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1

The Cuban health care system and factors currently undermining it  

Microsoft Academic Search

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

Kamran Nayeri

1995-01-01

2

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

Microsoft Academic Search

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

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

3

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

PubMed

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

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

2014-07-01

4

Accessibility and use of essential medicines in health care: Current progress and challenges in India  

PubMed Central

Essential Medicine Concept, a major breakthrough in health care, started in 1977 when World Health Organization (WHO) published its first list. Appropriate use of essential medicines is one of the most cost-effective components of modern health care. The selection process has evolved from expert evaluation to evidence-based selection. The first Indian list was published in 1996 and the recent revision with 348 medicines was published in 2011 after 8 years. Health expenditure is less in India as compared to developed countries. India faces a major challenge in providing access to medicines for its 1.2 billion people by focusing on providing essential medicines. In the future, countries will face challenges in selecting high-cost medicines for oncology, orphan diseases and other conditions. There is a need to develop strategies to improve affordable access to essential medicines under the current health care reform.

Bansal, Dipika; Purohit, Vilok K.

2013-01-01

5

Human factors and ergonomics in home care: Current concerns and future considerations for health information technology  

PubMed Central

Sicker patients with greater care needs are being discharged to their homes to assume responsibility for their own care with fewer nurses available to aid them. This situation brings with it a host of human factors and ergonomic (HFE) concerns, both for the home care nurse and the home dwelling patient, that can affect quality of care and patient safety. Many of these concerns are related to the critical home care tasks of information access, communication, and patient self-monitoring and self-management. Currently, a variety of health information technologies (HITs) are being promoted as possible solutions to those problems, but those same technologies bring with them a new set of HFE concerns. This paper reviews the HFE considerations for information access, communication, and patients self-monitoring and self-management, discusses how HIT can potentially mitigate current problems, and explains how the design and implementation of HIT itself requires careful HFE attention.

Or, Calvin K.L.; Valdez, Rupa S.; Casper, Gail R.; Carayon, Pascale; Burke, Laura J.; Brennan, Patricia Flatley; Karsh, Ben-Tzion

2010-01-01

6

Optimizing health for complex adults in primary care: current challenges and a way forward.  

PubMed

As the population ages, the quantity and complexity of comorbidities only increases in the primary care setting. Health systems strive to improve quality of care and enhance cost savings, but current administrative and payment systems do not easily support the implementation of existing evidence and best practices for multimorbid adults in most primary care offices. This perspectives piece sets forth a research agenda in the area of implementation science at the intersection of geriatrics and general internal medicine. We challenge academic medical centers, medical societies, journals, and funders to actively value and support investigation in this area as much as traditional research pathways. PMID:24557512

Day, Hollis; Eckstrom, Elizabeth; Lee, Sei; Wald, Heidi; Counsell, Steven; Rich, Eugene

2014-06-01

7

Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review  

PubMed Central

Background Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. Purpose This paper explores the extent to which integrated primary health care (PHC) is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. Methods A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. Results Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. Conclusion Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development.

Lionis, Christos; Symvoulakis, Emmanouil K; Markaki, Adelais; Vardavas, Constantine; Papadakaki, Maria; Daniilidou, Natasa; Souliotis, Kyriakos; Kyriopoulos, Ioannis

2009-01-01

8

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

PubMed Central

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

Linder, Regina

2012-01-01

9

Health and Health Care  

Microsoft Academic Search

Health plays a central role in people’s perceptions of their quality of life, and access to good health care is a key ingredient\\u000a in an overall sense of security and well-being. This chapter examines how health and health care have evolved over the course\\u000a of Ireland’s economic boom. Media coverage highlights the negatives: increasing suicide, road deaths, binge drinking and

Richard Layte; Anne Nolan; Brian Nolan

10

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

Microsoft Academic Search

Infection preventionists (IP) play an increasingly important role in preventing health care-associated infection in the physical environment associated with new construction or renovation of health care facilities. The Guidelines for Design and Construction of Hospital and Healthcare Facilities, 2010, formerly known as ''AIA Guidelines'' was the origin of the ''infection control risk assess- ment'' now required by multiple agencies. These

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

2010-01-01

11

Is reasonable access what we want? Implications of, and challenges to, current Canadian policy on equity in health care.  

PubMed

Considerations of equity in the context of health care systems are often related closely to the presence or level of prices incurred by users of health care services. Some politicians and commentators have suggested that the removal of user charges under the Canadian health care system has led to equal access to care. But it is not clear that the equity principle inferred from these claims corresponds to the equity goals of current Canadian health policy. In this article the authors identify the precise equity principle that lies behind current health policy in Canada and consider the extent to which that principle is reflected in the performance of the system. They then consider other approaches to equity in health care in the context of the stated objectives of Canadian health policy and identify the implications of pursuing reasonable access in future health policy. The authors suggest that the implications of the current equity goals have not been recognized by policy makers, and if they were to be recognized it is not clear that they would be acceptable to Canadian populations and/or policy makers. Moreover, some of the implications would appear to be incompatible with other stated objectives of public policy. PMID:8080493

Birch, S; Abelson, J

1993-01-01

12

Why Current and Former Recipients of Foster Care Need High Quality Mental Health Services  

Microsoft Academic Search

This commentary presents data about the emotional, behavioral, and substance abuse disorders of youth in foster care and former\\u000a recipients of foster care (“alumni”) in the United States to underscore the reasons why high quality mental health services\\u000a are essential.

Peter J. Pecora

2010-01-01

13

Reform of Primary Health Care  

Microsoft Academic Search

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

Jeanette Lancaster; Wade Lancaster

1995-01-01

14

Child Care Health Connections, 2002.  

ERIC Educational Resources Information Center

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

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

2002-01-01

15

Women Veterans Health Care  

MedlinePLUS

... be a sign of dementia. Learn more » Comprehensive Primary Care No other health service in the world understands ... care anywhere. Learn more » Women and Dementia Comp. Primary Care WVCC Women Veterans Health Care Did you know ...

16

[Epidemiology of mental health care].  

PubMed

Mental health care epidemiology seeks to investigate the practical situation of the health care system and services for individuals with mental disorders. In the past decades, mental health care structures in Germany were successively transformed from long-term inpatient treatment capacities to decentralized outpatient and day clinic services. Currently, the proportional relation between treatment facilities in different settings has been stabilized and the strategy of mental health care development focuses on innovative and integrative models of care provision. The aim is to integrate fragmented services by the introduction of network structures to overcome rigid sector boundaries. The need for health care services is associated with multiple factors such as population-based epidemiological data, usage behavior, and health politics. Due to scarce data and poor standards of care it is difficult to determine if current structures of mental health services cover the actual needs. Therefore, a substantial increase of mental health service research is needed. PMID:22371103

Jäger, M; Rössler, W

2012-03-01

17

Health care in Brazil  

Microsoft Academic Search

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

A Haines

1993-01-01

18

[Health care and regional disparities].  

PubMed

Municipalities in Germany have to advance health care structures to be resistant to demographic transitions and to the changing health care needs of the regional population in upcoming years. Therefore, it is important to note that needs vary from region to region and that care structures have to be differentiated according to this. Indeed regionality and community care have been increasingly referred to in current debate on improving care structures. But the discussed approaches remain relatively unclear and, moreover, fail to overcome care fragmentation and legal or sectoral perspectives. This paper points out the current lack of systematic knowledge about regional health disparities as well as knowledge about models of health care that are appropriate especially for disadvantaged communities and also rural regions. Moreover, knowledge of steering mechanisms that enforce the development of regional care systems are not developed yet. PMID:23474864

Hämel, K; Ewers, M; Schaeffer, D

2013-06-01

19

Primary Health Care.  

ERIC Educational Resources Information Center

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…

Lauffer, Sandra, Ed.

1979-01-01

20

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

NASA Astrophysics Data System (ADS)

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.

Jemison, Mae C.; Thomas, J. Segun

21

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

PubMed

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

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

2012-01-01

22

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

PubMed

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

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

2012-11-01

23

Teamwork in health care.  

PubMed

It is becoming increasingly clear that maintaining and improving the health of the population, and doing so in a financially sustainable manner, requires the coordination of acute medical care with long-term care, and social support services, that is, team-based care. Despite a growing body of evidence on the benefits of team-based care, the health care ecosystem remains "resistant" to a broader implementation of such care models. This resistance is a function of both system-wide and organizational barriers, which result primarily from fragmentation in reimbursement for health care services, regulatory restrictions, and the siloed nature of health professional education. To promote the broader adoption of team-based care models, the health care system must transition to pay for value reimbursement, as well as break down the educational silos and move toward team-based and value-based education of health professionals. PMID:24896572

Landman, Natalie; Aannestad, Liv K; Smoldt, Robert K; Cortese, Denis A

2014-01-01

24

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

ERIC Educational Resources Information Center

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

Halfon, Neal; And Others

1994-01-01

25

Types of health care providers  

MedlinePLUS

This article describes health care providers involved in primary care, nursing care, and specialty care. This is just ... PRIMARY CARE A primary care provider (PCP) is a person you may see first for checkups and health ...

26

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

PubMed

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

Krieger, L M

1998-09-01

27

For Health Care Providers  

Cancer.gov

For Health Care Providers Training Categories Palliative Care Clinical Trials Translational Research Palliative Care Education in Palliative and End-of-Life Care For Oncology (EPEC™-O )Format: Web-based self-study, 3 plenary sessions and 15 content

28

Health Care Reform and the Academic Health Center.  

ERIC Educational Resources Information Center

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

Kimmey, James R.

1994-01-01

29

American Health Care Association  

MedlinePLUS

... AHCA/NCAL PAC Federal Political Directors Political Events Solutions Facility Operations Affordable Care Act Clinical Emergency Preparedness Finance Health Information Technology Integrity Medicaid Medicare Patient ...

30

Vacation health care  

MedlinePLUS

Travel health tips ... BEFORE LEAVING Planning ahead of time can make your travels smoother and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 - 6 weeks before ...

31

Monitoring health care.  

PubMed

Health risk determinants in obstetrics and gynecology are readily obtainable from state birth records. This study demonstrates the manner in which these determinants may be used to assess health care delivery and monitor its progress. The over-all problem is quite complex. Some parameters are interrelated, while others are not. In addition, any specific parameter may be causally related to many different antecedents, acting singly or in combination. Hence, one must take care not to generalize about deficiencies in our health care systems and thereby propose simplistic, unworkable solutions. However, the study does clearly identify certain specific areas of risk which deserve greater attention than they have hitherto received from health care officials, physicians, and responsible citizens. We believe that the approach outlined in this paper offers a means to achieve unbiased, ongoing monitoring of health care, which may, in turn, be used in attempts to improve the delivery of health services. PMID:1166865

Herrmann, W L; Moore, J S

1975-10-15

32

Health Care System Accessibility  

PubMed Central

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.

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

2006-01-01

33

Lean health care.  

PubMed

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

Hawthorne, Henry C; Masterson, David J

2013-01-01

34

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

Microsoft Academic Search

BACKGROUNDOsteoarthritis 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.AIMTo 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.DESIGNNarrative review.METHODA literature

G Peat; R McCarney; P Croft

2001-01-01

35

Health-Care Hub  

ERIC Educational Resources Information Center

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…

Bowman, Darcia Harris

2004-01-01

36

Should we ration health care?  

PubMed

The paper begins by drawing a distinction between "allocation"--the distribution of resources between different categories, and "rationing"--the distribution of scarce resources within a single category. I argue that the current allocation of funds to health care makes some form of rationing unavoidable. The paper next considers proposals by Daniel Callahan and Norman Daniels supporting age rationing publicly-financed life-extending medical care. I provide reasons for doubting that either argument succeeds. The final section of the paper sets forth an alternative approach which holds that if people have any rights to health care, then they have a right to a decent minimum. PMID:10296994

Jecker, N S

1989-01-01

37

Health care automation companies.  

PubMed

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

1995-12-01

38

Knowledge and Attitudes of Health Care Providers Working in Primary Health Care Units Concerning Emergency Contraception  

Microsoft Academic Search

Aims: The aim of the current study was to explore the extent of knowledge health care providers working in primary health care units in Aydin, Turkey, had about emergency contraception (EC), to determine whether they provide EC counseling, and to understand the barriers and misconceptions in this context. Methods: A total of 120 health care professionals working in primary health

Hilmiye Aksu; Mert Kucuk; Banu Karaoz

2010-01-01

39

Mercury and health care.  

PubMed

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

Rustagi, Neeti; Singh, Ritesh

2010-08-01

40

Health Care Megatrends and Health Psychology  

Microsoft Academic Search

Health psychology is a major new area of professional psychological practice that has emerged during a period of rapid changes in the health care industry. In this article, published literature is examined for historical, educational, and health care delivery system contributions. Four megatrends in medicine and health care that impinge upon health psychology are described.

Richard H. Dana; W. Theodore May

1986-01-01

41

Containing Health Care Costs  

PubMed Central

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.

Derzon, Robert A.

1980-01-01

42

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

ERIC Educational Resources Information Center

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

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

2013-01-01

43

Health care interactional suffering in palliative care.  

PubMed

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

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

2014-05-01

44

Health care and the elderly.  

PubMed

America's health care crisis is hitting our elderly and threatens to cripple Medicare, the elderly's financial support system. Medicare was designed to ensure that every elderly American would be protected against the destruction of life savings as a result of illness. Elderly Americans would be able to enjoy their golden years without the financial burden of medical bills. Today, this vision is almost extinct. Medicare has been placed on the endangered species list. Market predictions indicate that Medicare's Hospital insurance Trust Fund will be depleted by 1988 if current trends continue. The elderly presently must pay on the average about 14% of their health care bill. In addition, Medicare pays little for long-term care; and about 45% of long-term care is paid for out-of-pocket by the elderly and their families. Alternative approaches are desperately needed of Medicare if our elderly are to survive. PMID:10311941

Eisdorfer, C

1985-01-01

45

Plan for Home Health Care in the Bluegrass Region.  

National Technical Information Service (NTIS)

This plan for home health care in the Kentucky Bluegrass Region provides for medical care and supportive services to sick or disabled persons according to Kentucky State health care regulations and policies. Currently there are six home agencies operating...

1974-01-01

46

Hurdles to health: immigrant and refugee health care in Australia  

Microsoft Academic Search

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

Sally B Murray; Sue A Skull

2005-01-01

47

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

ERIC Educational Resources Information Center

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

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

2009-01-01

48

Future delivery of health care: Cybercare  

Microsoft Academic Search

Health-care system reforms can change the structure of the current U.S. health-care system, from centralized large hospitals to a distributed, networked healthcare system. In our model, medical care is delivered locally in neighborhoods and individual homes, using computer technologies like telemedicine, to link patients and primary care providers to tertiary medical providers. This decentralization could reduce costs enough to provide

C. EVERETT KOOP; ROBYN MOSHER; LUIS KUN; JIM GEILING; ELIOT GRIGG; SARAH LONG; RONALD C. MERRELL; RICHARD SATAVA; JOSEPH M. ROSEN

2008-01-01

49

Refugee health: a new model for delivering primary health care.  

PubMed

Providing health care to newly arrived refugees within the primary health care system has proved challenging. The primary health care sector needs enhanced capacity to provide quality health care for this population. The Primary Care Amplification Model has demonstrated its capacity to deliver effective health care to patients with chronic disease such as diabetes. This paper describes the adaption ofthe model to enhance the delivery ofhealth care to the refugee community. A 'beacon' practice with an expanded clinical capacity to deliver health care for refugees has been established. Partnerships link this practice with existing local general practices and community services. Governance involves collaboration between clinical leadership and relevant government and non-government organisations including local refugee communities. Integration with tertiary and community health sectors is facilitated and continuing education of health care providers is an important focus. Early incorporation of research in this model ensures effective feedback to inform providers of current health needs. Although implementation is currently in its formative phase, the Primary Care Amplification Model offers a flexible, yet robust framework to facilitate the delivery of quality health care to refugee patients. PMID:21133306

Kay, Margaret; Jackson, Claire; Nicholson, Caroline

2010-01-01

50

Environmental Health: Health Care Reform's Missing Pieces.  

ERIC Educational Resources Information Center

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

Fadope, Cece Modupe; And Others

1994-01-01

51

National Health Care Skill Standards.  

ERIC Educational Resources Information Center

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

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

52

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

PubMed

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

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

2014-03-01

53

Psychology's Role in Health Care.  

ERIC Educational Resources Information Center

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…

American Psychological Association, Washington, DC.

54

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

PubMed Central

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

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

2014-01-01

55

Advance health care directives and "public guardian": the Italian supreme court requests the status of current and not future inability.  

PubMed

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

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

2014-01-01

56

National Health Care Skill Standards.  

ERIC Educational Resources Information Center

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…

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

57

Modeling Health Care Policy Alternatives  

PubMed Central

Background Computer models played an important role in the health care reform debate, and they will continue to be used during implementation. However, current models are limited by inputs, including available data. Aim We review microsimulation and cell-based models. For each type of model, we discuss data requirements and other factors that may affect its scope. We also discuss how to improve models by changing data collection and data access procedures. Materials and Methods We review the modeling literature, documentation on existing models, and data resources available to modelers. Results Even with limitations, models can be a useful resource. However, limitations must be clearly communicated. Modeling approaches could be improved by enhancing existing longitudinal data, improving access to linked data, and developing data focused on health care providers. Discussion Longitudinal datasets could be improved by standardizing questions across surveys or by fielding supplemental panels. Funding could be provided to identify causal parameters and to clarify ranges of effects reported in the literature. Finally, a forum for routine communication between modelers and policy makers could be established. Conclusion Modeling can provide useful information for health care policy makers. Thus, investing in tools to improve modeling capabilities should be a high priority.

Ringel, Jeanne S; Eibner, Christine; Girosi, Federico; Cordova, Amado; McGlynn, Elizabeth A

2010-01-01

58

The health care learning organization.  

PubMed

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

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

1996-01-01

59

Health captology--application of persuasive technologies to health care.  

PubMed

Professionals in industries such as advertising and sales have used techniques of persuasion to enhance the efficacy of marketing campaigns and sales revenues. In contrast, health care has traditionally relied on the persuasive power of facts and evidence to encourage healthy behavior. The evidence suggests, however, that this current approach is failing. Health care experts and opinion leaders cite overwhelming evidence of an epidemic in diseases such as obesity and diabetes, despite numerous initiatives to educate the public how to prevent morbidity and mortality. Health captology, the application of persuasive technology to health care, attempts to leverage proven persuasive techniques to improve clinical outcomes. PMID:15853239

Chan, Albert S

2004-01-01

60

Health Care-Associated Native Valve Endocarditis in Patients with no History of Injection Drug Use: Current Importance of Non-Nosocomial Acquisition  

PubMed Central

Background The clinical profile and outcome of nosocomial and non-nosocomial health care–associated native valve endocarditis are not well defined. Objective To describe the prevalence, clinical characteristics, and outcomes of nosocomial and non-nosocomial health care–associated native valve endocarditis. Design Prospective observational study. Setting 61 hospitals in 28 countries. Patients Patients with definite native valve endocarditis and no history of injection drug use who were enrolled in the International Collaboration on Endocarditis–Prospective Cohort Study from June 2000 to August 2005. Measurements Characteristics of nosocomial and non-nosocomial health care–associated native valve endocarditis cases were described and compared with those cases acquired in the community. Results Health care–associated native valve endocarditis was present in 557 (34%) of 1622 patients with native valve endocarditis and no history of injection drug use (nosocomial native valve endocarditis 303 patients [54%]; non-nosocomial health care–associated native valve endocarditis 254 patients [46%]). Staphylococcus aureus was the most common cause of health care-associated native valve endocarditis (nosocomial native valve endocarditis, 47%; non-nosocomial health care–associated native valve endocarditis, 42%; p=0.3), with a notable proportion of methicillin-resistant S. aureus (nosocomial native valve endocarditis, 57%; non-nosocomial health care–associated native valve endocarditis, 41%; p=0.014). Patients with health care–associated native valve endocarditis had lower rates of cardiac surgery (41% health care–associated native valve endocarditis vs 51% community-acquired native valve endocarditis, p<0.001) and higher in-hospital mortality rates than patients with community-acquired native valve endocarditis (25% health care–associated native valve endocarditis vs. 13% community-acquired native valve endocarditis vs., p<0.001). Multivariable analysis confirmed a higher mortality associated with health care–associated native valve endocarditis (incidence risk ratio=1.20 (CI 95%, 1.03–1.61). Limitations This study involves tertiary hospitals with cardiac surgery programs. The results may not be generalized to patient populations receiving care in other types of facility. Conclusions More than one-third of all cases of native valve endocarditis in non-drug users involve contact with health care. S. aureus is the leading cause of health care–associated native valve endocarditis. Non-nosocomial health care–associated native valve endocarditis is common, especially in the US. Patients with health care-associated and community-acquired native valve endocarditis differ in their presentation, microbiology, and outcome. By contrast, patients with nosocomial and non-nosocomial healthcare-associated endocarditis are similar.

Benito, Natividad; Miro, Jose M.; de Lazzari, Elisa; Cabell, Christopher H; del Rio, Ana; Altclas, Javier; Commerford, Patrick; Delahaye, Francois; Dragulescu, Stefan; Giamarellou, Helen; Habib, Gilbert; Kamarulzaman, Adeeba; Kumar, A. Sampath; Nacinovich, Francisco M.; Suter, Fredy; Tribouilloy, Christophe; Venugopal, K; Moreno, Asuncion; Fowler, Vance G.

2013-01-01

61

Women Veterans Health Care: Frequently Asked Questions  

MedlinePLUS

... A full continuum of health care, including comprehensive primary care (care for acute and chronic illness and gender- ... local VA health care facility to arrange a primary care appointment. return to top How do I get ...

62

Unlearning in health care  

PubMed Central

Learning in health care is essential if healthcare organisations are to tackle a challenging quality of care agenda. Yet while we know a reasonable amount about the nature of learning, how learning occurs, the forms it can take, and the routines that encourage it to happen within organisations, we know very little about the nature and processes of unlearning. We review the literature addressing issues pivotal to unlearning (what it is, why it is important, and why it is often neglected), and go further to explore the conditions under which unlearning is likely to be encouraged. There is a difference between routine unlearning (and subsequent re-learning) and deep unlearning—unlearning that requires a substantive break with previous modes of understanding, doing, and being. We argue that routine unlearning merely requires the establishment of new habits, whereas deep unlearning is a sudden, potentially painful, confrontation of the inadequacy in our substantive view of the world and our capacity to cope with that world competently.

Rushmer, R; Davies, H

2004-01-01

63

Healthcare epidemiology: the current status of planning for pandemic influenza and implications for health care planning in the United States.  

PubMed

The United States needs to be better prepared for a large-scale medical catastrophe, be it a natural disaster, a bioterrorism act, or a pandemic. There are substantial planning efforts now devoted to responding to an influenza pandemic. Here, we review these efforts and identify some harsh realities: (1) the US health care system is private, competitive, broke, and at capacity, so that any demand for surge cannot be met with existing economic resources, hospital beds, manpower, or supplies; (2) the emphasis placed on the development and rapid production of an effective vaccine is excellent, but the effort is underfunded to meet global demand; (3) and the Centers for Disease Control and Prevention's community mitigation measures, such as the use nonpharmacological and social interventions (e.g., use of face masks or respirators, social distancing, and closure of schools), lack validation and could have substantial indirect and unintended consequences. Finally, international collaborations are essential for disease surveillance and to assure investigator access to influenza strains, equitable vaccine distribution, and availability of critical supplies from offshore sources. PMID:18279045

Bartlett, John G; Borio, Luciana

2008-03-15

64

Health-Care Reform for Childbirth  

PubMed Central

In this column, the editor of The Journal of Perinatal Education discusses the current health-care crisis and the need for health-care reform to promote, support, and protect natural, safe, and healthy childbirth. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote normal birth.

Budin, Wendy C.

2010-01-01

65

Government Spending on Health Care  

Microsoft Academic Search

The economic constraints of the last decade have led western industrialized nations to consider, if not actually adopt, more stringent controls over costly social policies such as health care. Using recent, nationally representative data from the United States, Great Britain, West Germany, Italy, and Australia, this paper provides an international comparison of attitudes towards government spending on health care. Attitudes

Bernadette C. Hayes; Audrey VandenHeuvel

1996-01-01

66

Prospects for Health Care Reform.  

ERIC Educational Resources Information Center

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

Kastner, Theodore

1992-01-01

67

Congress enacts health care reform.  

PubMed

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

2010-03-01

68

[Health care reform as a development of the health care system].  

PubMed

The German health care system is undergoing a serious crisis. Current health care policies have been failing badly. The parties involved in the provision of health care are willing and able to conduct health reform. All healthcare workers expect to be included in the decision-making processes. They anticipate that their expertise and skills will be appreciated and employed to make improvements. Wise and thoughtful health policy decisions would focus on measures to support innovative practices within the existing system and strengthen current change processes. It is proposed that the reform be based on sustainable procedures. Change Management within the health care system should be guided by the principles of the Learning Organisation and the varied experience with sophisticated industrial management practices. Successful health systems development opens up new opportunities for social and economic growth. PMID:17902407

Huber, Ellis

2007-01-01

69

Academic Health Centers and Health Care Reform.  

ERIC Educational Resources Information Center

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

Miles, Stephen H.; And Others

1993-01-01

70

Health Professionals' Knowledge of Women's Health Care.  

ERIC Educational Resources Information Center

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

Beatty, Rebecca M.

2000-01-01

71

Trends in Health Care Systems Delivery.  

ERIC Educational Resources Information Center

The trend now driving American health care is that the payors are refusing to pay the true economic costs. Health care technology and the public's demand for it, the growth of managed care (Health Maintenance Organizations), and the need to increase the effectiveness of health care are affecting health care delivery. (MLW)

Hughes, Edward F. X.

1989-01-01

72

Personalized health care: from theory to practice.  

PubMed

The practice of medicine stands at the threshold of a transformation from its current focus on the treatment of disease events to an emphasis on enhancing health, preventing disease and personalizing care to meet each individual's specific health needs. Personalized health care is a new and strategic approach that is driven by personalized health planning empowered by personalized medicine tools, which are facilitated by advances in science and technology. These tools improve the capability to predict health risks, to determine and quantify the dynamics of disease development, and to target therapeutic approaches to the needs of the individual. Personalized health care can be implemented today using currently available technologies and know-how and thereby provide a market for the rational introduction of new personalized medicine tools. The need for early adoption of personalized health care stems from the necessity to reduce the egregious and wasteful burden of preventable chronic diseases, which is not effectively addressed by our current approach to care. PMID:22180345

Snyderman, Ralph

2012-08-01

73

Health care's service fanatics.  

PubMed

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

Merlino, James I; Raman, Ananth

2013-05-01

74

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

SciTech Connect

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

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

2009-08-15

75

Toward an Understanding of Health Care Delay Among Ethnic Minorities: Examining Health Care Behaviors Among Military Young-Adult Males.  

National Technical Information Service (NTIS)

The importance of eliminating health disparities in the United States has become a top priority in public health efforts. Ethnic minorities have historically different experiences and access to health care services that may influence their current attitud...

N. A. Vaughn

2001-01-01

76

Healthy Aging: Paying for Health Care  

MedlinePLUS

... This information in Spanish ( en español ) Paying for health care More information on paying for health care Better ... Coping without insurance More information on paying for health care Explore other publications and websites Age Page: Choosing ...

77

Health Care: Constitutional Rights and Legislative Powers.  

National Technical Information Service (NTIS)

The health care reform debate raises many complex issues including those of coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health care as a constitutiona...

K. S. Swendiman

2012-01-01

78

Asian American health care attitudes.  

PubMed

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

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

1999-01-01

79

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

ERIC Educational Resources Information Center

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…

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

80

New developments in a consolidating health care industry.  

PubMed

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

Taylor, D; Kleiner, B H

1998-01-01

81

Efficiency of families managing home health care  

Microsoft Academic Search

Over the last decade, cost-containment pressures, health care reform debates, movement to case-managed health care, and reductions\\u000a in health care benefits have required most families to be responsible for selecting specific health care services that keep\\u000a costs to a minimum. As Eddy [17-20] discussed in a series of articles on making decisions in health care, the consensus among\\u000a health care

Carol E. Smith; Susan V. M. Kleinbeck; Karen Fernengel; Linda S. Mayer

1997-01-01

82

Unfair inequalities in health and health care.  

PubMed

Inequalities in health and health care are caused by different factors. Measuring "unfair" inequalities implies that a distinction is introduced between causal variables leading to ethically legitimate inequalities and causal variables leading to ethically illegitimate inequalities. An example of the former could be life-style choices, an example of the latter is social background. We show how to derive measures of unfair inequalities in health and in health care delivery from a structural model of health care and health production: "direct unfairness", linked to the variations in medical expenditures and health in the hypothetical distribution in which all legitimate sources of variation are kept constant; "fairness gap", linked to the differences between the actual distribution and the hypothetical distribution in which all illegitimate sources of variation have been removed. These two approaches are related to the theory of fair allocation. In general they lead to different results. We propose to analyse the resulting distributions with the traditional apparatus of Lorenz curves and inequality measures. We compare our proposal to the more common approach using concentration curves and analyse the relationship with the methods of direct and indirect standardization. We discuss how inequalities in health care can be integrated in an overall evaluation of social inequality. PMID:18829124

Fleurbaey, Marc; Schokkaert, Erik

2009-01-01

83

Universal health care: the changing international discourse.  

PubMed

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

Bisht, Ramila

2013-01-01

84

VHA enrollees' health care coverage and use of care.  

PubMed

The authors examined health care coverage for Veterans' Health Administration (VHA) enrollees and how their reliance on VHA care varies by coverage, using the largest and most detailed survey of veterans using VHA services ever conducted. The results showed that a majority of veterans who use VHA services have alternative health care coverage and that most of them use both VHA and non-VHA health care. The findings have important implications for quality of care and coordination of care. PMID:12800686

Shen, Yujing; Hendricks, Ann; Zhang, Shuo; Kazis, Lewis E

2003-06-01

85

Variations in lay health theories: implications for consumer health care decision making.  

PubMed

Wide variations in how contemporary consumers think about health and make health care decisions often go unrecognized by health care marketers and public policy decision makers. In the current global environment, prevailing Western viewpoints on health and conventional biomedicine are being challenged by a countervailing belief system forming the basis for alternative health care practices. The ways American consumers once thought about health have changed and multiplied in this new era of competing health paradigms. Our study provides empirical evidence for this assertion in two ways. First, it demonstrates that in the current environment consumers think about health and health care in a multiplicity of very different ways, leading to the conclusion that we should not classify health care consumers as either conventional or alternative. Second, the results provide clues as to how individuals holding diverse health theories make health care decisions that impact health behaviors, treatment efficacy, and satisfaction judgments. PMID:18955468

Shaw Hughner, Renée; Schultz Kleine, Susan

2008-12-01

86

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

ERIC Educational Resources Information Center

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

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

1999-01-01

87

Model Child Care Health Policies.  

ERIC Educational Resources Information Center

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…

Aronson, Susan; Smith, Herberta

88

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

PubMed Central

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.

Eskandari, Manije; Abbaszadeh, Abbas; Borhani, Fariba

2013-01-01

89

Integrating Oral Health Care into Primary Health Care System  

PubMed Central

Introduction. Systematic evaluation is an integral part of the organization and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. This study aimed to assess the knowledge and practice of primary health care (PHC) personnel regarding their duties toward oral health. Methods and Material. A cross-sectional study was carried out among three groups of PHC personnel in the city of Kerman (Iran). Volunteer personnel completed a piloted questionnaire which included demographic data, some question regarding their knowledge about oral health, their duties and also their practice regarding public oral health. All data were analyzed using chi-square and Pearson correlation test. Results. One hundred and fifty-seven out of 225 eligible personnel participated in the study. Sixty percent were auxiliary health workers (Behvarz). All personnel had a good level of knowledge regarding oral health. Despite significant differences among the knowledge of the personnel toward oral health, there was no significant difference between their knowledge related to their duties regarding oral health. The auxiliary health worker group had a higher rate (45.6%) for better public oral health practice. Conclusion. The study showed the personnel have good knowledge of their duties regarding oral health. However, their practice is not in line with their knowledge and needs more attention.

Hajizamani, Abolghasem; Malek Mohammadi, Tayebeh; Hajmohammadi, Ebadollah; Shafiee, Shahin

2012-01-01

90

Day care health risks  

MedlinePLUS

... hepatitis A virus. It is spread by poor hand washing after going to the bathroom or changing a ... and then preparing food. In addition to good hand washing, day care staff and children should get the ...

91

Health care accommodation in Scotland.  

PubMed

The Medical and Nursing Advisers of the Scottish Health Service, Common Services Agency, Building Division, advise upon the planning of health care accommodation. The overall spread of beds by function is given in a review of existing health care buildings in the year 1981. The numbers of hospital beds and of various groups of staff in the hospital and community services are calculated per 100,000 population so that any unusual disparity can be ascertained. One of the parameters for health building planning is fiscal control and so the cost per hospital in-patient week is tabulated for eight groups of specialities. The appropriate responsibilities of the Regional Councils in Scotland in 1979 are considered along with the responsibilities of Health Boards because part of each Social Work Department's work is the provision of accommodation and social care for those in need as opposed to the National Health Service responsibility for the health care of those in hospital and in the community. An overall view of residential accommodation for those requiring medical treatment or social care is presented in tabular form. The views expressed are not necessarily those of the Common Services Agency. PMID:7146882

Maclachlan, J

1982-10-01

92

45 CFR 162.414 - Implementation specifications: Health care clearinghouses.  

Code of Federal Regulations, 2013 CFR

...Implementation specifications: Health care clearinghouses. 162.414 ...Standard Unique Health Identifier for Health Care Providers § 162.414 Implementation specifications: Health care clearinghouses. A health...

2013-10-01

93

The Health Care Home Model: Primary Health Care Meeting Public Health Goals  

PubMed Central

In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home.

Greene, Danielle

2012-01-01

94

Help Yourself to Health Care.  

ERIC Educational Resources Information Center

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

Snyder, Sarah

95

Improving China's Health Care System  

Microsoft Academic Search

Overall, health outcomes in China have improved tremendously over the past three decades, especially thanks to the reduction in some traditional infectious diseases. However, death rates from chronic diseases have been on the rise, not least owing to changes in life styles and deteriorating environmental conditions. Supply of health care is overwhelmingly provided publicly and hospitals have been absorbing a

Richard Herd; Yu-Wei Hu; Vincent Koen

2010-01-01

96

Health care's 100 most wired.  

PubMed

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

Solovy, A; Serb, C

1999-02-01

97

Health Care Reform's Effect on Private Medical Practices  

Microsoft Academic Search

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

Spencer R Clark

2011-01-01

98

Optimization of preventive health care facility locations  

Microsoft Academic Search

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

Wei Gu; Xin Wang; S. Elizabeth McGregor

2010-01-01

99

Veteran's Health Care Issues.  

National Technical Information Service (NTIS)

The Department of Veterans Affairs (VA) provides services and benefits to veterans who meet certain eligibility criteria. VA carries out its programs nationwide through three administrations and the Board of Veterans Appeals (BVA). The Veterans Health Adm...

S. V. Panangala

2007-01-01

100

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

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

Addington-Hall, Julia M; Karlsen, Saffron

2005-01-01

101

Health Care Financing Review, 1987 Annual Supplement.  

National Technical Information Service (NTIS)

Quality of care research is the subject of the entire issue of the Health Care Financing Review. Aspects discussed in detail are: Quality of health care measurement: a research priority; Monitoring adverse outcomes of surgery using administrative data; Me...

1987-01-01

102

Who's on Your Health Care Team?  

MedlinePLUS

... easy access to the care you need. Your Health Care Team Work with your doctors to create the ... expect from your primary diabetes doctor. Visiting Your Health Care Team Stay up-to-date on our latest ...

103

Counseling and Mental Health Care in Palestine  

ERIC Educational Resources Information Center

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

Shawahin, Lamise; Ciftci, Ayse

2012-01-01

104

Health care coalitions: continuity and change.  

PubMed

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 extensive and informed development and sharing of data. Coalitions reflect and need to recognize the inevitable internal conflicts and interests of the constituent organizations. While some coalitions tend to flounder on internal conflicts and capacity to generate effective leadership; many are fruitfully addressing the hard issues of health care in a community, such as managed care, capitation payments, excess beds and capital requirements, and access to health care by the uninsured. As coalitions mature, beyond discourse and data, they are likely to concentrate on a few of the distinctive problems of their communities and the interaction within the health care environment to address these problems. PMID:10304443

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

1988-01-01

105

Rural health care support mechanism. Final rule.  

PubMed

In this document, the Federal Communications Commission reforms its universal service support program for health care, transitioning its existing Internet Access and Rural Health Care Pilot programs into a new, efficient Healthcare Connect Fund. This Fund will expand health care provider access to broadband, especially in rural areas, and encourage the creation of state and regional broadband health care networks. Access to broadband for medical providers saves lives while lowering health care costs and improving patient experiences. PMID:23476995

2013-03-01

106

Health Care Reform: A Values Debate.  

ERIC Educational Resources Information Center

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

Popko, Kathleen

1992-01-01

107

Five Steps to Safer Health Care  

MedlinePLUS

... Health Systems Hospital Resources Long-Term Care Resources Primary Care Resources System Design Resources Prevention & Chronic Care Announcements Evidence-Based Decisionmaking Improving Primary Care Practice Resources Quality & Patient Safety Comprehensive Unit-based ...

108

Managed care and children with special health care needs  

Microsoft Academic Search

Providing care to children with special health care needs within a managed care environment presents special challenges for providers and parents alike. The goal of managed care is to contain costs by encouraging or requiring members to obtain services through a designated network. In managed care programs, children and families may experience limited access to specialized care and services, along

Jeanne M. Rhoades Smucker

2001-01-01

109

School Readiness Goal Begins with Health Care Reform.  

ERIC Educational Resources Information Center

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

Penning, Nick

1992-01-01

110

Fitch ratings. Health care special report.  

PubMed

Fitch Ratings continues to believe that the current and projected personnel shortages, especially among registered nurses (RNs). present one of the greatest operating challenges for health care providers nationwide. As noted in Fitch Research on "Health Care Staffing Shortage," dated June 21, 2001 (available on Fitch's web site at www.fitchratings. com), staffing is an area that is creating enormous expense inflation for health care providers and presenting one of the biggest areas of uncertainty in assessing an organization's credit quality. Shortages are becoming increasingly widespread, affecting health care providers in urban and rural areas regardless of size. Since health care is a labor intensive business, salary and benefit costs are key determinants of profitability. Fitch believes the attention given to the nursing shortage and potential looming crisis has created a sense of urgency, with many hospitals developing innovative strategies for work force development. In addition, federal, state, and local governments are creating programs and/or providing financial support to help alleviate shortages. Yet, the benefits of many of these initiatives may not be realized for many years, and Fitch expects health care providers to continue experiencing inflating salary and benefit expenses with growing temporary staffing usage and competitive pressure to increase overall compensation. Fitch believes managing labor costs is critical to achieving profitability, especially as the ability to increase revenue diminishes. Fitch believes the nursing shortage will continue to represent an area of extreme expense pressure for health care providers for years to come. Imbalanced supply and demand, which is expected to worsen as retiring nurses outstrip replacements, should create financial strain for many providers in an industry that is gearing up to meet the aging population's anticipated demand for more services. Fitch plans to closely monitor management strategies for dealing with vacancy and turnover rates, as well as trends in agency spending, to determine financial implications among its rated portfolio. PMID:14528733

2003-01-01

111

Finding Low-Cost Mental Health Care  

MedlinePLUS

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

112

Health care clinics in Cambodia.  

PubMed

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

Wollschlaeger, K

1995-04-01

113

Brentwood community health care assessment.  

PubMed

Background: The Community Alliance for Research Empowering Social Change (CARES) is an academic-community research partnership designed to train community members on research methods and develop the infrastructure for community-based participatory research (CBPR) to examine and address racial/ethnic health disparities. The Brentwood Community Health Assessment (BCHA) was developed through a CBPR pilot project grant from CARES.Objectives: The purpose of the BCHA is to assess health care utilization and identify existing barriers to health care access among a multi-ethnic community in the Hamlet of Brentwood, New York.Methods: Using CBPR approaches, the community-academic research partnership develop the study design and survey instrument. Trained Bilingual (English/Spanish) data collectors verbally administered surveys door-to-door to residents of Brentwood from October 2010 to May 2011. Inclusion criteria required participants to be at least 18 years of age and speak either English or Spanish.Results: Overall, 232 residents completed the BCHA; 49% were male, 66% Hispanic, 13% non-Hispanic White, 13% non-Hispanic Black, 29% had less than a high school education, and 33% were born in United States. The assessment results revealed that most residents are able to access health care when needed and the most significant barriers to health care access are insurance and cost.Conclusions: We describe the community-academic partnered process used to develop and implement the BCHA and report assessment findings; the community-partnered approach improved data collection and allowed access into one of Suffolk County's most vulnerable communities. PMID:24859100

Goodman, Melody S; Gonzalez, Maria; Gil, Sandra; Si, Xuemei; Pashoukos, Judith L; Stafford, Jewel D; Ford, Elsa; Pashoukos, Dennis A

2014-01-01

114

Decreased Awareness of Current Smoking Among Health Care Providers of HIV-positive Compared to HIV-negative Veterans  

Microsoft Academic Search

BACKGROUND  Cigarette smoking is an important risk factor for morbidity and mortality in HIV-positive patients on combination antiretroviral\\u000a therapy.\\u000a \\u000a \\u000a \\u000a OBJECTIVE  To determine whether awareness of smoking differs between HIV and non-HIV providers, and to identify factors associated with\\u000a failure to recognize current smoking.\\u000a \\u000a \\u000a \\u000a DESIGN  Observational study.\\u000a \\u000a \\u000a \\u000a PARTICIPANTS  801 HIV-positive and 602 HIV-negative patients, 72 HIV and 71 non-HIV providers enrolled in the Veterans Aging

Kristina Crothers; Joseph L. Goulet; Maria C. Rodriguez-Barradas; Cynthia L. Gibert; Adeel A. Butt; R. Scott Braithwaite; Robin Peck; Amy C. Justice

2007-01-01

115

Transforming a health care information management system.  

PubMed

The article presents results from a survey of 98 top executives at Baylor Health Care System (BHCS), a large, multifunction health care organization in Dallas, Texas. The survey assessed the executives' perceptions of current BHCS quality practices using the first survey developed for the health care industry based on the Malcolm Baldrige National Quality Award (MBNQA) criteria. Findings regarding the quality of BHCS internal and external data and information include the need for a $50 million information system transformation to achieve seven critical success factors for all business units and improved internal and external data and information for the business process redesign and quality transformation. Results highlight the need for further research investigating the information and analysis MBNQA criteria. PMID:10174724

Prybutok, V R; Spink, A

1997-11-01

116

Home health-care bibliography.  

PubMed

A home health-care bibliography is presented. The bibliography includes a selection of references to descriptive reports, research papers, editorials, letters, and commentaries on home health-care (HHC) services. This bibliography represents important literature from the past 12 years on program planning, marketing, trends, and reimbursement for HHC services as well as specific types of home therapy. The bibliography can be helpful to pharmacy administrators and clinicians who are interested in designing HHC programs or becoming involved in the provision of home therapy. PMID:3085486

Harris, W L; Mellott, P J

1986-03-01

117

Changing health-care systems.  

PubMed

Many governments are encouraging competition for resources between health centres in an attempt to reduce costs and improve the quality of services. However, opponents to managed care believe that this will create more administrative costs and reduce patient choice. So-called purchasing organizations are being established to direct patients to the most cost-effective care. Assessing performance is complicated as very sick or difficult-to-treat patients are likely to be more costly. Statistical techniques can be used to clarify the impact of risk factors, such as smoking, on the outcome of care. PMID:18611652

Holthof, B

1995-01-01

118

Positive rights, negative rights and health care.  

PubMed

In the current debate about healthcare reform in the USA, advocates for government-ensured universal coverage assume that health care is a right. Although this position is politically popular, it is sometimes challenged by a restricted view of rights popular with libertarians and individualists. The restricted view of rights only accepts 'negative' rights as legitimate rights. Negative rights, the argument goes, place no obligations on you to provide goods to other people and thus respect your right to keep the fruits of your labour. A classic enumeration of negative rights includes life, liberty, and the pursuit of happiness. Positive rights, by contrast, obligate you either to provide goods to others, or pay taxes that are used for redistributive purposes. Health care falls into the category of positive rights since its provision by the government requires taxation and therefore redistribution. Therefore, the libertarian or individualist might argue that health care cannot be a true right. This paper rejects the distinction between positive and negative rights. In fact, the protection of both positive and negative rights can place obligations on others. Furthermore, because of its role in helping protect equality of opportunity, health care can be tied to the rights to life, liberty, and the pursuit of happiness. There is, therefore, good reason to believe that health care is a human right and that universal access should be guaranteed. The practical application, by governments and non-governmental organisations, of several of the arguments presented in this paper is also discussed. PMID:20935318

Bradley, Andrew

2010-12-01

119

Discussion of patient-centered care in health care organizations.  

PubMed

The tradition of inherent knowledge and power of health care providers stands in stark contrast to the principles of self-determination and patient participation in patient-centered care. At the organizational level, patient-centered care is a merging of patient education, self-care, and evidence-based models of practice and consists of 4 broad domains of intervention including communication, partnerships, health promotion, and physical care. As a result of the unexamined discourse of knowledge and power in health care, the possibilities of patient-centered care have not been fully achieved. In this article, we used a critical social theory lens to examine the discursive influence of power upon the integration of patient-centered care into health care organizations. We begin with an overview of patient-centered care, followed by a discussion of the various ways that it has been introduced into health care organizations. We proceed by deconstructing the inherent power and knowledge of health care providers and shed light on how these long-standing traditions have impeded the integration of patient-centered care. We conclude with a discussion of viable solutions that can be used to implement patient-centered care into health care organizations. This article presents a perspective through which the integration of patient-centered care into health organizations can be examined. PMID:22722519

Fredericks, Suzanne; Lapum, Jennifer; Schwind, Jasna; Beanlands, Heather; Romaniuk, Daria; McCay, Elizabeth

2012-01-01

120

Universal health care in India: Panacea for whom?  

PubMed

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

Qadeer, Imrana

2013-01-01

121

Ethics of rural health care  

Microsoft Academic Search

One quarter of the US population live in areas designated as rural. Delivery of rural health care can be difficult with unique challenges including limited access to specialists such as oncologists. The Rural Cancer Outreach Program is an alliance between an academic medical center and five rural hospitals. Due to the presence of this program, the appropriate use of narcotics

Laurie J. Lyckholm; Mary Helen Hackney; Thomas J. Smith

2001-01-01

122

Hedging opportunities in health care.  

PubMed

Medical care futures contracts offer new hedging opportunities to increase protection against unexpected price changes. Commodity futures contracts can be designed explicitly to hedge volatile group health insurance premiums and capitated hospital and physician prices. This article describes one way to design and use these hedging instruments. PMID:10103960

Hayes, J A

1990-03-01

123

Simulation in Health Care Education  

Microsoft Academic Search

During the past 15 years there has been widespread adoption of sim- ulation in health care education as a method to train and assess learners. Multiple fac- tors have contributed to this movement, including reduced patient availability, limited faculty teaching time, technological advances in diagnosis and treatment that require a new skills set, greater attention to patient safety with the

S. Barry Issenberg; Ross J. Scalese

2008-01-01

124

Interactive Computerized Health Care Education  

Microsoft Academic Search

Acknowledgments: This work has been supported by grants from the National Science Foundation (IRI-9523646 and IRI-9701617) and by a gift from the University of Wisconsin Medical School, Department of Medicine 2 2 Abstract The Patient Education and Activation System (PEAS) project aims to prepare people to take a more active role in their health care decisions. In this paper, we

Susan W. McRoy; Alfredo Liu-Perez; Syed S. Ali

125

Towards an alternative economics of health care.  

PubMed

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

Hodgson, Geoffrey M

2009-01-01

126

Global health and primary care research  

Microsoft Academic Search

A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in primary care is essential to inform practice and to develop better health systems and

John W. Beasley; Barbara Starfield; Chris van Weel; Walter W. Rosser; Cynthia L. Haq

2007-01-01

127

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

PubMed

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

Guo, Kristina L

2010-01-01

128

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

Microsoft Academic Search

BACKGROUND: Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential

Don E Detmer

2003-01-01

129

Financing the health care Internet.  

PubMed

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

Robinson, J C

2000-01-01

130

US Health Care Reform and the Future of Dentistry  

PubMed Central

THE PATIENT PROTECTION and Affordable Care Act has grand ambitions: to provide insurance coverage to more than 30 million currently uninsured Americans, to slow increases in health care costs, to reorganize the health care delivery system, and to improve the quality of care provided to all. Where does the oral health community fit in this initiative? Should dentists “scope up” to become a more active part of the primary care workforce? Or should dentists “scope down” and delegate parts of the traditional dental tool kit to midlevel practitioners? Our nation's public health largely depends on whether we can create a more integrated and public health–oriented delivery system. The oral health, physical health, and public health communities should address this challenge together.

2011-01-01

131

Prospects for National Health Care in the United States  

Microsoft Academic Search

This paper provides an overview of both the current health care crisis in the United States and various reform proposals (some based on Canadian and British models) being considered at the federal and state levels. The proposals discussed fall into three categories-multiple payer national health insurance programs, one payer national health insurance programs, and a national health service program. The

Steven Soifer; Mary Lou Balassone; Jack Johnstone

1992-01-01

132

Job satisfaction in health-care organizations  

PubMed Central

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.

Bhatnagar, Kavita; Srivastava, Kalpana

2012-01-01

133

The Cultural Geography of Health Care Delivery.  

ERIC Educational Resources Information Center

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)

Gesler, Wilbert M.

1987-01-01

134

Whither the state in Yugoslav health care?  

PubMed

As part of their broader sociopolitical system of self-managing socialism, the Yugoslavs have attempted to create a health care system which is simultaneously destaticized, depoliticized, decentralized, democratized and economically and socially efficient. This paper provides a description and evaluation of the evolving self-managed health sector in post-World War II Yugoslavia. I argue that, despite repeated institution restructuring and innovation and some noteworthy accomplishments, the Yugoslavs have fallen short of their health objectives. After presenting alternative explanations for these shortcomings, I propose that they can best be understood in terms of the contradictions the Yugoslavs have encountered in their efforts to simultaneously pursue destatization, depoliticization, decentralization, democratization and social and economic efficiency. I conclude with an ideologically unpopular proposal that some form of continuous and legitimate central state coordination may be necessary to resolve current critical problems in Yugoslav health care (e.g. persistent deficits in health financing, shortages of basic medical supplies, duplication of expensive medical technology, unemployed health workers despite unmet health needs, persistent health inequalities). PMID:4071110

Parmelee, D E

1985-01-01

135

ARTEMIS: a collaborative framework for health care.  

PubMed

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

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

1993-01-01

136

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

PubMed

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

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

2013-01-01

137

Point-of-care systems, informatics, and health care delivery.  

PubMed

Evolving information technology has had profound effects on business operations and the marketplace. The health care services industry, particularly hospitals, clinics, and medical offices, has historically lagged behind other industries in the implementation of comprehensive, integrated, computerized data management tools. Health care reformers are looking to the promises of the information technology "revolution" as a means of improving systemic efficiency and health care quality. This study discusses the impact of informatics, or information technology, on the delivery of health care services. We present the evolution of informatics and the predicted future benefits of integrated computerized patient records and point-of-care systems. PMID:10162811

Montoya, I D; Carlson, J W

1996-12-01

138

The Emerging Imperative for Health Care  

Microsoft Academic Search

There are widespread and growing concerns about the variable and too often inadequate quality of health care in the United States. As a result, health care quality is being questioned and subjected to scrutiny as never before. Awareness of the quality deficits, combined with rising health care expenditures and changing attitudes of payers and consumers, has given rise to a

Kenneth W. Kizer

139

Special Health Care Procedures in the Schools.  

ERIC Educational Resources Information Center

A study of 147 school districts in Georgia examined the extent to which special health care procedures are performed in a school setting, the involvement of teachers performing special health care procedures, training and supervision issues, and the availability of written procedures. Results found teachers performed health care procedures more…

Heller, Kathryn Wolff; And Others

1997-01-01

140

Communicating in Multicultural Health Care Organizations.  

ERIC Educational Resources Information Center

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

Kreps, Gary L.; Kunimoto, Elizabeth

141

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

ERIC Educational Resources Information Center

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

McManus, Marilyn C., Ed.

1996-01-01

142

Satisfaction with Health Care among Latinas  

PubMed Central

Despite growing interest in disparities in access to health care, relatively little is known about different facets of care among Latinas, their satisfaction with the care they receive, and the predictors of satisfaction. This study examined whether various health care access and context factors, the quality of the patient-physician interaction, and medical mistrust predict satisfaction with health care among Latina immigrants in New York City. Structured interviews were conducted with 220 Latinas predominantly from the Dominican Republic and aged 40 years or over. Of the access to health care variables examined, greater waiting time predicted dissatisfaction with health care. Greater quality of the patient-physician interaction predicted less dissatisfaction. The effect of the patient-physician interaction on dissatisfaction was mediated, in part, by waiting time. The results illustrate the important role of specific health care factors in satisfaction with care.

Abraido-Lanza, Ana F.; Cespedes, Amarilis; Daya, Shaira; Florez, Karen R.; White, Kellee

2013-01-01

143

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

Microsoft Academic Search

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

Antonio Giuffrida; Shireen El-Wahab; Rafael Anta

2009-01-01

144

Empowering women and health care.  

PubMed

Women health workers have made great contributions to the health of their community for many years. In India, women physicians have established some hospitals, e.g., Christian Medical Colleges in Ludhiana and Vellore. Some such hospitals operate in remote areas to serve the poor and the suffering. Women health workers of Jamkhed, Deen Bandhu of Pachod, have proved that village women can improve the health status of their community, particularly that of women and children, if they receive encouragement to learn health care skills In India, community health care lies mainly with women (e.g., nursing personnel and in rural areas). Yet, despite their competence and experience, few become physicians, health project directors, and administrators because the society continues to be patriarchal and discriminates against females. Women need to become empowered to ensure equal opportunities for training and promotion and equal wages for equal work. In Bangladesh, use of bicycles to visit houses allows women paramedical workers from Gonasasthya Kendra, Sawar, freedom and imparts confidence. People must identify customs, practices, laws, attitudes, religious misrepresentations, and policies that discriminate against women and then oppose them. They should set these changes in motion at home, in villages, and from district to national, and even global levels. In India, society blames the mother for having a girl, but the man donates the chromosome determining sex. In Gandhigram, a woman physician and her peers have effected an apparent change in attitude toward the birth of a girl. Now the people confer equal happiness to her birth as they do to a boy's birth. Yet, female infanticides still occur in some villages of Salem District of Tamil Nadu. Sex determination tests often lead to abortion of female fetuses. Once a woman marries she has no right to her maternal home and often suffers from domestic violence. Many people resist legislation to grant women more rights, e.g., property rights. Various media promote women's empowerment. PMID:12286352

Shiva, M

1993-02-01

145

['European primary care': a visionary report of the Dutch Health Council on primary health care in the European Union].  

PubMed

Although the agenda of the European Union (EU) does not directly provide for it, it seems reasonable to assume that due to the process of European social and economic integration there will be mounting pressure on the presently widely differing systems for primary care to move towards a more uniform orientation. In 2004, during its rotating presidency of the EU, the Dutch government asked its Health Council for advice on the current level of knowledge with regard to the organisation and significance of primary care. The Council formulated a set of key recommendations for the future development of primary care in Europe. The Council defines primary care as: generalist care, consisting of general medical, paramedical and pharmaceutical care, nursing and supportive care and non-specialised mental and social health care together with preventive and health educational activities linked to these forms of care. This care is for all health problems, is aimed at ambulatory patients, and is delivered close to the patients' homes. It is easily accessible to all, and provides emergency care when necessary. The main differences in the provision of primary care between countries in Europe concern the presence or absence of registration with a general practitioner and the gate-keeper role of primary care. International comparative research has identified the presence of precisely these features as predictors of better health outcomes in terms of morbidity and mortality. They therefore form a prominent role in the key recommendations, which state, among other things, that a patient should choose a primary-care team in the context of an integrated care circuit, thereby giving up his or her freedom to select care givers outside that circuit, in the interest of quality continuity and the efficiency of care. Other key recommendations are: close cooperation between primary-care teams, preventive services and public health and occupational health, a transparent provision on information between all providers of care, and the creation of a European Center for primary-care development. PMID:15932132

Thomas, S

2005-05-14

146

Competition and integration in Swedish health care.  

PubMed

Despite of an insignificant track record of quasi-market models in Sweden, new models of this kind have recently been introduced in health care; commonly referred to as "choice of care". This time citizens act as purchasers; choosing the primary care centre or family physician they want to be treated by, which, in turn, generates a capitation payment to the chosen unit. Policy makers believe that such systems will be self-remedial, that is, as a result of competition the strong providers survive while unprofitable ones will be eliminated. Because of negative consequences of the fragmented health care delivery, policy makers at the same time also promote different forms of integrated health care arrangements. One example is "local health care", which could be described as an upgraded community-oriented primary care, supported by adaptable hospital services, fitting the needs of a local population. This article reviews if it is possible to combine this kind of integrated care system with a competition driven model of governance, or if they are incompatible. The findings indicate that some choice of care schemes could hamper the development of integration in local health care. However, geographical monopolies like local health care, enclosed in a non-competitive context, lack the stimulus of competition that possibly improves performance. Thus, it could be argued that if choice of care and local health care should be combined, patients ought to choose between integrated health care arrangements and not among individual health professionals. PMID:20153910

Ahgren, Bengt

2010-07-01

147

Contribution of Primary Care to Health Systems and Health  

PubMed Central

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

Starfield, Barbara; Shi, Leiyu; Macinko, James

2005-01-01

148

The demand for private health care under national health insurance  

Microsoft Academic Search

This study explores the demand for private health care and supplemental health insurance in Israel, where universal national health insurance provides all inhabitants with a standard package of medical care. Our theoretical model and empirical study follow research previously conducted in four other countries. It was found that the self-employed in Israel demand more private health services and supplemental health

Y. Machnes

2006-01-01

149

Beneficence, justice, and health care.  

PubMed

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

Kelleher, J Paul

2014-03-01

150

Health care facility and community strategies for patient care surge capacity  

Microsoft Academic Search

Recent terrorist and epidemic events have underscored the potential for disasters to generate large numbers of casualties. Few surplus resources to accommodate these casualties exist in our current health care system. Plans for “surge capacity” must thus be made to accommodate a large number of patients. Surge planning should allow activation of multiple levels of capacity from the health care

John L. Hick; Dan Hanfling; Jonathan L. Burstein; Craig DeAtley; Donna Barbisch; Gregory M. Bogdan; Stephen Cantrill

2004-01-01

151

New perspectives on health and health care policy  

Microsoft Academic Search

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

Darren Lubotsky; Bhashkar Mazumder; Zach Seeskin

2010-01-01

152

Health Care Reform: Opportunities for Improving Adolescent Health.  

ERIC Educational Resources Information Center

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

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

153

Worried and wired: effects of health anxiety on information-seeking and health care utilization behaviors.  

PubMed

Although online health information-seeking has been widely studied and findings suggest a variety of motivations behind an individual's health information-seeking behavior, little is known about how this information influences health utilization behaviors. Thus, the current study investigates the relationship between online health information seeking and health care utilization such as visiting a doctor. Additionally, this project expands the literature by examining the moderating role of health anxiety. Results suggest that an individual's level of health anxiety moderates the relationship between online health information seeking and health care utilization decisions. PMID:16901253

Eastin, Matthew S; Guinsler, Natalie M

2006-08-01

154

Quality-of-care challenges for rural health.  

PubMed

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

Moscovice, I; Rosenblatt, R

2000-01-01

155

Paid Sick Days and Health Care Use  

PubMed Central

Background In identifying factors of health care use, past research has focused on individual-level characteristics or on the health care system itself. This study investigates whether access to paid sick days, an amenable environmental factor outside the health care system, is associated with primary and emergency care use. Methods A nationally representative sample of 14,302 U.S. working adults extracted from the 2007 National Health Interview Survey data was used. Multiple logistic regressions were performed, controlling for demographic variables, health conditions and status, and access to health care. Results Workers with lower socioeconomic status, poorer health status, or without health insurance or regular places for care were more likely to lack paid sick leave than higher-status workers. For all U.S. working adults, access to paid sick days benefits was significantly associated with increased use of outpatient care but not with reduced use of ER. For U.S. working adults with health insurance coverage, access to paid sick days benefits was significantly associated with increased use of outpatient care and reduced use of emergency care. Conclusions A public policy mandating paid sick days may help facilitate timely access to primary care, reduce avoidable emergency care use, and reduce health disparities among workers.

Cook, Won Kim

2011-01-01

156

Physicians’ utilization of health care  

Microsoft Academic Search

OBJECTIVE: To describe how physicians attend to their own health care needs.\\u000a \\u000a \\u000a SETTING: Rhode Island.\\u000a \\u000a \\u000a \\u000a \\u000a PARTICIPANTS: A random sample of Blue Cross\\/Blue Shield providers. The 306 respondents (67% of 458) primarily (92%) had MD or DO degrees.\\u000a The nonphysician providers were chiropractors, dentists, optometrists, and podiatrists.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN: A mailed survey provided data describing the respondents’ medical conditions and utilization of

Tom J. Wachtel; Victoria L. Wilcox; Anne W. Moulton; Dominick Tammaro; Michael D. Stein

1995-01-01

157

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

PubMed

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

Guo, Kristina L

2010-01-01

158

Literacy and learning in health care.  

PubMed

The relationship between literacy and health outcomes are well documented in adult medicine, yet specific causal pathways are not entirely clear. Despite an incomplete understanding of the problem, numerous interventions have already been implemented with variable success. Many of those who proposed earlier strategies assumed the problem to originate from reading difficulties only. Given the timely need for more effective interventions, it is of increasing importance to reconsider the meaning of health literacy to advance our conceptual understanding of the problem and how best to respond. One potentially effective approach might involve recognizing the known associations between a larger set of cognitive and psychosocial abilities with functional literacy skills. Here we review the current health literacy definition and literature and draw on relevant research from the fields of education, cognitive science, and psychology. In this framework, a research agenda is proposed that considers an individual's "health-learning capacity," which refers to the broad constellation of cognitive and psychosocial skills from which patients or family members must draw to effectively promote, protect, and manage their own or a child's health. This new, related concept will lead, ideally, to more effective ways of thinking about health literacy interventions, including the design of health-education materials, instructional strategies, and the delivery of health care services to support patients and families across the life span. PMID:19861481

Wolf, Michael S; Wilson, Elizabeth A H; Rapp, David N; Waite, Katherine R; Bocchini, Mary V; Davis, Terry C; Rudd, Rima E

2009-11-01

159

Dual Loyalty in Prison Health Care  

PubMed Central

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.

Stover, Heino; Wolff, Hans

2012-01-01

160

Greater involvement of people living with HIV in health care  

PubMed Central

Greater Involvement of People Living with HIV/AIDS represents a mobilising and an organising principle for the involvement of people living with HIV in program and policy responses. People with HIV have been at the forefront of designing and implementing effective HIV treatment, care and prevention activities. However, governments and health systems have yet to act to fully harness the potential and resources of people living with HIV in addressing the epidemic. The lives and experiences of people living with HIV highlight the need for a shift in the existing paradigm of disease management. The high prevalence of HIV amongst health care providers in many countries, exacerbated by stigma towards those with HIV in the health care professions, is seriously undermining the capacity of health systems and signals the need to change the current nature of health care delivery. Moreover, the negative experiences of many people with HIV in relation to their health care as well as in their daily social interactions, coupled with the ever-limited current investment in treatment, care and support, demonstrate that the current system is drastically failing the majority of people with HIV. Current health management systems urgently need to be more effectively maximised, to increase the quality of standards of health care systems and services in resource poor countries. An integrated approach to health care based on a human rights framework, grounded in community realities and delivered in partnership and solidarity with people living with HIV, offers the most viable approach to overcoming the crisis of HIV in the health care system.

2009-01-01

161

Tuberculosis among health care workers.  

PubMed

To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB. PMID:21392441

Baussano, Iacopo; Nunn, Paul; Williams, Brian; Pivetta, Emanuele; Bugiani, Massimiliano; Scano, Fabio

2011-03-01

162

Rx for Rising Health Care Premiums.  

ERIC Educational Resources Information Center

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)

Younger, Sandra Millers

1990-01-01

163

Special Issue: The Family and Health Care.  

ERIC Educational Resources Information Center

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

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

1985-01-01

164

Keynote Address: The Health Care Environment.  

ERIC Educational Resources Information Center

An address to dental school deans looks at anticipated changes in the health care system, the public sector's changing role in health care, and draws implications for dentistry. It is suggested that academic health centers, and especially dental schools, will be particularly affected by these trends. (MSE)

Wilensky, Gail

1996-01-01

165

Selecting Performance Indicators for Prison Health Care  

Microsoft Academic Search

Improving prison health care requires a robust measurement dashboard that addresses multiple domains of care. We sought to identify tested indicators of clinical quality and access that prison health managers could use to ascertain gaps in performance and guide quality improvement. We used the RAND\\/UCLA modified Delphi method to select the best indicators for correctional health. An expert panel rated

Steven M. Asch; Cheryl L. Damberg; Liisa Hiatt; Stephanie S. Teleki; Rebecca Shaw; Terry E. Hill; Rhondee Benjamin-Johnson; David P. Eisenman; Sonali P. Kulkarni; Emily Wang; Brie Williams; Ambeshie Yesus; Corita R. Grudzen

2011-01-01

166

The American Health Care System and the Role of the Medical Profession in Solving Its Problems  

Microsoft Academic Search

n the current issue of The Annals, two opposing view- points (1) are presented on the optimal organizational structure for health care insurance in the United States. Himmelstein and Woolhandler argue that a single-payer national health care insurance system would solve many of the current problems in financing, access, and delivery of health care; whereas Goodman suggests that reform should

John Mayer

2010-01-01

167

Appropriate Perspectives for Health Care Decisions  

Microsoft Academic Search

NICE uses cost-effectiveness analysis to compare the health benefits expected to be gained by using a technology with the health that is likely to be forgone due to additional costs falling on the health care budget and displacing other activities that improve health. This approach to informing decisions will be appropriate if the social objective is to improve health, the

Karl Claxton; Simon Walker; Steven Palmer; Mark Sculpher

2010-01-01

168

Assessing business leaders' perspectives on health care issues.  

PubMed

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

McDermott, D R; Brinkman, L H

1990-01-01

169

Health Care Experiment at Many Farms  

ERIC Educational Resources Information Center

Describes an experimental program of health care for a Navajo community, and discusses the use of personal physician care where a para-medical referral system may have been more technologically efficient. (AL)

McDermott, Walsh; And Others

1972-01-01

170

The burden of health care costs for working families.  

PubMed

Health care spending represents a growing share of our national income, and based on current projections, will increase from 16% of the gross domestic product today to 20% by 2018. What does this mean for typical working families with private health insurance, who shoulder the financial burden of maintaining the current system? In this Issue Brief, Polsky and Grande construct a typical health care budget for working families of various income levels, calculate the percentage of total compensation devoted to health care over time, and project how rising health care costs will affect standards of living in the future. Their findings remind us that what works today also has to work tomorrow. Sustainability depends critically on successful cost containment. PMID:19795545

Polsky, Daniel; Grande, David

2009-07-01

171

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

PubMed Central

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.

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

2006-01-01

172

Consumer Financial Issues in Health Care  

Microsoft Academic Search

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

Deanna L. Sharpe

173

Challenges to equity in health and health care: a Zimbabwean case study.  

PubMed

The current economic crisis in Africa has posed a serious challenge to policies of comprehensive and equitable health care. This paper examines the extent to which the Zimbabwe government has achieved the policy of "Equity in Health" it adopted at independence in 1980, that is provision of health care according to need. The paper identifies groups with the highest level of health needs in terms of both health status and economic factors which increase the risk of ill health. It describes a series of changes within the health sector in support of resource redistribution towards health needs, including a shift in the budget allocation towards preventive care, expansion of rural infrastructures, increased coverage of primary health care, introduction of free health services for those earning below Z$150 a month in 1980, increased manpower deployment in the public sector and the reorientation of medical training towards the health needs of the majority. The implementation of equity policies in health have however been challenged by several trends and features of the health care system, these becoming more pronounced in the economic stagnation period after 1983. These include the reduction in allocations to local authorities, increasing the pressure for fees, the static nominal level of the free health care limit despite inflation, the continued concentration of financial, higher cost manpower and other resources within urban, central and private sector health care and the lack of effective functioning of the referral system, with high cost central quaternary facilities being used as primary or secondary level care by nearby urban residents. While primary health care expansion has clearly been one of the success stories of Zimbabwe's health care post 1980, the paper notes plateauing coverage, with evidence of lack of coverage in more high risk, socio-economically marginal communities. Measures to address these continuing inequalities are discussed. Their implementation is seen to be dependent on increasing the capacity and organisation of the poor to more strongly influence policy and resource distribution in the health sector. PMID:1906200

Loewenson, R; Sanders, D; Davies, R

1991-01-01

174

Spirulina in health care management.  

PubMed

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

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

2008-10-01

175

[French national health insurance. The current situation].  

PubMed

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

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

2010-06-01

176

Identification of Energy Issues in Health Care.  

National Technical Information Service (NTIS)

This report delineates significant issues that should be considered in order to achieve energy conservation in health care facilities. Comprehensive, factual, and practical solutions must be found for two reasons. First, escalating costs in both health ca...

R. Plunkett

1978-01-01

177

Coming Together To Cut Health Care Costs.  

ERIC Educational Resources Information Center

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)

Heron, W. David; Donatelli, Ben

2003-01-01

178

Consumer-driven health care marketing.  

PubMed

In this article, a health care marketing executive takes an opposing view: That the consumer will not only continue to exercise choice but also, at annual renewal time, veto power. In part, that is because the consumers are feeling the rising cost of health care much more directly than in the past, through ever-higher premiums, deductibles and copayments. As they assumed more of the burden of medical care delivery, consumers are becoming more knowledgeable about and discriminating toward the health care system and provider plans they are offered. They understand--as does their employer--that no longer are all health care plans alike or at parity with each other. The consumer is also demanding greater access to freedom of provider choice, quality of health care coverage. PMID:10164646

Upton, R L

1997-01-01

179

Clinical applications of telehealth in mental health care  

Microsoft Academic Search

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

B. Hudnall Stamm

1998-01-01

180

45 CFR 162.406 - Standard unique health identifier for health care providers.  

Code of Federal Regulations, 2010 CFR

...unique health identifier for health care providers. 162.406 Section 162...Unique Health Identifier for Health Care Providers § 162.406 Standard unique health identifier for health care providers. (a) Standard....

2010-10-01

181

45 CFR 162.406 - Standard unique health identifier for health care providers.  

Code of Federal Regulations, 2010 CFR

...Standard unique health identifier for health care providers. 162.406 Section...Standard Unique Health Identifier for Health Care Providers § 162.406 Standard unique health identifier for health care providers. (a)...

2009-10-01

182

45 CFR 162.406 - Standard unique health identifier for health care providers.  

Code of Federal Regulations, 2013 CFR

...Standard unique health identifier for health care providers. 162.406 Section...Standard Unique Health Identifier for Health Care Providers § 162.406 Standard unique health identifier for health care providers. (a)...

2013-10-01

183

Health Care Costing: Data, Methods, Future Directions  

Cancer.gov

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

184

Female farmworkers' health during pregnancy: health care providers' perspectives.  

PubMed

Pregnant farmworkers and their fetuses are at increased risk of negative health outcomes due to environmental and occupational factors at their workplaces. Health care providers who serve farm communities can positively affect workers' health through the informed care they deliver. Yet, interviews with rural health care providers reveal limited knowledge about agricultural work or occupational and environmental health risks during pregnancy. Professional associations, government organizations, academic institutions, and practice settings must renew their efforts to ensure that environmental and occupational health education, especially as it relates to women and their children, is incorporated into academic and practice environments. PMID:23799657

Kelley, Maureen A; Flocks, Joan D; Economos, Jeannie; McCauley, Linda A

2013-07-01

185

Toward a 21st-century health care system: Recommendations for health care reform  

Microsoft Academic Search

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

K. Arrow; A. Auerbach; J. Bertko; L. P. Casalino; F. J. Crosson; A. Enthoven; E. Falcone; R. C. Feldman; V. R. Fuchs; A. M. Garber; M. R. Gold; D. A. Goldman; G. K. Hadfield; M. A. Hall; R. I. Horwitz; M. Hooven; P. D. Jacobson; T. S. Jost; L. J. Kotlikoff; J. Levin; S. Levine; R. Levy; K. Linscott; H. S. Luft; R. Mashal; D. McFadden; D. Mechanic; D. Meltzer; J. P. Newhouse; R. G. Noll; J. B. Pietzsch; P. Pizzo; R. D. Reischauer; S. Rosenbaum; W. Sage; L. D. Schaeffer; E. Sheen; B. N. Silber; J. Skinner; S. M. Shortell; S. O. Thier; S. Tunis; L. Wulsin Jr; P. Yock; G. B. Nun; S. Bryan; O. Luxenburg; Ven van de W. P. M. M; J. Cooper

2009-01-01

186

45 CFR 162.410 - Implementation specifications: Health care providers.  

Code of Federal Regulations, 2013 CFR

...Implementation specifications: Health care providers. 162.410 Section...Standard Unique Health Identifier for Health Care Providers § 162.410 Implementation specifications: Health care providers. (a) A covered...

2013-10-01

187

45 CFR 162.410 - Implementation specifications: Health care providers.  

Code of Federal Regulations, 2010 CFR

...Implementation specifications: Health care providers. 162.410 Section...Standard Unique Health Identifier for Health Care Providers § 162.410 Implementation specifications: Health care providers. (a) A covered...

2009-10-01

188

45 CFR 162.410 - Implementation specifications: Health care providers.  

Code of Federal Regulations, 2010 CFR

...Implementation specifications: Health care providers. 162.410 Section...Standard Unique Health Identifier for Health Care Providers § 162.410 Implementation specifications: Health care providers. (a) A covered...

2010-10-01

189

The Catholic church and U.S. health care reform.  

PubMed

The Catholic Church is the largest (and arguably the best organized) single denomination in the United States, and it has extensive holdings in the health care field. It therefore has a material stake in the current debate over health care reform, as well as a moral interest in a question touching on the ethics of resource distribution. The position of the church on health care is analyzed as a case study of how organized religion interacts with and attempts to influence social policy in a pluralistic society. PMID:8689443

Angrosino, M V

1996-03-01

190

Transferring patients to tertiary health care: the role of family and Primary Health Care Teams  

PubMed Central

Purpose One of the main problems of health systems is to ensure access and proper coordination between different health services. This problem is particularly felt when a patient is transferred from one level to another, especially for long-term care. Therefore, it is essential to develop new organizational models, which should meet user’s need. The primary Health Care (PHC) within the current Portuguese Primary Health Care Reform (PPHCR) could develop an important role, due to intrinsic innovative aspects associated with new governance model based on the development of a small family health multi-professional unit (USF) with functional and technical autonomy, integrated within a network with other functional units and the establishment of Health Center Clusters, producing meaningful healthcare delivered value. Theory Grounded on the health services utilization model of Dutton (1986) and on multidisciplinary assessment and decision-making model of Beckingham and Baumann (1990) for ageing families. Research question In the PPHCR context, how families experience the decision-making process of transferring an elderly relative with dementia? Research method An exploratory case study, with two embedded units of analysis (Ying 2003): families of the elderly with dementia and primary health care teams, Data were collected through semi-structured interviews and focus group. The data analysis was achieved through thematic content analysis (Bardin 2008) and descriptive statistical analysis with the support of computer program SPSS. See Figure 1 for the conceptual research model. Results Families who had shared their decision-making process with health care teams, recognize their fundamental role as mediator between the families and the complexity of the health and social system. The families, who had been followed up by the Primary Health Care Teams (PHCT), were more satisfied with their decision. However, there still exist some difficulties to address in order to benefit from a more integrated care: The communication between the different functional health units and health and social professionals is sometimes inadequate, with gaps, causing delays in response time, especially in crisis situations; Misunderstood and overlap competencies among team members; Different interpretations of referrals practices and clinical criteria to transferring patients. Restrict use of new technologies. Conclusions The PPHCR has been an opportunity to create innovation in healthcare delivering value, which is recognized through the families who had been accompanied by the Primary Health Care Teams. However, there still exist some problems, mainly associated to team-work, communication and the use of new technologies. To achieve an innovation culture of excellence it is fundamental the development by PHCT of integration competences and the capacity to introduce project-based approaches that would foster collaboration initiatives. Discussion What are the key integration competences that PHCT must domain?How can we measured the degree of health care delivery integration?

Joaquim, Filipa; Lapao, Luis

2012-01-01

191

Health Training Needs of Child Care Professionals.  

ERIC Educational Resources Information Center

Child care professionals in Hawaii were surveyed to assess health training needs. Respondents reported a high degree of comfort in managing common health conditions. The most commonly requested health services involved speech/language testing and vision/hearing screening. The most requested health/safety workshop topic was behavioral problems. The…

Caulfield, Rick; Kataoka-Yahiro, Merle

2001-01-01

192

Inquiries into health care: learning or lynching?  

Microsoft Academic Search

There is a spectrum of reasons for inquiries into health care: learning, catharsis, reassurance, and accountability. The tension is immediately obvious. Is the primary purpose learning or lynching? We need to learn from major health inquiries. New Zealand needs a culture of inquiry that encourages health professionals to discuss their concerns. We need mechanisms that enable health professionals to share,

Ron Paterson

193

Legislating health care coverage for the unemployed.  

PubMed

Because the unemployed and their families are often likely to develop stress-related health problems, ensuring them access to health care is a public health issue. Congressional efforts thus far to legislate health coverage for the unemployed have proposed a system that recognizes people's basic need for coverage but has several limitations. PMID:4029798

Palley, H A; Feldman, G; Gallner, I; Tysor, M

1985-01-01

194

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

ERIC Educational Resources Information Center

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…

Kastner, Theodore A.; Walsh, Kevin K.

2006-01-01

195

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

PubMed

Migrant farmworkers are one of the most health care-impoverished populations in the United States. Mobility, hazardous occupations, cultural diversity, and low socioeconomic status place migrants, and particularly migrant children, at high risk for inadequate health care and preventable health problems. This article presents a synthesis of the existing research on migrant demographics, major health risks, and geographic, financial, and cultural barriers to health care access. Innovative nursing strategies to enhance access and improve the health of migrant children are explored. These include the use of lay community outreach workers, the creation of alternative health care delivery models, and the development of information tracking systems. PMID:9592438

Gwyther, M E; Jenkins, M

1998-01-01

196

Library Services and Health Care Administration.  

ERIC Educational Resources Information Center

Discusses progress made in meeting the information needs of health care administrators and the role of the library in providing information for administrative decision making. Highlights include health care economics; a shifting power structure; quality improvement initiatives; standards; communicating the role and value of library services; and…

Buchanan, Holly Shipp

1993-01-01

197

Military Family and the Health Care System.  

National Technical Information Service (NTIS)

This chapter reviews the scientific literature on the role of the family in health promotion, self/family care, social support, health care utilization, and recovery. Although it is clear that military families have a direct impact on the demand for healt...

D. S. Nice

1993-01-01

198

Teaching Primary Health Care: An Interdisciplinary Approach.  

ERIC Educational Resources Information Center

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

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

1998-01-01

199

Safe Practices for Better Health Care.  

National Technical Information Service (NTIS)

Modern health care is highly complex, high risk, and error prone. Not surprisingly, health care errors and consequent adverse events are a leading cause of death and injury, even though well-documented methods to prevent the occurrence of many of these er...

K. W. Kizer L. N. Blum

2005-01-01

200

Medical Devices Used in Home Health Care.  

National Technical Information Service (NTIS)

The report was written by the CDRH Ad Hoc Home Health Care Committee in order to begin to address specific concerns associated with medical devices used in home health care. The report includes summaries of the following eight device-related issues: accre...

C. L. Backinger E. J. McCarthy

1992-01-01

201

Health Care Industry. Workforce & Workplace Literacy Series.  

ERIC Educational Resources Information Center

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;…

BCEL Brief, 1991

1991-01-01

202

Power Rx for the health care industry  

Microsoft Academic Search

While electricity has had a huge impact on the health care community through the development of highly sophisticated diagnostic tools and procedures, more mundane electro-technologies offer substantial opportunities as well. From innovative lighting techniques to energy management systems to new technologies for medical waste disposal, advanced electricity-based technologies can enhance health care services and help cut costs when facilities know

Lamarre

1994-01-01

203

The Pharmaceutical Industry and Health Care Reform  

Microsoft Academic Search

While the goals of President Clinton's health care reform plan—to expand access to health care by the underserved and reduce the unacceptably high cost of care—are important, his proposed mechanisms for doing so include provisions that are counterproductive. Blacklisting certain drugs from the Medicare program, imposing red tape on physicians who participate in Medicare, and establishing a Medicare rebate tax

1994-01-01

204

The Pharmaceutical Industry and Health Care Reform  

Microsoft Academic Search

:While the goals of President Clinton's health care reform plan—to expand access to health care by the underserved and reduce the unacceptably high cost of care—are important, his proposed mechanisms for doing so include provisions that are counterproductive. Blacklisting certain drugs from the Medicare program, imposing red tape on physicians who participate in Medicare, and establishing a Medicare rebate tax

William L. Lucas

1994-01-01

205

Catastrophic payments for health care in Asia  

Microsoft Academic Search

Out-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population. We focus on payments that are catastrophic, in the sense of severely disrupting household living standards, and approximate such payments by

Eddy van Doorslaer; Owen ODonnell; Ravindra P. Rannan-Eliya; Aparnaa Somanathan; Shiva Raj Adhikari; Charu C. Garg; Deni Harbianto; Alejandro N. Herrin; Mohammed Nazmul Huq; Shamsia Ibragimova; Anup Karan; Tae-Jin Lee; Gabriel M. Leung; Jui-Fen Rachel Lu; Chiu Wan Ng; Badri Raj Pande; Rachel Racelis; Sihai Tao; Keith Tin; Kanjana Tisayaticom; Laksono Trisnantoro; Chitpranee Vasavid; Yuxin Zhao

2007-01-01

206

Integrated health care systems: emerging models.  

PubMed

Health care institutions and professionals are transforming the organizational structure of the nation's delivery system. Buyers and payers of health care are seeking more effective and efficient services for their dollars. Several new model organizational structures seek to put the providers who are aligning themselves with one another into a better position to deal with today's marketplace. PMID:8945275

Riley, D W

1994-01-01

207

Biomedical equipment systems for rural health care  

Microsoft Academic Search

Biomedical equipment technology can be of significant help in bringing health care to large rural populations. Of the possible technology alternatives, providing an equipment package to the health worker to take to the domestic site is most appropriate. Equipment choice must give priority to preventive care especially for the mother and the child. Besides the general equipment design features of

Sujoy K. Guha

1992-01-01

208

Lasers and optics in health care  

Microsoft Academic Search

Lasers and optics have affected health care in a myriad of ways. This paper surveys their impact on three aspects of health care: (1) surgery and medicine, (2) biology, and (3) biotechnology. In surgery, fiber optics have enabled the development of endoscopes, which allow access to most sites within the body. Endoscopes have, in turn, led to the development of

THOMAS F. DEUTSCH

1997-01-01

209

A Comprehensive Primary Health Care Delivery Model.  

ERIC Educational Resources Information Center

This primary health care model is based on four assumptions: emphasis on collective, not individual, needs; coordination of preventive/episodic care with secondary/tertiary care; comprehensive, holistic approach; and partnership and equality among professional disciplines and community members. Stakeholders involved are medical, nursing, and…

Pullen, Carol; And Others

1994-01-01

210

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

PubMed

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

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

2014-06-01

211

Pertussis Vaccination for Health Care Workers  

PubMed Central

Pertussis, an acute respiratory infection caused by Bordetella pertussis, classically manifests as a protracted cough illness. The incidence of pertussis in the United States has been increasing in recent years. Immunity wanes after childhood vaccination, leaving adolescents and adults susceptible to infection. The transmission of pertussis in health care settings has important medical and economic consequences. Acellular pertussis booster vaccines are now available for use and have been recommended for all adolescents and adults. These vaccines are safe, immunogenic, and effective. Health care workers are a priority group for vaccination because of their increased risk of acquiring infection and the potential to transmit pertussis to high-risk patients. Health care worker vaccination programs are likely to be cost-effective, but further research is needed to determine the acceptability of pertussis vaccines among health care workers, the duration of immunity after booster doses, and the impact of vaccination on the management of pertussis exposures in health care settings.

Sandora, Thomas J.; Gidengil, Courtney A.; Lee, Grace M.

2008-01-01

212

Chronic Insomnia and Health Care Utilization in Young Adults  

Microsoft Academic Search

Chronic insomnia is prevalent, contributes a significant economic burden, and people with insomnia have increased health care utilization (HCU). The purpose of this study was to investigate the relationship between chronic insomnia and HCU in a population with fewer medical\\/mental health problems, using current operational definitions of chronic insomnia and multiple measures of HCU. Participants with chronic insomnia had greater

Adam D. Bramoweth; Daniel J. Taylor

2012-01-01

213

The Potential Impact of Health Care Reform on Higher Education.  

ERIC Educational Resources Information Center

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

Reace, Diana

1994-01-01

214

Managed Care: What Mental Health Counselors Need To Know.  

ERIC Educational Resources Information Center

Surveys leaders from various roles in the managed-care and mental-health professions to identify current and future marketplace trends affecting the clinical practice of mental-health counseling. Identifies training and continuing education needs based upon these interviews. (Author/GCP)

Lawless, Linda L.; Ginter, Earl J.; Kelly, Kevin R.

1999-01-01

215

Transforming Care Delivery through Health Information Technology  

PubMed Central

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

Wheatley, Benjamin

2013-01-01

216

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

ERIC Educational Resources Information Center

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)

Hildick, Sue; Kohler, Peter O.

1998-01-01

217

Selective primary health care: the counter revolution.  

PubMed

Primary health care in the WHO sense was triggered indirectly by the failure of the Malaria Eradication Programme. The response to this failure was an ideological change which considered that health services were not purely a way of delivering health care interventions to people but were something important to individuals and groups in their own right. Key changes of this idea called primary health care were linked to qualities such as power, ownership, equity and dignity. Such an ideological change involves the evolution of new forms to reflect the changes in content and some of these structures still require development. The advocates of highly selected and specific health interventions plus the managerial processes to implement them have ignored, or put on one side, the ideas which are at the core of what could be described as the primary health care revolution. They are in this sense counter revolutionaries. PMID:3388069

Newell, K W

1988-01-01

218

Vaccine perceptions among Oregon health care providers.  

PubMed

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

Bean, Sandra J; Catania, Joseph A

2013-09-01

219

Remote health-care monitoring using Personal Care Connect  

Microsoft Academic Search

Caring for patients with chronic illnesses is costly—nearly $1.27 trillion today and predicted to grow much larger. To address this trend, we have designed and built a platform, called Personal Care Connect (PCC), to facilitate the remote monitoring of patients. By providing caregivers with timely access to a patient's health status, they can provide patients with appropriate preventive interventions, helping

Marion Blount; Virinder M. Batra; Andrew N. Capella; Maria Ebling; William F. Jerome; Sherri M. Martin; Michael Nidd; Michael R. Niemi; Steven P. Wright

2007-01-01

220

Health care technology and quality of care.  

PubMed

The increasing costs and complexity of technologic advances in diagnosis and treatment have been accompanied by other important issues. They are often moral or ethical in nature; they include the public's desire and determination to have access to these "high-tech" advances; and the quality and equity with which those advances are apportioned and applied must be addressed. Seven criteria that can be applied to technology assessment are identified as is a process for that assessment. Together, these procedures can provide valuable information and assistance to those who make decisions about health benefits coverage--both in the public and the private sectors. PMID:2980910

Schaffarzick, R W

1987-08-01

221

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

ERIC Educational Resources Information Center

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

Hudson, Christopher G.; DeVito, Jo Anne

1994-01-01

222

Investigation of health care waste management in Binzhou District, China  

SciTech Connect

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

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

2010-02-15

223

Assistive Communication Robot for Preoperative Health Care  

Microsoft Academic Search

\\u000a Health care costs and ageing population are two factors which are of major concern to western governments in the 21st century.\\u000a Existing work in affective health care is primary focused on developing avatars in the tele-health space. This paper reports\\u000a on the modeling of emotions (anxiety level) of patients in pre-operative stage using communication robots to assist nurses\\u000a in providing

Rajiv Khosla; Mei-Tai Chu; Kerstin Denecke; K. G. Yamada; T. Yamaguchi

2010-01-01

224

Toward a health care financing strategy for the nation. Report of the National Health Policy Seminar.  

PubMed Central

All people in the United States have a need for access to comprehensive high quality health care. Such need is so universal and fundamental, not only to personal health, but also to equitable pursuit of all opportunity in a modern and just society, that it is viewed increasingly in the context of rights. Although the current array of health financing programs--Medicare, Medicaid, employer-based medical care insurance benefits, private medical care insurance, and other current insurance methods--have major accomplishments to their credit in providing access to care, the United States falls short in guaranteeing that conceptual right. The result is that 35 to 40 million people in the United States have no insurance coverage at all for medical care expenses, and an unknown number of people have coverage that is grossly inadequate. In addition, our current medical care system is characterized by: significant barriers to equitable access to care, apart from lack of coverage of the direct costs; major deficiencies in services for rehabilitation, long-term care, and home care; extreme variablity in the utilization and quality of care. We also must acknowledge failures in fundamental programs that directly affect the health of our people, such as health manpower, housing, education, and protection against occupational and environmental hazards. However, these matters are outside the purview of this statement. We propose a program, under the leadership of the federal government, with state and local government and the private sector having significant roles to play, that will respond to these shortcomings in our health care system. The program would finance health services comprehensively and equitably, minimize duplication, inefficiency, and the uneven quality of care, and would emphasize health promotion and disease prevention.

1990-01-01

225

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

PubMed

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

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

2011-09-01

226

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

PubMed Central

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.

Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

2011-01-01

227

Telemedicine Health Care Delivery System.  

National Technical Information Service (NTIS)

The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and ...

J. H. Sanders

1991-01-01

228

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

Microsoft Academic Search

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

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

2005-01-01

229

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

ERIC Educational Resources Information Center

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

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

2007-01-01

230

Health systems organization for emergency care.  

PubMed

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

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

2013-10-01

231

Health Care Policy Issues as a Result of the Genetic Revolution: Implications for Public Health  

PubMed Central

The genetic revolution has spawned 4 distinct issues of universal importance to health care policy and society: genetic privacy, regulation and standardization of genetic tests, gene patenting, and education. Adequate policy advancements for these 4 areas are lacking. Stringent controls must be placed on individual health records to prevent their misuse. Genetic testing within the clinical setting should undergo thorough evaluation before it is implemented. Regulations are needed to prevent the monopolization of DNA sequences. Society and health care professionals must be educated about the scope of genetic testing because current trends indicate that genetic and molecular assessments are destined to become a routine component of health care.

Ojha, Rohit P.; Thertulien, Raymond

2005-01-01

232

[Primary care in maternal-child health].  

PubMed

The theoretical and methodological elements of primary health care (PHC) include a philosophy of work and an epistemological focus toward the processes of health and illness, as well as a practical medical anthropological knowledge of the culture-specific aspects of disease. The work methodology of PHC requires care of the individual as a bio-psycho-socio-affective being integrated into a particular environment; none of the aspects of being should be neglected or given priority. Care should also be integrated in the sense of providing preventive health care as well as curative and rehabilitative services, in all phases from training of health personnel to record keeping. The primary health care team is multidisciplinary in constitution and interdisciplinary in function. PHC assumes that health care will be accessible to users and that continuity of care will be provided. The need for community participation in all phases of health care has been reiterated in several international health declarations. A well-functioning PHC system will require new types of pre- and postgraduate health education in a changing social and professional system and continuing education under adequate supervision for health workers. Research capability for identifying community health problems, a rigorous evaluation system, and epidemiologic surveillance are also needed. All of these elements are applicable to the field of maternal and child health as well as to PHC. The most appropriate place to intervene in order to correct existing imbalances in access to health care for mothers and children is in the PHC system. Examples of areas that should be stressed include vaccinations, nutrition, psychomotor development, early diagnosis and treatment for handicapped children, prevention of childhood accidents, school health and absenteeism, all aspects of health education, adoption and alternatives to abandonment of children, alcoholism and addiction, adolescent pregnancy and family planning, dental health, and mental problems. Trained primary care pediatricians working within the community as part of the PHC system will be required to confront and solve complex health problems. The training needed does not signify a new speciality or subspeciality, but rather a training methodology and a new type of professional practice. PMID:3752740

Pedreira Massa, J L

1986-07-01

233

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

PubMed

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

Fortuit, P

2005-09-01

234

Health Update: Development of New National Child Care Health Standards.  

ERIC Educational Resources Information Center

Discusses the absence of national standards which are uniformly applicable to health, safety, sanitation, and nutrition aspects of child care programs. Explains the responsive collaborative project of the American Academy of Pediatrics and American Public Health Association to develop national reference standards for out-of-home child care

Aronson, Susan S.

1988-01-01

235

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

PubMed

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

Babaskin, D V

2011-01-01

236

Analytic Support for Washington Citizens' Work Group on Health Care: Evaluation of Health Care Reform Proposals. Washington, DC: Mathematica Policy Research  

Microsoft Academic Search

Mathematica evaluated five health care reform proposals for the state of Washington in 2008. The proposals featured, respectively: reduced regulation in the current market; Massachusetts-style insurance reforms with a health insurance connector; a health partnership program similar to the current state employee health plan; a state-operated single payer plan; and a program that would guarantee catastrophic coverage for all residents.

Deborah Chollet; Jeffrey Ballou; Alison Wellington; Thomas Bell; Allison Barrett; Gregory Peterson; Stephanie Peterson

2009-01-01

237

Promoting coordination in Norwegian health care1  

PubMed Central

Introduction The Norwegian health care system is well organized within its two main sectors—primary health and long-term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures. Policy practice Enhancing coordination between primary and secondary health care has been central in Norwegian health care policy in the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term “Coordination Reform”. These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented. Discussion The article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.

Rom?ren, Tor Inge; Torjesen, Dag Olaf; Landmark, Brynjar

2011-01-01

238

Geographic Disparities in Children's Mental Health Care  

Microsoft Academic Search

Objective. It is widely believed that only a minority of vulnerable children and adolescents receive any mental health services. Although health care dispar- ities associated with sociodemographic characteristics are well known, almost no information exists about another potentially important source of disparity for children: How does state of residence affect mental health service use? Methods. Observational analysis was conducted us-

Roland Sturm; Jeanne S. Ringel; Tatiana Andreyeva

2010-01-01

239

Space technology in remote health care  

NASA Technical Reports Server (NTRS)

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

Belasco, N.

1974-01-01

240

Health Care Reform: Recommendations and Analysis.  

ERIC Educational Resources Information Center

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

Lewit, Eugene M.; And Others

1993-01-01

241

Health Care Issues of Incarcerated Women.  

ERIC Educational Resources Information Center

Presents health profile of the female offender. Discusses needs in areas of gynecology, breast assessment, and health education and services related to childbearing and parenting. Describes incarcerated health care delivery system and looks to communication and education, nursing personnel, and community resources for potential solutions to…

McGaha, Glenda S.

1987-01-01

242

Medical informatics and health care organizations.  

PubMed

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

Holden, F M

1991-01-01

243

Reflections on curative health care in Nicaragua.  

PubMed Central

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

Slater, R G

1989-01-01

244

Spina Bifida: Guidelines of Care for Children with Special Health Care Needs.  

ERIC Educational Resources Information Center

These guidelines were written to help families coordinate the health care that may be needed by a child with spina bifida. The booklet begins with general information about spina bifida. It then discusses the goals of health care, the health care team, the importance of periodic health care, and record keeping procedures. The child's health care

Minnesota State Dept. of Health, Minneapolis. Services for Children with Handicaps.

245

The Ottawa Charter and acute health care.  

PubMed

The Ottawa Charter is a significant document in relation to health promotion and the priorities for action needed to facilitate health for all people. The relevance of this document to an intensive care setting and the extent to which it may be translated into meaningful practice is examined in this paper. Acute care is an area lying at the extreme end of tertiary health, and at first glance it may be difficult to reconcile the significance of health promotion and the Ottawa Charter with this particular area of health care practice. On closer inspection, however, the relevance of the Charter lies in its impact on the number and type of patients seen in the Intensive Care Unit, and on the effect that the implementation of the health promotion action areas has on the client base. Even at the extreme end of tertiary care it is equally important to be aware of public health issues and to advocate, enable and mediate, where necessary, on behalf of and alongside patients, particularly as we care for them when they are most vulnerable. A commitment to both action and meaningful practice must continue to be pursued while equity in health remains a goal to be achieved. PMID:18556735

Munster, Francesca

2008-06-01

246

Mercy health promoter: A paradigm for just health care  

PubMed Central

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

Clark, Peter A.; Schadt, Sam

2013-01-01

247

Mercy health promoter: a paradigm for just health care.  

PubMed

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

Clark, Peter A; Schadt, Sam

2013-01-01

248

Statements of Antitrust Enforcement Policy in Health Care.  

National Technical Information Service (NTIS)

The antitrust guidelines for health care providers are designed to encourage agreements that promote efficiency in the health care industry and lower health care costs to consumers. The nine statements detail new antitrust enforcement policies and princip...

1996-01-01

249

20 CFR 402.65 - Health care information.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Health care information. 402.65 Section...RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under titles XVIII...

2013-04-01

250

47 CFR 54.602 - Health care support mechanism.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Health care support mechanism. 54.602... Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.602 Health care support mechanism. (a)...

2013-10-01

251

47 CFR 54.601 - Health care provider eligibility.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Health care provider eligibility. 54.601... Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.601 Health care provider eligibility....

2013-10-01

252

45 CFR 162.1401 - Health care claim status transaction.  

Code of Federal Regulations, 2013 CFR

... 2013-10-01 2013-10-01 false Health care claim status transaction. 162.1401 ...REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Claim Status § 162.1401 Health care claim status transaction. The...

2013-10-01

253

42 CFR 476.76 - Cooperation with health care facilities.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Cooperation with health care facilities. 476.76 Section... § 476.76 Cooperation with health care facilities. Before implementation...review procedures with each involved health care...

2013-10-01

254

20 CFR 402.65 - Health care information.  

...2014-04-01 2014-04-01 false Health care information. 402.65 Section 402...RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under titles XVIII and XIX...

2014-04-01

255

7 CFR 205.238 - Livestock health care practice standard.  

...2014-01-01 false Livestock health care practice standard. 205.238 Section...Requirements § 205.238 Livestock health care practice standard. (a) The producer...and maintain preventive livestock health care practices, including: (1)...

2014-01-01

256

Nongrowth strategies and options in health care.  

PubMed

Changing economic and market forces in health care delivery have stimulated much management thinking about innovative, entrepreneurial forms of strategic growth. Along with this thinking comes a new imperative to rethink strategies to include nongrowth options in either services or markets. The health care manager must go beyond describing the strategies and tactics as simple reversals of the organizational pattern of growth in explaining the available nongrowth options. Examples of nine nongrowth options demonstrate their practicality and relevance to health care organizations. PMID:10302290

Breindel, C L

1988-01-01

257

Future developments in health care performance management  

PubMed Central

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

Crema, Maria; Verbano, Chiara

2013-01-01

258

Future developments in health care performance management.  

PubMed

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

Crema, Maria; Verbano, Chiara

2013-01-01

259

Finding a lasting cure for U.S. health care.  

PubMed

In "Making Competition in Health Care Work" (July-August 1994), Elizabeth Olmsted Teisberg, Michael E. Porter, and Gregory B. Brown ask a question that has been absent from the national debate on health care reform: How can the United States achieve sustained cost reductions while at the same time maintaining quality of care? The authors argue that innovation driven by rigorous competition is the key to successful reform. A lasting cure for health care in the United States should include four basic elements: corrected incentives to spur productive competition, universal insurance to secure economic efficiency, relevant information to ensure meaningful choice, and innovation to guarantee dynamic improvement. In this issue's Perspectives section, eleven experts examine the current state of the health care system and offer their views on the shape that reform should take. Some excerpts: "On the road to innovation, let us not forget to develop the tools that allow physicians, payers, and patients to make better decisions." I. Steven Udvarhelyi; "Health care is not a product or service that can be standardized, packaged, marketed, or adequately judged by consumers according to quality and price." Arnold S. Relman; "Just as antitrust laws are the wise restraints that make competition free in other sectors of the economy, so the right kind of managed competition can work well in health care." Edward M. Kennedy "Biomedical research should be considered primarily an investment in the national economic well-being with additional humanitarian benefits." Elizabeth Marincola. PMID:10137002

Udvarhelyi, I S; Relman, A S; Binder, G M; Spence, R K; Kennedy, E M; Grossman, J H; Termeer, H A; Raines, L J; Marincola, E; Pyle, T O

1994-01-01

260

Health and Safety Considerations: Caring for Young Children with Exceptional Health Care Needs.  

ERIC Educational Resources Information Center

This manual on health and safety considerations in caring for young children with exceptional health care needs is a product of Project EXCEPTIONAL (EXceptional Children: Education in Preschool Techniques for Inclusion, Opportunity-building, Nurturing And Learning), which has the goal of increasing the quality and quantity of inclusive child care

Presler, Betty

261

Financial burden of health care expenditures: Turkey.  

PubMed

In this study, we examine whether and to what extent the health insurance system in Turkey provided adequate protection against high out of pocket expenditures in the period prior to "The Health Transformation Programme". Furthermore, we examine the distribution of out of pocket expenditures by demographic characteristics, poverty status, health service type, access to health care and self-reported health status. We employ the 2002/03 National Household Health Expenditure Survey data to analyze financial burden of health care expenditure. Following the literature, we define high burdens as expenses above 10 and 20% of income. We find that 19% of the nonelderly population were living in families spending more than 10% of family income and that 14% of the nonelderly population were living in families spending more than 20% of family income on health care. Furthermore, the poor and those living in economically less developed regions had the greatest risk of high out of pocket burdens. The risk of high financial burdens varied by the type of insurance among the insured due to differences in benefits among the five separate public schemes that provided health insurance in the pre-reform period. Our results are robust to three alternative specifications of the burden measure and including elderly adults in the sample population. We see that prior to the reforms there were not adequate protection against high health expenditures. Our study provides a baseline against which policymakers can measure the success of the health care reform in terms of providing financial protection. PMID:23113149

Sulku, S Nur; Bernard, D Minbay

2012-01-01

262

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

PubMed Central

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

2011-01-01

263

Current Awareness in Health Education, October 1983.  

National Technical Information Service (NTIS)

Citations and abstracts of current journal articles, monographs, conference proceedings, reports, and other documents are provided. The following topics are included: Community Health Education; Health Education in Occupational Settings; Health Education ...

1983-01-01

264

The ORIGINS of Primary Health Care and SELECTIVE Primary Health Care  

PubMed Central

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

Cueto, Marcos

2004-01-01

265

Case Studies in Primary Health Care  

NSDL National Science Digital Library

How does one learn about primary health care? Some might attend public health schools while others will find different ways to explore this fascinating field on their own. One particularly nice resource on the subject is this course from the Johns Hopkins School of Public Health. Offered as part of the Open Course Ware initiative, the course was first developed in the fall of 2011 and was co-taught by Henry Taylor and Henry Perry. It was designed to introduce students to "the origins, concepts, and development of community-based primary health care through case studies from both developing and developed countries." The materials here include the syllabus, lecture materials, readings, and assignments. Within the Lecture Materials section visitors can watch or listen to conversions on the roots of community-based primary health care and women's empowerment via public health. Additionally, visitors can look over the course assignments or check out some of the discussion questions.

Perry, Henry; Taylor, Henry

2011-01-01

266

Financing health care in the United Arab Emirates.  

PubMed

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

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

2013-01-01

267

Assessing Health Care Needs Among Street Homeless and Transitionally Housed Adults  

Microsoft Academic Search

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

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

2011-01-01

268

Latina Self-Reported Mental Health and Delay in Health Care in a New Latino Destination  

PubMed Central

Understanding how depression and/or anxiety affect use of health care among Latinas in rapidly growing new Latino destinations, population where the growth rate of the Latino population exceeds the national average, may enhance community engagement efforts. Using community-based participatory research, a questionnaire assessing health care use was administered to 289 Latinas. Most (70%) reported delaying healthcare, and self-reported depression/anxiety was associated with a 3.1 fold (95% CI: 1.6 - 5.9) increase in delay, after adjusting for current health status, acculturation, age, education and place of birth. Mental health disparities exist among Latinas, which are related to delays in use of health care. A gap exists regarding health education interventions for Latinas. More research is needed to identify successful models, especially in new Latino destinations as they may be particularly vulnerable to delay care.

Westin, Emily Leckman; Rossy-Millan, Jose

2010-01-01

269

[Quality of maternal and child health care in different models of Primary Health Care].  

PubMed

This study evaluated the quality of the maternal and child health care in two different models of Primary Health Care. Interviews were carried out by trained personnel with 1200 families randomly selected. Processes of assistance for maternal and child health care were evaluated by Family Health Strategy Teams and traditional health centers. In the evaluation of child health care, the precocity of the first consultation, the regular assessment of growth and development, the recommendations for accident prevention and prophylactic use of iron supplementation and vitamin A had been statistically associated with the model of the health care. Regarding prenatal health care the results showed statistically significant differences between the two models for breastfeeding counseling, nutritional recommendations and cervical preventive screening using Papanicolaou smear. For women health care out of pregnancy period, the results revealed that counseling for breasts auto-examination, preventive screening using Papanicolaou smear in last year and participation in family planning programs were associated with health Primary Health Care model. All the pointed differences had shown better performance of the Family Health Strategy Teams. PMID:21049154

Caldeira, Antônio Prates; Oliveira, Rafael Morroni de; Rodrigues, Oreston Alves

2010-10-01

270

Implementation of Advanced Health Care Technology into Existing Competency-Based Health Care Program. Final Report.  

ERIC Educational Resources Information Center

A project was undertaken to develop new curriculum materials that could be incorporated into an existing health assistant program to cover recent advances in health care technology. Area physicians' offices were toured and meetings were held with administrators of local hospitals in order to discover what kinds of advances in health care

Klemovage, Shirley

271

Home Health Care: An Alternative in Institutionalization (Home Health Care Task Force Program Implementation Committee).  

National Technical Information Service (NTIS)

Inflation, increasing costs of health care delivery in institutions, and the increasing need to be more cost efficient in matching needs with services, indicate that home health care may have a critical role in the '80s. Emphasis on providing home health ...

1981-01-01

272

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

PubMed

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

Davies, G

1990-07-01

273

A Study of Health Care Delivery System for Foot Care.  

National Technical Information Service (NTIS)

The objectives of the present study are to assess the current patterns of foot care service. The first portion of this report is devoted to a description of the foot care providers; due to the dearth of reported information on general practitioners, this ...

1980-01-01

274

Revolutionizing Health Care Through Information Technology.  

National Technical Information Service (NTIS)

The U.S. health care system is acknowledged to be the world's most advanced scientifically and technologically. But amid multimilliondollar diagnostic instruments, highly trained caregivers, and a vast facilities infrastructure, the most fundamental and p...

2004-01-01

275

Religion, Spirituality and Your Mental Health Care  

MedlinePLUS

Religion, Spirituality and Your Mental Health Care Quick Links Facts for Families - Numerical List Facts for Families - ... and print a PDF version of this document . Religion and spirituality can be important in the lives ...

276

Effect of Wealth on Health Insurance and Health Care Expenditures  

Microsoft Academic Search

While there is an extensive literature estimating the effects of income on health insurance and expenditures, the effect of wealth has not been widely studied. Given the recent significant declines in the global financial and housing markets, it is important to estimate the effect of wealth on the demand for health insurance and health care expenditures. Wealth and lifetime income

Didem Bernard; William Encinosa; Jessica Banthin

2010-01-01

277

Integrating Public Health and Personal Care in a Reformed US Health Care System  

PubMed Central

Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access. Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy. The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns.

Chernichovsky, Dov

2010-01-01

278

Captive insurance companies in health care.  

PubMed

A health care system or individual hospital should consider establishing a captive insurance company if any one of the following situations exist: The organization's professional liability program is arranged with a self-insured retention of $500,000 or more, or consideration is being given to such an arrangement. A trust fund has been established for a self-insured exposure--professional liability, workers' compensation, or employee benefits. A portion of the organization's professional liability excess insurance program is arranged with an insurer that uses a fronting insurer. The organization currently sponsors, or is considering sponsoring, a physicians' liability insurance program for medical staff members. If any of those situations exist, a comprehensive feasibility study should be undertaken, preferably by an independent, objective organization that does not have a financial interest in the outcome of the study. PMID:10116676

Huntington, R R

1992-01-01

279

Emerging trends in health care finance.  

PubMed

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

Sterns, J B

1994-01-01

280

The physician's perception of health care.  

PubMed

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

Lawrence, R S

1994-01-01

281

Veterans Health Administration -- More Than Just Caring.  

National Technical Information Service (NTIS)

This program provides a fast-paced look at the provision of medical care to veterans through the Veterans Health Administration (VHA). It focuses on four important missions - medical care, medical research, medical education, and VA/DOD support. The prima...

1994-01-01

282

The Health of Children in Foster Care  

ERIC Educational Resources Information Center

This qualitative study of school nurses describes what the nurses want to do for school children in foster care, what they are actually doing, and how the school organization affects the provision of care. The study looked at the nurses' practice through the lens of the Social Ecological Model of Health, identified interventions using the…

Schneiderman, Janet U.

2004-01-01

283

Plasma health care - AIMS, constraints, and progress  

Microsoft Academic Search

Health Care covers three areas of interest for cold atmospheric pressure plasmas: Cosmetics, Hygiene and Medicine. These areas can be subdivided into personal and professional care. In this review will concentrate on Hygiene and Medicine. In professional hygiene the most important plasma contribution is sterilization, decontamination and disinfection. The main aim is the prevention of diseases or their containment. Progress

G. E. Morfill; J. L. Zimmerman; S. Karrer

2010-01-01

284

Improving Health Care for Assisted Living Residents  

ERIC Educational Resources Information Center

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…

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

2007-01-01

285

Model Child Care Health Policies. Fourth Edition.  

ERIC Educational Resources Information Center

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

Aronson, Susan S.

286

Mental health stigma and primary health care decisions.  

PubMed

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

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

2014-08-15

287

Are health care professionals able to judge cancer patients' health care preferences correctly? A cross-sectional study  

Microsoft Academic Search

BACKGROUND: Health care for cancer patients is primarily shaped by health care professionals. This raises the question to what extent health care professionals are aware of patients' preferences, needs and values. The aim of this study was to explore to what extent there is concordance between patients' preferences in cancer care and patients' preferences as estimated by health care professionals.

Hester Wessels; Alexander de Graeff; Klaske Wynia; Miriam de Heus; Cas LJJ Kruitwagen; Saskia CCM Teunissen; Emile E Voest

2010-01-01

288

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

PubMed Central

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

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

2010-01-01

289

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

PubMed Central

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

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

2012-01-01

290

Health care expenditure and income in Europe.  

PubMed

In this work we have tried to analyse the variations in health care expenditure in all the countries of the European Community except Greece and Portugal. We have wanted to provide additional evidence on the empirical relationship between expenditure on health care and income. Our analysis, starting from the approach of Fuchs and Baumol, has been an extension of the traditional studies on health care international comparisons, in at least three directions: we have not imposed any restrictions on the price effects, we have analysed dynamic models instead of the cross-sectional analysis and we have used proper deflators. We have deflated health care expenditure in each country by means of its sectoral price index and by the purchasing parity power of its currency, to allow international comparisons. In the former case we express health care in terms of 'expenditure', in the latter we express health care in terms of 'weighted quantity'. Income elasticities, in the short and in the long-run, have been estimated using econometric methods that allow us to obtain simultaneously equilibrium long-run relationships, if any, and adjustment processes in the short-run. We have found cointegrating relationships and we have estimated consistent estimators of the elasticities. The estimated income elasticities are greater than one in all the models analysed. PMID:8261034

Murillo, C; Piatecki, C; Saez, M

1993-07-01

291

Mental Health Services in General Health Care. Volume 2. Coordinated Mental Health Care in Neighborhood Health Centers.  

National Technical Information Service (NTIS)

Advantages of providing primary health and mental health services in the same location are argued from a standpoint of the author's experience and a review of the relevant literature. Alternatives to current national mental health policy are suggested to ...

J. F. Borus, B. J. Burns, A. M. Jacobson, L. B. Macht, R. G. Morrill

1979-01-01

292

States with more health care spending have better-quality health care: lessons about Medicare.  

PubMed

Based on broad measures of health system quality and performance, states with more total health spending per capita have better-quality care. This fact contrasts with a previous finding that states with higher Medicare spending per enrollee have poorer-quality care. However, quality results from the total funds available and not from Medicare or any single payer. Moreover, Medicare payments are disproportionately high in states that have a disproportionately large social burden and low health care spending overall. These and other vagaries of Medicare spending pose critical challenges to research that depends on Medicare spending to define regional variation in health care. PMID:19056754

Cooper, Richard A

2009-01-01

293

Pharmacy in the health care center: a model for health care delivery.  

PubMed

Health care consumers use a plethora of services which are accessible on an ambulatory basis. These include the services of pharmacists, optometrists, nurses, dentists, audiologists, orthotics, and so forth. Since many of these services are provided in physically and financially separate facilities and often are not located in close proximity to one another, consumers may spend a large amount of time traveling between locations. Economic inefficiencies due to the size and dispersion of separate and independent facilities may produce an increase in the cost of ambulatory health care services. Thus, the concept of a health care center, an ambulatory health care analog to the multispecialty shopping center, is proposed as a potential alternative and improvement in the delivery of these services. Space, location, personnel, and initial capital requirements for a model health care center are projected based on existing data for the establishment of each separate auxiliary health care facility. Projections are made to determine the appropriate and necessary site for the health care center's trade area. Potential revenues are calculated by examining some pharmacy operations which are beginning to pioneer these areas and utilizing revenue figures for the various individual services. The results indicate that the pharmacy, as a frequently visited health care facility, may be an excellent choice around which to develop the health care center concept in metropolitan areas. PMID:10256904

Stark, D C; Wertheimer, A I

1982-01-01

294

Clinical Preventive Services for Older Adults: The Interface Between Personal Health Care and Public Health Services  

PubMed Central

Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers. To achieve maximum health results, prevention must be integrated across community and clinical settings. Many preventive services are portable, deliverable in either clinical or community settings. Capitalizing on that flexibility can improve uptake and health outcomes. Significant reductions in health disparities, mortality, and morbidity, along with decreases in health spending, are achievable through improved collaboration and synergy between population health and personal health systems.

Richards, Chesley L.; Shenson, Douglas

2012-01-01

295

Johns Hopkins Bloomberg School of Public Health: Refugee Health Care  

NSDL National Science Digital Library

These online course materials were generated from a Johns Hopkins Bloomberg School of Public Health (JHSPH) course on Refugee Health Care. The materials were put online as part of the JHSPH OpenCourseWare program which provides "free, searchable access to JHSPH's course materials for educators, students, and self-learners around the world." The Refugee Health Care course "addresses the provision of basic health requirements for refugees and the coordination of care among agencies concerned with them." Site visitors will find a selection of downloadable lecture notes on such topics as Hemorrhagic Fever Outbreak Investigation, Control of Communicable Diseases, Health and Human Rights Principles for Refugee Health, and more. The site also offers a downloadable Reading List, and case study materials.

296

Corporate social responsibility and the future health care manager.  

PubMed

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

Collins, Sandra K

2010-01-01

297

Role of primary health care in ensuring access to medicines.  

PubMed

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

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

2010-06-01

298

Health care consumerism movement takes a step forward.  

PubMed

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

Thompson, Michael; Cutler, Charles M

2010-01-01

299

e Health networking to cater to Rural Health Care and Health Care for the Aged  

Microsoft Academic Search

This paper deals with health care problems in India and the possible solutions from the information and communication technologies (ICT) point of view. It first presents the requirements of the rural population, the aged, the chronic patients, and the accident victims, and then brings out the appropriate ICT to tailor to the needs of healthcare as an integrated solution to

D. S. Venkateswarlu; K. S. Verma; K. S. R. Murthy

2007-01-01

300

Health care technology as a policy issue  

Microsoft Academic Search

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

H. David Banta

1994-01-01

301

Planning health care on dairy farms  

Microsoft Academic Search

TWENTY-FIVE years ago, the gurus of the veterinary profession extolled the benefits of preventive medicine and the 'whole herd' approach to cattle health care. Although the message was slow to penetrate, their ideas and ideals are now being received and applied. In this article, Richard Sibley discusses some of the important considerations when formulating and applying a herd health plan

Richard Sibley

2000-01-01

302

Insurance and Innovation in Health Care Markets  

Microsoft Academic Search

Innovation policy often involves an uncomfortable trade-off between rewarding innovators sufficiently and providing the innovation at the lowest possible price. However, in health care markets with insurance for innovative goods, society may be able to ensure efficient rewards for inventors and the efficient dissemination of inventions. Health insurance resembles a two-part pricing contract in which a group of consumers pay

Darius Lakdawalla; Neeraj Sood

2005-01-01

303

Synthesis of Private Sector Health Care Initiatives.  

National Technical Information Service (NTIS)

This report is part of the Private Sector Health Care Initiatives Project, sponsored by the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services (DHHS). The project as a whole is designed to yie...

1984-01-01

304

Medicaid, the States and Health Care Reform  

Microsoft Academic Search

Health care reform in the US is relying extensively on Medicaid for achieving universal health coverage. This article addresses the question of whether Medicaid is an appropriate foundation for reducing the ranks of the uninsured, given its dependence on economic conditions and the vulnerability of state budgets, along with the ever-changing preferences of governors and legislators. This article assesses the

Laura Katz Olson

2012-01-01

305

Children and Federal Health Care Cuts.  

ERIC Educational Resources Information Center

This Children's Defense Fund report summarizes findings of a national survey, which indicate detrimental effects of Federal budget cuts in health care funds on economically disadvantaged mothers and children. Suggests that health funds for mothers and children are more important than defense expenditures and tax cuts for the non-needy. (MJL)

Freedomways, 1983

1983-01-01

306

Hispanic Health Care Survey of Southeastern Wisconsin.  

ERIC Educational Resources Information Center

The results of a study on the health care needs and utilization patterns of Hispanic (primarily Mexican American) families in southeastern Wisconsin are presented in this report. The methodology of the study, which included two surveys in a 9 county area, is described. Findings of the two studies, one focusing on health services utilization by…

Kvasnica, Barbara; And Others

307

Child Health USA 2013: Prenatal Care Utilization  

MedlinePLUS

Child Health USA 2013 An illustrated collection of current and historical data, published annually. Search Main Navigation Preface ... Use File. Analysis conducted by the Maternal and Child Health Bureau. Less Than High School Diploma 58.0 ...

308

Geographical Information Systems and Health: Current State and Future Directions  

PubMed Central

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.

2012-01-01

309

Health Care Financing Study, South Carolina Health Service Area 1.  

National Technical Information Service (NTIS)

The present health care system has evolved during a period of strong economic growth, low unemployment, businesses providing comprehensive first dollar group hospitalization plans for their employees, governmental grant programs, Medicare/Medicaid and rea...

1982-01-01

310

["Health is life": children's perceptions of health care].  

PubMed

The purpose of this study was to explore perceptions of health among children in the care of child protective services in Haute-Savoie (France). A qualitative study was conducted to explore children's perceptions of health care. The study involved interviews with children and a quality of life questionnaire. The results show that many aspects of the quality of life of children in care are adversely affected, including energy, sleep, pain, and emotional responses. The children interviewed also identified two main issues in their life: their relationship with their family and their education. The results show that children in care tend to have a passive view of health, which appears to be related to a lack of self-confidence and to a lack of trust in relationships and institutions. The results highlight the impact of social factors on health inequalities and confirm the importance of social relationships, the sense of control over one's life, and the feeling of recognition. PMID:23472983

Robin, Pierrine

2012-01-01

311

Who pays for health care in Ghana?  

PubMed Central

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

2011-01-01

312

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

Microsoft Academic Search

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

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

2010-01-01

313

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

PubMed Central

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

Detmer, Don E

2003-01-01

314

Lifestyle interventions in primary health care: professional and organizational challenges  

PubMed Central

Background: Interventions that support patient efforts at lifestyle changes that reduce tobacco use, hazardous use of alcohol, unhealthy eating habits and insufficient physical activity represent important areas of development for health care. Current research shows that it is challenging to reorient health care toward health promotion. The aim of this study was to explore the extent of health care professional work with lifestyle interventions in Swedish primary health care, and to describe professional knowledge, attitudes and perceived organizational support for lifestyle interventions. Methods: The study is based on a cross-sectional Web-based survey directed at general practitioners, other physicians, residents, public health nurses and registered nurses (n = 315) in primary health care. Results: Fifty-nine percent of the participants indicated that lifestyle interventions were a substantial part of their duties. A majority (77%) would like to work more with patient lifestyles. Health professionals generally reported a thorough knowledge of lifestyle intervention methods for disease prevention. Significant differences between professional groups were found with regard to specific knowledge and extent of work with lifestyle interventions. Alcohol was the least addressed lifestyle habit. Management was supportive, but structures to sustain work with lifestyle interventions were scarce, and a need for national guidelines was identified. Conclusions: Health professionals reported thorough knowledge and positive attitudes toward lifestyle interventions. When planning for further implementation of lifestyle interventions in primary health care, differences between professional groups in knowledge, extent of work with promotion of healthy lifestyles and lifestyle issues and provision of organizational support such as national guidelines should be considered.

Weinehall, Lars; Jerden, Lars; Nystrom, Monica E.; Johansson, Helene

2014-01-01

315

Inquiries into health care: learning or lynching?  

PubMed

There is a spectrum of reasons for inquiries into health care: learning, catharsis, reassurance, and accountability. The tension is immediately obvious. Is the primary purpose learning or lynching? We need to learn from major health inquiries. New Zealand needs a culture of inquiry that encourages health professionals to discuss their concerns. We need mechanisms that enable health professionals to share, learn, and implement changes for improvement. We need processes that support more informed scrutiny of health service quality by the public and media. There will continue to be a place for inquiries by the HDC and Coroners where external scrutiny is necessary. PMID:19098953

Paterson, Ron

2008-11-28

316

Health Care Policy and Medical Sociology  

Microsoft Academic Search

\\u000a Health policy concerns are important, but to some extent, understudied within medical sociology, ­particularly at the overall\\u000a broadest system level. Even in smaller studies that look at specific aspects of health care and health behavior issues, sociologists\\u000a have not paid much attention in the past few decades to drawing out the implications of the research being done for policy\\u000a questions

Jennie Jacobs Kronenfeld

317

The politics of health care reform.  

PubMed

Reform of the health care system is a complex process. Opinions vary as to the need for reform and the specific policy changes to be implemented. The Clinton administration has presented a proposal for health care policy reform, but alternative proposals have been recommended. A review of the legislative process indicates the many opportunities to amend or "kill" proposed health reform legislation. Given lack of success of the broad changes proposed in the Clinton plan, it is expected that incremental approaches will be more tried in the future. Active participation of neuroscience nurses in this process is strongly encouraged. The projected impact of health care reform on neuroscience nursing practice must be considered. PMID:7769327

Sklar, C J

1995-02-01

318

Virtual health care center in Georgia.  

PubMed

Application of telemedicine systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for creation of national networks does not seem to be widely appreciated. The article describes the "Virtual Health Care Knowledge Center in Georgia" project. Its aim was the set up of an online integrated web-based platform to provide remote medical consultations and eLearning cycles. The project "Virtual Health Care Knowledge Center in Georgia" was the NATO Networking Infrastructure Grant dedicated for development of telemedicine in non-NATO countries. The project implemented a pilot to organize the creation of national eHealth network in Georgia and to promote the use of innovative telemedicine and eLearning services in the Georgian healthcare system. In June 2007 it was continued under the NATO Networking Infrastructure Grant "ePathology--Virtual Pathology Center in Georgia as the Continuation of Virtual Health Care Center". PMID:18673518

Schrader, Thomas; Kldiashvili, Ekaterina

2008-01-01

319

Hepatitis B and the infected health care worker: Public safety at what cost?  

PubMed Central

Public safety and the right of the health care worker to practise without prejudice based on underlying illness may be at odds for those affected by the hepatitis B virus (HBV). Nevertheless, HBV does not preclude entry into a health care profession, and the risk of transmission from health care worker to patient is not uniform across the spectrum of health care fields. In the present article, the authors present an overview of the literature regarding transmission of HBV from the health care worker to the patient, and the current recommendations that vary from province to province within Canada. The establishment of national guidelines to standardize monitoring of HBV infection among health care workers would improve health care work-place safety and patient care.

Bhat, Mamatha; Ghali, Peter; Deschenes, Marc; Wong, Philip

2012-01-01

320

The Need for More Research on Language Barriers in Health Care: A Proposed Research Agenda  

PubMed Central

Many U.S. residents who speak little English may face language barriers when seeking health care. This article describes what is currently known about language barriers in health care and outlines a research agenda based on mismatches between the current state of knowledge of language barriers and what health care stakeholders need to know. Three broad areas needing more research are discussed: the ways in which language barriers affect health and health care, the efficacy of linguistic access service interventions, and the costs of language barriers and efforts to overcome them. In each of these areas, we outline specific research questions and recommendations.

Jacobs, Elizabeth; Chen, Alice HM; Karliner, Leah S; Agger-Gupta, Niels; Mutha, Sunita

2006-01-01

321

Essential health care: a framework for its definition and implementation in health districts.  

PubMed

This paper presents a framework for the definition and implementation of essential health care. It is based upon current experiences in developing countries. Its aim is to facilitate the description, in operational terms, of a range of activities for clearly defined targets--individuals, families and communities. It seeks to bring to the attention of responsible citizens and professionals the major areas which they should address in the search for "Health for All by the year 2000". It is hoped that this will facilitate integration of health care into socio-economic development activities; and promote a partnership between people and governments in community health development. PMID:6495368

Monekosso, G L

1984-10-01

322

Mechanisms for communicating within primary health care teams  

PubMed Central

ABSTRACT OBJECTIVE To explore the types of communication used within primary health care teams (PHCTs), with a particular focus on the mechanisms teams use to promote optimal clinical and administrative information sharing. DESIGN A descriptive qualitative study. SETTING Primary health care teams in Ontario between August 2004 and October 2005. PARTICIPANTS Purposive sampling was used to recruit 121 members from 16 PHCTs reflecting a range of health care professionals, including family physicians, nurse practitioners, nurses, pharmacists, dietitians, social workers, office managers, health promoters, and receptionists. METHODS Individual in-depth interviews were conducted. An iterative analysis process was used to examine the verbatim transcripts created from the interviews. Techniques of immersion and crystallization were used in the analysis. MAIN FINDINGS Analysis of the data revealed that communication occurs through formal and informal means. Formal communication included regular team meetings with agendas and meeting minutes, memorandums, computer-assisted communication, and communication logs. Informal communication methods were open and opportunistic, reflecting the traditional hallway consultation. For patient care issues, face-to-face communication was preferred. Team member attributes facilitating communication included approachability, availability, and proximity. Finally, funding issues could be an impediment to optimal communication. CONCLUSION Primary health care is experiencing demands for enhanced and efficient communication that optimizes team functioning and patient care. This study describes formal and informal mechanisms of communication currently used by PHCTs. Attributes that facilitate team communication, such as approachability, availability, and proximity of team members, were highlighted. New funding arrangements might alleviate concerns about remuneration for attendance at meetings.

Brown, Judith Belle; Lewis, Laura; Ellis, Kathy; Stewart, Moira; Freeman, Thomas R.; Kasperski, M. Janet

2009-01-01

323

The impact of ethnicity on attitudes toward health care reform in New Mexico  

Microsoft Academic Search

Latinos tend to have significantly lower levels of access to general and top quality medical care than do non-Latino whites, and although disparities in access to health care have diminished for all other minority groups over time, they have widened for Latinos. Given these trends, current attempts to provide universal health care at both the national and state levels across

Gabriel R. Sanchez; Amy Sue Goodin; Amelia A. Rouse; Richard Santos

2010-01-01

324

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

PubMed

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

Ono, N

1998-01-01

325

Community health workers and primary health care in Honduras.  

PubMed

Community participation and utilization of community health workers (CHWs) are essential components of the primary health care model. The success of CHWs is dependent on their training and subsequent community support. Community-prepared nurses are ideal CHW educators. A training program for CHWs was implemented in Honduras emphasizing the principles of adult learning and problem-based learning. Following a 4-month program of training a primary health care clinic was opened and managed by CHWs for a population over 10,000. Approximately 80% of local health problems were managed by the CHWs proving that well-trained CHWs can have a significant impact on the delivery of health care. PMID:8240881

Quillian, J P

1993-01-01

326

Primary care in Cuba: A public health approach  

Microsoft Academic Search

Cuba's primary health care model is presented. Unlike ambulatory care services, which are but one component of primary care, Cuba's model is a comprehensive public health approach that meets the World Health Organization's definition of primary care. The history of the development of Cuba's model is presented, including an update on the innovative neighborhood\\/home clinics. Achievements in health outcomes as

Karen A. Swanson; Janice M. Swanson; Ayesha E. Gill; Chris Walter

1995-01-01

327

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

ERIC Educational Resources Information Center

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

Naughton, June C., Ed.; And Others

328

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

PubMed Central

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

Beacham, Barbara L.; Deatrick, Janet A.

2013-01-01

329

Health Care Delivery in Athletics.  

ERIC Educational Resources Information Center

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

Clarke, Kenneth S.

1982-01-01

330

Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities  

ERIC Educational Resources Information Center

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

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

2007-01-01

331

Use of Electronic Health Records in Residential Care Communities  

MedlinePLUS

... 2013 Use of Electronic Health Records in Residential Care Communities On This Page Key findings Most residential ... National Survey of Residential Care Facilities Most residential care communities did not use electronic health records in ...

332

Giving Teens a Voice in Health Care Decisions  

MedlinePLUS

Giving Teens a Voice in Health Care Decisions KidsHealth > Parents > Doctors & Hospitals > Caring for a Seriously or Chronically Ill ... role in managing their own care. Why Include Teens? Time flies. Before you know it, your 13- ...

333

Defining care products to finance health care in the Netherlands.  

PubMed

A case-mix project started in the Netherlands with the primary goal to define a complete set of health care products for hospitals. The definition of the product structure was completed 4 years later. The results are currently being used for billing purposes. This paper focuses on the methodology and techniques that were developed and applied in order to define the casemix product structure. The central research question was how to develop a manageable product structure, i.e., a limited set of hospital products, with acceptable cost homogeneity. For this purpose, a data warehouse with approximately 1.5 million patient records from 27 hospitals was build up over a period of 3 years. The data associated with each patient consist of a large number of a priori independent parameters describing the resource utilization in different stages of the treatment process, e.g., activities in the operating theatre, the lab and the radiology department. Because of the complexity of the database, it was necessary to apply advanced data analysis techniques. The full analyses process that starts from the database and ends up with a product definition consists of four basic analyses steps. Each of these steps has revealed interesting insights. This paper describes each step in some detail and presents the major results of each step. The result consists of 687 product groups for 24 medical specialties used for billing purposes. PMID:21350859

Westerdijk, Machiel; Zuurbier, Joost; Ludwig, Martijn; Prins, Sarah

2012-04-01

334

Demand-Driven Care and Hospital Choice. Dutch Health Policy Toward Demand-Driven Care: Results from a Survey into Hospital Choice  

Microsoft Academic Search

In the Netherlands, current policy opinion emphasizes demand-driven health care. Central to this model is the view, advocated\\u000a by some Dutch health policy makers, that patients should be encouraged to be aware of and make use of health quality and health\\u000a outcomes information in making personal health care provider choices. The success of the new health care system in the

Christiaan J. Lako; Pauline Rosenau

2009-01-01

335

States With More Health Care Spending Have Better-Quality Health Care: Lessons About Medicare  

Microsoft Academic Search

Based on broad measures of health system quality and performance, states with more total health spending per capita have better-quality care. This fact contrasts with a previous finding that states with higher Medicare spending per enrollee have poorer- quality care. However, quality results from the total funds available and not from Medicare or any single payer. Moreover, Medicare payments are

Richard A. Cooper

2009-01-01

336

Improving motivation among health care workers in private health care organizations : A perspective of nursing personnel  

Microsoft Academic Search

Purpose – The study aims to explore the experiences of nursing personnel in private health care organizations in Lithuania, in terms of their work motivation and satisfaction, promotion and quitting the job, interpersonal interaction at work and to identify areas for sustainable improvement to the health care services they provide. Design\\/methodology\\/approach – The research problem includes the following questions. What

Zydziunaite Vilma; Katiliute Egle

2007-01-01

337

Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans  

ERIC Educational Resources Information Center

Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…

Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.

2008-01-01

338

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

ERIC Educational Resources Information Center

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

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

2001-01-01

339

Information Technology in the Health Care Industry: A Primer  

Microsoft Academic Search

The paper discusses current and future applications of information technology within the health care industry. It presents some broad strategies for approaching information technology investments and various tools available. It also discusses how information technology can support the medical providers' competitive strategy.

Peter B. Southard; Soongoo Hong; Keng Siau

2000-01-01

340

Sixth Conference on the Industrial Organization of Health Care.  

National Technical Information Service (NTIS)

The grant was to support the Sixth Conference on the Industrial Organization of Health Care. The purpose of the conference was to allow the presentation of leading researchers in this field and the dissemination of information of current research. More th...

C. A. Ma

2004-01-01

341

A Survey of Autism Knowledge in a Health Care Setting  

ERIC Educational Resources Information Center

The current study extends research by Stone [Cross-disciplinary perspectives on autism? "Journal of Pediatric Psychology, 12", (1988) 615; A comparison of teacher and parent views of autism. "Journal of Autism and Development Disorders, 18", (1988) 403] exploring the knowledge and beliefs about autism across multiple health care professions. One…

Heidgerken, Amanda, D.; Geffken, Gary; Modi, Avani; Frakey, Laura

2005-01-01

342

Cultural competence in health care: an emerging theory.  

PubMed

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

Soulé, Isabelle

2014-01-01

343

From needs to health care needs.  

PubMed

One generally considered plausible way to allocate resources in health care is according to people's needs. In this paper I focus on a somewhat overlooked issue, that is the conceptual structure of health care needs. It is argued that what conceptual understanding of needs one has is decisive in the assessment of what qualifies as a health care need and what does not. The aim for this paper is a clarification of the concept of health care need with a starting point in the general philosophical discussion about needs. I outline three approaches to the concept of need and argue that they all share the same conceptual underpinnings. The concept of need is then analyzed in terms of a subject x needing some object y in order to achieve some goal z. I then discuss the relevant features of the object y and the goal z which make a given need qualify as a health care need and not just a need for anything. PMID:23344674

Gustavsson, Erik

2014-03-01

344

Just health care (I): Is beneficence enough?  

PubMed

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

Fleck, L M

1989-06-01

345

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

ERIC Educational Resources Information Center

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

Institute of Medicine (NAS), Washington, DC.

346

Increasing psychology's role in health research and health care.  

PubMed

The reductionistic, exclusionary, and dualistic tenets of the biomedical model have profoundly affected U.S. health care and health research as well as psychology practice, psychological science, and graduate education in psychology. Although the biomedical model was a success story in many ways, by the end of the 20th century its limitations had become increasingly apparent. These limitations included the biomedical model's failure to adequately address the changing nature of disease facing the U.S. health care system, escalating health care costs, the role of behavior in health and illness, and patients' mental health concerns. Medicine's recent paradigm shift from the biomedical to the biopsychosocial model is occurring in U.S. health care, professional medical education, and health research, with significant implications for psychology. This paradigm shift provides psychology with both opportunities and challenges. Psychology must proactively and deliberately embrace the biopsychosocial model if it is to take full advantage of the opportunities this paradigm shift presents. The American Psychological Association can play an important leadership role in this effort. PMID:23895594

Johnson, Suzanne Bennett

2013-01-01

347

Health Literacy Implications for Health Care Reform: Workshop Summary.  

National Technical Information Service (NTIS)

Prior to the workshop, panelists were provided with a commissioned paper prepared by the Center for Health Care Strategies, reviewing the provisions of the ACA as they relate to health literacy.1 To set the stage for the panel discussions the authors of t...

2011-01-01

348

Health care reform 2009-2010: a neurosurgeon's perspective.  

PubMed

Organized neurosurgery through its Washington Committee developed a number of principles against which all health care reform legislation was measured, and none of the bills were acceptable. The American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) worked through multiple venues to modify or reject the legislation. In the author's view, the American Medical Association (AMA) supported the bills because its board of trustees was too focused on eliminating the sustainable growth rate, or SGR. Physicians failed to shape the health care debate. The leadership of many medical organizations was not prepared for the debate. Many had no experience in this arena and thus were too willing to let lobbyists dictate their position. In the future there are 3 things organized neurosurgery must do: be prepared, never give in, and stick with their principles. Organized neurosurgery must be prepared by developing leaders that have experience in the full spectrum of organized medicine. Neurosurgeons must not count on others, and because the specialty is small all must be involved. Neurosurgeons must never give in. Organized neurosurgery started 2009 with little support for its positions but by the end of the debate had convinced many other organizations, representing almost 500,000 physicians, to take their position. From an organizational point of view, neurosurgeons should now do 3 things: 1) reform or reject the AMA; 2) develop a real surgical coalition; and 3) change the current political environment. Neurosurgeons must also follow their principles. In the author's opinion the most important principles are: health care as a responsibility, medical liability reform, and the right to privately contract. In the United Kingdom and Germany, where health care is considered a right rather than a responsibility, bureaucratic entities determine whether you have the right to health care just as the Independent Payment Advisory Board, established under the new health care reform law in the US, will soon limit by rationing of health care under the guise of cutting costs. If, however, health care is a responsibility not a right, the obligation is shifted from society to the individual. It puts the patient and the doctor in charge. It is a far better mechanism to control costs and preserve quality without rationing. It becomes our obligation to have health care, and it puts us in charge of our destiny. Proven liability reform was not included in the health care legislation despite the fact that up to $200 billion per year is spent on defensive medicine. Another and possibly the most important principle ignored in the legislation is the right for a patient and his/her physician to privately contract under Medicare without penalty. PMID:21121764

Tippett, Troy M

2010-12-01

349

Economic Effects of Health Care Reform on Virginia  

Microsoft Academic Search

This study estimates the impact of the 2010 health care reform law (the Patient Protection and Affordable Care Act\\/Health Care and Education Reconciliation Act) on Virginia’s economy. Health care reform is a complex and multifaceted law that was enacted with the joint goals of improving health insurance coverage for U.S. residents, decreasing the costs of health care, and improving overall

Terance J. Rephann

2011-01-01

350

U.S. Health Care Policy and the Rising Uninsured  

Microsoft Academic Search

The lack of adequate health insurance affects one's ability to access care, which directly affects one's health. In the 21st century, there are 44 million people in the United States without health care insurance. The majority of people without health care insurance are working people under age 65, because most people over age 65 are retired and have health insurance

Thomas Falen

2005-01-01

351

Value-Driven Health Care: The purchaser perspective  

PubMed Central

Summary The four cornerstones of value-driven health care are health information technology standards, quality standards, price standards and incentives. Value-driven health care seeks to directly link quality health care to reimbursement. The four cornerstones of this movement are health information technology standards, quality standards, price standards and incentives. These standards and the how purchasers plan to implement them are summarized.

Carlos, Ruth C.

2008-01-01

352

Restructuring military health care: the winds of change blow stronger.  

PubMed

The Military Health Services System is an enormously complex enterprise, consisting of more than 400,000 personnel in the active, reserve, and civilian workforce, operating 148 hospitals and over 800 medical and dental clinics worldwide, and serving nearly 9 million beneficiaries. Expenditures on military health care activities will exceed $15 billion in 1993. Yet many people in leadership positions in government--both inside and outside the Department of Defense--question whether the current organization of the Military Health Services System is appropriate to accomplish the Department's medical missions. Some insiders have observed that having three military medical services is having two too many--that a single "purple" medical service, or at least a single management structure such as a Defense Health Agency, would better meet military mission requirements as the Defense Department undergoes post-Cold War downsizing. One of the most pressing challenges facing military health care managers is how to best organize resources to provide timely access to quality care and achieve economies at a time when civilian health care is itself in turmoil. This article provides a long-awaited update on the spirited debate over the need to reorganize the Military Health Services System--and the prescriptions ordered so far to cure the system's perceived organizational ills. PMID:10127290

Lanier, J O; Boone, C

1993-01-01

353

Addressing Racial and Ethnic Disparities in Health Care  

MedlinePLUS

... Health Systems Hospital Resources Long-Term Care Resources Primary Care Resources System Design Resources Prevention & Chronic Care Announcements Evidence-Based Decisionmaking Improving Primary Care Practice Resources Quality & Patient Safety Comprehensive Unit-based ...

354

Study Finds Personal Health Records Do Not Impact Hypertension Care  

MedlinePLUS

... Health Systems Hospital Resources Long-Term Care Resources Primary Care Resources System Design Resources Prevention & Chronic Care Announcements Evidence-Based Decisionmaking Improving Primary Care Practice Resources Quality & Patient Safety Comprehensive Unit-based ...

355

Project on Matching Census 1986 Database and Manitoba Health Care Files: Private Households Component  

Microsoft Academic Search

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

Christian Houle; Jean-Marie Berthelot; Pierre David; Cam Mustard; D. Sc; Roos L; M. C. Wolfson

1996-01-01

356

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

ERIC Educational Resources Information Center

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

Kaplan, Mitchell A.; Inguanzo, Marian M.

2011-01-01

357

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

ERIC Educational Resources Information Center

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

Pires, Sheila A.; Stroul, Beth A.

358

Health care reform and global budgeting.  

PubMed

Americans seem to have reached a consensus about the urgent need to devise a cost containment strategy that leaves intact a pluralistic health care system. One option is global budgeting--the imposition of a national health care budget with all-payer price controls. This article reviews the factual and legal bases for global budgeting and examines proposed mechanisms to cap expenditures or fix prices for all medical goods and services. Also discussed are the implications of financial restraints on a free market economy, the experiences of other countries attempting to control health care costs while providing universal coverage, the complications of global budgeting, and ways to safeguard medical excellence and innovation if global budgeting is adopted. PMID:10126799

Domolky, S

1993-01-01

359

ERP implementation in rural health care.  

PubMed

Enterprise resource planning (ERP) systems provide organizations with the opportunity to integrate individual, functionally-oriented information systems. Although much of the focus in the popular press has been placed on ERP systems in large for-profit organizations, small hospitals and clinics are candidates for ERP systems. Focusing information systems on critical success factors (CSFs) allows the organization to address a limited number of areas associated with performance. This limited number of factors can provide management with an insight into dimensions of information that must be addressed by a system. Focuses on CSFs for small health-care organizations. In addition, also considers factors critical to the implementation of health-care information systems. Presents two cases. The results indicate support for the continuing use of CSFs to help focus on the benefits of ERPs. Focusing on groups of tangible and intangible benefits can also assist the rural health-care organization in the use of ERPs. PMID:12211339

Trimmer, Kenneth J; Pumphrey, Lela D; Wiggins, Carla

2002-01-01

360

Power Rx for the health care industry  

SciTech Connect

While electricity has had a huge impact on the health care community through the development of highly sophisticated diagnostic tools and procedures, more mundane electro-technologies offer substantial opportunities as well. From innovative lighting techniques to energy management systems to new technologies for medical waste disposal, advanced electricity-based technologies can enhance health care services and help cut costs when facilities know where and how to apply them. Recognizing that few hospitals and clinics have the in-house expertise to fully exploit such opportunities, EPRI has launched an initiative to help utilities deliver the Institute's research results to this crucial customer segment. The resulting partnerships promise to be of mutual benefit to the utility and health care industries as they both move through a period of substantial change. 6 figs.

Lamarre, L.

1994-06-01

361

Health Care Costs Workshop Agenda  

Cancer.gov

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

362

Definition of Roles and Responsibilities of Health Care Team Members in a Population-Based Model of Primary Health Care Delivery.  

National Technical Information Service (NTIS)

Group Health Cooperative of Puget Sound is currently designed to provide episodic care to patients in the primary care setting. In order to meet the preventive, self-limiting, episodic, and chronic care of its enrollees, the Cooperative has decided to tak...

C. L. Thieschafer

1997-01-01

363

Embracing the notion that context is crucial in prison mental health care  

Microsoft Academic Search

This paper focuses on the mental health of adult male prisoners and the mental health care provided within Her Majesty's Prison Service (HMPS), United Kingdom (UK). Currently, the level of mental health need within this population is high, and prison mental health services require additional positive developments. The prison milieu is not always conducive to good mental health, and is

Melanie Jordan

2010-01-01

364

Mapping the literature of health care chaplaincy  

PubMed Central

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

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

2013-01-01

365

Physicians' Plan for a healthy Minnesota. The MMA proposal for health care reform. The report of the Minnesota Medical Association Health Care Reform Task Force.  

PubMed

The health care system in the United States, according to some, is on the verge of imploding. The rapidly rising cost of services is causing more and more Minnesotans to forego needed care. At the same time, the increasing costs are placing additional pressure on families, businesses, and state and local government budgets. The Minnesota Medical Association's (MMA) Health Care Reform Task Force has proposed a bold new approach that seeks to ensure affordable health care for all Minnesotans. The proposal is a roadmap to provide all Minnesotans with affordable insurance for essential health care services. In creating this plan, the task force strove to achieve three common reform goals: expand access to care, improve quality, and control costs. To achieve those ends, it has proposed a model built on four key features: (1) A strong public health system, (2) A reformed insurance market that delivers universal coverage, (3) A reformed health care delivery market that creates incentives for increasing value, (4) Systems that fully support the delivery of high-quality care. The task force believes that these elements will provide the foundation for a system that serves everyone and allows Minnesotans to purchase better health care at a relatively lower price. Why health care reform again? The average annual cost of health care for an average Minnesota household is about 11,000 dollars--an amount that's projected to double by 2010, if current trends continue. Real wages are not growing fast enough to absorb such cost increases. If unabated, these trends portend a reduction in access to and quality of care, and a heavier economic burden on individuals, employers, and the government. Furthermore, Minnesota and the United States are not getting the best value for their health care dollars. The United States spends 50 percent more per capita than any other country on health care but lags far behind other countries in the health measures of its population. PMID:15853031

2005-03-01

366

45 CFR 162.404 - Compliance dates of the implementation of the standard unique health identifier for health care...  

Code of Federal Regulations, 2010 CFR

...standard unique health identifier for health care providers. 162.404 Section...Standard Unique Health Identifier for Health Care Providers § 162.404 Compliance...standard unique health identifier for health care providers. (a) Health...

2009-10-01

367

45 CFR 162.404 - Compliance dates of the implementation of the standard unique health identifier for health care...  

Code of Federal Regulations, 2010 CFR

...standard unique health identifier for health care providers. 162.404 Section...Standard Unique Health Identifier for Health Care Providers § 162.404 Compliance...standard unique health identifier for health care providers. (a) Health...

2010-10-01

368

Software quality assessment for health care systems.  

PubMed

The problem of defining a quality model to be used in the evaluation of the software components of a Health Care System (HCS) is addressed. The model, based on the ISO/IEC 9126 standard, has been interpreted to fit the requirements of some classes of applications representative of Health Care Systems, on the basis of the experience gained both in the field of medical Informatics and assessment of software products. The values resulting from weighing the quality characteristics according to their criticality outline a set of quality profiles that can be used both for evaluation and certification. PMID:10179767

Braccini, G; Fabbrini, F; Fusani, M

1997-01-01

369

Megamarketing strategies for health care services.  

PubMed

Megamarketing, as coined by Kotler (1968), is a strategic way of thinking which takes an enlarged view of the skills and resources needed to enter and operate in obstructed or protected markets. The concept of megamarketing emphasizes the mastering and coordination of economic, psychological, political, and public relation skills and suggest that organizations can take a proactive stance in shaping macroenvironmental conditions. As health care delivery is characterized by a highly regulated environment, this marketing approach has definite applications for the health care marketer. PMID:10106844

Mobley, M F; Elkins, R L

1990-01-01

370

[The future of public health care hospitals].  

PubMed

The subvention from the government for public health care system hospitals will decrease in Finland 1993. This causes that in future hospitals will work more like private enterprises. Expenses have to be covered by incomes from sales of health care services. Hospitals have to be able to estimate the demand of their services and the situation caused by the competition. They have to be able to create new profile and also be able to market their services. The presupposition for all things mentioned above is the creativity of people working in different wards. Creativity helps to obtain the same or even better quality of services with smaller resources. PMID:8427951

Miettinen, M; Miettinen, S

1993-01-01

371

Health and Mobility: Current Status and Future Paradigms  

Microsoft Academic Search

The movement of telemedicine to the wireless and mobile Internetable applications is imminent in the next few years. This migration from the desktop platforms to the wireless and mobile configurations will have significant impact on the future health care delivery system and their globalisation. The recent telecommunications and biomedical computing advances will significantly enhance the current methodologies of telemedicine and

Robert S. H. Istepanian; Sapal Tachakra; Konstantinos A. Banitsas

372

Across the health-social care divide: elderly people as active users of health care and social care.  

PubMed

Several ways in which elderly people may assume an active role when using welfare services are discussed here. Selected findings are presented from a study that explored the experience and behaviour of elderly people on discharge from inpatient care with regard to criteria indicating user influence or control (namely participation, representation, access, choice, information and redress). Data were collected via semistructured interviews with service users (n = 30) soon after their return home from hospital. A number of differences were revealed between health care and social care in relation to users being provided with opportunities to assume an active role and in being willing and able to assume an active role. These differences were manifest in elderly service users accessing services, seeking information, exercising choice and acting independently of service providers. It appeared paradoxical that contact points were more easily defined with regard to health care yet users were more likely to exercise choice and act independently in securing social care. It is suggested that social care needs and appropriate service delivery are more easily recognised than making the link between perceived health care needs and appropriate services. In addition, it appeared that informal and private providers are more widely available and accessible for social care. If comprehensive continuing care is to be provided, incorporating both health and social care elements, greater uniformity appears to be required across the welfare sector. Lessons for social care provision from the delivery of health care suggest the clear definition of contact points to facilitate service use. Making health care more accessible, however, does not appear to be easily attainable due to the monopoly provision of health care and the lack of direct purchasing power by potential users. PMID:11560726

Roberts, K

2001-03-01

373

Health care reform and equity: promise, pitfalls, and prescriptions.  

PubMed

The United States has made little progress during the past decade in addressing health care disparities. Recent health care reforms offer an historic opportunity to create a more equitable health care system. Key elements of health care reform relevant to promoting equity include access, support for primary care, enhanced health information technology, new payment models, a national quality strategy informed by research, and federal requirements for health care disparity monitoring. With effective implementation, improved alignment of resources with patient needs, and most importantly, revitalization of primary care, these reforms could measurably improve equity. PMID:21242565

Fiscella, Kevin

2011-01-01

374

[Evolution of primary health care in Spain].  

PubMed

Coinciding with the celebration of the 35th anniversary of the journal of nursing, invented in 1977, conducted a systematic review of all issues published (371) to identify items (222) and news (94) related to primary care health. Events are arranged temporarily and refer to accompanying the evolution of primary care model. The Analysis Shows the evolution of primary care, since its inception in 1978, has been reflected in the type of articles and the content of news published, be an excellent indicator of its development and contribution for the nurses. PMID:23390875

Martínez Riera, José Ramón

2012-12-01

375

Health care of homeless veterans  

Microsoft Academic Search

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

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

2003-01-01

376

Medicaid managed care and public health data.  

PubMed Central

In summary, there are a number of ways in which state public health data can be of value in the design of Medicaid managed care plans. At the level of the purchaser, such as a state Medicaid agency, public health data can assist in decision-making around pricing policy and can be useful in prioritizing interventions for those conditions that most severely affect the covered population. Quality assurance standards such as the HEDIS clinical performance measures can be used to define a baseline of prevention-oriented services or, by adding additional customized data points, to emphasize a particular service. From the standpoint of the managed care plan, public health data can be useful in understanding the needs of a community it serves or would like to serve and in estimating the prevalence of various conditions in that community that will influence the premium it will charge. Thus, there are multiple routes through which public health goals and priorities can be incorporated into managed care and can leverage the power of managed care to improve the public's health. Images p228-a

Rutherford, G W; Backer, H D

1999-01-01

377

The Contribution of Health Services Research to Improved Dermatologic Care  

PubMed Central

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

Chren, Mary-Margaret

2011-01-01

378

Sharing the Caring: Rethinking Current Policies.  

ERIC Educational Resources Information Center

This article presents an argument for reforming Australian public policy in favor of social care, rather than family, residential, or community care, for the elderly, sick, and disabled. After noting policy assumptions that families are the focus of caring and women are the natural caregivers, the paper describes changes in Australian family…

Edgar, Don

1992-01-01

379

Social Learning Theory and Behavioral Health Care  

Microsoft Academic Search

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

Kenton L. Burns

1979-01-01

380

[Health care structure legislation--reform of health insurance].  

PubMed

On January 1st, 1993, the German Health Care Structure Reform Act has come into effect. It will fundamentally change the system of health insurance as well as the health care system. By the reform act, new structural and controlling elements have been installed in all central branches of health care, and, at the same time, a new order for the competition between the sickness funds has been established. Far-reaching structural alterations affect the hospital sector, the drug market and the system of ambulatory care. In the hospital sector, there will be a change-over to a price system consisting of special payments, payment according to diagnostic-related groups, and differentiated per-diem rates. On the drug market there will be introduced, besides a drug budget for doctors, a positive list for pharmaceuticals which will be worked out jointly by representatives of the medical profession and the sickness funds. In the ambulatory sector, licensing restrictions for doctors intending to set up practice will be introduced and the importance of the general practitioner or family doctor will be enhanced. The Health Care Structure Reform Act provides for self-government of the sickness funds and the medical profession with a wide range of controlling and shaping instruments. It also places the Ministry of Health in a better position to take influence. After the expire of the budgeting phase, competitive elements resp. extended controlling measures in the contracts sector will become more and more important features of the health care system. It remains to be seen whether the new controlling instruments will suffice to cause the intended limitation of expenditure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8471809

Pick, P

1993-03-01

381

State health care reform: An analysis of strategies  

Microsoft Academic Search

The United States health care system faces significant challenges, particularly with problems of the uninsured and with the rising costs of care. These problems lead many to study and discuss strategies for reforming the health care system. Four different plans for ideal health care reform, set forth by notable scholars or organizations, are explained herein. Then, states within the United

Jennifer M Wrathall

2007-01-01

382

Health Care Reform: How Will It Impact You?  

ERIC Educational Resources Information Center

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

Lukaszewski, Thomas

1993-01-01

383

Intelligent Patient and Nurse Scheduling in Ambulatory Health Care Centers  

Microsoft Academic Search

Ambulatory health care centers are the major arena for delivery of primary health care to patients. In contrast to hospital or urgent care scheduling systems, ambulatory health care centers offer different challenge for scheduling optimization. The aim is similar, i.e. to reduce the average waiting time and maintain high resource utilization, but the concept is different. In this paper we

G. Stiglic; P. Kokol

2005-01-01

384

Cancer care--A stress for health professionals  

Microsoft Academic Search

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

Nicole Delvaux; Darius Razavi; Christine Farvacques

1988-01-01

385

Developing targets for public health initiatives to improve palliative care  

PubMed Central

Background Palliative Care is an approach that improves quality of life for patients and their families facing the problems associated with incurable life-threatening illness. In many countries, due to the rapidly ageing population, increasingly more people are suffering from serious chronic disease towards the end of life, making further development in palliative care a major public health challenge. The aim of this study was to develop the first targets for public health initiatives to improve palliative care in Germany. Methods Based on the findings from pilot studies (qualitative interviews and surveys with different stakeholders in the health care system), we conducted a modified Delphi study with two rounds of questionnaires with experts in public health and palliative care. In the first round, the experts commented on the findings from the pilot studies. The answers were evaluated descriptively and with qualitative content analysis, resulting in the formulation of 25 targets. These were presented to the experts in the second Delphi round to assess each of them separately with regard to its importance and current implementation (7-point answer scales) and in relation to the other targets (defining the five most important of the 25 targets). Results Six most relevant targets for public health initiatives to improve palliative care in Germany were worked out: Supporting palliative care as a basic attitude for the care of people in the last phase of life; coordinating healthcare for people in the last phase of life; establishing cooperation among health professions and disciplines; establishing education in palliative care for all professional groups with contact to people in the last phase of life; reviewing the evidence of palliative care measures; offering support to family members who are caring for someone in the last phase of life. Conclusions To systematically develop palliative care, it makes sense to define fields of action with individual targets. For Germany, it can be recommended to give priority to the targets that were highlighted as the most relevant in this study. The next step will be to develop, implement and evaluate tangible measures to achieve these targets.

2010-01-01

386

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

PubMed

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

George, Victoria M; Shocksnider, Julie

2014-01-01

387

Orphan care in Malawi: current practices.  

PubMed

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

Beard, Betty J

2005-01-01

388

Where does the US experience of managed care currently stand?  

PubMed

After an historical review of the advent of managed care in the USA, this article presents cost-control mechanisms, changes in the medical practice and consequences on patient health. The article also explains the development of the HMO using the transaction costs theory and the subsequent orientations of the US health care system. PMID:15991459

Simonet, D

2005-01-01

389

Health insurance in India: need for managed care expertise.  

PubMed

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

Thomas, Thomas K

2011-02-01

390

A telemedicine health care delivery system  

NASA Technical Reports Server (NTRS)

The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.

Sanders, Jay H.

1991-01-01

391

Serious Technology Assessment for Health Care Information Technology  

PubMed Central

Abstract United States health care is engaged in an ambitious project to make its clinical and administrative records “100% electronic.” Substantial benefits are expected in both clinical care delivery and medical research (especially for public health surveillance and outcomes/effectiveness studies). Substantial costs also potentially accrue, beyond the large outlays for an expanded computer and telecommunications infrastructure. Privacy and confidentiality are obviously at risk if such systems cannot be made secure. Limited empirical evidence currently available suggests health information systems security may not be very good, at least in the “average” institutional setting. Privacy-focused critics of electronic record-keeping are sometimes accused of taking Luddite stands, insufficiently attentive to IT's benefits. It may also be fair to worry about a certain Panglossian tendency in “industry” commentary, insufficiently attentive to potential problems. Better federal and state laws structuring health data use will help; the industry must also attend more candidly to the technical uncertainties.

Cushman, Reid

1997-01-01

392

The VA Maryland Health Care System's telemental health program.  

PubMed

The VA Maryland Health Care System introduced videoconferencing technology to provide psychiatry, evidenced-based psychotherapy, case management, and patient education at rural clinics where it was difficult to recruit providers. Telemental health services enable rural clinics to offer additional services, such as case management and patient education. Services have been expanded to urban outpatient clinics where a limited number of mental health clinic hours are available. This technology expands the availability of mental health providers and services, allowing patients to receive services from providers located at distant medical centers. PMID:22662735

Koch, Edward F

2012-05-01

393

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

PubMed

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

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

2012-01-01

394

How Stigma Interferes with Mental Health Care  

ERIC Educational Resources Information Center

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

Corrigan, Patrick

2004-01-01

395

Health Care Assistant. Instructor [Guide.] Revised.  

ERIC Educational Resources Information Center

This instructor's guide contains 65 lessons designed to aid teachers in presenting a course in basic nursing procedures for students studying for careers as health care assistants. Lesson plans consist of a scope, objectives, suggested supplementary teaching and learning items; references, an introduction, a lesson outline, handouts, evaluation…

Missouri Univ., Columbia. Instructional Materials Lab.

396

Public trust in Dutch health care  

Microsoft Academic Search

This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used in a research project to monitor trust and to predict behaviour of people such

G. F. M. Straten; R. D. Friele; P. P. Groenewegen

2002-01-01

397

General practitioners' perceptions of effective health care  

Microsoft Academic Search

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

Zelda Tomlin; Charlotte Humphrey; Stephen Rogers

1999-01-01

398

Solar Energy for Health Care Institutions.  

National Technical Information Service (NTIS)

Solar energy is discussed in a booklet designed to help health care administrators prepare to use solar energy to achieve savings and stabilize rising energy costs. Solar energy is suggested because the sun is the most abundant and inexhaustible source of...

R. D. Cummings

1976-01-01

399

Health Care Struggle between Young and Old.  

ERIC Educational Resources Information Center

Discusses establishing relative priorities between health care needs of the young and the old. Argues that it is fair to limit assistance to those already old when there are genuine social needs for children. The elderly should lead the way in recognizing the importance of the needs of children. (SLD)

Callahan, Daniel

1991-01-01

400

Health care's most wired. A wired exchange.  

PubMed

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

Solovy, Alden

2004-08-01

401

HEALTH CARE RESOURCE USE AND STROKE OUTCOME  

Microsoft Academic Search

Abstract Background and Purpose: Outcome in patients hospitalized for acute stroke varies considerably be- tween populations. Within the framework of the GAIN International trial, a large multicenter trial of a neuroprotective agent (gavestinel, glycine antagonist), stroke outcome in relation to health care resource use has been compared in a large number of countries, allowing for differences in case mix. Methods:

Kjell Asplund; Sharron Ashburner; Kathy Cargill; Margaret Hux; Ken Lees

402

Health Care Communication with Low Literate Patients.  

ERIC Educational Resources Information Center

Low literate patients face difficulties when they read health care information. The complex process of reading can be summarized in five steps: input, decoding, encoding, output, and feedback. Each occurs automatically for the fluent reader; the low literate reader might encounter stumbling blocks in one or more of the steps. Once the patient has…

McKeon, Christine A.

403

Health Care Assistant Core. Instructor Manual.  

ERIC Educational Resources Information Center

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

Feilner, Veronica; Robling, Jeannine

404

Life Contentment and Mental Health Care Satisfaction  

ERIC Educational Resources Information Center

Objective: It is now well documented that satisfaction with mental health services is influenced by a variety of other factors (e.g., race, diagnosis, functioning level). Because of a generally brighter outlook, this study examined whether care satisfaction is also influenced by contentment in housing, social relations, or existence in general.…

Prince, Jonathan D.

2005-01-01

405

Ownership Status and Home Health Care Performance  

PubMed Central

Few studies have analyzed for-profit and nonprofit differences in the home health care sector. Using data from the National Home and Hospice Care Survey, we found that patients in nonprofit agencies were more likely to be discharged within 30 days under Medicare cost-based payment compared to patients in for-profit agencies. However, this difference in length of enrollment did not translate into meaningful differences in discharge outcomes between nonprofit and for-profit patients, suggesting that – under a cost-based payment system – nonprofits may behave more efficiently relative to for-profits. These results highlight the importance of organizational and payment factors in the delivery of home health care services.

Grabowski, David C.; Huskamp, Haiden A.; Stevenson, David G.; Keating, Nancy L.

2009-01-01

406

Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization  

PubMed Central

Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools – accountability measures and payment designs – to improve access to and quality of care for patients with behavioral health needs.

Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

2012-01-01

407

Primary mental health care for survivors of collective sexual violence in Rwanda.  

PubMed

This paper draws attention to the obligation and opportunity to respond to the mental health impacts of collective sexual violence (CSV) among genocide-rape survivors in post-genocide Rwanda. Qualitative data gathered from CSV survivors who were members of Rwandan women's genocide survivor associations are presented to illustrate how they strive to overcome adversity while seeking access to quality mental health care and using informal community mental health services. The results reveal that a system of high quality, holistic health and mental health care is yet needed to meet Rwandan CSV survivors' complex and serious health and mental health needs. Given that a rural health system, modelled on community-based, comprehensive HIV/AIDS care and treatment, is currently being implemented in Rwanda, we recommend enhancements to this model that would contribute to meeting the mental health care needs of CSV survivors while benefiting the health and mental health system as a whole within Rwanda. PMID:20658404

Zraly, Maggie; Rubin-Smith, Julia; Betancourt, Theresa

2011-01-01

408

Allied Health Technologies Multiskilled Patient Care Technician Curriculum.  

ERIC Educational Resources Information Center

This curriculum guide explains the national health care skills standards and lists skill standards for health care technicians, especially in Michigan. The 10 sections of the guide cover the following: (1) introduction to the national health care skills strands; (2) allied health technologies multiskilled curriculum framework and program design…

Wiersema, Mary; Stacy, Carole Ann

409

Barriers to Health Care among the Elderly in Japan  

PubMed Central

Japan is undergoing a set of health care reforms aimed at cutting rising health care costs and increasing the efficiency of health care delivery. This empirical study used a large-scale community survey on 15,302 elderly people 65 years and older (56.0% women) conducted in seven municipalities in 2006, to reveal clear-cut evidence of barriers to necessary care. The reasons for not getting health care is attributed to health care cost for the elderly with lower income, while higher income counterparts reported being busy or having a condition not serious enough to seek care.

Murata, Chiyoe; Yamada, Tetsuji; Chen, Chia-Ching; Ojima, Toshiyuki; Hirai, Hiroshi; Kondo, Katsunori

2010-01-01

410

Elderly and long-term care trends and policy in Taiwan: challenges and opportunities for health care professionals.  

PubMed

The purpose of this article is to address the trends and policy of elderly and long-term care in Taiwan. In response to the increasing demand of an aging society, healthcare professionals play crucial roles in elderly and long-term care and quality assurance of services. This article focuses on the current situation of elderly health care, demands of long-term care, long-term care policy in Taiwan, draft of the Long-term Care Services Act, and draft of the Long-term Care Insurance Act. After the 10-year long-term care project was proposed by the Taiwan government, the supply of health care services and demand for long-term care have created many challenges and opportunities for innovative health professional development. Challenges consist of low old dependency ratio caused by low birth rate, lack of elderly and long-term care related manpower, services and education reform related to long-term care for the future society, and interprofessional collaboration and team work of long-term care. Opportunities include expanding the roles and the career pathways of healthcare professionals, promoting the concepts of active aging and good quality of life, and developing industrial cooperation related to long-term care services. Under these circumstances, healthcare professonals are actively involved in practice, education and research of long-term care services that ensure elderly and disabled people can live a healthier and better life. PMID:22974664

Wang, Hsiu-Hung; Tsay, Shwn-Feng

2012-09-01

411

Women's Health and Women's Health Care: Recommendations of the 1996 AAN Expert Panel on Women's Health.  

ERIC Educational Resources Information Center

Fundamental features of excellent women's health care are as follows: awareness of women's lives and diversity, comprehensive life-span care, a range of services and providers, and accessibility. Policy recommendations include not limiting health care benefits to employment, focus on prevention and promotion, and expansion of advanced practice…

Conway-Welch, Colleen; And Others

1997-01-01

412

Health Insurance, Medical Care, and Health Outcomes: A Model of Elderly Health Dynamics  

ERIC Educational Resources Information Center

Prescription drug coverage creates a change in medical care consumption, beyond standard moral hazard, arising both from the differential cost-sharing and the relative effectiveness of different types of care. We model the dynamic supplemental health insurance decisions of Medicare beneficiaries, their medical care demand, and subsequent health

Yang, Zhou; Gilleskie, Donna B.; Norton, Edward C.

2009-01-01

413

Health Care for Micronesians and Constitutional Rights  

PubMed Central

Under the Compacts of Free Association (COFA), people from the Freely Associated States — the Republic of Palau (ROP), the Republic of the Marshall Islands (RMI), and the Federated States of Micronesia (FSM) — have been migrating to the United States in increasing numbers. In 1996, Congress passed broad welfare reform (Personal Responsibility and Work Opportunity Reconciliation Act) which limited certain federal benefits previously available to COFA migrants, including Medicaid benefits. Prior to July 2010, the State of Hawai‘i had continued to include COFA migrants under its state-funded Medicaid program. In the face of budget constraints, the State removed these people from its Medicaid rolls. A challenge on the legal basis of the denial of equal protection of the laws, ie, the Fourteenth Amendment to the US Constitution, was successful in reinstating health care to the COFA migrants in December 2010. From the health worker's perspective, regardless of various social justice arguments that may have been marshaled in favor of delivering health care to the people, it was an appeal to the judicial system that succeeded. From the attorney's perspective, the legal victories are potentially limited to the four walls of the courtroom without community involvement and related social justice movements. Together, the authors propose that in order to better address the issue of health care access for Micronesian peoples, we must work together, as health and legal advocates, to define a more robust vision of both systems that includes reconciliation and community engagement.

Shek, Dina

2011-01-01

414

Cost-effectiveness analysis in health care.  

PubMed

With the skyrocketing costs of modern health care, many health policy planners turn to cost effective analysis (CEA) or cost benefit analysis (CBA) to get quantitative answers for appropriateness of health procedures. This article analyzes how well approaches like CEA or CBA handle the hidden ethical judgements for such problems as: alternative treatments for an identical goal, the most effective utilization of funds earmarked for a particular goal, empirical support for the adoption of previously underfunded medical programs, and exposing noncostworthy care. Areas of analysis that involve human capital methodologies, whereby human value is often defined by economic worth, was shown to discriminate against low wage earners. The quandary of how to determine the value of human life and health is an essential problem but is certainly not straight forward. A particular criticism of CEA where there exist ethical shortcomings is the analysis of health care for the elderly (e.g. the elderly have a worse expenditure of dollars for lifespan extension). If CEA or CBA is applied in an appropriate manner, CEA can encompass many of our democratic society's values, and therefore philosophers, historians, and students of the humanities are encouraged to provide input in this domain of analysts and economics. PMID:2501235

Emery, D D; Schneiderman, L J

1989-01-01

415

The Patient Health Questionnaire-9 for detection of major depressive disorder in primary care: consequences of current thresholds in a crosssectional study  

PubMed Central

Background There is a need for brief instruments to ascertain the diagnosis of major depressive disorder. In this study, we present the reliability, construct validity and accuracy of the PHQ-9 and PHQ-2 to detect major depressive disorder in primary care. Methods Cross-sectional analyses within a large prospective cohort study (PREDICT-NL). Data was collected in seven large general practices in the centre of the Netherlands. 1338 subjects were recruited in the general practice waiting room, irrespective of their presenting complaint. The diagnostic accuracy (the area under the ROC curve and sensitivities and specificities for various thresholds) was calculated against a diagnosis of major depressive disorder determined with the Composite International Diagnostic Interview (CIDI). Results The PHQ-9 showed a high degree of internal consistency (ICC = 0.88) and test-retest reliability (correlation = 0.94). With respect to construct validity, it showed a clear association with functional status measurements, sick days and number of consultations. The discriminative ability was good for the PHQ-9 (area under the ROC curve = 0.87, 95% CI: 0.84-0.90) and the PHQ-2 (ROC area = 0.83, 95% CI 0.80-0.87). Sensitivities at the recommended thresholds were 0.49 for the PHQ-9 at a score of 10 and 0.28 for a categorical algorithm. Adjustment of the threshold and the algorithm improved sensitivities to 0.82 and 0.84 respectively but the specificity decreased from 0.95 to 0.82 (threshold) and from 0.98 to 0.81 (algorithm). Similar results were found for the PHQ-2: the recommended threshold of 3 had a sensitivity of 0.42 and lowering the threshold resulted in an improved sensitivity of 0.81. Conclusion The PHQ-9 and the PHQ-2 are useful instruments to detect major depressive disorder in primary care, provided a high score is followed by an additional diagnostic work-up. However, often recommended thresholds for the PHQ-9 and the PHQ-2 resulted in many undetected major depressive disorders.

2010-01-01

416

Existential caring in the family health experience: a proposed conceptualization.  

PubMed

Empirical realities and technological advances in the clinical practice context continuously call for ethical dialogue among healthcare providers. The nurse's voice of advocacy for humane caring grounded in an existential understanding of the complexities of the health experience remains a salient responsibility of moral agency. If nurses are to care for families, as society requires, then nurse caring, a phenomenon currently defined and understood primarily at the individual patient-nurse level, must be diligently and broadly explored in terms of its worth to guide nursing service with families. The purpose of this theoretical paper is to explore a conceptualization of care with families in the health experience that emanates from the philosophical tenets of existentialism and underpinnings of symbolic interactionism and is interpreted into action by the ethics of care. Current and classic literature, inclusive of philosophical and empirical works, provide the background for analysis of the following elements: existential caring orientation, family perspective, family-nurse interaction, construction of meaning, family meaning construction, nurse meaning construction, family-nurse co-construction of meaning and existential advocacy. Existential philosophy is understood as the basic underlying lens guiding the nurse in taking an existential caring orientation as depicted in the resultant conceptualization. Caring in the family health experience is best facilitated by a relational stance where the nurse acknowledges the family's unique perspective. Through the family-nurse interaction the nurse gains understanding of the family's perspective being constructed. Nursing practice with families confronting the empirical realities and technological advances of the new millennium will be enriched when moral agency includes ethical dialogue among healthcare providers and families. Existential advocacy with and for families grounded in the nurse's understanding of the family perspective enhances the context for moral agency. PMID:18269430

Meiers, Sonja J; Brauer, Donna J

2008-03-01

417

Justice, health care, and the elderly.  

PubMed

Concern over rising health costs in the United States has led to an intensifying policy debate over health care for the elderly and a rethinking of questions on intergenerational justice and the claims of the aged on social resources. Major contributions to this debate have been made by Daniel Callahan in his Setting Limits (Simon & Schuster; 1987) and by Norman Daniels in his Am I My Parents' Keeper? (Oxford University Press; 1988). Brock reviews Callahan's and Daniels' work, identifying the central focus of both as the age-group problem of resource allocation. He sees Callahan as calling upon a communitarian political philosophy and Daniels as arguing from a tradition of political liberalism. While disagreeing in part with both authors, Brock identifies compatible elements in their arguments that contribute significantly to the public debate over health care and the aged. PMID:11651943

Brock, Dan W

1989-01-01

418

Availability and accessibility of rural health care.  

PubMed

The 1980s saw a retrenchment of the ideology that government intervention could solve the problems of inadequate access to health services in rural areas. Increased emphasis was placed on an ideology that promoted deregulation and competitive market solutions. During the 1980s, the gap in the availability of physicians in metropolitan versus nonmetropolitan areas widened. Also during that time period, the gap between metropolitan and nonmetropolitan populations' utilization of physician services widened. In addition, many indicators of the health status of nonmetropolitan residents versus metropolitan residents worsened during the 1980s. As we enter the 1990s, concern about equitable access to needed health care services and for the vulnerability and fragility of rural health systems has resurfaced. A number of national policies and a research agenda to improve accessibility and availability of health services in rural areas are being considered. PMID:10107686

Hicks, L L

1990-10-01

419

Primary health care in Senegal: lessons learned.  

PubMed

USAID began funding the Rural Health Delivery Services Project (RHDS) in Sine Saloum region (later divided into 2 regions--Kaolack and Fatick) of Senegal in 1977. Its aim was to improve the health of rural inhabitants and to set up a model health care delivery system. It specifically set out to increase agricultural output by reducing illness-related absence from work. USAID funds and local taxes paid for the construction of almost 400 village health huts, each staffed by a 1st aid worker and a traditional birth attendant. In 1982, 90% of villagers sought preventive and curative services from the health huts. In 1984, USAID extended funding to a 2nd phase of the RHDS II/Child Survival (CS) project which aimed to expand preventive health efforts and to introduce new preventive services targeting pregnant women and children. These services were immunizations, malaria control, oral rehydration therapy, and growth monitoring. Other objectives were to integrate these services and to institute program sustainability. Other agencies also were involved, such as UNICEF. RHDS II/CS successfully integrated several interventions at health hut and health post levels. An evaluation team found that the spirit of village-based primary health care made the RHDS system work. No follow-up survey to a 1982-83 baseline survey occurred, making it difficult for the team to determine whether RHDS II/CS achieved child survival goals. It recommended that teams have both expatriate and native representatives who are flexible and adaptable to local conditions and constraints and that agencies be pragmatic in their objectives and expectations about what evaluation teams can accomplish and provide advance documents to team members to allow them more of their often limited time in the country to do field work. The team called for donor agencies to cooperate on reporting requirements. It also suggested that new programs should be added to existing health systems and structures instead of forsaking previous successes. PMID:1458220

Hauck, F R; King, J; Vian, T

1992-01-01

420

Primary care in Bosnia and Herzegovina. Health care and health status in general practice ambulatory care centres.  

PubMed Central

OBJECTIVE: To assess the health care and health status of patients attending primary care clinics in Bosnia and Herzegovina. DESIGN: Assisted administration patient survey. SETTING: Two ambulatory care clinics (ambulantas) in each of three cities in Bosnia and Herzegovina: Tuzla, Mostar, and Banja Luka. PARTICIPANTS: Patients attending the ambulantas during a 1-week period in March 1999; 885 answered questionnaires. MAIN OUTCOME MEASURES: Each patient listed demographic characteristics and answered questions on satisfaction with health care and with the physical and financial accessibility of health care services and medications. A validated health status questionnaire (EuroQoL), previously used in parts of the former Yugoslavia, was administered. RESULTS: Only 22% of patients were employed; 57% could not pay the nominal fee to see a physician; 71% walked to the clinic; mean distance from patients' homes to the clinics was 2.3 km; 63% could not get the medications prescribed (in 85% of cases because of cost, not availability); 80% to 90% of answers to satisfaction questions suggested high satisfaction with the care patients received from their doctors; 67% of the time patients were referred to a specialist by general practitioners; 33% had problems walking; 17% had problems with self-care; 36% had problems with usual daily activities; 72% had at least some pain or discomfort; and 62% described at least some anxiety or depression. The three cities showed significant differences; patients in Tuzla generally had lower health status and more problems with health care. CONCLUSION: Unemployment and financial considerations reduced health care access in Bosnia and Herzegovina. While only one third of patients had physical difficulties, two thirds had emotional problems or pain. Satisfaction with physicians' care was high.

Godwin, M.; Hodgetts, G.; Bardon, E.; Seguin, R.; Packer, D.; Geddes, J.

2001-01-01

421

Primary care as a platform for full continuum health care risk management.  

PubMed

Health care clinical and financial risk is a multivectored problem, requiring multivectored solutions that extend beyond primary care. Worksite clinics have emerged that leverage empowered primary care, but incorporate a range of tactics aimed at driving appropriate care and cost by disrupting health care's perverse incentives. This article describes some of those approaches and shows evidence of the performance that can result. PMID:24402068

Klepper, Brian

2013-01-01

422

Women's Preconceptional Health and Use of Health Services: Implications for Preconception Care  

PubMed Central

Objective To improve understanding of women's use of health care before pregnancy, by analyzing how the health status and health risks of pre- and interconceptional women are associated with health services use. Data Source Data are from a cross-sectional random-digit dial telephone survey of a representative sample of 2002 women ages 18–45 years from the Central Pennsylvania Women's Health Study (CePAWHS). A subsample of 1,325 respondents with current reproductive capacity, classified by reproductive life stage (preconceptional or interconceptional), was analyzed. Study Design Bivariate and multiple logistic regression analyses were conducted to determine how health needs (including indices of health status and health risks related to adverse pregnancy outcomes) are associated with five indicators of health services use (receipt of a regular physical exam, obstetrician–gynecologist [ob/gyn] visit, receipt of a set of recommended screening services, receipt of health counseling services on general health topics, and receipt of pregnancy-related counseling), controlling for predisposing and enabling variables. Principal Findings Only half of women at risk of pregnancy report receiving counseling about pregnancy planning in the past year. One-third of women surveyed did not receive routine physical examinations and screening services, and over half received little or no health counseling. Multivariate analyses showed that all the measures of health needs except for negative health behavior were related to some type of health services use. Psychosocial stress was associated with having a recent ob/gyn visit, with receiving general health counseling, and with receiving pregnancy planning counseling. Cardiovascular risk was positively associated with receiving general health counseling and a regular physical exam, but negatively associated with seeing an ob/gyn. Positive health behaviors were associated with receiving screening services and with receiving general health counseling. Preconceptional reproductive life stage was positively associated with receiving a regular physical exam and negatively associated with having an ob/gyn visit. Conclusions Pre- and interconceptional women with specific health care needs may not receive appropriate health care before pregnancy. Improving pregnancy experiences and outcomes requires more comprehensive preconception health care and more preventive care before the first pregnancy.

Hillemeier, Marianne M; Weisman, Carol S; Chase, Gary A; Dyer, Anne-Marie; Shaffer, Michele L

2008-01-01

423

National standard health care provider identifier--HCFA. Proposed rule.  

PubMed

This rule proposes a standard for a national health care provider identifier and requirements concerning its use by health plans, health care clearinghouses, and health care providers. The health plans, health care clearinghouses, and health care providers would use the identifier, among other uses, in connection with certain electronic transactions. The use of this identifier would improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It would implement some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996. PMID:10179329

1998-05-01

424

Children with special health care needs: how immigrant status is related to health care access, health care utilization, and health status.  

PubMed

To compare health care access, utilization, and perceived health status for children with SHCN in immigrant and nonimmigrant families. This cross-sectional study used data from the 2003 California Health Interview Survey to identify 1404 children (ages 0-11) with a special health care need. Chi-square and logistic regression analyses were used to examine relations between immigrant status and health access, utilization, and health status variables. Compared to children with special health care needs (CSHCN) in nonimmigrant families, CSHCN in immigrant families are more likely to be uninsured (10.4 vs. 4.8%), lack a usual source of care (5.9 vs. 1.9%), report a delay in medical care (13.0 vs. 8.1%), and report no visit to the doctor in the past year (6.8 vs. 2.6%). They are less likely to report an emergency room visit in the past year (30.0 vs. 44.0%), yet more likely to report fair or poor perceived health status (33.0 vs. 16.0%). Multivariate analyses suggested that the bivariate findings for children with SHCN in immigrant families largely reflected differences in family socioeconomic status, parent's language, parental education, ethnicity, and children's insurance status. Limited resources, non-English language, and limited health-care use are some of the barriers to staying healthy for CSHCN in immigrant families. Public policies that improve access to existing insurance programs and provide culturally and linguistically appropriate care will likely decrease health and health care disparities for this population. PMID:19554437

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

2010-07-01

425

Digital health care: where health care, information technology, and the Internet converge.  

PubMed

The digital health care industry applies information technologies to facilitate communications, commerce, transactions, business problem solving, and enhanced decision making for one or more groups that supply, consume, or finance health care services and products. The variation among companies is significant, but each one attempts to leverage information technology to drive sustainable evolutionary change. In an overview of the industry, a framework is provided to understand the maze of business plans. PMID:11184348

Frank, S R; Williams, J R; Veiel, E L

2000-01-01

426

[Elderly care in the supplementary health system].  

PubMed

The purpose of this study was to identify and analyze the assistance provided to the elderly by the supplementary health care system. Information was collected from interviews with managers of chronic diseases management programs and/or of specific programs in this area. Information was organized in cases and analyzed. Eleven companies operating private health plans in the cities of Rio de Janeiro and Sao Paulo were investigated. A general care model for the elderly was defined for the analysis. This model consists in a proposal for a care and assistance system hierarchically organized according to the deterioration of the functional capacity of the elderly (levels of dependence). None of the six companies that had health plans for the elderly already implemented provided full assistance to all enrolled seniors. There are major differences in the stage of development of their programs. Four companies had already implemented plans and two companies had plans in development. Even with the teams of managers and professionals working on some level within the advocated model, none of these companies followed any logic of integrated care and monitoring in all stages of the ageing process in accordance with the degree of dependence of the associate. PMID:18813610

Veras, Renato Peixoto; Caldas, Célia Pereira; Araújo, Denizar Viana; Mendes, Rosana Kuschniere Walter

2008-01-01

427

Health Literacy: Critical Opportunities for Social Work Leadership in Health Care and Research  

ERIC Educational Resources Information Center

One-third of U. S. adults do not have adequate health literacy to manage their health care needs; and low health literacy is a major concern due to its association with poor health outcomes, high health care costs, and health communication problems. Low health literacy is a potential driver of health disparities, and its alleviation is central to…

Liechty, Janet M.

2011-01-01

428

Budget-makers and health care systems.  

PubMed

Health programs are shaped by the decisions made in budget processes, so how budget-makers view health programs is an important part of making health policy. Budgeting in any country involves its own policy community, with key players including budgeting professionals and political authorities. This article reviews the typical pressures on and attitudes of these actors when they address health policy choices. The worldview of budget professionals includes attitudes that are congenial to particular policy perspectives, such as the desire to select packages of programs that maximize population health. The pressures on political authorities, however, are very different: most importantly, public demand for health care services is stronger than for virtually any other government activity. The norms and procedures of budgeting also tend to discourage adoption of some of the more enthusiastically promoted health policy reforms. Therefore talk about rationalizing systems is not matched by action; and action is better explained by the need to minimize blame. The budget-maker's perspective provides insight about key controversies in healthcare policy such as decentralization, competition, health service systems as opposed to health insurance systems, and dedicated vs. general revenue finance. It also explains the frequency of various "gaming" behaviors. PMID:23958590

White, Joseph

2013-10-01

429

Teaching primary health care: a comprehensive approach.  

PubMed

The MEDEX Primary Health Care Series, an integrated training system for everyone in primary care (PHC), was published in 1983. It is now used in over 70 countries and has demonstrated its value in the developing world. The Series lays considerable emphasis on the crucial link between the performance of health workers and the management support with which they are provided. It was the result of 10 years of development and field testing. The Series is so widely employed because its development involved health centers and health workers associated in PHC programs in Guyana, Lesotho, Micronesia, Pakistan, and Thailand. It also addresses everyday problems and provides pragmatic solutions which PHC programs can apply. Attention is given to the development of skills in health workers, using a competency-based methodology, in contrast to the concentration on knowledge acquition found in more conventional training programs. Training activities are detailed for as little as 15 minutes at a time in courses lasting 6-15 months. Dialogic methods are used for the more peripheral workers who may not be literate. Management is given systematic, practical treatment. The Series advocates disease prevention and health promotion and helps to train health workers to diagnose an treat the most common clinical problems. It can be used to strengthen existing programs or to start new ones. It has a consistent formant, facilitating local adaption. Any part of the Series can be copied or reproduced for noncommercial purposes without persmission from the publisher. The Series is based on the realistic and pragmatic organization of health care delivery systems found in most countries and places great importance on the use of health center presonnel to orientate and link resources at the center to needs at the periphery. Nurses, the health center person at the middle level of the PHC, often fulfills the role of trainer and supervisor of the community health worker. The diagnostic, curative and community health skills in the Series are consistent with the expanding role of nursing in PHC. The Series is published in English but also available in a mini-edition in Spanish with increasing interest in a French translation. Various sections have been translated into 21 other languages. A newsletter and a network of series users (MEDINET) has been established. PMID:3252832

Smith, R A; Mehra, S; Devereaux, M O; Rich, J

1988-01-01

430

Adopted Children with Special Health Care Needs: Characteristics, Health, and Health Care by Adoption Type. ASPE Research Brief.  

National Technical Information Service (NTIS)

This research brief presents information on adopted children with special health care needs, using data from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN). The analysis takes advantage of questions in the NS-CSHCN tha...

2008-01-01

431

Health policies and the relationships between socioeconomic status, access to health care, and health  

PubMed Central

Health policies tend to focus on improving the access to health care of persons of low-socioeconomic status to improve their health. This commentary argues that health policies directly directed at health and socioeconomic status (and other components of individual welfare) will also be effective if one wants to improve the well-being of the poor.

2013-01-01

432

The range and diversity of providers' viewpoints towards the Iraqi primary health care system: an exploration using Q-methodology  

PubMed Central

Background The increasingly recognized need for reorganizing the primary health care services in Iraq calls for a comprehensive assessment of the system to better understand its problems and needs for development. As part of such comprehensive assessment and due to the important role of primary health care providers in adopting any change, we ought to explore the range and diversity of viewpoints of primary health care providers towards the Iraqi primary health care system. Methods This explorative study was carried out in Erbil governorate, Iraq from May to July 2011. Data were collected from primary health care providers using Q-methodology to elicit subjective viewpoints and identify shared patterns among individuals. Forty primary health care providers representing eight primary health care centers sorted 41 statements reflecting different aspects of the Iraqi primary health care system into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis was used to derive latent viewpoints through centroid factor extraction and varimax rotation of factors. Results Analysis of the participants’ Q-sorts resulted in four distinct viewpoints among primary health care providers toward the current primary health care system. One factor emphasized positive aspects of the current primary health care system that is content with the current primary health care system. The other three factors highlighted the negative aspects and they included (i) professionally-centered viewpoint, (ii) comprehensive perception and problem-based solutions and (iii) critical to leadership/governance aspects of the system. Conclusions This study revealed diverse viewpoints of primary health care providers toward the current Iraqi primary health care system and recognized the particular issues related to each viewpoint. The findings can contribute to a better understanding of health policy makers and primary health care managers concerning the problems facing the primary health care system that might contribute to change in the management of this system.

2013-01-01

433

Health Care Costs in End-of-Life and Palliative Care: The Quest for Ethical Reform  

Microsoft Academic Search

Health reform in the United States must address both access to medical services and universal insurance coverage, as well as health care cost containment. Uncontrolled health care costs will undermine improvements in access and coverage in the long-run, and will also be detrimental to other important social programs and goals. Accordingly, the authors offer an ethical perspective on health care

Bruce Jennings; Mary Beth Morrissey

2011-01-01

434

Reforming the Health Care System for Children and the Elderly to Balance Cure and Care.  

ERIC Educational Resources Information Center

Issues in balancing health services and costs in a changing society, where groups have differential access to health care, are discussed, including need for a universal health care system, growing cost of health care for the elderly, prolongation of life among older adults, and the claims of children on services. (MSE)

Callahan, Daniel

1992-01-01

435

Mapping the literature of health care management  

PubMed Central

Objectives: The research provides an overview of the health care management literature and the indexing coverage of core journal literature. Method: Citations from five source journals for the years 2002 through 2004 were studied using the protocols of the Mapping the Literature of Allied Health Project and Mapping the Literature of Nursing Project. The productivity of cited journals was analyzed by applying Bradford's Law of Scattering. Results: Journals were the most frequently cited format, followed by books. Only 3.2% of the cited journal titles from all 5 source journals generated two-thirds of the cited titles. When only the health care management practitioner–oriented source journals were considered, two-thirds of the output of cited journal titles came from 10.8% of the titles. Science Citation Index and PubMed provided the best overall coverage of the titles cited by all 5 source journals, while the cited titles from the 2 practitioner-oriented journals were covered most completely by Social Sciences Citation Index and Business Source Complete. Conclusions: Health care management is a multidisciplinary field. Librarians must consider the needs of their users and assist them by providing the necessary materials and combination of indexes to access this field adequately.

Taylor, Mary K.; Gebremichael, Meseret D.; Wagner, Catherine E.

2007-01-01

436

Sustainable medicines and global health care.  

PubMed

The global population has now exceeded 7 billion, and forests and other resources around the world are being irreversibly depleted for energy, food, shelter, material goods, and drugs to accommodate population needs. For most of the world's population, plants, based on many well-established systems of medicine, in either crude or extract form, represent the foundation of primary health care for the foreseeable future. Contemporary harvesting methods for medicinal plants are severely depleting these critical indigenous resources. However, maintaining and enhancing the availability of quality medicinal agents on a sustainable basis is an unappreciated public health care concept. To accomplish these goals for future health care, and restore the health of the Earth, a profound paradigm shift is necessary: ALL medicinal agents should be regarded as a sustainable commodity, irrespective of their source. Several approaches to enhancing the availability of safe and efficacious plant-based medicinal agents will be presented including integrated strategies to manifest the four pillars (information, botany, chemistry, and biology) for medicinal plant quality control. These integrated initiatives involve information systems, DNA barcoding, metabolomics, biotechnology, nanotechnology, in-field analysis of medicinal plants, and the application of new detection techniques for the development of medicinal plants with enhanced levels of safe and reproducible biological agents. PMID:21308611

Cordell, Geoffrey A

2011-07-01

437

Enabling innovation in health-care delivery.  

PubMed

Achieving lasting performance improvement in health care is a demanding challenge. Service delivery processes are frequently fragmented with many symptoms of poor behaviour observable. Competing vested interests within the National Health Service (NHS) and experiences of muddled and muddied top-down government exhortation suggest the need for a balanced perspective in which the expectations of patients, staff, management and government can be considered, agreed and enabled. Our conclusion is that effective innovation is best achieved by establishing a 'Train-Do-Train-Do' cycle in which all 'players' in the system must be actively involved. The particular methodology of 'managing by projects' for effective bottom-up step-by-step innovation in NHS practice is described. It takes a holistic and systematic view of health-care delivery as a service business process to be optimized via a five-step procedure. The core tool element of this methodology is the multidiscipline natural-group task force used to execute the change process in an enterprise. When properly constituted, motivated and driven, it is very capable of transforming a 'mess' into an effective health-care delivery process. PMID:18647942

Parnaby, John; Towill, Denis R

2008-08-01

438

[The scientific entertainer in primary health care].  

PubMed

The scientific method is capable of being applied in primary care. In this article we defend the role of the "scientific entertainer "as strategic and necessary in achieving this goal. The task has to include playful and light-hearted content. We explore some words in English that may help us to understand the concept of "scientific entertainer" from a semantic point of view (showman, master of ceremonies, entrepreneur, go-between) also in Spanish language (counsellor, mediator, methodologist) and finally in Latin and Greek (tripalium, negotium, chronos, kairos). We define the clinical, manager or research health-worker who is skilled in primary care as a "primarylogist". PMID:22018794

Ortega-Calvo, Manuel; Santos, José Manuel; Lapetra, José

2012-09-01

439

Health in Day Care: A Manual for Health Professionals.  

ERIC Educational Resources Information Center

Addressed especially to community pediatricians, but also useful to other health workers, this manual discusses aspects of day care that require a physician's attention. Chapter I historically traces the positive effect of a nurturing environment upon the development of the infant and child, covering the period from the early 1900s to the present.…

Deitch, Selma R., Ed.

440

Health Insurance Eligibility, Utilization of Medical Care, and Child Health  

Microsoft Academic Search

The authors study the effect of public insurance for children on their utilization of medical care and health outcomes by exploiting recent expansions of the Medicaid program to low-income children. These expansions doubled the fraction of children eligible for Medicaid between 1984 and 1992. Take-up of these expansions was much less than full, however, even among otherwise uninsured children. Despite

Janet Currie; Jonathan Gruber

1996-01-01

441

Integration of child health information systems: current state and local health department efforts.  

PubMed

Public health departments at the state and local levels are pursuing integration strategies to consolidate child health information systems to improve child health. Eighteen health departments were interviewed in this exploratory research study to gather information to describe their current activities related to integrating child health information systems. Results illustrate the common systems being brought together and the technical process for doing so, financing mechanisms, range of anticipated information-users and their method of access to the integrated system, and common internal and external challenges and strengths that the health departments face. The evidence suggests a trend towards more efficient and thoughtful use of the multiplicity of information systems within public health departments as programs consolidate and share data and expand electronic communication with their external partners in the health care delivery system to improve children's health. PMID:15643356

Fehrenbach, S Nicole; Kelly, Janet C R; Vu, Christie

2004-11-01

442

Health related issues for individuals with special health care needs.  

PubMed

More than 50 million individuals in the United States with developmental disabilities, complex medical problems, significant physical limitations, and a vast array of other conditions considered under the rubric of "disabilities" live in our communities, many as a result of deinstitutionalization and mainstreaming. Children and adults with special health care needs have become a much more integral and visible component of everyday life. This process represents an ongoing change in perceptions about individuals with disabilities and subsequent reform of policies concerning the rights and the principles of care for people with special needs. The reform was built upon an increased role for the family and community health practitioners in providing needed care. PMID:19269390

Waldman, H Barry; Rader, Rick; Perlman, Steven P

2009-04-01

443

Correlates of Maternal Health Care Utilization in Rohilkhand Region, India  

PubMed Central

Background: Until date, the importance of maternal health care services in reducing maternal mortality and morbidity has received a significant recognition. Most of the maternal deaths can be prevented if women have access to basic antenatal, natal and postnatal care. However, uptake of maternal health care services is far from universal even in settings where they are extensively available. Aim: The aim of this study is to assess the pattern and identify underlying factors on maternal health care utilization in rural areas of Bareilly. Subjects and Methods: This was a cross-sectional study was conducted during June-December 2011. Six villages were selected by convenience out of 99 villages in Bhojipura Block of Bareilly district, Uttar Pradesh to cover maximum number of women. All currently married women aged between 15 and 49 years who had delivered a child within last 1 year were interviewed by house-to-house survey and comprised the study unit. Their socioeconomic and demographic characteristics, reproductive history and knowledge of specific obstetric complications were taken. The information was gathered on various aspects of maternal-care utilization. In analyzing data, both bivariate and multivariate analyses were employed, using the Microsoft Excel and SPSS for Windows, Version 15.0 (SPSS Inc., Chicago, Illinois,USA). Results: Most (88.6%; 343/387) of pregnancies had registration for antenatal care (ANC). Majority (69.7%; 239/343) of them were registered between 16 and 24 weeks. Only 28.5% (110/343) of women received ANC from a private doctor. Maternal health care service utilization from health personnel was significantly associated with age at marriage ?18 years, family size ?3, birth order ?2, nuclear family and higher socio-economic status. Most of the pregnancy related complications were found among women aged >30 years, with birth order ?3, having birth interval <24 months, among Muslims, working mothers and among those belonging to joint family. Mother's education and husband's occupation were found to be strong predictors for the utilization of maternal health care using the logistic regression. Conclusion: Utilization of maternal health care services is high. However this can be improved by community based education program.

Srivastava, A; Mahmood, SE; Mishra, P; Shrotriya, VP

2014-01-01

444

The Role of Data in Health Care Disparities in Medicaid Managed Care  

PubMed Central

Background The Affordable Care Act includes provisions to standardize the collection of data on health care quality that can be used to measure disparities. We conducted a qualitative study among leaders of Medicaid managed care plans, that currently have access to standardized quality data stratified by race and ethnicity, to learn how they use it to address disparities. Methods We conducted semi-structured interviews with 21 health plan leaders across 9 Medicaid managed care plans in California. We used purposive sampling to maximize heterogeneity in geography and plan type (e.g., non-profit, commercial). We performed a thematic analysis based on iterative coding by two investigators. Results We found 4 major themes. Improving overall quality was tightly linked to a focus on standardized metrics that are integral to meeting regulatory or financial incentives. However, reducing disparities was not driven by standardized data, but by a mix of factors. Data were frequently only examined by race and ethnicity when overall performance was low. Disparities were attributed to either individual choices or cultural and linguistic factors, with plans focusing interventions on recently immigrated groups. Conclusions While plans' efforts to address overall quality were often informed by standardized data, actions to reduce disparities were not, at least partly because there were few regulatory or financial incentives driving meaningful use of data on disparities. Standardized data, as envisaged by the Affordable Care Act, could become more useful for addressing disparities if they are combined with policies and regulations that promote health care equity.

Moskowitz, David; Guthrie, Bruce; Bindman, Andrew B.

2012-01-01

445

The Mexican-American in the Health Care System.  

ERIC Educational Resources Information Center

Mexican Americans differ from Anglo Americans in their types of health problems, relation to the American health care system, and responses to health care. Mexican Americans tend to underutilize available health resources because of fear of discrimination, perception of health workers as government representatives, and language and cultural…

Stambler, Moses

446

[Information system in primary health care].  

PubMed

The Croatian Ministry of Health started a health care system computerization project aimed at strengthening the collaboration among health care institutions, expert groups and individual health care providers. A tender for informatic system for Primary Health Care (PHC) general practice, pediatrics and gynecology, a vital prerequisite for project realization, has now been closed. Some important reasons for undertaking the project include rationalization of drug utilization, savings through a reduced use of specialists, consultants and hospitalization, then achievement of better cooperation, work distribution, result linking, data quality improvement (by standardization), and ensuring proper information-based decision making. Keeping non-standardized and thus difficult to process data takes too much time of the PHC team time. Since, however, a vast amount of data are collected on only a few indicators, some important information may remain uncovered. Although decisions made by health authorities should rely on evidence and processed information, the authorities spend most of the time working with raw data from which their decisions ultimately derive. The Informatic Technology (IT) in PHC is expected to enable a different approach. PHC teams should be relieved from the tedious task of data gathering and the authorities enabled to work with the information rather than data. The Informatics Communication Technology (ICT) system consists of three parts: hardware (5000 personal computers for work over the Internet), operative system with basic software (editor, etc.), and PHC software for PHC teams. At the national level (National Public Health Informatics System), a software platform will be built for data collection, analysis and distribution. This data collection will be based on the International Classification of Primary Care (ICPC-2) standard to ensure the utilization of medical records and quality assessment. The system permits bi-directional data exchange between a central database and sources at different levels, across the spectrum from basic PHC teams to local authorities. This will enable data collection control, comparisons with national averages and prompt distribution of information over the Internet. The investment into IT is a strategic imperative having no alternative. A cost/benefit analysis has shown its operation in the PHC system to return the investment in two years. As defined according to the Project priorities (with measurable objectives), the use of new technologies will be introduced by stages. PMID:16095193

Stevanovi?, Ranko; Stani?, Arsen; Varga, Sinisa

2005-01-01

447

The Interlinkages between Primary Health Care and Adult Education.  

ERIC Educational Resources Information Center

Illustrates the three central tenets of primary health care (equality, systemic dynamics, and self-reliance) and highlights points of similarity with adult education. Demonstrates adult education's role in promoting health care: information, mobilization, and integration. (SK)

Tandon, Rajesh

1982-01-01

448

Community Health Centers: Providers, Patients, and Content of Care  

MedlinePLUS

... 40 years, community health centers (CHCs) have provided primary care and behavioral and mental health services in medically ... 72%) and PAs (72%) served as the patient's primary care provider more frequently than NPs (58%). Table 1. ...

449

Marriage, Cohabitation, and Men's Use of Preventive Health Care Services  

MedlinePLUS

... 2014 Marriage, Cohabitation, and Men's Use of Preventive Health Care Services On This Page Key findings Married men ... other not-married men to have had a health care visit in the past 12 months. Figure 1. ...

450

Health Care Reform: Out Greatest Opportunity...Ever!  

ERIC Educational Resources Information Center

Discusses inevitability of health care reform in United States, considers the reform process itself, and explains the plan of the President's Task Force on National Health Care Reform. Also considers the prospects for Congressional response to reform proposals. (NB)

Keigher, Sharon M.

1993-01-01