Health care librarians and information literacy: an investigation.

    PubMed

    Kelham, Charlotte

    2014-09-01

    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

  11. Suicide Prevention: An Emerging Priority For Health Care.

    PubMed

    Hogan, Michael F; Grumet, Julie Goldstein

    2016-06-01

    Suicide is a significant public health problem. It is the tenth leading cause of death in the United States, and the rate has risen in recent years. Many suicide deaths are among people recently seen or currently under care in clinical settings, but suicide prevention has not been a core priority in health care. In recent years, new treatment and management strategies have been developed, tested, and implemented in some organizations, but they are not yet widely used. This article examines the feasibility of improving suicide prevention in health care settings. In particular, we consider Zero Suicide, a model for better identification and treatment of patients at risk for suicide. The approach incorporates new tools for screening, treatment, and support; it has been deployed with promising results in behavioral health programs and primary care settings. Broader adoption of improved suicide prevention care may be an effective strategy for reducing deaths by suicide. PMID:27269026

  12. Applying economic principles to health care.

    PubMed Central

    Scott, R. D.; Solomon, S. L.; McGowan, J. E.

    2001-01-01

    Applying economic thinking to an understanding of resource use in patient care is challenging given the complexities of delivering health care in a hospital. Health-care markets lack the characteristics needed to determine a "market" price that reflects the economic value of resources used. However, resource allocation in a hospital can be analyzed by using production theory to determine efficient resource use. The information provided by hospital epidemiologists is critical to understanding health-care production processes used by a hospital and developing economic incentives to promote antibiotic effectiveness and infection control. PMID:11294724

  13. Health Care Industry. Workforce & Workplace Literacy Series.

    ERIC Educational Resources Information Center

    BCEL Brief, 1991

    1991-01-01

    This brief gives an overview of the topic of workplace literacy in the health care industry and lists program contacts. The following 35 organizations operate basic skills upgrading programs for health care workers: American Hospital Association; Chinese American Civic Association; Massachusetts Department of Employment and Training; BostonWorks;…

  14. Health Care Provider Physical Activity Prescription Intervention

    ERIC Educational Resources Information Center

    Josyula, Lakshmi; Lyle, Roseann

    2013-01-01

    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…

  15. Primary care NPs: Leaders in population health.

    PubMed

    Swartwout, Kathryn D

    2016-08-18

    A 2012 Institute of Medicine report calls primary and public healthcare workers to action, tasking them with working together to improve population health outcomes. A Practical Playbook released in 2014 enables this public health/primary care integration. Primary care NPs are in an excellent position to lead the charge and make this integration happen. PMID:27434390

  16. Viewing health care as a war theater.

    PubMed

    Kessler, D M

    1988-03-01

    Strategies for success in the health-care marketplace are similar to those used on the battlefield. The following article applies the teachings of Niccolo Machiavelli, Karl von Clausewitz, Napolean Bonaparte and other classic military strategists to power management, marketing and competition in health-care organizational management. PMID:10302345

  17. FastStats: Home Health Care

    MedlinePlus

    ... Submit What's this? Submit Button NCHS Home Home Health Care Recommend on Facebook Tweet Share Compartir Data are ... Data Alzheimer’s disease Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over [ ...

  18. Research Challenges in Future Health Care Systems

    NASA Astrophysics Data System (ADS)

    Kulatunga, Harini

    Future health care systems will involve a network of heterogeneous resources providing different levels of service and will comprise of a physical and a virtual decision and control layer. The initial results presented here will lead to health care delivery with on-line decision making in order to meet QoS requirements and management targets.

  19. A Guide to Adolescent Health Care EPSDT.

    ERIC Educational Resources Information Center

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

    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…

  20. Child Health and Access to Medical Care

    ERIC Educational Resources Information Center

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

  1. Teaching Primary Health Care: An Interdisciplinary Approach.

    ERIC Educational Resources Information Center

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

    1998-01-01

    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)

  2. Financial management in leading health care systems.

    PubMed

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

    2000-01-01

    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

  3. Medicaid Managed Care Model of Primary Care and Health Care Management for Individuals with Developmental Disabilities

    ERIC Educational Resources Information Center

    Kastner, Theodore A.; Walsh, Kevin K.

    2006-01-01

    Lack of sufficient accessible community-based health care services for individuals with developmental disabilities has led to disparities in health outcomes and an overreliance on expensive models of care delivered in hospitals and other safety net or state-subsidized providers. A functioning community-based primary health care model, with an…

  4. Wholistic Health Care: Challenge to Health Providers.

    ERIC Educational Resources Information Center

    McKay, Susan

    1980-01-01

    Due to the increasing influence of the holistic health movement, health providers will increasingly be challenged to reexamine their roles in patient relationships, increase the extent of interdisciplinary teamwork, emphasize health education and positive health behaviors, examine the usefulness of various alternative therapies, and consider the…

  5. Integrating Behavioral Health into Primary Care.

    PubMed

    McGough, Peter M; Bauer, Amy M; Collins, Laura; Dugdale, David C

    2016-04-01

    Depression is one of the more common diagnoses encountered in primary care, and primary care in turn provides the majority of care for patients with depression. Many approaches have been tried in efforts to improve the outcomes of depression management. This article outlines the partnership between the University of Washington (UW) Neighborhood Clinics and the UW Department of Psychiatry in implementing a collaborative care approach to integrating the management of anxiety and depression in the ambulatory primary care setting. This program was built on the chronic care model, which utilizes a team approach to caring for the patient. In addition to the patient and the primary care provider (PCP), the team included a medical social worker (MSW) as care manager and a psychiatrist as team consultant. The MSW would manage a registry of patients with depression at a clinic with several PCPs, contacting the patients on a regular basis to assess their status, and consulting with the psychiatrist on a weekly basis to discuss patients who were not achieving the goals of care. Any recommendation (eg, a change in medication dose or class) made by the psychiatrist was communicated to the PCP, who in turn would work with the patient on the new recommendation. This collaborative care approach resulted in a significant improvement in the number of patients who achieved care plan goals. The authors believe this is an effective method for health systems to integrate mental health services into primary care. (Population Health Management 2016;19:81-87). PMID:26348355

  6. Integrating Behavioral Health into Primary Care

    PubMed Central

    Bauer, Amy M.; Collins, Laura; Dugdale, David C.

    2016-01-01

    Abstract Depression is one of the more common diagnoses encountered in primary care, and primary care in turn provides the majority of care for patients with depression. Many approaches have been tried in efforts to improve the outcomes of depression management. This article outlines the partnership between the University of Washington (UW) Neighborhood Clinics and the UW Department of Psychiatry in implementing a collaborative care approach to integrating the management of anxiety and depression in the ambulatory primary care setting. This program was built on the chronic care model, which utilizes a team approach to caring for the patient. In addition to the patient and the primary care provider (PCP), the team included a medical social worker (MSW) as care manager and a psychiatrist as team consultant. The MSW would manage a registry of patients with depression at a clinic with several PCPs, contacting the patients on a regular basis to assess their status, and consulting with the psychiatrist on a weekly basis to discuss patients who were not achieving the goals of care. Any recommendation (eg, a change in medication dose or class) made by the psychiatrist was communicated to the PCP, who in turn would work with the patient on the new recommendation. This collaborative care approach resulted in a significant improvement in the number of patients who achieved care plan goals. The authors believe this is an effective method for health systems to integrate mental health services into primary care. (Population Health Management 2016;19:81–87) PMID:26348355

  7. How physicians can change the future of health care.

    PubMed

    Porter, Michael E; Teisberg, Elizabeth Olmsted

    2007-03-14

    Today's preoccupation with cost shifting and cost reduction undermines physicians and patients. Instead, health care reform must focus on improving health and health care value for patients. We propose a strategy for reform that is market based but physician led. Physician leadership is essential. Improving the value of health care is something only medical teams can do. The right kind of competition--competition to improve results--will drive dramatic improvement. With such positive-sum competition, patients will receive better care, physicians will be rewarded for excellence, and costs will be contained. Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective care. Three principles should guide this change: (1) the goal is value for patients, (2) medical practice should be organized around medical conditions and care cycles, and (3) results--risk-adjusted outcomes and costs--must be measured. Following these principles, professional satisfaction will increase and current pressures on physicians will decrease. If physicians fail to lead these changes, they will inevitably face ever-increasing administrative control of medicine. Improving health and health care value for patients is the only real solution. Value-based competition on results provides a path for reform that recognizes the role of health professionals at the heart of the system. PMID:17356031

  8. The Canadian health care system: past, present, and future.

    PubMed

    Stolberg, Harald O

    2004-09-01

    This review offers American radiologists the information required to understand the Canadian health care system. It includes a brief history of the Canadian system and describes the relationship between health care and the Canadian constitution. A comprehensive appraisal of current conditions addresses the performance of the Canadian system and provides an overview of policy and planning responsibilities for health care across Canada. It includes not only the roles and responsibilities of the federal government and of the provincial and territorial governments in health care, but also those of professional organizations. In this context, significant differences between Canada and the United States are discussed, including: the development of professional fees; billing mechanisms and audits; and medicolegal and turf issues, such as self-referral and imaging by nonradiologists. A description of professional organizations includes the central responsibility of the Royal College of Physicians and Surgeons of Canada for professional training and development, and of national and provincial medical organizations. There are descriptions of medical schools and research organizations as well as federal organizations responsible for health information and technology assessment. Problems encountered in recent years because of the curtailment of health care spending are addressed. The future of Canadian health care is considered in light of a recent report titled Building on Values: The Future of Health Care in Canada. Issues of particular interest to radiologists are emphasized. PMID:17411676

  9. [Health care of refugees - A short review with focus on infectious diseases].

    PubMed

    Lange, Berit; Stete, Katarina; Bozorgmehr, Kayvan; Camp, Johannes; Kranzer, Katharina; Kern, Winfried; Rieg, Siegbert

    2016-06-01

    Few guidelines for health care of refugees exist in Germany. Screening as a part of initial health checks as well as general organisation of early health care for refugees is very heterogenous across different regions. Current experience will be relevant to develop integrated health care models. Prevention and care of infectious diseases are an important part of early health care for refugees, even if non-communicable diseases and mental health conditions should also be considered in every effort to design early health care models. We are presenting a pragmatic review of current evidence for prevention and care of tuberculosis, HIV, chronic viral hepatitis and other infectious diseases. More evidence is needed to assess morbidity and efficacy of early health care interventions and integrated care models in refugees. PMID:27254625

  10. Health care enters the real world.

    PubMed

    Schroeder, N J

    1987-01-01

    The U.S. health care system is undergoing restructuring as a result of a complex interplay of social, political, and economic forces. Where once the medical profession had a monopoly position in the health care system, its position has been challenged by the Federal Trade Commission under the Sherman Antitrust Act. More and more, the health care field is characterized by entrepreneurialism, a concept that is at odds with the traditional tenets of the medical profession. The restructuring of health care in the U.S. has the potential to allow the entrepreneur to function to the benefit of patients, despite the fact that this is a change resisted by those providing health care services. PMID:10312135

  11. Future trends in the health care economy.

    PubMed

    Kajander, J; Samuels, M

    1996-01-01

    Most articles on the future of health care are by professionals involved in the delivery of health care services. This article is unique in that trends are examined from the perspective of the public and purchasers of care. The authors focus on 12 trends that are or will be affecting the industry, and on the sometimes unintended consequences and new conflicts that may develop. PMID:8889976

  12. The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.

    PubMed

    Ung, Brian L; Mullins, C Daniel

    2015-01-01

    The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142

  13. Redistributive effects in public health care financing.

    PubMed

    Honekamp, Ivonne; Possenriede, Daniel

    2008-11-01

    This article focuses on the redistributive effects of different measures to finance public health insurance. We analyse the implications of different financing options for public health insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing. PMID:18347823

  14. Orthopedic Health: Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment

    MedlinePlus

    ... Orthopedic Health Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment Past Issues / Spring 2009 Table of Contents ... or the sound of bone rubbing on bone Diagnosis No single test can diagnose osteoarthritis. It is ...

  15. The organisation of health care in Nepal.

    PubMed

    Bentley, H

    1995-06-01

    The focus of this paper is to examine the organisation of health care in Nepal from the literature available. After setting the study in context and examining health care in general, a more in-depth, look is taken at Primary Health Care (PHC) and how this recent emphasis is affecting nurse education. This leads into an analysis of whether or not nurses are the most appropriate personnel to deliver PHC. The fundamental issues of improving adult female literacy rates and providing a clean water supply are suggested as means whereby Nepal's health provision could be greatly improved. PMID:7665314

  16. Transforming Care Delivery through Health Information Technology

    PubMed Central

    Wheatley, Benjamin

    2013-01-01

    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

  17. Correctional health care: implications for public health policy.

    PubMed Central

    Adams, Diane L.; Leath, Brenda A.

    2002-01-01

    "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

  18. Lean methodology in health care.

    PubMed

    Kimsey, Diane B

    2010-07-01

    Lean production is a process management philosophy that examines organizational processes from a customer perspective with the goal of limiting the use of resources to those processes that create value for the end customer. Lean manufacturing emphasizes increasing efficiency, decreasing waste, and using methods to decide what matters rather than accepting preexisting practices. A rapid improvement team at Lehigh Valley Health Network, Allentown, Pennsylvania, implemented a plan, do, check, act cycle to determine problems in the central sterile processing department, test solutions, and document improved processes. By using A3 thinking, a consensus building process that graphically depicts the current state, the target state, and the gaps between the two, the team worked to improve efficiency and safety, and to decrease costs. Use of this methodology has increased teamwork, created user-friendly work areas and processes, changed management styles and expectations, increased staff empowerment and involvement, and streamlined the supply chain within the perioperative area. PMID:20619772

  19. The Potential Impact of Health Care Reform on Higher Education.

    ERIC Educational Resources Information Center

    Reace, Diana

    1994-01-01

    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)

  20. Strategic service quality management for health care.

    PubMed

    Anderson, E A; Zwelling, L A

    1996-01-01

    Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes. PMID:8763215

  1. Health systems organization for emergency care.

    PubMed

    Pedroto, Isabel; Amaro, Pedro; Romãozinho, José Manuel

    2013-10-01

    The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, requires their admission in hospital units with conveniently equipped facilities, as is done for heart attack and stroke patients. Little information of gastroenterology emergencies as a function of structure, processes and outcome is available at the organizational level. Surveys that have been conducted in different countries just assess local treatment outcome and question the organizational structure and existing resources but its impact on the outcome is not clear. Most studies address the problem of upper gastrointestinal bleeding and the out-of-hours endoscopy services in the hospital setting. The demands placed on emergency (part of the overall continuum of care) are obvious, as are the needs for the efficient use of resources and processes to improve the quality of care, meaning data must cover the full care cycle. Gastrointestinal emergencies, namely gastrointestinal bleeding, must be incorporated into the overall emergency response as is done for heart attack and stroke. This chapter aims to provide a review of current literature/evidence on organizational health system models towards a better management of gastroenterology emergencies and proposes a research agenda. PMID:24160936

  2. Perceptions of Oral Health, Preventive Care, and Care-Seeking Behaviors Among Rural Adolescents

    PubMed Central

    Dodd, Virginia J.; Logan, Henrietta; Brown, Cameron D.; Calderon, Angela; Catalanotto, Frank

    2015-01-01

    BACKGROUND An asymmetrical oral disease burden is endured by certain population subgroups, particularly children and adolescents. Reducing oral health disparities requires understanding multiple oral health perspectives, including those of adolescents. This qualitative study explores oral health perceptions and dental care behaviors among rural adolescents. METHODS Semistructured individual interviews with 100 rural, minority, low socioeconomic status adolescents revealed their current perceptions of oral health and dental care access. Respondents age ranged from 12 to 18 years. The sample was 80% black and 52% male. RESULTS Perceived threat from dental disease was low. Adolescents perceived regular brushing and flossing as superseding the need for preventive care. Esthetic reasons were most often cited as reasons to seek dental care. Difficulties accessing dental care include finances, transportation, fear, issues with Medicaid coverage and parental responsibility. In general, adolescents and their parents are in need of information regarding the importance of preventive dental care. CONCLUSIONS Findings illuminate barriers to dental care faced by low-income rural adolescents and counter public perceptions of government-sponsored dental care programs as being “free” or without cost. The importance of improved oral health knowledge, better access to care, and school-based dental care is discussed. PMID:25388597

  3. Home Health Care: What It Is and What to Expect

    MedlinePlus

    ... care + Share widget - Select to show What’s home health care & what should I expect? What's home health care? Home health care is a wide range of ... listed. What should I expect from my home health care? Doctor’s orders are needed to start care. Once ...

  4. Oregon's experiment in health care delivery and payment reform: coordinated care organizations replacing managed care.

    PubMed

    Howard, Steven W; Bernell, Stephanie L; Yoon, Jangho; Luck, Jeff; Ranit, Claire M

    2015-02-01

    To control Medicaid costs, improve quality, and drive community engagement, the Oregon Health Authority introduced a new system of coordinated care organizations (CCOs). While CCOs resemble traditional Medicaid managed care, they have differences that have been deliberately designed to improve care coordination, increase accountability, and incorporate greater community governance. Reforms include global budgets integrating medical, behavioral, and oral health care and public health functions; risk-adjusted payments rewarding outcomes and evidence-based practice; increased transparency; and greater community engagement. The CCO model faces several implementation challenges. If successful, it will provide improved health care delivery, better health outcomes, and overall savings. PMID:25480844

  5. The Future of U.S. Health Care and Its Effect on Health Care Education.

    ERIC Educational Resources Information Center

    Hildick, Sue; Kohler, Peter O.

    1998-01-01

    Traces trends in health care, including growth of managed care, increased consumer choice, and changes in administration and funding of academic health centers, and examines the challenges they create for teaching, research, and practice. The Oregon Health Plan and its effect on Oregon Health Sciences University are used for illustration. (MSE)

  6. Health profiles of adolescents in foster care.

    PubMed

    Kools, Susan; Paul, Steven M; Jones, Rasheda; Monasterio, Erica; Norbeck, Jane

    2013-01-01

    The purpose of this paper is to describe health profiles of adolescents in foster care. The Child Health and Illness Profile-Adolescent Edition clustered adolescents in foster care into 13 mutually exclusive health profiles using dimensions of satisfaction with health, risks, resilience, and discomfort. Health profiles were further characterized into four health status rankings from best to worst health status. Many reported best health status (39%); nearly equal numbers (30.6%) had profiles indicating poor or worst health status, particularly girls and those with high risk behaviors, aggression, sexual abuse, or suicidality. It is valuable to identify health characteristics of the most vulnerable subgroups of foster youth to tailor specific interventions. PMID:23036596

  7. Medical informatics and health care organizations.

    PubMed

    Holden, F M

    1991-01-01

    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

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

    ERIC Educational Resources Information Center

    Hudson, Christopher G.; DeVito, Jo Anne

    1994-01-01

    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…

  9. Investigation of health care waste management in Binzhou District, China

    SciTech Connect

    Ruoyan, Gai; Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang; Yoshihisa, Shirayama; Tang Wei; Chushi, Kuroiwa

    2010-02-15

    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.

  10. 29 CFR 825.125 - Definition of health care provider.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Definition of health care provider. 825.125 Section 825.125... Definition of health care provider. (a) The Act defines “health care provider” as: (1) A doctor of medicine... providing health care services. (b) Others “capable of providing health care services” include only:...

  11. 29 CFR 825.125 - Definition of health care provider.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Definition of health care provider. 825.125 Section 825.125... Definition of health care provider. (a) The Act defines “health care provider” as: (1) A doctor of medicine... providing health care services. (b) Others “capable of providing health care services” include only:...

  12. Health care and equity in India

    PubMed Central

    Balarajan, Yarlini; Selvaraj, S; Subramanian, S V

    2011-01-01

    India’s health system faces the ongoing challenge of responding to the needs of the most disadvantaged members of Indian society. Despite progress in improving access to health care, inequalities by socioeconomic status, geography and gender continue to persist. This is compounded by high out-of-pocket expenditures, with the rising financial burden of health care falling overwhelming on private households, which account for more than three-quarter of health spending in India. Health expenditures are responsible for more than half of Indian households falling into poverty; the impact of this has been increasing pushing around 39 million Indians into poverty each year. In this paper, we identify key challenges to equity in service delivery, and equity in financing and financial risk protection in India. These include imbalanced resource allocation, limited physical access to quality health services and inadequate human resources for health; high out-of-pocket health expenditures, health spending inflation, and behavioral factors that affect the demand for appropriate health care. Complementing other paper in this Series, we argue for the application of certain principles in the pursuit of equity in health care in India. These are the adoption of equity metrics in monitoring, evaluation and strategic planning, investment in developing a rigorous knowledge-base of health systems research; development of more equity-focused process of deliberative decision-making in health reform, and redefinition of the specific responsibilities and accountabilities of key actors. The implementation of these principles, together with strengthening of public health and primary care services, provide an approach for ensuring more equitable health care for India’s population. PMID:21227492

  13. Primary health care of the newborn baby.

    PubMed

    Bhakoo, O N; Kumar, R

    1990-01-01

    More than 50% of infant deaths in India occur during the neonatal period. High priority therefore needs to be given to improving the survival of newborns. A large number of neonatal deaths have their origin in the perinatal period and are mainly determined by the health and nutritional status of the mother, the quality of care during pregnancy and delivery, and the immediate care of the newborn at birth. Main causes of neonatal mortality are birth asphyxia, respiratory problems, and infections, especially tetanus. Most such deaths occur among low birthweight babies. Hypothermia, undernutrition, and mismanaged breast feeding may also indirectly contribute to neonatal mortality. Community-based studies have, however, demonstrated that most neonatal mortality can be affordably prevented through primary health care. Efforts are underway to expand the health care infrastructure, but the outreach of maternal and child health care remains unsatisfactory especially in rural areas. PMID:12319228

  14. Orientation to Multicultural Health Care in Migrant Health Programs.

    ERIC Educational Resources Information Center

    Trotter, Robert T., II

    This guide furnishes health care providers serving migrant and seasonal farmworkers with information to cope with the complexities of health care delivery in a multiethnic, multicultural environment. Section I provides an introduction to basic cultural concepts that influence the outcome of interactions between providers and their migrant…

  15. [Professional health cards (CPS): informatic health care system in France].

    PubMed

    Fortuit, P

    2005-09-01

    The Professional Health Card Public interest group (Groupement d'Intérêt Public-Carte de professionnel de Santé (GIP-CPS)) was founded in 1993 as a joint initiative by the different parties involved in health care in France: the state, the representatives of the health care professions and the compulsory and complementary health insurance organizations. The CPS system enables safe exchange and electronic sharing of medical data. Via Intranet connections and Extranet hosting of medical files, databases, the CPS system enables health care professionals who access servers to be identified with certainty. For email exhanges, the CPS systems guarantees the sender's identity and capacity. The electronic signature gives legal value to the email. The system also enables confidential email. The health card system (CPS) contributes to making the health service efficient. Shared medical files, health care networks, health warning systems or electronic requests for reimbursement of health insurance expenses all use the CPS system. More than 300,000 health care professionals use it regularly. The freedom of movement of patients throughout Europe has led to the growth of exchanges and information sharing between health professionals in the States of the Union. More and more health professionals will be leaving their own countries to work in foreign countries in the future. It is essential that their freedom of movement is accompanied by the ability to prove their rights to practice. PMID:16385785

  16. Oral health, oral health care and dental services--the consumer perspective.

    PubMed

    Rudolph, M J; Gilbert, L; Brand, A A

    1994-12-01

    As part of a National Oral Health Survey conducted in 1988/89, community knowledge of and attitudes towards oral health and oral health care were examined in the various population groups in South Africa. A wide range of issues were explored. These included amongst others, help-seeking and oral health behaviour, sources of health information and attitudes to dentists and dental care. Given the major political change that has recently occurred in the country, the results of the survey suggest that these findings could profitably be used in future dental personnel planning as well as in the re-structuring of the health services that is currently taking place. PMID:8613567

  17. Child Health and Access to Medical Care

    PubMed Central

    Leininger, Lindsey; Levy, Helen

    2016-01-01

    It might seem strange to ask whether increasing access to medical care can improve children’s health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children’s health. Nonetheless, they find that, on the whole, policies to improve access indeed improve children’s health, with the caveat that context plays a big role—medical care “matters more at some times, or for some children, than others.” Focusing on studies that can plausibly show a causal effect between policies to increase access and better health for children, and starting from an economic framework, they consider both the demand for and the supply of health care. On the demand side, they examine what happens when the government expands public insurance programs (such as Medicaid), or when parents are offered financial incentives to take their children to preventive appointments. On the supply side, they look at what happens when public insurance programs increase the payments that they offer to health-care providers, or when health-care providers are placed directly in schools where children spend their days. They also examine how the Affordable Care Act is likely to affect children’s access to medical care. Leininger and Levy reach three main conclusions. First, despite tremendous progress in recent decades, not all children have insurance coverage, and immigrant children are especially vulnerable. Second, insurance coverage alone doesn’t guarantee access to care, and insured children may still face barriers to getting the care they need. Finally, as this issue of Future of Children demonstrates, access to care is only one of the factors that policy makers should consider as they seek to make the nation’s children healthier. PMID:27516723

  18. MEDICAL CARE AND PUBLIC HEALTH SERVICES

    PubMed Central

    Emerson, Haven

    1952-01-01

    Medical care applies to the individual, and public health to the community. One is the concentrated application of diagnosis and treatment for the life, the comfort of a patient, and includes guidance in health as for motherhood, infancy, childhood and old age. Public health services, provided by the community through its local government and the local department of health, are concerned with the prevention of diseases of all kinds. Some are controlled by sanitary authority, but the majority of preventable diseases are dealt with by public health education. It is not the function of the health department to treat the sick. The family physicians, the hospitals and dispensaries provide for medical care. Medical care of the sick and public health protection are two parallel activities to make use of medical science, one for treatment, the other for prevention of disease. PMID:13009462

  19. Corporate moral responsibility in health care.

    PubMed

    Wilmot, S

    2000-01-01

    The question of corporate moral responsibility--of whether it makes sense to hold an organisation corporately morally responsible for its actions, rather than holding responsible the individuals who contributed to that action--has been debated over a number of years in the business ethics literature. However, it has had little attention in the world of health care ethics. Health care in the United Kingdom (UK) is becoming an increasingly corporate responsibility, so the issue is increasingly relevant in the health care context, and it is worth considering whether the specific nature of health care raises special questions around corporate moral responsibility. For instance, corporate responsibility has usually been considered in the context of private corporations, and the organisations of health care in the UK are mainly state bodies. However, there is enough similarity in relevant respects between state organisations and private corporations, for the question of corporate responsibility to be equally applicable. Also, health care is characterised by professions with their own systems of ethical regulation. However, this feature does not seriously diminish the importance of the corporate responsibility issue, and the importance of the latter is enhanced by recent developments. But there is one major area of difference. Health care, as an activity with an intrinsically moral goal, differs importantly from commercial activities that are essentially amoral, in that it narrows the range of opportunities for corporate wrongdoing, and also makes such organisations more difficult to punish. PMID:11079341

  20. Leveraging the military health system as a laboratory for health care reform.

    PubMed

    Dorrance, Kevin A; Ramchandani, Suneil; Neil, Nancy; Fisher, Harry

    2013-02-01

    The Patient Protection and Affordable Care Act recently passed into law is poised to profoundly affect the provision of medical care in the United States. In today's environment, the foundation for most ongoing comparative effectiveness research is financial claims data. However, there is an alternative that possesses much richer data. That alternative, uniquely positioned to serve as a test system for national health reform efforts, is the Department of Defense Military Health System. This article describes how to leverage the Military Health System and provide effective solutions to current health care reform challenges in the United States. PMID:23495458

  1. Unintended consequences of health care legislation.

    PubMed

    Thrall, James H

    2011-10-01

    Unintended consequences of health care legislation threaten the financial and social well-being of the United States. Examples of major legislation resulting in unintended and unforeseen consequences include the Social Security Amendments Acts of 1989 and 1993 (the Stark laws), the Balanced Budget Act of 1997, and the Social Security Amendments Act of 1965 (Medicare and Medicaid). Each of these has had unintended financial and social outcomes. Spending for Medicare and Medicaid now equals an unsustainable 23% of the federal budget. Major reasons for unintended consequences include failure to appreciate the complexity of the issues, the open-ended nature of medical advances with attendant increases in costs, the inducement of change in behaviors in response to legislation, and the moral hazard of people spending other people's money. Actions that should be considered to avoid unintended consequences include more involvement of health professionals in the design of legislation, the inclusion of triggers to target review of legislatively defined programs, and the setting of time limits for sun-setting legislation. The ACR has played an important advocacy role and should continue to offer input to legislators, federal policymakers, and other stakeholders. Many opportunities exist to address the current financial situation by reducing the amount of unnecessary care delivered. Both major US political parties need to find the political will to compromise to chart the way forward. Some level of sacrifice is likely to be necessary from patients and providers and other stakeholders. PMID:21962782

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    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…

  3. Implementation of the Care Programme Approach across Health and Social Services for Dual Diagnosis Clients

    ERIC Educational Resources Information Center

    Kelly, Michael; Humphrey, Charlotte

    2013-01-01

    Background: Care for clients with mental health problems and concurrent intellectual disability (dual diagnosis) is currently expected to be provided through the care programme approach (CPA), an approach to provide care to people with mental health problems in secondary mental health services. When CPA was originally introduced into UK mental…

  4. Reflections on curative health care in Nicaragua.

    PubMed Central

    Slater, R G

    1989-01-01

    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

  5. Psychological Science and Innovative Strategies for Informing Health Care Redesign: A Policy Brief.

    PubMed

    Rosenbaum Asarnow, Joan; Hoagwood, Kimberly E; Stancin, Terry; Lochman, John E; Hughes, Jennifer L; Miranda, Jeanne M; Wysocki, Tim; Portwood, Sharon G; Piacentini, John; Tynan, Douglas; Atkins, Marc; Kazak, Anne E

    2015-01-01

    Recent health care legislation and shifting health care financing strategies are transforming health and behavioral health (a broad term referring to mental health, substance use, and health behavior) care in the United States. Advances in knowledge regarding effective treatment and services coupled with incentives for innovation in health and behavioral health care delivery systems make this a unique time for mobilizing our science to enhance the success of health and behavioral health care redesign. To optimize the potential of our current health care environment, a team was formed composed of leaders from the Societies of Clinical Child & Adolescent Psychology, Pediatric Psychology, and Child and Family Policy and Practice (Divisions 53, 54, and 37 of the American Psychological Association). This team was charged with reviewing the scientific and policy literature with a focus on five major issues: (a) improving access to care and reducing health disparities, (b) integrating behavioral health care within primary care, (c) preventive services, (d) enhancing quality and outcomes of care, and (e) training and workforce development. The products of that work are summarized here, including recommendations for future research, clinical, training, and policy directions. We conclude that the current emphasis on accountable care and evaluation of the outcomes of care offer numerous opportunities for psychologists to integrate science and practice for the benefit of our children, families, and nation. The dramatic changes that are occurring in psychological and behavioral health care services and payment systems also require evolution in our practice and training models. PMID:26430948

  6. Space technology in remote health care

    NASA Technical Reports Server (NTRS)

    Belasco, N.

    1974-01-01

    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.

  7. Health Care Reform: Recommendations and Analysis.

    ERIC Educational Resources Information Center

    Lewit, Eugene M.; And Others

    1993-01-01

    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…

  8. The Employer-Led Health Care Revolution.

    PubMed

    McDonald, Patricia A; Mecklenburg, Robert S; Martin, Lindsay A

    2015-01-01

    To tame its soaring health care costs, intel tried many popular approaches: "consumer-driven health care" offerings such as high-deductible/low-premium plans, on-site clinics and employee wellness programs. But by 2009 intel realized that those programs alone would not enable the company to solve the problem, because they didn't affect its root cause: the steadily rising cost of the care employees and their families were receiving. Intel projected that its health care expenditures would hit a whopping $1 billion by 2012. So the company decided to try a novel approach. As a large purchaser of health services and with expertise in quality improvement and supplier management, intel was uniquely positioned to drive transformation in its local health care market. The company decided that it would manage the quality and cost of its health care suppliers with the same rigor it applied to its equipment suppliers by monitoring quality and cost. It spearheaded a collaborative effort in Portland, Oregon, that included two health systems, a plan administrator, and a major government employer. So far the Portland collaborative has reduced treatment costs for certain medical conditions by 24% to 49%, improved patient satisfaction, and eliminated over 10,000 hours worth of waste in the two health systems' business processes. PMID:26540959

  9. Telecommunications, health care, and legal liability

    NASA Astrophysics Data System (ADS)

    Levy, Chris

    1990-06-01

    Regulation of health care telecommunications is fragmented in Canada. Further neither the legislative nor the administrative nor the judicial processes have managed to respond successfully to the impact of telecommunications technology. The result is a legal environment that is necessarily speculative for both telecommunications service providers and health care personnel and facilities. Critical issues include ensuring confidentiality for sensitive patient records and health information liability of telecommunications service providers for inaccurate transmission liability of health care providers for use or non-use of telecommunications services. Limitation of legal liability for both telecommunications and health care service providers is likely to be most effective when based on contract but the creation of the necessary contracts is potentially unduly cumbersome both legally and practically. 1. CONSTITUTIONAL ASPECTS Telecommunications systems that are empowered to operate or connect cross provincial or international boundaries are subject to federal regulation bu the scheme is incomplete in respect of a system set up as a provincial agency. Health care on the other hand is very much a matter of provincial rather than federal authority as a matter of strict law but the fiscal strength of the federal government enables it to provide money to the provinces for financing health care and to4 use this as a device for securing compliance with certain federal standards. Nevertheless the political willingness of the federal health authorities to impose standards on the provinces

  10. [Informatics in the Croatian health care system].

    PubMed

    Kern, Josipa; Strnad, Marija

    2005-01-01

    Informatization process of the Croatian health care system started relatively early. Computer processing of data of persons not covered by health insurance started in 1968 in Zagreb. Remetinec Health Center served as a model of computer data processing (CDP) in primary health care and Sveti Duh General Hospital in inpatient CDP, whereas hospital administration and health service were first introduced to Zagreb University Hospital Center and Sestre Milosrdnice University Hospital. At Varazdin Medical Center CDP for health care services started in 1970. Several registries of chronic diseases have been established: cancer, psychosis, alcoholism, and hospital registries as well as pilot registries of lung tuberculosis patients and diabetics. Health statistics reports on healthcare services, work accidents and sick-leaves as well as on hospital mortality started to be produced by CDP in 1977. Besides alphanumeric data, the modern information technology (IT) can give digital images and signals. Communication in health care system demands a standardized format of all information, especially for telemedicine. In 2000, Technical Committee for Standardization in Medical Informatics was founded in Croatia, in order to monitor the activities of the International Standardization Organization (ISO) and Comite Européen de Normalisation (CEN), and to implement their international standards in the Croatian standardization procedure. The HL7 Croatia has also been founded to monitor developments in the communication standard HL7. So far, the Republic of Croatia has a number of acts regulating informatization in general and consequently the informatization of the health care system (Act on Personal Data Confidentiality, Act on Digital Signature, Act of Standardization) enacted. The ethical aspect of data security and data protection has been covered by the Code of Ethics for medical informaticians. It has been established by the International Medical Informatics Association (IMIA

  11. Environmental Health Data in Europe: Current Approaches.

    ERIC Educational Resources Information Center

    Elias, A. W., Ed.

    1990-01-01

    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,…

  12. Mercy health promoter: A paradigm for just health care

    PubMed Central

    Clark, Peter A.; Schadt, Sam

    2013-01-01

    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

  13. Health Care Robotics: A Progress Report

    NASA Technical Reports Server (NTRS)

    Fiorini, Paolo; Ali, Khaled; Seraji, Homayoun

    1997-01-01

    This paper describes the approach followed in the design of a service robot for health care applications. Under the auspices of the NASA Technology Transfer program, a partnership was established between JPL and RWI, a manufacturer of mobile robots, to design and evaluate a mobile robot for health care assistance to the elderly and the handicapped. The main emphasis of the first phase of the project is on the development on a multi-modal operator interface and its evaluation by health care professionals and users. This paper describes the architecture of the system, the evaluation method used, and some preliminary results of the user evaluation.

  14. Simulation modeling for the health care manager.

    PubMed

    Kennedy, Michael H

    2009-01-01

    This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement. PMID:19668066

  15. Future developments in health care performance management.

    PubMed

    Crema, Maria; Verbano, Chiara

    2013-01-01

    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

  16. Future developments in health care performance management

    PubMed Central

    Crema, Maria; Verbano, Chiara

    2013-01-01

    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

  17. Health care evaluation, utilitarianism and distortionary taxes.

    PubMed

    Calcott, P

    2000-09-01

    Cost Utility Analysis (CUA) and Cost Benefit Analysis (CBA) are methods to evaluate allocations of health care resources. Problems are raised for both methods when income taxes do not meet the first best optimum. This paper explores the implications of three ways that taxes may fall short of this ideal. First, taxes may be distortionary. Second, they may be designed and administered without reference to information that is used by providers of health care. Finally, the share of tax revenue that is devoted to health care may be suboptimal. The two methods are amended to account for these factors. PMID:11184801

  18. Geographical Information Systems and Health: Current State and Future Directions

    PubMed Central

    2012-01-01

    This paper provides an introduction to Geographical Information Systems (GIS) and how they can be used. It reviews the current state of GIS use in health care before identifying the barriers to more pervasive use of GIS in health. Finally, it makes recommendations for the direction of health GIS research over the next decade and concludes with a call to action to health informatics researchers to stop ignoring a tool and methodology that has such immense potential for improving the health of our communities. PMID:22844644

  19. Managed care in four managed competition OECD health systems.

    PubMed

    Shmueli, Amir; Stam, Piet; Wasem, Jürgen; Trottmann, Maria

    2015-07-01

    Managed care emerged in the American health system in the 1980s as a way to manage suppliers' induced demand and to contain insurers' costs. While in Israel the health insurers have always been managed care organizations, owning health care facilities, employing medical personnel or contracting selectively with independent providers, European insurers have been much more passive, submitting themselves to collective agreements between insurers' and providers' associations, accompanied by extensive government regulation of prices, quantities, and budgets. With the 1990s reforms, and the introduction of risk-adjusted "managed competition", a growing pressure to allow the European insurers to manage their own care - including selective contracting with providers - has emerged, with varying speed of the introduction of policy changes across the individual countries. This paper compares experiences with managed care in Israel, The Netherlands, Germany and Switzerland since the 1990s. After a brief description of the health insurance markets in the four countries, we focus comparatively on the emergence of managed care in the markets for ambulatory care and inpatient market care. We conclude with an evaluation of the current situation and a discussion of selected health policy issues. PMID:25776034

  20. [Community financing for health care in Africa: mutual health insurance].

    PubMed

    Richard, V

    2005-01-01

    Health care in sub-Saharan Africa is increasingly financed by direct payments from the population. Mutual health insurance plans are developing to ensure better risk sharing. However mutual health insurance cannot fully resolve all equity issues. The low resources available for contribution and the limited availability of care services especially in the public sector cannot guarantee the quality of care necessary for the development of mutual health insurance. National governments must not forget their responsibility especially for defining and ensuring basic services that must be accessible to all. Will mutual health insurance plans be a stepping-stone to universal health care coverage and can these plans be successfully implemented in the context of an informal economy? PMID:15903084

  1. Six Sigma in health care management and strategy.

    PubMed

    Carrigan, Martin D; Kujawa, David

    2006-01-01

    In the years ahead, health care organizations will continue to face numerous challenges from longstanding and currently unresolved issues and new and emerging trends. Some of these include workforce shortages, rising consumerism, patient and stakeholder expectations, quality and patient safety, reimbursement, an aging population, regulatory constraints, and disaster preparedness. Health care organizations will need to adopt effective strategic tools, such as Six Sigma, to improve efficiency and effectiveness. Failure to do so will not only threaten their ability to remain competitive and provide quality care to the communities they serve, but their own survival will also be jeopardized by shrinking margins caused by continued downward pressure on reimbursement. PMID:16699328

  2. Understanding and Measuring Health Care Insecurity

    PubMed Central

    Tomsik, Philip E.; Smith, Samantha; Mason, Mary Jane; Zyzanski, Stephen J.; Stange, Kurt C.; Werner, James J.; Flocke, Susan A.

    2015-01-01

    Purpose To define the concept of “health care insecurity,” validate a new self-report measure, and examine the impact of beginning care at a free clinic on uninsured patients’ health care insecurity. Methods Consecutive new patients presenting at a free clinic completed 15 items assessing domains of health care insecurity (HCI) at their first visit and again four to eight weeks later. Psychometrics and change of the HCI measure were examined. Results The HCI measure was found to have high internal consistency (α=0.94). Evidence of concurrent validity was indicated by negative correlation with VR-12 health-related quality of life physical and mental health components and positive correlation with the Perceived Stress Scale. Predictive validity was shown among the 83% of participants completing follow-up: HCI decreased after beginning care at a free clinic (p<.001). Conclusion Reliably assessing patient experience of health care insecurity is feasible and has potential to inform efforts to improve quality and access to care among underserved populations. PMID:25418245

  3. Massachusetts health care reform: is it working?

    PubMed

    McAdoo, Joshua; Irving, Julian; Deslich, Stacie; Coustasse, Alberto

    2013-01-01

    Before 2006, Massachusetts had more than 500 000 residents who lacked health insurance. Governor Mitt Romney enacted landmark legislation requiring all residents to obtain health insurance. Also, the legislation established a health insurance exchange for the purpose of broadening the choices of insurance plans made available to individuals in the state. The purpose of this research was to assess the Massachusetts health care reform in terms of access, cost, and sustainability. The methodology used was a literature review from 2006 to 2013; a total of 43 references were used. Health reform resulted in additional overall state spending of $2.42 billion on Medicaid for Massachusetts. Since the 2006 reform, 401 000 additional residents have obtained insurance. The number of Massachusetts residents who had access to health care increased substantially after the health care reform was enacted, to 98.1% of residents. The Massachusetts health care reform has not saved money for the state; its funding has been covered by Federal spending. However, reform has been sustained over time because of the high percentage of state residents who have supported the state mandate to obtain health care coverage. PMID:24168866

  4. Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts

    PubMed Central

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-01-01

    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

  5. Should health care providers be accountable for patients' care experiences?

    PubMed

    Anhang Price, Rebecca; Elliott, Marc N; Cleary, Paul D; Zaslavsky, Alan M; Hays, Ron D

    2015-02-01

    Measures of patients' care experiences are increasingly used as quality measures in accountability initiatives. As the prominence and financial impact of patient experience measures have increased, so too have concerns about the relevance and fairness of including them as indicators of health care quality. Using evidence from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys, the most widely used patient experience measures in the United States, we address seven common critiques of patient experience measures: (1) consumers do not have the expertise needed to evaluate care quality; (2) patient "satisfaction" is subjective and thus not valid or actionable; (3) increasing emphasis on improving patient experiences encourages health care providers and plans to fulfill patient desires, leading to care that is inappropriate, ineffective, and/or inefficient; (4) there is a trade-off between providing good patient experiences and providing high-quality clinical care; (5) patient scores cannot be fairly compared across health care providers or plans due to factors beyond providers' control; (6) response rates to patient experience surveys are low, or responses reflect only patients with extreme experiences; and (7) there are faster, cheaper, and more customized ways to survey patients than the standardized approaches mandated by federal accountability initiatives. PMID:25416601

  6. Challenges to Native American health care.

    PubMed Central

    Noren, J; Kindig, D; Sprenger, A

    1998-01-01

    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

  7. Electronic health record functionality needed to better support primary care

    PubMed Central

    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

    2014-01-01

    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

  8. [Managed care. Its impact on health care in the USA, especially on anesthesia and intensive care].

    PubMed

    Bauer, M; Bach, A

    1998-06-01

    Managed care, i.e., the integration of health insurance and delivery of care under the direction of one organization, is gaining importance in the USA health market. The initial effects consisted of a decrease in insurance premiums, a very attractive feature for employers. Managed care promises to contain expenditures for health care. Given the shrinking public resources in Germany, managed care seems attractive for the German health system, too. In this review the development of managed care, the principal elements, forms of organisation and practical tools are outlined. The regulation of the delivery of care by means of controlling and financial incentives threatens the autonomy of physicians: the physician must act as a "double agent", caring for the interest for the individual patient and being restricted by the contract with the managed care organisation. Cost containment by managed care was achieved by reducing the fees for physicians and hospitals (and partly by restricting care for patients). Only a fraction of this cost reduction was handed over to the enrollee or employer, and most of the money was returned with profit to the shareholders of the managed care organisations. The preeminent role of primary care physicians as gatekeepers of the health network led to a reduced demand for specialist services in general and for university hospitals and anesthesiologists in particular. The paradigm of managed care, i.e., to guide the patient and the care giver through the health care system in order to achieve cost-effective and high quality care, seems very attractive. The stress on cost minimization by any means in the daily practice of managed care makes it doubtful if managed care should be an option for the German health system, in particular because there are a number of restrictions on it in German law. PMID:9676303

  9. The ORIGINS of Primary Health Care and SELECTIVE Primary Health Care

    PubMed Central

    Cueto, Marcos

    2004-01-01

    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

  10. THE NEOLIBERAL TURN IN AMERICAN HEALTH CARE.

    PubMed

    Gaffney, Adam

    2015-01-01

    Leaving millions both uninsured and underinsured, the Affordable Care Act does not create a system of universal health care in the United States. To understand its shortcomings, we have to understand it as part of a historic shift in the political economy of American health care. This "neoliberal turn" began as a reaction against the welfare state as it expanded during the New Deal and post-World War II period. What began as a movement associated with philosophers like Friedrich Hayek ultimately had a powerful impact via the attraction of powerful corporate sponsors and political supporters, and it was to historically transform American health care thought and organization. In health policy circles, for example, it can be seen in a rising emphasis on "moral hazard," overuse, and cost sharing above a concern with universalism and equity. It was likewise manifested by the corporatization of the health maintenance organization and the rise of the "consumer-driven" health care movement. By the time of the health care reform debate, the influence of corporate "stakeholders" was to prove predominant. These developments, however, must be construed as connected parts of a much larger political transformation, reflected in rising inequality and privatization, occurring both domestically and internationally. PMID:26460446

  11. [Organizing health care: an ethical perspective].

    PubMed

    2013-06-01

    Health care at population level is a complex problem. Having this in mind, the purpose of this paper is to focus on the goods that are ethically relevant in the process of caring for health at this level. We briefly analyze some of the Chilean health statistics that, although they show important improvements along the years, demonstrate that certain conditions are to be deemed as inadequate by both healthcare providers and patients. Ethics is a central component to determine how to structure and organize health care systems and how they should operate. We emphasize human dignity as an ethical corner stone of the health care system, along with other important values such as justice and humanization, under the scope of the ends of medicine, and other components such as technical competence of providers and the financing of the whole process. We conclude that as far as a health care system is organized in a way that medical practice is well ordered, primarily and fundamentally according the ends of medicine and the good of persons, such a health care system is ethically adequate. PMID:24121582

  12. Disparities in Health Care Quality among Minority Women

    MedlinePlus

    ... 3-EF Go to Online Store Disparities in Health Care Quality Among Minority Women Selected Findings From the ... race and ethnicity are combined. Return to Contents Health Care Delivery and Systems Information about health care delivery ...

  13. [Redesigning Swiss ambulatory health care system].

    PubMed

    Bays, J-M; Ninane, F; Morin, D; Héritier, F; Cassis, I; Cornuz, J

    2012-11-28

    Primary care medicine is first in line to meet the necessary changes in our health care system. Innovations in this field pursue three types of objectives: accessibility, quality and continuity of care. The Department of ambulatory care and community medicine of the University of Lausanne (Policlinique médicale universitaire) is committed to this path, emphasizing interprofessional collaboration. The doctor, nurse and medical assistant coordinate their activities to contribute efficiently to meet the needs of patients today and tomorrow. This paper also addresses how our department, as a public and academic institution, might play a major role as a health care network actor. A master degree dissertation in health management has started to identify the critical success factors and the strategic core competencies needed to achieve this development. PMID:23240239

  14. Big data in health care.

    PubMed

    Schouten, Pieter

    2013-02-01

    By identifying and applying advanced revenue cycle analytics, healthcare providers can: Free up cash. Find new revenues without harming core services. Improve productivity, profitability, and patient care. PMID:23413667

  15. Types of health care providers

    MedlinePlus

    ... GYN as their primary care provider. Nurse practitioners (NPs) are nurses with graduate training. They can serve ... common concerns and routine screenings) and family planning. NPs can prescribe medications. A physician assistant (PA) can ...

  16. Types of health care providers

    MedlinePlus

    ... trained to care for the sick. Advanced practice nurses have education and experience beyond the basic training and licensing ... include nurse practitioners (NPs) and the following: Clinical nurse specialists (CNSs) have training in a field such as cardiac, psychiatric, or ...

  17. Self-care in mental health services: a narrative review.

    PubMed

    Lucock, Mike; Gillard, Steve; Adams, Katie; Simons, Lucy; White, Rachel; Edwards, Christine

    2011-11-01

    Self-care is an important approach to the management of long-term health conditions and in preventing ill-health by living a healthy lifestyle. The concept has been used to a limited extent in relation to mental health, but it overlaps with the related concepts of recovery, self-management and self-help. These related concepts all entail individuals having more choice and control over treatment and a greater role in recovery and maintaining their health and well-being. This paper reviews qualitative empirical research that provides information on the nature of self-care in mental health from the perspective of people experiencing mental health problems. Twenty qualitative studies were identified from a systematic search of the literature. The methods used in these studies were critically appraised and key themes across studies identified self-care behaviours and processes supporting self-care. The paper also highlights challenges to this approach in mental health and provides a conceptual framework of the relationships between self-care support, self-care behaviours and strategies, and well-being for the individual. It also highlights limitations in the current evidence base and identifies areas for future research. PMID:21749527

  18. Integration: the firm and the health care sector.

    PubMed

    Laugesen, Miriam J; France, George

    2014-07-01

    Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations. PMID:24759287

  19. Caring for migrant and refugee children: challenges associated with mental health care in pediatrics.

    PubMed

    Nadeau, Lucie; Measham, Toby

    2006-04-01

    This article reviews aspects of the mental health care of migrant and refugee children. It highlights the challenges of access to care for these children and of considering the role of pediatricians in their mental health care. It also looks at the sources of differences in presentation of mental health issues of migrant youth when compared with dominant culture youth, examining the contributions of culture, context, and the families' own views. Models of care will be described that have tried to elicit a better understanding of the difficulties migrant and refugee children may encounter. Some avenues through which we may expand our current psychiatric models of care will also be addressed. These avenues include the use of interpreters and cultural brokers, addressing the debate around ethnic matching between therapists and patients, promoting a sensitivity to otherness and mediation, and looking at the importance of time issues. PMID:16682882

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

    PubMed Central

    Curtis, P

    1995-01-01

    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

  1. National Health Care Anti-Fraud Association

    MedlinePlus

    ... issued a proposed rule intended to make program integrity enhancements to the provider enrollment processes under Medicare, ... service to our members and to champion the integrity of our nation's health care system. Read More ...

  2. Primary health care nurse practitioners in Canada.

    PubMed

    DiCenso, Alba; Auffrey, Lucille; Bryant-Lukosius, Denise; Donald, Faith; Martin-Misener, Ruth; Matthews, Sue; Opsteen, Joanne

    2007-08-01

    Canada, like many countries, is in the midst of primary health care reform. A key priority is to improve access to primary health care, especially in remote communities and areas with physician shortages. As a result, there is an increased emphasis on the integration of primary health care nurse practitioners. As of March 2006, legislation exists in all provinces and two territories in Canada that allows nurse practitioners (NPs) to implement their expanded nursing role. In this paper, we will briefly review the historical development of the NP role in Canada and situate it in the international context; describe the NP role, supply of NPs in the country, and the settings in which they work; propose an NP practice model framework; summarize facilitators and barriers to NP role implementation in primary health care delivery; and outline strategies to address the barriers. PMID:18041990

  3. [Communication in health care - legal aspects].

    PubMed

    Mina, András

    2016-04-24

    This paper is focusing on the legal aspects of communication in health care, especially on doctor-patient relationship, responsibility for information, communication of adverse events, and legal declarations. PMID:27084442

  4. Ensuring optimal health care for LGBT patients.

    PubMed

    Glasper, Alan

    2016-07-14

    Emeritus Professor Alan Glasper, from the University of Southampton, discusses a Royal College of Nursing policy that highlights the complexities of providing high-quality and non-discriminatory health care. PMID:27409790

  5. Health care philanthropies: how communities can participate.

    PubMed

    1996-09-01

    When a nonprofit hospital or health plan converts to for-profit status, the value of its assets endows a charitable foundation. As a result, billions of health care dollars are being shifted into new philanthropic institutions with an explicit mission to "improve the health of the community." But this issue of States of Health argues that mission can only be accomplished if consumers are involved significantly in the conversion process. PMID:11503873

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

    ERIC Educational Resources Information Center

    Washington State Workforce Training and Education Coordinating Board, Olympia.

    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…

  7. Benefits and Systems of Care for Maternal and Child Health under Health Care Reform: Workshop Highlights.

    ERIC Educational Resources Information Center

    Abel, Cynthia H., Ed.

    This report discusses the health care needs of and benefits for women, children, and adolescents in light of national health care reform proposals put forth in 1994, and is based on presentations and discussions at an invitational workshop on maternal and child health. The report asserts that since women and children are disproportionately…

  8. Access to Health Care for Hispanic Women: A Primary Health Care Perspective.

    ERIC Educational Resources Information Center

    Juarbe, Teresa C.

    1995-01-01

    Describes and analyzes from a primary health care perspective how sociopolitical and cultural issues are key factors that influence the health of Hispanic women and their ability to access health care. Looks at the implications for nursing practice, theory, and research and advocates social and political changes needed to improve the situation.…

  9. Financing health care in the United Arab Emirates.

    PubMed

    Taha, Nabila Fahed; Sharif, Amer Ahmad; Blair, Iain

    2013-01-01

    Newcomers to the United Arab Emirates (UAE) health care system often enquire about the way in which UAE health services are financed particularly when funding issues affect eligibility for treatment. The UAE ranks alongside many western counties on measures of life expectancy and child mortality but because of the unique population structure spends less of its national income on health. In the past as a wealthy country the UAE had no difficulty ensuring universal access to a comprehensive range of services but the health needs of the UAE population are becoming more complex and like many countries the UAE health system is facing the twin challenges of quality and cost. To meet these challenges new models of health care financing are being introduced. In this brief article we will describe the evolution of UAE health financing, its current state and likely future developments. PMID:24228347

  10. The Health Care Dilemma. Second Edition.

    ERIC Educational Resources Information Center

    McTaggart, Aubrey C.; McTaggart, Lorna, M.

    The purpose of this book is to provide useful information about the components of quality health care and to suggest ways for the consumer to find and avail himself of the best care possible. The following subjects are covered, including brief histories of sociological background and suggestions on how to judge competency: (1) physicians,…

  11. Improving Health Care for Assisted Living Residents

    ERIC Educational Resources Information Center

    Kane, Robert L.; Mach, John R., Jr.

    2007-01-01

    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…

  12. Obamacare Paying Off with Improved Health Care

    MedlinePlus

    ... areas during the period when the Affordable Care Act (ACA), also called Obamacare, was being established across the United States. The ACA was signed into law by President Barack Obama in 2010, but many features of the health care reform law were not fully implemented until 2014. The ...

  13. Model Child Care Health Policies. Fourth Edition.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    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)…

  14. Multidisciplinary teamwork in US primary health care.

    PubMed

    Solheim, Karen; McElmurry, Beverly J; Kim, Mi Ja

    2007-08-01

    Primary health care (PHC) is a systems perspective for examining the provision of essential health care for all. A multidisciplinary collaborative approach to health care delivery is associated with effective delivery and care providers' enrichment. Yet data regarding multidisciplinary practice within PHC are limited. The purpose of this exploratory qualitative descriptive study was to better understand team-based PHC practice in the US. Aims included (a) describing nursing faculty involvement in PHC, (b) analyzing ways that multidisciplinary work was enacted, and (c) recommending strategies for multidisciplinary PHC practice. After institutional review board (IRB) protocol approval, data collection occurred by: (a) surveying faculty/staff in a Midwestern nursing college (N=94) about their PHC practice, and (b) interviewing a purposive sample of nursing faculty/staff identified with PHC (n=10) and their health professional collaborators (n=10). Survey results (28% return rate) were summarized, interview notes were transcribed, and a systematic process of content analysis applied. Study findings show team practice is valued because health issues are complex, requiring different types of expertise; and because teams foster comprehensive care and improved resource use. Mission, membership attributes, and leadership influence teamwork. Though PHC is not a common term, nurses and their collaborators readily associated their practice with a PHC ethos. PHC practice requires understanding community complexity and engaging with community, family, and individual viewpoints. Though supports exist for PHC in the US, participants identified discord between their view of population needs and the health care system. The following interpretations arise from this study: PHC does not explicitly frame health care activity in the US, though some practitioners are committed to its ethics; and, teamwork within PHC is associated with better health care and rewarding professional

  15. Risk management issues in postmenopausal health care.

    PubMed

    Edozien, Leroy C

    2007-12-01

    As in other areas of clinical activity, unintended harm to patients may occur in the course of postmenopausal health care, and measures to ensure patient safety should be actively promoted. This paper discusses the application of some basic principles of risk management to postmenopausal health care. To facilitate communication and reduce errors in diagnosis and treatment, risk management should be incorporated in the development of a dedicated menopause service. PMID:18088524

  16. Emerging trends in health care finance.

    PubMed

    Sterns, J B

    1994-01-01

    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

  17. Health care choices: sharing the quality message.

    PubMed

    2001-01-01

    Information on health-care quality (in the form of report cards) is playing an increasingly important role in consumers' health-care decision making. In this brief we discuss how you can help your clients sort through available quality information and how you can prepare a report card using the approach developed by the Foundation for Accountability (FACCT), our guest authors this month. PMID:11859891

  18. Organization theory. Analyzing health care organizations.

    PubMed

    Cors, W K

    1997-02-01

    Organization theory (OT) is a tool that can be applied to analyze and understand health care organizations. Transaction cost theory is used to explain, in a unifying fashion, the myriad changes being undertaken by different groups of constituencies in health care. Agency theory is applied to aligning economic incentives needed to ensure Integrated Delivery System (IDS) success. By using tools such as OT, a clearer understanding of organizational changes is possible. PMID:10164970

  19. The English and Swedish health care reforms.

    PubMed

    Glennerster, H; Matsaganis, M

    1994-01-01

    England and Sweden have two of the most advanced systems of universal access to health care in the world. Both have begun major reforms based on similar principles. Universal access and finance from taxation are retained, but a measure of competition between providers of health care is introduced. The reforms therefore show a movement toward the kind of approach advocated by some in the United States. This article traces the origins and early results of the two countries' reform efforts. PMID:8034391

  20. New systems of care for substance use disorders: treatment, finance, and technology under health care reform.

    PubMed

    Pating, David R; Miller, Michael M; Goplerud, Eric; Martin, Judith; Ziedonis, Douglas M

    2012-06-01

    This article outlined ways in which persons with addiction are currently underserved by our current health care system. However, with the coming broad scale reforms to our health care system, the access to and availability of high-quality care for substance use disorders will increase. Addiction treatments will continue to be offered through traditional substance abuse care systems, but these will be more integrated with primary care, and less separated as treatment facilities leverage opportunities to blend services, financing mechanisms, and health information systems under federally driven incentive programs. To further these reforms, vigilance will be needed by consumers, clinicians, and policy makers to assure that the unmet treatment needs of individuals with addiction are addressed. Embedded in this article are essential recommendations to facilitate the improvement of care for substance use disorders under health care reform. Ultimately, as addiction care acquires more of the “look and feel” of mainstream medicine, it is important to be mindful of preexisting trends in health care delivery overall that are reflected in recent health reform legislation. Within the world of addiction care, clinicians must move beyond their self-imposed “stigmatization” and sequestration of specialty addiction treatment. The problem for addiction care, as it becomes more “mainstream,” is to not comfortably feel that general slogans like “Treatment Works,” as promoted by Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment during its annual Recovery Month celebrations, will meet the expectations of stakeholders outside the specialty addiction treatment community. Rather, the problem is to show exactly how addiction treatment works, and to what extent it works-there have to be metrics showing changes in symptom level or functional outcome, changes in health care utilization, improvements in workplace attendance and

  1. Validation of the Health Care Surrogate Preferences Scale

    ERIC Educational Resources Information Center

    Buckey, Julia W.; Abell, Neil

    2004-01-01

    Recent advances in health care technology have increased the number of health care decisions made by acute care patients and those who act on their behalf, known as health care surrogates. This study reports on the validation of a new measure, the Health Care Surrogate Preferences Scale. Designed to assess the willingness of adults to perform and…

  2. The physician's perception of health care.

    PubMed Central

    Lawrence, R S

    1994-01-01

    A general malaise appears to have settled on the American medical scene; most Americans continue to trust their own physicians but do not trust the medical profession or the health system as a whole, while many physicians feel harassed by the regulatory, bureaucratic, or litigious intrusions upon the patient-doctor relationship. The strains on mutual trust among physicians, their patients, and the public are being played out against a background of contradictions. The advances of biomedicine are offset by the neglect of social and behavioural aspects of medical care. Preoccupation with specialized, hospital-based treatment is accompanied by isolation of public health and preventive interests from medical education and practice. Society remains uncertain whether health care is a right or a privilege while accepting public responsibility for financing the health care of certain groups such as the indigent sick (Medicaid), the elderly (Medicare), Native Americans, or members of the armed forces and veterans. Rising expectations about better outcomes through advances in technology are accompanied by rising anxieties about cost, appropriateness of care, access, and quality. Physicians must alter their perception of health care by adopting a population-based approach to need, a commitment to restoring equity in staffing patterns and compensation between primary care and specialty care, and adoption of a social contract that provides for full access by all Americans to basic cost-effective preventive and clinical services before spending on less cost-effective services. PMID:8064752

  3. [Update on Current Care guidelines: ADHD (attention-deficit/hyperactivity disorder, children and adolescents)].

    PubMed

    2012-01-01

    The updated Current Care guideline for children and adolescents with ADHD covers both diagnosis and treatment. Psychosocial support is provided when hyperactivity problems arise, even before specific diagnosis. While psychosocial interventions are effective in the treatment of ADHD, the core symptoms are best treated with medication, such as methylphenidate, dexamphetamine, lisdexamphetamine or atomoxetine. Collaboration between families, primary health care services, specialist consultation services and day-care and school professionals is essential within the chain of care. PMID:22486070

  4. The Disabled: Their Health Care and Health Insurance.

    ERIC Educational Resources Information Center

    Adler, Michele

    This paper examines issues concerning access to health care for persons with disabilities, specifically the health status of the disabled, utilization and cost of services, and a comparison of health insurance coverage of persons with and without disabilities. Three age groups (children, working-age adults, and the elderly) are considered. Data…

  5. Managing organizational change: strategies for the female health care supervisor.

    PubMed

    Davies, G

    1990-07-01

    In responding to resistance to change in the current health care organization, the new female supervisor can learn to support her staff in encountering and accepting these changes. The strategies and skills discussed above are characteristic of a supervisory style that may naturally occur for women, but also can be incorporated into the leadership style of men in health care management today. Health care leaders of tomorrow must work from an androgynous framework in which the behavior patterns and responses of each gender are learned and used appropriately by both men and women. Sargent suggests that the best managers are androgynous and that this is the inevitable wave of the future. Whether man or woman, a supervisor should learn, accept, and use methods that are characteristic of both sexes to be successful in managing people. Women and men must learn from each other's strengths and share these diverse skills. Given that women now outnumber men in health care management positions and organizations are changing to a more nurturing environment, the androgynous supervisor will be the successful leader of the future. Finally, women in health care supervisory positions have the potential to bring change where it is badly needed. Women in these roles often have a system wide view of health care policy issues that recognizes less federal commitment to social programs. Many women in health care positions believe that the issues of children, women, the elderly, the poor, and the homeless need focused attention. The growing number of women in health care supervisory and leadership roles is an important factor in changing national health policy for the benefit of these groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10105044

  6. Recent developments in health care law: partners in innovation.

    PubMed

    Berry, Roberta M; Bliss, Lisa; Caley, Sylvia; Lombardo, Paul A; Rooker, Jerri Nims; Todres, Jonathan; Wolf, Leslie E

    2010-06-01

    This article reviews recent developments in health care law, focusing on the engagement of law as a partner in health care innovation. The article addresses: the history and contents of recent United States federal law restricting the use of genetic information by insurers and employers; the recent federal policy recommending routine HIV testing; the recent revision of federal policy regarding the funding of human embryonic stem cell research; the history, current status, and need for future attention to advance directives; the recent emergence of medical-legal partnerships and their benefits for patients; the obesity epidemic and its implications for the child's right to health under international conventions. PMID:20490620

  7. Primary health services at district level in South Africa: a critique of the primary health care approach

    PubMed Central

    2012-01-01

    Background The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa’s progress and attempts at implementing primary health care, various factors still limit its success. Discussion Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, and blame is apportioned when expectations are not met. It is important for all health practitioners to consider the contextual influences on health and ill-health and to recognise the role of the underlying determinants of ill-health, namely, social, economic and environmental influences. The primary health care approach provides a strong framework for this delivery but it is not widely applied. There is a need for renewed political and policy commitments toward quality primary health care delivery, re-orientation of health care workers, integration of primary health care activities into other community-based development, improved management skills and effective coordination at all levels of the health system. There should also be optimal capacity building, and skills development in problem-solving, communication, networking and community participation. Summary A well-functioning district health system is required for the re-engineering of primary health care. This strategy requires a strong leadership, a strengthening of the current district heath system and a greater emphasis on health promotion, prevention, and community participation and empowerment. PMID:22748078

  8. Applying business management models in health care.

    PubMed

    Trisolini, Michael G

    2002-01-01

    Most health care management training programmes and textbooks focus on only one or two models or conceptual frameworks, but the increasing complexity of health care organizations and their environments worldwide means that a broader perspective is needed. This paper reviews five management models developed for business organizations and analyses issues related to their application in health care. Three older, more 'traditional' models are first presented. These include the functional areas model, the tasks model and the roles model. Each is shown to provide a valuable perspective, but to have limitations if used in isolation. Two newer, more 'innovative' models are next discussed. These include total quality management (TQM) and reengineering. They have shown potential for enabling dramatic improvements in quality and cost, but have also been found to be more difficult to implement. A series of 'lessons learned' are presented to illustrate key success factors for applying them in health care organizations. In sum, each of the five models is shown to provide a useful perspective for health care management. Health care managers should gain experience and training with a broader set of business management models. PMID:12476639

  9. VA Health Care Facilities Locator

    MedlinePlus

    ... Minority Veterans Plain Language Surviving Spouses & Dependents Adaptive Sports Program ADMINISTRATION Veterans Health Administration Veterans Benefits Administration National Cemetery Administration U.S. Department of Veterans ...

  10. Health care data in the United States.

    PubMed

    Rice, D P

    1983-06-01

    This article serves as an introduction to the following article, An Inventory of U.S. Health Care Data Bases. As an introduction, this article-reviews the characteristics of U.lS. Health Care Data. These characteristics include a lack of common definition and uniformity of reporting of observations, systems that are sometimes duplicative, and a resistance to data sharing on the part of collecting agencies, arising from the pluralistic American health care economy. Yet federal, state, and local governments as well as private organizations need health data to operate and evaluate their programs. Moreover, recent shifts to block grants and cutbacks in federal funding without accountability requirements will adversely affect our ability to adequately monitor the impact of these programs on the nation's health. The article discusses these data issues, but also emphasizes the need for coordination between the government and private sectors. PMID:10261971

  11. Health Care Reform, Care Coordination, and Transformational Leadership.

    PubMed

    Steaban, Robin Lea

    2016-01-01

    This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid. This maximizes the roles of nurses across the continuum as transformational leaders in the patient/family and nursing relationship. The author explores the role of the nurse in a transactional versus transformational relationship with patients, leading to actualization of the nurse in care coordination. Focusing on the role of the nurse leader, the challenges and necessary actions for optimization of the professional nurse role are explored, using principles of transformational leadership. PMID:26938188

  12. Seamless health care for chronic diseases in a dual health care system: managed care and the role of family physicians.

    PubMed

    Lee, A

    1998-01-01

    Neither private nor state run health care systems are perfect. Although there is increasing evidence that Health Maintenance Organizations (HMOs) provide comparable care at lower cost, HMOs tend to select healthy patients. The dual health care system in Hong Kong spends about 3.9 per cent of GDP, with health indices among the best in the world. Hong Kong still faces the problem of escalating health care expenditure. One should take advantage of the dual health care system to evolve a new paradigm for a primary-led seamless health care service. The Diabetes Centre of a university teaching hospital together with the University of Community and Family Medicine has started a structured shared care programme in diabetes mellitus, involving general practitioners in both the private and public sectors integrating the primary and secondary care, and the private and public sectors. This programme starts to develop an infrastructure for providing quality care at an affordable cost for a large pool of patients with chronic disease. Unlike other "managed care schemes", this one is not run by profit-oriented companies, but by health professionals with an interest in providing best possible care at an affordable cost. The "disease management" approach needs a care delivery system without traditional boundaries; and a continuous improvement process which develops and refines the knowledge base, guidelines and delivery system. PMID:10351265

  13. Achieving Population Health in Accountable Care Organizations

    PubMed Central

    Walker, Deborah Klein

    2013-01-01

    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

  14. The Health and Social Care Act 2012

    PubMed Central

    2013-01-01

    Although the National Health Service (NHS) is regarded as a national treasure, it is no longer immune from the colossal financial pressures brought about by global recession. Economic sustainability has largely driven the reform process leading to the Health and Social Care Act (HSCA) 2012, however; other considerations have also played a role in the journey to turn the health and social care service into an institution which is fit for the 21st-century needs. This article examines the impact of the HSCA 2012 on those made vulnerable through mental ill health. It then considers three issues: First, whether parity between mental and physical health can have life beyond political rhetoric; second, what impact driving up efficiency within the NHS will have upon mental health patients; and finally, the extent to which the personalisation agenda can be meaningfully applied within the mental health context. PMID:26273147

  15. Current trends in palliative heart care.

    PubMed

    Shi, Rongyun

    2016-02-01

    Palliative care is an alternate therapeutic approach that involves specialised medical care of a patient diagnosed with serious life threatening illness like heart failure (HF). The prime aim of the palliative care is to provide patient with relief from the symptoms, pain, physical stress, and mental stress of the diagnosed disease. The palliative care helps in improving the quality of life for both the patient and the family. Advanced HF is a disease process that carries a high burden of symptoms, suffering, and death. Palliative care can complement traditional care to improve symptom amelioration, patient-caregiver communication, emotional support, and medical decision making. The present review summarized all the available on alternative palliative approaches provided to heart patient by a team of physicians, nurses and other healthcare professionals. PMID:25926080

  16. Health needs assessment in primary care: the evolution of a practical public health approach.

    PubMed

    Kilduff, A; McKeown, K; Crowther, A

    1998-05-01

    The purpose of the paper is to place health needs assessment in its primary care context. This is a dynamic context where changes in policies, staff roles and patient expectations have all to be considered. Given this complexity and the variations between practices, it is necessary to help primary health care teams (PHCTs) to understand their stage of development and how this will directly affect any health needs assessment. The technical and methodological aspects of health needs assessment have been explored and described by others, and that work will not be duplicated here. This paper reviews the health needs assessment (HNA) work of the Ribblesdale Total Purchasing Project (RTPP) and then sets this review against the political, organisational, professional and practical pressures that currently confront primary care. Out of this analysis emerges a diagnostic and development tool which links together, and emphasises the intimate relationships between, five stages of development needed for effective primary care-oriented health needs assessment work. The emphasis is on understanding the place of health needs assessment within the general processes and systems of the primary health care team. The paper concludes by suggesting ways in which public health practitioners and specialists might approach the task of supporting and influencing the evolution of the recently proposed Primary Care Groups and Primary Care Trusts. The overall intention of the article is to stimulate debate and action. PMID:9629025

  17. Challenges in Diabetes Care: Can Digital Health Help Address Them?

    PubMed

    Iyengar, Varun; Wolf, Alexander; Brown, Adam; Close, Kelly

    2016-07-01

    In Brief There is great enthusiasm for the potential of digital health solutions in medicine and diabetes to address key care challenges: patient and provider burden, lack of data to inform therapeutic decision-making, poor access to care, and costs. However, the field is still in its nascent days; many patients and providers do not currently engage with digital health tools, and for those who do, the burden is still often high. Over time, digital health has excellent potential to collect data more seamlessly, make collected data more useful, and drive better outcomes at lower costs in less time. But there is still much to prove. This review offers key background information on the current state of digital health in diabetes, six of the most promising digital health technologies and services, and the challenges that remain. PMID:27621530

  18. Association between Electronic Health Records and Health Care Utilization

    PubMed Central

    Edwards, A.; Kern, L.M.

    2015-01-01

    Summary Background The federal government is investing approximately $20 billion in electronic health records (EHRs), in part to address escalating health care costs. However, empirical evidence that provider use of EHRs decreases health care costs is limited. Objective To determine any association between EHRs and health care utilization. Methods We conducted a cohort study (2008–2009) in the Hudson Valley, a multi-payer, multiprovider community in New York State. We included 328 primary care physicians in predominantly small practices (median practice size four primary care physicians), who were caring for 223,772 patients. Data from an independent practice association was used to determine adoption of EHRs. Claims data aggregated across five commercial health plans was used to characterize seven types of health care utilization: primary care visits, specialist visits, radiology tests, laboratory tests, emergency department visits, hospital admissions, and readmissions. We used negative binomial regression to determine associations between EHR adoption and each utilization outcome, adjusting for ten physician characteristics. Results Approximately half (48%) of the physicians were using paper records and half (52%) were using EHRs. For every 100 patients seen by physicians using EHRs, there were 14 fewer specialist visits (adjusted p < 0.01) and 9 fewer radiology tests (adjusted p = 0.01). There were no significant differences in rates of primary care visits, laboratory tests, emergency department visits, hospitalizations or readmissions. Conclusions Patients of primary care providers who used EHRs were less likely to have specialist visits and radiology tests than patients of primary care providers who did not use EHRs. PMID:25848412

  19. Health Care Indicators: Hospital, Employment and Price Indicators for the Health Care Industry: Third Quarter 1997

    PubMed Central

    Seifert, Mary Lee; Heffler, Stephen K.; Donham, Carolyn S.

    1998-01-01

    This regular feature of the journal includes a discussion of recent trends in health care spending, employment, and prices. The statistics presented in this article are valuable in their own right and 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:25372024

  20. Health Care Indicators: Hospital, Employment, and Price Indicators for the Health Care Industry: First Quarter 1996

    PubMed Central

    Sensenig, Arthur L.; Heffler, Stephen K.

    1996-01-01

    This regular feature of the journal includes a discussion of recent trends in health care spending, employment, and prices. The statistics presented in this article are valuable in their own right and 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:10165035

  1. Universal health care, American style: a single fund approach to health care reform.

    PubMed

    Beauchamp, D E

    1992-06-01

    With increasing momentum for health care reform, attention is shifting to finance reform that will provide for direct methods for controlling health care spending. This article outlines the two principal paths to direct cost control and outlines a national plan that retains our multiple sources of payment, yet also contains a powerful direct cost control technique: a single fund to finance all health care. PMID:10119318

  2. Economic analysis of health care interventions.

    PubMed

    Konski, Andre

    2008-07-01

    According to US government statistics, health care expenditures approached $2 trillion in 2005 or $6,697/person, with spending expected to exceed $4.1 trillion by 2016 (http://www.cms.hhs.gov/NationalHealthExpendData/). Total Centers for Medicare and Medicaid Services spending (including Medicaid, State Children's Health Insurance Program (SCHIP), and Medicare) was $660.7 million in 2005. Despite the decline in the growth rate of health care spending growth over the past 4 years, health care spending increased 6.9% from 2004 to 2005 and was 16% of the gross domestic product (GDP) in 2005 and forecasted to be 19.6% of the GDP by 2016. Although the percentage of GDP may not concern providers of health care products or services, it has an affect on the rest of the economy. Spending on health care by employers or patients increases the cost of the products produced, making goods produced here in the United States less attractive to world markets in the age of globalization in addition to leaving less money for patients to spend on other goods and services or save. PMID:18513626

  3. What is accountability in health care?

    PubMed

    Emanuel, E J; Emanuel, L L

    1996-01-15

    Accountability has become a major issue in health care. Accountability entails the procedures and processes by which one party justifies and takes responsibility for its activities. The concept of accountability contains three essential components: 1) the loci of accountability--health care consists of at least 11 different parties that can be held accountable or hold others accountable; 2) the domains of accountability--in health care, parties can be held accountable for as many as six activities: professional competence, legal and ethical conduct, financial performance, adequacy of access, public health promotion, and community benefit; and 3) the procedures of accountability, including formal and informal procedures for evaluating compliance with domains and for disseminating the evaluation and responses by the accountable parties. Different models of accountability stress different domains, evaluative criteria, loci, and procedures. We characterize and compare three dominant models of accountability: 1) the professional model, in which the individual physician and patient participate in shared decision making and physicians are held accountable to professional colleagues and to patients; 2) the economic model, in which the market is brought to bear in health care and accountability is mediated through consumer choice of providers; and 3) the political model, in which physicians and patients interact as citizen-members within a community and in which physicians are accountable to a governing board elected from the members of the community, such as the board of a managed care plan. We argue that no single model of accountability is appropriate to health care. Instead, we advocate a stratified model of accountability in which the professional model guides the physician-patient relationship, the political model operates within managed care plans and other integrated health delivery networks, and the economic and political models operate in the relations between

  4. 47 CFR 54.633 - Health care provider contribution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Health care provider contribution. 54.633... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a) Health care provider contribution. All health...

  5. 47 CFR 54.633 - Health care provider contribution.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Health care provider contribution. 54.633... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a) Health care provider contribution. All health...

  6. Public health capacity in the provision of health care services.

    PubMed

    Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

    2015-12-01

    In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services. PMID:24687803

  7. [Economics of health care in Mali].

    PubMed

    Coulibaly, S O; Keita, M

    1996-01-01

    From the results obtained regarding the financing of health care in Mali, we emphasize two important points. First, there is a lack of criteria for the distribution of finding in the health care sector, resulting in a waste of resources. Secondly, there is an absence of adequate pharmaceutical policies. The field studies led in 1987 provided the following observations. The rate of occupation of the beds is very low. Also, the numerous new investments are not yet put into service because of the lack of necessary equipment of qualified personnel. In addition, this does not consider the excessive investments occurring in certain localities where neither the rate of frequentation nor the economic conditions will ever allow the use of the capacity created. Among the possible solutions for the crisis of health care funding in Mali, the following should be priority: first, to fight against the complete lack of organization of the activities at the health care centers; secondly, to fight against the waste and misappropriation of money resulting from the behavior of the medical and paramedical personnel: and thirdly, to clarify the management of the resources coming from the charges for each service. The pharmaceutical policies adopted and implemented in recent years Largely contributed to, first, the creation of competition between essential generic medications and nongeneric medications that can be replaced, and then, the destruction of the public network of drug distribution. These conditions considerably limited the distribution of essential medications; yet, this is the only manner of reducing the pharmaceutical expenses and accordingly, allowing more funding for other medical services. As the distribution network is disorganized, the only alternative for the population to obtain the medications at the lowest price was to create centers of purchasing and distribution and to multiply the number of retailers of essential medications. Extensive work has been conducted in

  8. Understanding Business Models in Health Care.

    PubMed

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2016-05-01

    The increasing focus on the costs of care is forcing health care organizations to critically look at their basic set of processes and activities, to determine what type of value they can deliver. A business model describes the resources, processes, and cost assumptions that an organization makes that will lead to the delivery of a unique value proposition to a customer. As health care organizations are beginning to transform their structure in preparation for a value-based delivery system, understanding business model theory can help in the redesign process. PMID:27018909

  9. Managing diversity in the health care workplace.

    PubMed

    Davidhizar, R; Dowd, S; Newman Giger, J

    1999-03-01

    Cultural diversity is increasing in the United States as increasing numbers of minorities enter the United States from abroad, and cultural diversity is especially prevalent in the health care workplace. In fact, the health care professions are particularly interested in the presence of minorities among caregivers because this often enhances the cultural competence of care delivery. Nevertheless, subtle discrimination can still be found, and managers must be alert that such behavior is not tolerated. Use of the Giger-Davidhizar Cultural Assessment Model can provide managers with information needed to respond to diversity among staff appropriately. PMID:10351046

  10. Status of simulation in health care education: an international survey

    PubMed Central

    Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam

    2014-01-01

    Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages. PMID:25489254

  11. Contributions of Physical Therapists to Primary Preventive Health Care.

    PubMed

    Nomura, Takuo

    2016-01-01

    The limitations of what physical therapists can differ from country to country. In Japan, physical therapists are national licensed health care professionals who can help patients improve or restore their mobility. Most Japanese physical therapists provide care for people in health care facilities, medical-welfare transitional facilities, and welfare facilities for the elderly. Currently, physical therapists are unable to sufficiently contribute to primary preventive health care in Japan. However, there are many health problems that physical therapists could help alleviate. For example, low back pain (LBP) more likely than any other condition prevents people from working; thus, making the establishment of effective measures to prevent and reduce LBP vital. An estimated 20,500,000 Japanese individuals have diabetes mellitus (DM) or are at a high risk of developing the disease. DM commonly accompanies stroke and/or heart disease, and is characterized by complications that result from chronic hyperglycemia. Evidence-based physical therapy is effective for the prevention and treatment of LBP and DM. The Japanese Physical Therapy Association established the Japanese Society of Physical Therapy (JSPT) in June 2013. The JSPT has 12 departmental societies and 10 sections. We believe that the JSPT will advance the study of the potential role of physical therapists in primary preventive health care. In the future, it is expected that Japanese physical therapists will contribute to primary preventive health care. PMID:27246148

  12. Marketing health care to employees: the structure of employee health care plan satisfaction.

    PubMed

    Mascarenhas, O A

    1993-01-01

    Providing cost-contained comprehensive quality health care to maintain healthy and productive employees is a challenging problem for all employers. Using a representative panel of metropolitan employees, the author investigates the internal and external structure of employee satisfaction with company-sponsored health care plans. Employee satisfaction is differentiated into four meaningful groups of health care benefits, whereas its external structure is supported by the traditional satisfaction paradigms of expectation-disconfirmation, attribution, and equity. Despite negative disconfirmation, employees register sufficiently high health care satisfaction levels, which suggests some useful strategies that employers may consider implementing. PMID:10129814

  13. Evidence-based medicine in health care reform.

    PubMed

    Hughes, Gordon B

    2011-10-01

    The Patient Protection and Affordable Care Act of 2010 mandates a national comparative outcomes research project agenda. Comparative effectiveness research includes both clinical trials and observational studies and is facilitated by electronic health records. A national network of electronic health records will create a vast electronic data "warehouse" with exponential growth of observational data. High-quality associations will identify research topics for pragmatic clinical trials, and systematic reviews of clinical trials will provide optimal evidence-based medicine. Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Thus, health care reform will provide a robust environment for comparative effectiveness research, systematic reviews, and evidence-based medicine, and implementation of evidence-based medicine should lead to improved quality of care. PMID:21860057

  14. Corporate social responsibility and the future health care manager.

    PubMed

    Collins, Sandra K

    2010-01-01

    The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior. PMID:21045586

  15. Medicaid enrollment choice into managed care health plans.

    PubMed

    Morton, L W

    1998-06-01

    Rural Aid to Families with Dependent Children (AFDC) Medicaid recipients were surveyed to identify factors that influenced their enrollment choice between two managed care health plans and the traditional Medicaid free-for-service plan. Bivariate and logistic regression analyses provided evidence that the Medicaid institutional information structure directly influenced recipient decision to enroll in managed care plans. Current smokers were more likely to choose a managed care plan in this sample. There was no evidence that health status, health service use patterns, marital status, or ethnicity was related to the enrollment decision. Of those who chose the traditional Medicaid fee-for-service plan, 41 percent reported that they did not understand what managed care was. PMID:9615563

  16. Political violence and Eritrean health care.

    PubMed

    Sabo, L E; Kibirige, J S

    1989-01-01

    In both colonial and post-colonial eras, the creation of nation states has often been accompanied by conflict and violence in Third World countries, particularly if such attempts have ignored previously existing cultural, religious and/or ethical differences. The illegitimacy of national state construction becomes even more apparent when the attempt is associated with conflicting geopolitical interests of the 'super-powers', as is in the case of the Horn of Africa. The 27 years of armed struggle of Eritrea to free itself from Ethiopian domination is a consequence of previous and continuing attempts to create a nation state serve the interests of the ex-colonialists and 'super-powers' at the expense of the needs and desires of the people. Throughout the 27 years of struggle with its inevitable disruption of civilian life and service provisions, Eritrea has continued to develop a needs-based health care system. The Eritrean People's Liberation Front (EPLF) has developed a health care system which directly involves the people themselves. Through careful selection of priorities and a national allocation system for the distribution of scarce resources, it has provided remarkably effective emergency services, primary care and preventive health services. Such an approach has avoided the errors committed by many other Third World countries who, through copying modern western medical care systems, developed secondary and tertiary medical care facilities which were irrelevant to the health care needs of the vast majority of their populations. PMID:2711219

  17. Health Care Performance Indicators for Health Information Systems.

    PubMed

    Hyppönen, Hannele; Ronchi, Elettra; Adler-Milstein, Julia

    2016-01-01

    Health Information Systems (HISs) are expected to have a positive impact on quality and efficiency of health care. Rapid investment in and diffusion of HISs has increased the importance of monitoring the adoption and impacts of them in order to learn from the initiatives, and to provide decision makers evidence on the role of HISs in improving health care. However, reliable and comparable data across initiatives in various countries are rarely available. A four-phase approach is used to compare different HIS indicator methodologies in order to move ahead in defining HIS indicators for monitoring effects of HIS on health care performance. Assessed approaches are strong on different aspects, which provide some opportunities for learning across them but also some challenges. As yet, all of the approaches do not define goals for monitoring formally. Most focus on health care structural and process indicators (HIS availability and intensity of use). However, many approaches are generic in description of HIS functionalities and context as well as their impact mechanisms on health care for HIS benchmarking. The conclusion is that, though structural and process indicators of HIS interventions are prerequisites for monitoring HIS impacts on health care outputs and outcomes, more explicit definition is needed of HIS contexts, goals, functionalities and their impact mechanisms in order to move towards common process and outcome indicators. A bottom-up-approach (participation of users) could improve development and use of context-sensitive HIS indicators. PMID:27198102

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

    PubMed Central

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

    2010-01-01

    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

  19. The Italian health-care system.

    PubMed

    France, George; Taroni, Francesco; Donatini, Andrea

    2005-09-01

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for health care is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist. PMID:16161196

  20. DRGs: the counterrevolution in financing health care.

    PubMed

    Dolenc, D A; Dougherty, C J

    1985-06-01

    The authors predict that the Diagnosis Related Group (DRG) system for prospective reimbursement of hospitals under Medicare, also used by several state Medicaid programs, will almost certainly be adopted in some version by private health insurers. Their thesis is that such a drastic alteration in health care economics will reduce access to care, compromise its quality, impede the development of new medical technologies, and accelerate the takeover of American medicine by large, for-profit corporations. Dolenc and Dougherty argue for an alternative system based on the assumption that health care is a right, not a commodity. In the interim they propose modifications in the DRG scheme to protect access to care by vulnerable groups and to subsidize non-profit hospitals by taxing for-profit ones. PMID:3926717