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Health care reform: historical and current perspectives.  


Health care in America, criticized today by patients and physicians alike, developed incrementally throughout the twentieth century into a system unique to the United States. Each effort to change it led to unintended consequences. There are many current proposals by presidential candidates and members of Congress for reform of the fragmentation of payment for, access to, and quality of care. There is increasing pressure from many sources to provide a solution. Will 2004 be the year we find it? PMID:14971861

King, Lucy Jane



Health care economics in Serbia: current problems and changes.  


One of the fundamental rights of every human being is to enjoy "the highest attainable standard of health". Achieving better health requires no only adequate medical knowledge and technologies, laws and social measures in the field of health care, but also sufficient funding for fulfilling people's right to health. However, economic crisis has left every community with limited possibility of investing in health care and forced them to use the available resources more efficiently. This is the reason why health financing policy represents an important and integral part of the health system concerned with how financial resources are generated, allocated and used. Development of new drugs and medical technologies, population aging, increased incidence of chronic diseases as well as the peoples' rising demands from health care providers lead to a constant increase of health system costs worldwide. In these circumstances, countries in transition, like Serbia, face difficult challenges in financing their health systems. Current economic crisis and budget constraints do not allow the Government to simply allocate more public revenues for health and solve the people's expectations by increasing the spending. Instead, Serbia is forced to start reforms to provide a more efficient health system. The reform processes are positioned within the wider context of European integration and public administration reforms. This paper provides a short description of the health care system in Serbia focusing on the healthcare economics and reforms and their influence on financial sustainability. PMID:25536810

Stosi?, Sanja; Karanovi?, Nevena



The Cuban health care system and factors currently undermining it.  


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

Nayeri, K



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

E-print Network

such as bioterrorism, obesity, emerging infectious diseases, global warming, health care costs and family violence. www, occupational therapy, physical therapy, and chiropractic. Our academic advisors are available to assist you, arts and science, environmental science, engineering, forensic science and medical physics, just


The health care industry: current issues and concerns.  


In order to meet growing demands for health service with improved access, cost controls, and increased productivity, it will be necessary to reorder the current system of providing these services. It should be remembered that: (1) Health must remain high on the scale of social, political, and economic priorities. (2) New money alone will not guarantee either capacity or effectiveness of the current health system. (3) Health care is too often delivered at the time and place and in a way convenient to the provider rather than the consumer. (4) Man power production for the health industry must adapt new modes of training and licensure in order to provide more flexible use of valuable human resources. (5) Resourse allocation should be the central responsibility of areawide and state comprehensive health planning agencies. (6) The consumer must play a stronger role in decision making and be provided a greater range of choices among alternative forms of health services. This decision-making power together with enough information to make the purchase of health care a maningful decision may lead to some new questions pertaining to health care. PMID:4613519

Terrill, T E



The Current State of Health Care for People with Disabilities  

ERIC Educational Resources Information Center

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

Breslin, Mary Lou; Yee, Silvia



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

Microsoft Academic Search

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

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


Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers  

Microsoft Academic Search

BackgroundThe Oral Care Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO) conducted a survey on clinical practices of oral\\/dental management of cancer patients among supportive health care providers. The main purpose was to evaluate the knowledge and current practice for preventing and managing oral side effects associated with

Gerry J. Barker; Joel B. Epstein; Karen B. Williams; Meir Gorsky; Judith E. Raber-Durlacher



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


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



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


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

Hanser, Suzanne B



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

Microsoft Academic Search

In this paper we describe female workers' health care, the women's and maternal protection system within the Japanese legal\\u000a system, the current status of female workers in Japan, and problems regarding methods of advancing health care and the women's\\u000a or maternal protection system. Motherhood is respected in the workplace in Japan, and in order to provide an environment in\\u000a which

M. Nohara; J. Kagawa



Health care informatics  

Microsoft Academic Search

The health care industry is currently experiencing a fundamental change. Health care organizations are reorganizing their processes to reduce costs, be more competitive, and provide better and more personalized customer care. This new business strategy requires health care organizations to implement new technologies, such as Internet applications, enterprise systems, and mobile technologies in order to achieve their desired business changes.

Keng Siau



Current directions in military health-care provider resilience.  


After more than a decade of war, the US military continues to place significant emphasis on psychological health and resilience. While research and programs that focus on the broader military community's resilience continue to emerge, less is known about and until recently little focus has been placed on military medical provider resilience. In this article, we review the literature on military medical provider resilience, provide an overview of the programmatic and technological advances designed to sustain and develop military medical provider resilience, and finally offer recommendations for future research. PMID:25617036

Lester, Paul B; Taylor, Lauren C; Hawkins, Stacy Ann; Landry, Lisa



Health Care Cost Containment  

Microsoft Academic Search

Effective and efficient delivery of health care is one of the critical issues facing the nation today. Currently, nearly 13% of the nation's GDP in spent on Health Care. Perhaps one-half of the increase in health care costs have been linked to the acquisition of new medical technology. This paper examines some of the issues relating to the acquisition and

Joe Nihom; Thomas R. Gillpatrick; Van R. Wood



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

PubMed Central

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

Barr, D A; Field, M G



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. PMID:19777112

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



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

E-print Network

Mobile Communications for Medical Care a study of current and future healthcare and health Communications for Medical Care ­ Final Report 2 21 April 2011 #12;Mobile Communications for Medical Care a study Programme 113 References 119 #12;Mobile Communications for Medical Care ­ Final Report 4 21 April 2011 #12

Talbot, James P.


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

PubMed Central

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

Linder, Regina



Home Health Care  


... Resize Text Printer Friendly Online Chat Home Health Care What is Home Health Care? How Do I ... About Home Health Care? What is Home Health Care? Home health care helps seniors live independently for ...


Women Veterans Health Care  


... Women Veterans Health Care Women Veterans Health Care Womens Health Women Veterans Health Care Home Program Overview About ... Priorities FAQs Women Veterans Call Center Providers WVPMs Women's Health Services Eligibility and Enrollment About VA Health Care ...


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


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

Nohara, M; Kagawa, J



Indian Health Care.  

ERIC Educational Resources Information Center

This report is an assessment of health care for American Indians and Alaska Natives who are eligible for medical and health-related services from the federal government. Chapters outline Federal-Indian relationships; provide demographic and economic information on the Indian population; trace current health status, changing health problems, and…

Congress of the U.S., Washington, DC. Office of Technology Assessment.


Health Care and Dependent Care Flexible  

E-print Network

the end of the current calendar year. Benefit elections are generally effective the first of the monthHealth Care and Dependent Care Flexible Spending Accounts Discovery Benefits, Inc. (866) 451 for certain health care and child care expenses with pre-tax dollars. FSA's may allow you to save money


Respiratory Home Health Care  


Respiratory Home Health Care Respiratory care at home can contribute to improved quality of life and significant cost savings. Your respiratory care ... your family and home situation to help your health care provider plan for your care after you are ...


Impact of current health care reform proposals on people with chronic illnesses  

E-print Network

Outlines the most challenging issues facing people with special health care needs. There is a need for the Medicaid Infrastructure Grants and other grants to identify cost effective strategies for providing access to ...

Hall, Jean P.; Moore, Janice M.; Otto, B.; Salley, S.



Sick Care vs Health Care: The Crisis in US Health  

Microsoft Academic Search

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

White African; Hispanic White African



National Health Care Survey

The National Health Care Survey (NHCS) encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.


Health care technology assessment  

NASA Astrophysics Data System (ADS)

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

Goodman, Clifford



Home health care  


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


Health Care Team  


... Newsroom Contact Us You are here Home » Health Care Team Good health care is always a team ... their families improve their quality of life. Patient Care Technician and Renal Technologist There are two kinds ...


[Swedish migration in a current, historical and international perspective: immigration put more demands on health care].  


Sweden will soon have a million foreign-born residents, representing almost 11 per cent of the population. As shown in the article, migration to Sweden is a continuing process rather than an isolated life event; for example, half of those who emigrated to Sweden in 1968 had returned to their home country or proceeded to a new country by 1988. The possible effects of the migration process upon immigrants, and the ensuing impact on primary health care, are examined in the article. Published findings suggest that immigrants--whether they migrate because of war, political or religious persecution, or for economic reasons--may experience increased stress, thus exacerbating any individual susceptibility to illness. Strategies for future research in migration medicine and primary health care are also discussed. PMID:9528248

Sundquist, J



Health Care Cost Containment  

Microsoft Academic Search

The Administration's proposals to reform the U.S. health care system sought to provide for universal health insurance coverage while containing the growth of health care spending. This paper focuses on the latter issue and discusses the ability of regulatory and market-oriented reforms to achieve health care cost containment from several angles: an international comparison of national cost containment measures, a

Ellen Marie Nedde



Report on Health Care Education in Nevada.  

ERIC Educational Resources Information Center

This document attempts to determine whether the University and Community College System of Nevada (UCCSN) is preparing a health care workforce that is appropriate for the current and future health care needs of the state of Nevada. To assess this issue, the system collected and analyzed current data in terms of the state of health and health care

Nevada Univ. and Community Coll. System, Reno. Office of the Chancellor.


Vacation health care  


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



... your Form 1095-A correct? See More Footer Health Insurance Marketplace Resources About the Affordable Care Act Regulatory ... Boulevard, Baltimore, MD 21244 Health Insurance Marketplace Resources About the Affordable Care Act Regulatory ...


Evaluating health care advertising.  


Evaluating health care advertising is a four-part process that enables health care managers to target particular markets and to determine the effects of advertising particular services and products. PMID:3170200

MacStravic, R S



Unplanned health care tourism.  


Health care tourism is often a preplanned event carefully laying out all the details. Sometimes, when one least expects it, medical care is needed outside of the mainland. This Editorial speaks to an unplanned experience. PMID:25436438

Powell, Suzanne K



Creonization of health care.  


As prefigured in the Greek tragedy Antigone, one of the primary conflicts in contemporary health care is that between humane concern for the individual and concern for society at large and administrative rules. The computerization of the health care system and development of large data bases will create new forms of this conflict that will challenge the self-definition of health care and health care professionals. PMID:2394563

Bulger, R J



Your Health Care Team  


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


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


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

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



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

NASA Technical Reports Server (NTRS)

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



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

NASA Technical Reports Server (NTRS)

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

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



Health Care Indicators  

PubMed Central

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

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



Developing primary health care  

Microsoft Academic Search

Primary health care is best provided by a primary health care team of general practitioners, community nurses, and other staff working together from good premises and looking after the population registered with the practice. It encourages personal and continuing care of patients and good communication among the members of the team. Efforts should be made to foster this model of

B Jarman; J Cumberlege



Health Care Cost Containment.  

ERIC Educational Resources Information Center

Emphasizing risk management, the authors point out that health care cost containment is feasible and outline a number of areas--including health maintenance organizations--in which cost containment has been successful in specific instances. (IRT)

Notkin, Herbert; Meader, Leland V.



[Pulmonary arterial hypertension in patients with congenital heart disease: current issues and health care situation].  


Defects of the heart and associated large vessels (CHD) are among the most frequent congenital anomalies. Owing to improved interdisciplinary management, about 90% of CHD patients reach adulthood. Up to 10% maintain or newly develop pulmonary arterial hypertension (PAH) over time, which impairs exercise tolerance and prognosis. Data on the health care situation of patients with PAH-CHD are limited. The ongoing Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA, Identifier NCT01347216) prospectively documents adult patients with all forms of pulmonary hypertension, if treated with PAH drugs (mean follow-up 40 months). As of 16 November 2012, 8% of the 3642 patients in the database had PAH-CHD. Of the latter, 104 were documented in great detail in specific CHD report forms. These patients were on average 39 years old, men in 39%, had a mean 6-minute walk distance of 370 ± 102 meters, and were in NYHA functional class I/II in 39%, III in 59%, und IV in 3%. Mean quality of life on the 100-point visual analogue scale (EQ-5 D) was 51. PAH-CHD patients received monotherapy in 80%, combination therapy in 9%, and no PAH drugs in 11%. Only 20% were on oral anticoagulation (OAC). Mean 4-year survival in incident patients (PAH-CHD diagnosis after start of the registry in 2007) was 79%, compared with 72% in patients with idiopathic PAH (IPAH). According to these registry data, patients with PAH-CHD have impaired exercise capacity, and substantially reduced quality of life. They receive combination therapy or OAC, respectively, less frequently than IPAH patients, however, their survival rate is higher. PMID:23720182

Kaemmerer, H; Gorenflo, M; Hoeper, M; Huscher, D; Ewert, P; Pittrow, D



Health Care for College Students  


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


The strategic genius of jonathan letterman: the relevancy of the american civil war to current health care policy makers.  


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

Place, Ronald J



Equity in health care.  


It has long been known that a segment of the population enjoys distinctly better health status and higher quality of health care than others. To solve this problem, prioritization is unavoidable, and the question is how priorities should be set. Rational priority setting would seek equity amongst the whole population, the extent to which people receive equal care for equal needs. Equity in health care is an ethical imperative not only because of the intrinsic worth of good health, or the value that society places on good health, but because, without good health, people would be unable to enjoy life's other sources of happiness. This paper also argues the importance of the health care's efficiency, but at the same time, it highlights how any innovation and rationalization undertaken in the provision of the health system should be achieved from the consideration of human dignity, making the person prevail over economic criteria. Therefore, the underlying principles on which this health care equity paper is based are fundamental human rights. The main aim is to ensure the implementation of these essential rights by those carrying out public duties. Viewed from this angle, equity in health care means equality: equality in access to services and treatment, and equality in the quality of care provided. As a result, this paper attempts to address both human dignity and efficiency through the context of equity to reconcile them in the middle ground. PMID:18611079

La Rosa-Salas, Virginia; Tricas-Sauras, Sandra



Education and Support Programs for Family Caregivers: Current Practices Across HealthCare Scenarios  

Microsoft Academic Search

\\u000a Family caregiving in the United States occurs within the context of several important societal changes that impinge directly\\u000a upon the experience and adjustment of ­persons who live with a chronic and debilitating health condition. In their day-to-day\\u000a routines, families have more influence on the personal health of each member than any other individual or any health service\\u000a provider (Elliott &

Timothy R. Elliott


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



Information Technology for Health Care in Mozambique  

E-print Network aiming at improving health information management within the primary health care sector. The aim of HISPInformation Technology for Health Care in Mozambique Editorial Introduction Eric Monteiro Associate that are relevant to the development of health information systems under the current social and political conditions

Monteiro, Eric


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



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



Mercury and health care  

PubMed Central

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

Rustagi, Neeti; Singh, Ritesh



Controlling Health Care Costs  

ERIC Educational Resources Information Center

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

Dessoff, Alan



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

ERIC Educational Resources Information Center

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

Mouton, Lauren; Bruce, Jacklyn



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

ERIC Educational Resources Information Center

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

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



Knowledge Management in Health care  

Microsoft Academic Search

While knowledge management (KM) is becoming an established discipline with many applications and techniques, its adoption in health care has been challenging. Though, the health care sector relies heavily on knowledge and evidenc e based medicine is expected to be implemented in daily health care activities; beside s, delivery of care replies on cooperation of several partners that need to

Christo El Morr; Julien Subercaze


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

E-print Network

Nile virus, global warming, health care costs and family violence. www, occupational therapy, physical therapy, chiropractic, kinesiology and many other fields. Our undergraduate and includes courses in biochemistry, human kinetics, arts and science, environmental science, engineering


Philadelphia Health Care  

E-print Network

Relations (Sweeten Alumni House) P36 5 Anatomy Chemistry Building of the School of Medicine M36 10 AnnenbergShoemaker Green Philadelphia Center for Health Care Sciences CHOP Children's Hospital South Campus Examiners Building Veterans Administration Nursing Home Child Guidance Center Children's Hospital

Sharp, Kim


Indian Health Service: Find Health Care  


... contains inpatient beds, organized staff including physician services, continuous nursing services and that provides comprehensive health care ... contains inpatient beds, organized staff including physician services, continuous nursing services and that provides comprehensive health care ...


Equity in health care utilization in Chile  

PubMed Central

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



Recertification of primary health care professionals  

Microsoft Academic Search

This bibliography contains literature about certification- and recertification of health care professionals. Certification and recertification are increasingly being used as quality assurance systems for professionals. As such (re)certification does fit in with the current developments towards quality management and quality systems in health care. The bibliography contains -international- literature about (re)certification of General Practitioners, Physical Therapists, Pharmacists, Dentists, Midwifes and

F. H. Boeringa; E. M. Sluijs



Health Care in Mozambique  

PubMed Central

Mozambique has been in a state of near civil war since 1980, which has prevented the country from providing any health care at all to most of its rural citizens. Medications are scarce, and the range of diagnostic tools is limited. The health clinics treat illnesses that include severe anemia, tuberculosis, malnutrition, sexually transmitted diseases, and injuries that are a result of the war, but the biggest killer of all remains malaria. Imagesp1131-ap1131-bp1131-cp1132-ap1132-bp1133-ap1133-b PMID:21221330

Williams, Betsy



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.


Leadership in Health Care Systems: Health Care Organization Management  

E-print Network

Leadership in Health Care Systems: Health Care Organization Management and Leadership Track ­ Program Evaluation in 2007: Our grads told us they needed more leadership, informatics and management, employer interviews, needs assessment The Program #12;Leadership in Heath Care Systems · Three tracks

Goldman, Steven A.


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


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

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



Antitrust implications of health care reform.  


Antitrust issues affect the insurance industry, hospital industry, and physicians. The authors explore the history of antitrust issues in the health care field and implications for future developments. Interest in antitrust has increased due to current merger and acquisition activities in the industry. With the failure of the Health Security Act, health care reform will be left to private industry. Will there be increasing or decreasing antitrust activity by the Department of Justice and Federal Trade Commission? PMID:10144613

Dempsey, J; Schmidt, W



Health federalism: the role of health care professionals in Nepal.  


Nepal has entered from its unitary system into a new "Federal Democratic Republic State". The current constitution presents basic health care services as a fundamental right. The Ministry for Health and Population has been providing resources to meet health demands, but managers are wrestling to meet these demands. Persistent disparities between rural and urban and across regions resulted inferior health outcomes, e.g., life expectancy in an urban district like Bhaktapur is 71 years, whereas in the rural district of Mugu it is 44 years. The poor health and poor access to health care in the past systems prompted people to seek a different model. Ultimately, all political parties except one have agreed on federalism. The exact number of federal states that are going to be created is unknown. In federalism, all federated states have to assume certain relationships between the locality, the region, and the nation that apply not only in politics but in health care too. Managing changes in health care organization during the transitional period and after restructuring the unitary Nepal into federal states should be carefully planned. In case, if new system also fails to deliver necessary health care services, the possibility of igniting of dissatisfaction, public unrest and even disintegration cannot be ignored. In order to outline a structure and give life to a health care system under federalism, health care professionals need to engage themselves seriously. PMID:20387368

Dulal, R K



Health Care System Responses to Children Exposed to Domestic Violence.  

ERIC Educational Resources Information Center

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

Culross, Patti L.



Public perceptions of Australia's doctors, hospitals and health care systems  

Microsoft Academic Search

Objective: To assess public perceptions of Australia's doctors, hospitals and health care systems. Design and participants: A cross-sectional national telephone survey of a random sample of 800 Australian adults in August 2007. Main outcome measures: Ratings of subjective trust in health care providers, public and private hospitals, private health insurers and Medicare; attitudinal ratings for the current health care system,

Elizabeth A Hardie; Christine R Critchley


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


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

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



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

PubMed Central

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

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



The promise of Lean in health care.  


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

Toussaint, John S; Berry, Leonard L



Managing the Care of Health  

E-print Network

. Part II of this paper uses this line of argument to reframe four major issues in this system exist to integrate, or coordi- nate, work in organizations.1 These are illustrated in Figure 1 the work. Key words: differentiation, integration, health care management, health care organization, health

Barthelat, Francois


Health-care reform and school-based health care.  


There is growing recognition that health and health care at school can significantly impact children's health. From childhood obesity interventions to new immunization mandates, schools are at the forefront of child health discussions. The 2008 presidential campaign and the renewed focus on health-care reform raise the possibility that in 2009 school health will play a larger role in health policy conversations than previously. This article explores the proposition that both school health and national health policy will benefit from closer attention to the role of school health within the U.S. health system. It offers a Maryland case study to suggest both the opportunities and operational challenges of linking school health to the larger community health system. PMID:19711651

Lear, Julia Graham; Barnwell, Elizabeth A; Behrens, Donna



Information Technology Outside Health Care  

PubMed Central

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

Tuttle, Mark S.



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


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



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

PubMed Central

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

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



Health and Disability: Partnerships in Health Care  

ERIC Educational Resources Information Center

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

Tracy, Jane; McDonald, Rachael



Space age health care delivery  

NASA Technical Reports Server (NTRS)

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

Jones, W. L.



Women Veterans Health Care: Frequently Asked Questions  


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


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. PMID:19414837

Benito, Natividad; Miró, José M.; de Lazzari, Elisa; Cabell, Christopher H; del Río, 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.



A medicare current beneficiary survey-based investigation of alternative primary care models in nursing homes: functional ability and health status outcomes.  


This study assessed how the health status and functioning of Medicare beneficiaries residing in nursing homes varies systematically with nurse practitioners (NPs) and physician assistants (PAs) providing primary care services. A secondary analysis was conducted using data from the 2006, 2007, and 2008 Medicare Current Beneficiary Surveys. The study sample included 433 participant-year observations within one of three cohorts: (a) medical doctor (MD)-only, those who received primary care services exclusively from a physician; (b) MD-dominant, those who received some primary care services from an NP or PA, but those visits accounted for less than one half of total primary care visits; and (c) NP/PA-dominant, those who received more than one half of their primary care visits from an NP or PA. Participants in the MD-only cohort had significantly less orientation and independence in activities of daily living compared to participants in the NP/PA-dominant cohort. Other study variables did not vary significantly by practice model. Although the study provides some evidence that NP/PA involvement is associated with improved functioning, it is premature to draw strong inferences. [Res Gerontol Nurs. 2015; 8(2):85-93.]. PMID:25643375

Abdallah, Lisa M; Van Etten, Deborah; Lee, A James; Melillo, Karen Devereaux; Remington, Ruth; Gautam, Ramraj; Gore, Rebecca J



Contagious Ideas from Health Care  

ERIC Educational Resources Information Center

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

Chaffee, Ellen



Target Audience: Health care professionals  

E-print Network

Valerie has been a social worker for over 20 years working in a variety of settings including health care (palliative care, chronic ill- ness), child welfare, and do- mestic violence. Valerie is an Assistant fatigue, work/life balance, and end-of-life care. Valerie is also a meditation teacher trained in the use

Hitchcock, Adam P.


Developing health care workforces for uncertain futures.  


Conventional approaches to health care workforce planning are notoriously unreliable. In part, this is due to the uncertainty of the future health milieu. An approach to health care workforce planning that accommodates this uncertainty is not only possible but can also generate intelligence on which planning and consequent development can be reliably based. Drawing on the experience of Health Workforce New Zealand, the author outlines some of the approaches being used in New Zealand. Instead of relying simply on health care data, which provides a picture of current circumstances in health systems, the author argues that workforce planning should rely on health care intelligence-looking beyond the numbers to build understanding of how to achieve desired outcomes. As health care systems throughout the world respond to challenges such as reform efforts, aging populations of patients and providers, and maldistribution of physicians (to name a few), New Zealand's experience may offer a model for rethinking workforce planning to truly meet health care needs. PMID:25607938

Gorman, Des



Teens, technology, and health care.  


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

Leanza, Francesco; Hauser, Diane



Transporting Children With Special Health Care Needs (RE9852)  

Microsoft Academic Search

Children with special health care needs should have access to proper resources for safe transportation. This statement reviews important considerations for transporting children with special health care needs and provides current guidelines for the protection of children with specific health care needs, including those with a tracheostomy, a spica cast, challenging behaviors, or muscle tone abnormalities as well as those

Poison Prevention


Lighting the way to interdisciplinary primary health care  

Microsoft Academic Search

Between 2004 and 2006, the Enhancing Interdisciplinary Collaboration in Primary Health Care (EICP) initiative undertook research on interdisciplinary collaboration. The last report prepared by the Initiative, Interdisciplinary Primary Health Care: Finding the Answers – A Case Study Report, offers a research-based blueprint for action by showcasing some current successful collaborative practices in primary health care. Several key learnings are discussed,

Gabriela Prada



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.



Organizing health care within political turmoil: the Palestinian case.  


Palestinians were given control over their own health services in late 1994. Since then they have been facing the challenge of reorganizing disordered health services into a cohesive, regulated and sustainable health care system. This paper focuses on the experience of organizing health care during political instability. It considers the ways that health care is currently provided and funded in the Palestinian Territories. The patterns of accessibility to health care services in terms of insurance coverage and provision (physical allocation) of services are discussed. Finally, the major health care policy changes in this transitional period are examined. PMID:12683274

Hamdan, Motasem; Defever, Mia; Abdeen, Ziad



Seasonal migration and health care.  


This article examines health care use and issues among seasonal migrants in an urban setting in the Sunbelt. The study, based on a survey of 230 American and Canadian snowbirds in Phoenix, Arizona, complements previous research on health care use among Canadian snowbirds in Florida. Our results show that health care use among seasonal migrants in Phoenix is substantial, and it varies by citizenship (American vs. Canadian), age, number of winter visits, and length of winter stay. We argue that health care use is symptomatic of social and emotional attachments to the winter residence that develop and deepen over a period of years. Phoenix snowbirds view their lifestyles as healthy, they are adept in adjusting to health decrements, and the majority plan to continue spending time in both their summer and winter residences as long as their health permits. PMID:10131552

McHugh, K E; Mings, R C



Health care's service fanatics.  


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



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

SciTech Connect

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

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



A Health Services Framework of Spiritual Care  

PubMed Central

Aims To introduce a health services framework of spiritual care that addresses the empirical and applied issues surrounding spirituality and nursing practice. Background Despite over 20 years of study, the concept of spirituality is still under development, which limits application to nursing practice. Methods Three studies using a health services framework are reviewed: (1) a survey study of dying patients and family that describes the providers, types, and outcomes of spiritual care; (2) an exploratory study of the process of spiritual care; and (3) a multi-level study of the structure and outcomes of spiritual care in long-term care facilities. Results Spiritual care recipients identify family or friends (41%), clergy (17%), and health care providers (29%) as spiritual care providers. The most frequently reported type of spiritual care was help in coping with illness (87%). Just over half (55%) of spiritual care recipients were very satisfied or somewhat satisfied with the care that they received. The processes of spiritual care involved: (1) presence, or the deliberate ideation and purposeful action of providing care that went beyond medical treatment; (2) opening eyes, or the process by which providers became aware of their patient’s storied humanity and the individualized experience of their current illness, and; (3) co-creating, which was a mutual and fluid activity between patients, family members, and care providers that began with an affirmation of the patient’s life experience and led to the generation of a holistic care plan that focused on maintaining the patient’s humanity and dignity. In long term care facilities, decedents who received spiritual care were perceived as receiving better overall care in the last month of life, when compared with those decedents who did not receive spiritual care. In addition, among those receiving support for their spiritual needs, care was rated more highly among those who received support from facility staff, such as nurses, than those who did not; no differences were observed based on the presence of other sources of support. Conclusions A health services framework provides a holistic view of spiritual care, one that is consistent with integrated nursing models. Implications for Nursing Management By focusing on the structure, process, and outcome elements of spiritual care within organizational settings, nursing management can develop feasible approaches to implement, improve, and evaluate the delivery of this unique type of care. PMID:23151104

Daaleman, Timothy P.



The current status of the Korean student health examination  

PubMed Central

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



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.


New developments in a consolidating health care industry.  


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



Hope for health and health care.  


Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers. PMID:24846726

Stempsey, William E



University Health Care Health Sciences Center  

E-print Network

visit, as the information is essential to providing the appropriate treatment for your child. Before and your child. University Health Care School of Medicine Division of Pediatric Nephrology & Hypertension

Feschotte, Cedric


Managing Home Health Care (For Parents)  


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


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

PubMed Central

Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices. Multi-national research may provide guidance about how to scale up eye health interventions that are integrated into primary health systems. PMID:23506686



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

Federal Register 2010, 2011, 2012, 2013, 2014

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



Asian American health care attitudes.  


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

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



Tax Exempt Financing of Health Care Facilities as a Component of the Market Approach to Health Care Cost Containment  

Microsoft Academic Search

This Comment will discuss the current health delivery system in the context of a Market Approach to health care cost containment. Political and financial issues in health care as well as current judicial and tax policies affecting Market Approach theory will be examined. The Comment concludes that targeted tax exempt financing must play a major role in establishing competitive forces

George A. King



Rural health care: redefining access.  


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

Collins, Chris



Accreditation Association for Ambulatory Health Care  


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


Helping You Choose Quality Behavioral Health Care  


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


Universal health care: the changing international discourse.  


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



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. PMID:24403941

Eskandari, Manije; Abbaszadeh, Abbas; Borhani, Fariba



Award Recipient Sharp HealthCare  

E-print Network

health care delivery system, serving greater than 27 percent of the county's 3 million plus residents enables Sharp to offer a full spectrum of health care services, from emergency, hospice, and mental health2007 Award Recipient Sharp HealthCare Sharp HealthCare is San Diego County's largest integrated


Agents of Change for Health Care Reform  

ERIC Educational Resources Information Center

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

Buchanan, Larry M.



Unfair inequalities in health and health care  

Microsoft Academic Search

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

Marc Fleurbaey; Erik Schokkaert



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


Health care cost containment  

Microsoft Academic Search

The prime objective of health policy is to improve the health of the population. This must be done with limited resources and at costs that do not impose an unsustainable burden on the economy and its international competitiveness. This is the crucial question to answer: Is the performance of the economy sufficient to allow further development of health services? If

Martin Dlouhý



Indian Health Care. Summary.  

ERIC Educational Resources Information Center

Undertaken at the request of House and Senate committees with responsibility for Indian affairs and government health programs, this study examines the health status of Indians and the services and technologies that are provided to them through Federal Indian health programs. The first half of the report contains background information and the…

Congress of the U.S., Washington, DC. Office of Technology Assessment.


Health care entrepreneurship: financing innovation.  


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

Grazier, Kyle L; Metzler, Bridget



[Palliative care, health and region].  


With the advent of the HPST (Hospital, Patients, Health and Regions) law, the area of Le Voironnais (Isère) and its healthcare institutions provide a structured health service favouring patients' access to palliative care whatever their age. To achieve this, they set up a management committee to which they integrated very early on a mobile palliative care team (EMSP). Despite their diversity, the institutions follow a common strategy in which the needs of elderly patients requiring palliative care are recognised in all accommodation sectors. PMID:20560273

Bertrand, Malik; Mallon, Anne-Catherine



Health Care Provider Initiative Strategic Plan  

ERIC Educational Resources Information Center

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

National Environmental Education & Training Foundation, 2012



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



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. PMID:22515874

Greene, Danielle



Health Care Reform Is Coming  

Microsoft Academic Search

During my career in Congress, we have achieved some success in expanding health insurance coverage and keeping services affordable, but the problem of 46 million uninsured and 25 million underinsured must be addressed. In February 2009, I introduced the Healthy Americans Act (S. 391\\/H.R. 1321; Wyden, 2009), a comprehensive bipartisan health care reform bill that covers all Americans without breaking

Ron Wyden



RESEARCH ARTICLE Health Care Outcomes  

E-print Network

RESEARCH ARTICLE Health Care Outcomes The CABG Surgery Volume­Outcome Relationship: Temporal Trends's Office of Statewide Health Planning and Development (OSHPD). Principal Findings. We found that during) from 2003 to 2004. Study Design. The patient was the primary unit of analysis, and in-hospital mor

Rocke, David M.


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



Microsoft Academic Search

With the growing mechanized life styles, human beings, especially the female generations are increasingly getting exposed to a variety of health and life risks and hazards. It has therefore, become imperative on the part of individuals and also governments to focus their efforts on a search for alternatives to meet the phenomenal rise in the expenses related to health care.

V. Jayalakshmi; Mahatma Gandhi


Health Care Basics: Choosing the  

E-print Network

(adult/pediatric) · Diabetes · Cardiovascular Disease · Chronic Heart Failure (CHF) · Chronic Kidney Disease · Chronic2012 Health Care Basics: Choosing the Best Option for Your Health "Creating A More Educated Georgia and treatment; general and targeted outreach and reminders to members; patient education and self

Hutcheon, James M.


Health care fraud and abuse.  


In recent years, health care fraud and abuse have become major issues, in part because of the rising cost of health care, industry consolidation, the emergence of private "whistle-blowers," and a change in the concept of fraud to include an emerging concern about quality of care. The 3 types of conduct that are generally prohibited by health care fraud laws are false claims, kickbacks, and self-referrals. False claims are subject to several criminal, civil, and administrative prohibitions, notably the federal civil False Claims Act. Kickbacks, or inducements with the intent to influence the purchase or sale of health care-related goods or services, are prohibited under the federal Anti-Kickback statute as well as by state laws. Finally, self-referrals-the referral of patients to an entity with which the referring physician has a financial relationship-are outlawed by the Ethics in Patient Referral Act as well as numerous state statutes. Consequences of violations of these laws can include, in addition to imprisonment and fines, civil monetary penalties, loss of licensure, loss of staff privileges, and exclusion from participation in federal health care programs. Federal criminal and civil statutes are enforced by the US Department of Justice; administrative actions are pursued by the Department of Health and Human Services' Office of Inspector General; and all state actions are pursued by the individual states. In addition, private whistle-blowers may, acting in the name of the United States, file suit against an entity under the False Claims Act. Enforcement of health care fraud and abuse laws has become increasingly commonplace and now affects many mainstream providers. This trend is likely to continue. PMID:10501120

Kalb, P E


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



Towards Open Information Management in Health Care  

Microsoft Academic Search

The utilization of information technology as tool in health care is increasing. The main benefits stem from the fact that information in electronic form can be transferred to different locations rapidly and from the possibility to auto- mate certain information management tasks. The current technological approach for this automation relies on structured, formally coded representation of information. We discuss the

J. Yli-Hietanen; S. Niiranen



UK HealthCare University of Kentucky  

E-print Network

HealthCare construction and facilities news In thIs Issue: UK HealthCare and Norton Healthcare officialsUK HealthCare University of Kentucky 800 Rose St. Lexington KY 40536 RENEWALYour resource for the latest UK HealthCare construction and facilities news WINTER 2011 RENEWALYour resource for the latest UK

MacAdam, Keith


Navigating Health Care with Your Family Doctor  


Navigating Health Care with Your Family Doctor Navigating Health Care With Your Family Doctor To be a smart patient, it’s best ... range of medical conditions. Family Medicine and Preventive Care This video describes family physicians' special training in ...


Health Care Reform and Alzheimer's Disease  


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


A systems view of health care for the poor.  

PubMed Central

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

Prasad, N.



[President Obama's health care reform: lessons to and from the Israeli health care system].  


In March 2010 the United States enacted the most significant health care reform in several decades. The Patient Protection and Affordable Care Act, amongst other provisions, addresses two of the main current shortcomings of the U.S. health system: the large portion of the population that are uninsured and the high percentage of hsealth expenditures (mostly private] which amounts to about 16% of the GDP. Changes to the current structure and financing of the U.S. health system will have implications for other health systems, for science (e.g., through enhanced federal funding for comparative effectiveness research), and for technological advance (e.g., through accelerated development and use of electronic health records). There are several lessons from the reform, and the factors leading to its implementation, for the Israeli health system. Firstly, the basic principles of the Israeli health system are a source of pride, and undermining its main values can have deleterious effects. Overreliance on private, out-of-pocket, spending and lack of support for public practice of medicine (in community and hospital settings) will weaken the public sector, strengthen the private sector, and could result in a tiered lower quality and less accessible public system with greater widening of gaps in health and health care utilization. This paper reviews the main provisions of the U.S. health care reform and the potential implications for the IsraeLi health system. PMID:21939111

Balicer, Ran D; Shadmi, Efrat



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


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

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



Engineering VA Health Care  

E-print Network

engineers to be effective Healthcare Technology Program Managers in the Veterans Health Administration and managerial skills to healthcare technology. In addition, the intern will receive assignments to prepare program, and coordinating new medical technology implementations. Throughout the training program

Adams, Mark


Health care coalitions: continuity and change.  


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



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



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

PubMed Central

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

Wald, J. S.



PHAR 3207 Leadership in Health Care PHAR 5207 Applied Leadership in Health Care  

E-print Network

PHAR 3207 Leadership in Health Care PHAR 5207 Applied Leadership in Health Care Course Syllabus exploring leadership theories as they relate to health care; professional health care students; and graduate students with interest in the subject of leadership within health care organizations. [Moodle: Course

Thomas, David D.


Health Care in the United States [and] Health Care Issues: A Lesson Plan.  

ERIC Educational Resources Information Center

An article on American health care which focuses on health care costs and benefits is combined with a lesson plan on health care issues to enable students to consider both issues of cost effectiveness and morality in decisions about the allocation of health care. The article covers the history of interest in health care, the reasons for the…

Lewis, John; Dempsey, Joanne R.



Measuring competition in health care markets.  

PubMed Central

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

Baker, L C



Finding Low-Cost Mental Health Care  


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


Manpower for Health Care.  

ERIC Educational Resources Information Center

The document is a collection of six papers on key problems in health manpower which were presented at a symposium during the 1974 spring meeting of the Institute of Medicine. A seventh paper provides a summary of the major themes at the conclusion of the program. All of the symposium papers deal with the principal manpower issues of supply,…

Institute of Medicine (NAS), Washington, DC.


Training Health Care Paraprofessionals  

ERIC Educational Resources Information Center

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

Linton, Corinne B.



Brentwood Community Health Care Assessment  

PubMed Central

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.



Phytotherapy in primary health care  

PubMed Central

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

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



Health Care Procedure Considerations and Individualized Health Care Plans  

ERIC Educational Resources Information Center

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

Heller, Kathryn Wolff; Avant, Mary Jane Thompson



Total quality in health care.  


Quality is at the top of American consumers' demand list, and consequently American manufacturing companies have been forced to assign priority to the development of high-quality products. To improve the quality of what they offer, many manufacturers use the management philosophy known as total quality management (TQM), and now the service sector is following in their footsteps. The health care industry is a good example of a service industry that can benefit greatly from TQM, and it is the purpose of this article to show how a health care provider can implement TQM and evaluate its effects. PMID:10178544

Brannan, K M



The value of pharmacists in health care.  


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

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



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

ERIC Educational Resources Information Center

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…

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



Universal health care in India: Panacea for whom?  


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

Qadeer, Imrana



Health Care Reform and Asthma Care Disparities in Minority Populations  

Microsoft Academic Search

Asthma affects almost 23 million people in the United States and ranks as a leading cause of health disparities among minority and low socioeconomic groups, with the largest impact on minority children. This article will examine how fragmented health care in the United States contributes to asthma care disparities in minority populations and will discuss how health care reform may

Lisa Cambridge



Health care reform and federalism.  


Health policy debates are replete with discussions of federalism, most often when advocates of reform put their hopes in states. But health policy literature is remarkably silent on the question of allocation of authority, rarely asking which levels of government ought to lead. We draw on the larger literatures about federalism, found mostly in political science and law, to develop a set of criteria for allocating health policy authority between states and the federal government. They are social justice, procedural democracy, compatibility with value pluralism, institutional capability, and economic sustainability. Of them, only procedural democracy and compatibility with value pluralism point to state leadership. In examining these criteria, we conclude that American policy debates often get federalism backward, putting the burden of health care coverage policy on states that cannot enact or sustain it, while increasing the federal role in issues where the arguments for state leadership are compelling. We suggest that the federal government should lead present and future financing of health care coverage, since it would require major changes in American intergovernmental relations to make innovative state health care financing sustainable outside a strong federal framework. PMID:20388867

Greer, Scott L; Jacobson, Peter D



Parkland Health Care Campus  

E-print Network

Total qty. Platinum level: 3 These are projects that have been certified via LEED for New Construction (LEED-NC) or LEED for Healthcare. Source USGBC Kiowa County Memorial Hospital OHSU Ctr for Health nd Healing Dell Children?s Hospital ESL...% reduction (in Hospital) Increase energy efficiency 17.5 ? 21% On track to exceed LEED for Healthcare (LEED-HC) Not pursuing ESL-KT-11-11-19 CATEE 2011, Dallas, Texas, Nov. 7 ? 9, 2011 ESL-KT-11-11-19 CATEE 2011, Dallas, Texas, Nov. 7 ? 9, 2011 A...

Jones, W., Sr.



Health care in the borderland.  


For over 30 years, Hidalgo County, a geographically isolated and financially stressed community in the southwestern corner of New Mexico, has struggled to develop a stable primary health care service.The retirement of the county's general practitioner in the 1970s was followed by several decades of misses, near-misses, and out-and-out failures, when the community found it difficult to attract and impossible to keep a physician. In order to organize and fund a stable medical clinic, the community had to adapt to the realities of a new era in medicine. Primary care physicians in rural communities need access to medical information and to specialists, help in coping with the economic pressures of medical care, and support that will enable them to develop a sustainable lifestyle. Hidalgo County now has a modern health care delivery system. The experiences that led to the creation of the present clinic provide insight into the problems for the delivery of primary health care in remote areas and suggest solutions that may be relevant to other communities across rural America. PMID:14593224

Treeson, David



Six Sigma in health care  

Microsoft Academic Search

Six Sigma, originally initiated by Motorola and General Electric, offers a process improvement strategy that has been successfully applied in manufacturing. Service firms have recently trended toward Six Sigma methodology for internal processes and consumer centric. The paper discusses implementing Six Sigma in the health-care sector. The paper introduces the challenges that face implementing Six Sigma in services, with a

Loay Sehwail; Camille DeYong



Health care insolvency and bankruptcy.  


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

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



The Utility of the Family Health Survey for Interdisciplinary Health Care Training in Family Health Assessment  

Microsoft Academic Search

Assessment is the key to identification of appropriate support and intervention in family health care. Current reviews of assessment tools and practice are being utilized in health prevention and intervention programs. The family, its function, structure, rules, and beliefs are known to have a significant relationship to the health behaviors and illness outcomes of family members (Gillis & Knafl, 1999;

Rhondda Faye Waddell



Health Care Visits to Check More Than Just Health?  


... News Spotlights Media Resources Selected Profiles & Interviews Multimedia Health Care Visits to Check More Than Just Health? Skip ... media links Share this: Page Content Study Shows Health Care Providers Can Help with School Readiness During Primary ...


[Managing diversity in Swiss Health care].  


The development of Migrant Friendly Hospitals is an important first step towards eliminating health care disparities in Switzerland and an important reminder to health policy makers and practitioners across the health care system of their responsibility to provide non-discriminatory quality health care to all patients. PMID:25603570

Bodenmann, P; Bossart, R; Di Bernardo, N; Dominice Dao, M; Durieux, S; Faucherre, F; Hudelson, P; Keller, M; Schuster, S; Zellweger, E; Houmard, S



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

ERIC Educational Resources Information Center

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

Perez-Escamilla, Rafael



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

E-print Network

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

Mascardi, Viviana


Disparities in health care: an overview.  


The most important predictor of quality of health care across all racial and ethnic groups is access, especially insurance status and the ability to pay for health care. If we consider populations with equal access to health care, two groups emerge with differing qualities of health care: non-minority and minority populations. When studies control for the stage of disease at presentation, comorbidities, severity of illness, and other variables, substantial differences in health care based on race and ethnicity can still be found. Raising the consciousness of this issue is an important step toward recognizing and eliminating health care disparities. PMID:14597489

Cohen, Jordan J



Current challenges of personal health information management  

Microsoft Academic Search

Purpose – Health care has come to a turning point. Particularly due to aging societies and economic pressure placed on health care system, health is rapidly becoming one's own responsibility. This fundamental paradigm shift does not only affect the way health care services that will be provided in the near future but it also places enormous health information management demands

Janne Lahtiranta



Budgeting in health care systems.  


During the last decade there has been a recognition that all health care systems, public and private, are characterised by perverse incentives (especially moral hazard and third party pays) which generate inefficiency in the use of scarce economic resources. Inefficiency is unethical: doctors who use resources inefficiently deprive potential patients of care from which they could benefit. To eradicate unethical and inefficient practices two economic rules have to be followed: (i) no service should be provided if its total costs exceed its total benefits; (ii) if total benefits exceed total costs, the level of provision should be at that level at which the additional input cost (marginal cost) is equal to the additional benefits (marginal benefit). This efficiency test can be applied to health care systems, their component parts and the individuals (especially doctors) who control resource allocation within them. Unfortunately, all health care systems neither generate this relevant decision making data nor are they flexible enough to use it to affect health care decisions. There are two basic varieties of budgeting system: resource based and production targeted. The former generates obsession with cash limits and too little regard of the benefits, particularly at the margins, of alternative patterns of resource allocation. The latter generates undue attention to the production of processes of care and scant regard for costs, especially at the margins. Consequently, one set of budget rules may lead to cost containment regardless of benefits and the other set of budget rules may lead to output maximization regardless of costs. To close this circle of inefficiency it is necessary to evolve market-like structures. To do this a system of client group (defined broadly across all existing activities public and private) budgets is advocated with an identification of the budget holder who has the capacity to shift resources and seek out cost effective policies. Negotiated output targets with defined budgets and incentives for decision makers to economise in their use of resources are being incorporated into experiments in the health care systems of Western Europe and the United States. Undue optimism about the success of these experiments must be avoided because these problems have existed in the West and in the Soviet bloc for decades and efficient solutions are noticeable by their absence. PMID:10269645

Maynard, A



Synthetic real estate: bringing corporate finance to health care.  


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

Varwig, D; Smith, J



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. PMID:23766585

Bhatnagar, Kavita; Srivastava, Kalpana



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.



CDC Vital Signs: Making Health Care Safer  


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


How Do Health Care Providers Diagnose Pheochromocytoma?  


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


How Do Health Care Providers Diagnose Vulvodynia?  


... Trials Resources and Publications En Español How do health care providers diagnose vulvodynia? Skip sharing on social media ... been ruled out. To diagnose vulvodynia, 1 a health care provider may recommend that a woman have blood ...


How Do Health Care Providers Diagnose Endometriosis?  


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


Transitions: From Pediatric to Adult Health Care  


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


How Do Health Care Providers Diagnose Hypoparathyroidism?  


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


Five Steps to Safer Health Care  


... on your PDA or mobile device Health Care Innovations Exchange Innovations and Tools to Improve Quality and Reduce Disparities ... Comparative Effectiveness Cross-Agency Communications Health Information Technology Innovations & Emerging Issues Patient Safety Prevention & Care Management Value ...


FastStats: Home Health Care  


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


Overview of health care and nursing informatics in the Netherlands  

Microsoft Academic Search

This paper describes developments in the use of information technology (IT) in Dutch health care. Since it is impossible to cover all current initiatives in the nations' health care system, the developments are described from the viewpoint of the nursing profession. Therefore the focus centres on users, clinical systems and nursing systems. However, more 'technology driven' issues are addressed as

W. T. F. Goossen



ARTEMIS: a collaborative framework for health care.  

PubMed Central

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

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



New Directions in HealthCare Reform  

Microsoft Academic Search

Managed health care, health maintenance organizations, and other cost containment measures driven by the private sector in conjunction with Congressionally funded initiatives are serving as the guiding forces in health-care reform in the United States. Within this move toward restructuring health-care services, the role of nurse practitioners is expanding and evolving. Nurse practitioners provide high-quality, cost-effective, and comprehensive primary care

Jeanette Lancaster; Wade Lancaster; Lisa L Onega



Ethics and geographical equity in health care  

PubMed Central

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

Rice, N.; Smith, P.



Family-Focused Mental Health Care Policy  

Microsoft Academic Search

Mental health care is undergoing many changes that affect families, which continue to provide much of the day-to-day care for mentally ill persons. This article reviews the history of mental health care in the United States from 1940 to the present as it has changed from a system of programs providing institutional care to a system of programs providing community

Mary Ann Camann



Advancing adolescent health and health services in Saudi Arabia: exploring health-care providers’ training, interest, and perceptions of the health-care needs of young people  

PubMed Central

Background Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results A total of 232 professionals participated. The majority (82.3%) reported sometimes or always coming into contact with adolescent patients. Less than half (44%), however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have specific health-care needs that are different than children or adults (82.3% and 84.0%, respectively). With respect to health services, the majority (85.8%) believed that adolescents should be hospitalized in adolescent-specific wards. Only 26.7% of health-care providers believed that patients should be transferred from child to adult health-care services at 12–13 years of age, as is currently practiced in the country. Conclusion A gap exists between the training, knowledge and skills of health-care providers, and the needs to address health-care issues of adolescents in Saudi Arabia. This coupled with the fact that health-care providers are interested in gaining more knowledge and skills and are supportive of changes in the health-care system provides an opportunity for building local capacity and instituting medical and nursing education and health-care reform that can better serve the needs of the country’s young population. PMID:25214805

AlBuhairan, Fadia S; Olsson, Tina M



Improving educationalpreparation for transcultural health care  

Microsoft Academic Search

There is increasing evidence that the health care needs of people from black and ethnic minoritygroups in England are not being met. A growing number of initiatives are being undertaken to remedy the situation. Many of them are focused on health care delivery at local and national levels. However, unless the preparation of health care professionals in the area of

Rita M. H. Le Var



Improving primary health care through technological innovation  

Microsoft Academic Search

Summary As a result of policy changes and developments on the demand side, the im- portance of technology in primary health care will grow fast. An approach to the implementation of new technologies in primary health care is presented in this arti- cle. First we describe the main problems in Dutch primary health care. The second step is to identify

Peter P. Groenewegen; Jack B. F. Hutten



Studienordnung des Masterstudiengangs ,,Health Care Management"  

E-print Network

Studienordnung des Masterstudiengangs ,,Health Care Management" an der Ernst-Moritz-Arndt-Universität Greifswald die fol- gende Studienordnung für den Masterstudiengang ,,Health Care Manage- ment" als Satzung Masterstudiengang (M.Sc.) ,,Health Care Management" an der Ernst-Moritz- Arndt-Universität Greifswald vom 15. März

Greifswald, Ernst-Moritz-Arndt-Universität


Studienordnung des Masterstudiengangs ,,Health Care Management"  

E-print Network

1 Studienordnung des Masterstudiengangs ,,Health Care Management" an der Ernst-Moritz-Arndt-Universität Greifswald die folgende Studienordnung für den Masterstudiengang ,,Health Care Management" als Satzung Master- studiengang (M.Sc.) ,,Health Care Management" an der Ernst-Moritz-Arndt-Universität Greifswald

Greifswald, Ernst-Moritz-Arndt-Universität


Fachprfungsordnung des Masterstudiengangs Health Care Management  

E-print Network

Fachprüfungsordnung des Masterstudiengangs Health Care Management an der Ernst-Moritz-Arndt-Universität Greifs- wald die folgende Prüfungsordnung für den Masterstudiengang (M. Sc.) ,,Health Care Management Prüfungsverfahren im Studiengang ,,Health Care Management". Ergänzend gilt die Gemeinsame Prüfungsord- nung für

Greifswald, Ernst-Moritz-Arndt-Universität


Rethinking primary health care ethics: ethics in contemporary primary health care in the United Kingdom  

Microsoft Academic Search

Ethics have long been recognized as underpinning primary health care. While dis- crete understandings of ethics have developed to support many areas of health care and research, there has been little attempt to formulate an ethics framework which is focused on primary health care. Developments both within and external to primary health care practice make it timely to address primary

Robyn Martin



Creating a high-value delivery system for health care.  


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

Teisberg, Elizabeth O; Wallace, Scott



Selective primary health care: Is efficient sufficient?  

Microsoft Academic Search

Developing countries are increasingly using economic evaluation methods to assess and plan their health services. Inappropriate application of these methods may lead to serious errors in developing primary health care strategies. In 'Selective Primary Health Care', Julia Walsh and Kenneth Warren present a logical approach to health planning based on cost-effectiveness techniques. Their paper is a timely example of the

Peter A. Berman



Health care resource allocation and individuals’ health care needs: examining the degree of fit  

Microsoft Academic Search

Previous studies examine associations between health system resources and an individual's use of health services, yet the importance of these resources in meeting an individual's health care needs is unclear. This paper examines the relationship between health care system characteristics, other social and economic characteristics of counties in a mid-western U.S. state and an individual's ability to meet health care

David Litaker; Thomas Ezra Love



Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals?  

Microsoft Academic Search

BACKGROUND: In 2001, the New Zealand government introduced its Primary Health Care Strategy (PHCS), aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand,

Jacqueline Cumming; Nicholas Mays; Barry Gribben



Rural health care in Mexico?  


A very large percentage of Mexico's population living in rural areas lacks resources for health care. Any new effort to provide such care must emphasize the health of the infant population because of the high percentage of infants in the country. Plans made at the national level have not been correlated with the conditions that exist in rural areas. For example, the majority of university programs are oriented toward urban medical practice, and the construction of more schools of medicine to solve the problem of doctors in rural areas is based on a mistaken premise. This problem has not been solved even in developed countries such as the United States where, as in Mexico, graduates in medicine migrate to the cities where optimal conditions are met for practicing the type of medicine for which they have been trained. Furthermore, it is both expensive and illogical to maintain urban doctors in rural areas where they cannot practice their profession for lack of resources; to do so is to deny the purpose of their education (27). Conventional schools of medicine, for reasons of investment and of structure, should teach only very selected groups of students who, on finishing their training, are fully capacitated to practice specialized medicine. A different system is required if we are to provide adequate health care in the rural communities. A system such as that described herein, adapted to the real need of rural communities, would avoid the necessity to create dysfunctional bureaucracies and would not destroy those institutions which have proved useful in the past. This study should be considered as one of the many pilot programs that should be initiated in order to determine the type of program that would best solve the problem of health care in rural Mexico. Other programs already being considered at the National Autonomous University of Mexico include the A36 plan of the Faculty of Medicine, now in operation; the work of C. Biro carried out in Netzahualcoyotl City (both focused on providing medical care to the urban poor); and the Open University program. Unless an efficient program designed to meet the needs of rural communities is quickly put into operation, Mexico will, in the near future, be facing the same problems now confronting Southeast Asia. PMID:4415665

Cañedo, L



The changing face of health care consumers.  


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



45 CFR 162.1401 - Health care claim status transaction.  

Code of Federal Regulations, 2010 CFR

... 2010-10-01 false Health care claim status transaction. 162.1401 Section 162.1401...ADMINISTRATIVE REQUIREMENTS Health Care Claim Status § 162.1401 Health care claim status transaction. The health care claim...



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



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

ERIC Educational Resources Information Center

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

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


Health Information Systems for Primary Health Care: Thinking About Participation  

E-print Network

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

Sahay, Sundeep


[Control of health care by the economist?].  


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

Henke, K D



Communication and Racial Inequities in Health Care  

Microsoft Academic Search

There are striking inequities in health outcomes between racial and ethnic groups in the United States, with many groups experiencing significantly poorer health outcomes than members of the racial majority, White (non-Hispanic) health care consumers. These disturbing health disparities exist even when controlling for differences in income and health insurance. Racial disparities in health outcomes are related to communication problems

Gary L. Kreps



The new market in health care: prospects for managed care in Australia.  


Most developed countries are experimenting or moving at full speed to implement new forms of health delivery based in part on capitation arrangements and stronger accountability of health service providers. Proposals for introduction of capitation or managed care have been advanced in Australia but have attracted strong opposition from the medical profession. This paper reviews the policy issues surrounding the introduction of managed care, including how Australia's current institutional forms may evolve into managed care provision. PMID:10159218

Duckett, S



Health care prices, the federal budget, and economic growth.  


Rising health care spending, led by rising prices, has had an enormous impact on the economy, especially on the federal budget. Our work shows that if rapid growth in health care prices continues, under current institutional arrangements, real economic growth and employment will be lower during the next two decades than if health price inflation were somehow reduced. How big the losses are and which sectors bear the brunt of the costs vary depending on how society chooses to fund the federal budget deficit that stems from the rising cost of federal health care programs. PMID:7657246

Monaco, R M; Phelps, J H



Literacy and learning in health care.  


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



Health Care for Older Persons in Singapore  

Microsoft Academic Search

Health care policy in Singapore is similar to that in the United States and the United Kingdom, where a residualist strategy is used to pass health care costs to individuals and their families, the rationale being that this enables the state to concentrate on devolution of care to the community and ensure efficient and affordable service to all Singaporeans. The

Peggy Teo



Financial Models for Integrated Behavioral Health Care  

Microsoft Academic Search

Integrated behavioral health care or “integrated care” is a distinct service delivery model aimed at early identification and appropriate intervention with that portion of medical\\/surgical patients presenting with behavioral health issues. The clinical rationale for integrated care and the potential for medical cost offset savings have been clearly substantiated in available research (Cummings, 2007; O’Donohue, Ferguson & Cummings, 2002), but

Blake Chaffee


Health care service use among vulnerable adolescents  

Microsoft Academic Search

This article describes the patterns of health care service use among a cohort of vulnerable adolescents with a history of homelessness and uses the Expanded Behavioral Model for Vulnerable Populations to examine factors associated with use of ambulatory and emergent care. We incorporated a health care interview into an existing longitudinal study of newly homeless adolescents, at their 24-month assessment

M. Rosa Solorio; Norweeta G. Milburn; Ronald M. Andersen; Sharone Trifskin; Lillian Gelberg



[Motivational interviewing in health care].  


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

Lev-Ran, Shaul; Nitzan, Uri



Unemployment and Health Care Utilization  

Microsoft Academic Search

\\u000a \\u000a Objectives  To determine if prior use of health services predicts subsequent risk of unemployment and to describe the acute effects of\\u000a exposure to unemployment on the use of health care services.\\u000a \\u000a \\u000a \\u000a Design  Prospective population-based study.\\u000a \\u000a \\u000a \\u000a Setting\\/Participants  18,272 employed and 1,498 unemployed individuals in a Canadian province in 1986.\\u000a \\u000a \\u000a \\u000a Main Outcome Measure  All cause and cause-specific rates of hospital admission and ambulatory physician contacts over

Allen Kraut; Cam Mustard; Randy Walld; Robert Tate


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

E-print Network

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

New Mexico, University of


Primary health care and health education in Japan  

Microsoft Academic Search

In this paper, the substance of the Alma Ata Declaration on Primary Health Care is discussed. Minimum requirements and working goals of Primary Health Care are reviewed. The health status of the Japanese people, and the medical and health delivery systems in Japan are considered, with reference to the Alma Ata Declaration. While the Alma Ata Declaration sets forth the

Mikio Yamamoto



Health and Health Care Disparities Among Homeless Women  

Microsoft Academic Search

While disparities in health and health care between vulnerable (e.g., minorities, low-income) and majority populations are well documented, less is known about disparities within these special populations that are large and diverse. Such knowledge is essential to determine the neediest within these generally needy populations, and to plan interventions to reduce their health and health care disparities. With data from

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



The legacy of apartheid in health and health care  

Microsoft Academic Search

This contribution analyses and systematiscs apartheid as a phenomenon and as a problem in South African health and health care. It is assumed that apartheid is one of the most decisive forces moulding the South African health care system as well as the health of the people, resulting in grave race-related disparities, inequalities, fragmentation and discrimination on the one hand,

H. C. J. van Rensburg; S. R. Benatar



Equity in health and health care: the Chinese experience  

Microsoft Academic Search

This paper examines the changes in equality of health and health care in China during its transition from a command economy to market economy. Data from three national surveys in 1985, 1986, and 1993 are combined with complementary studies and analysis of major underlying economic and health care factors to compare changes in health status of urban and rural Chinese

Yuanli Liu; William C. Hsiao; Karen Eggleston



Health care access: implications for higher education.  


The author discusses historical factors contributing to the health care crisis in America and reasons for the skyrocketing costs of health using an analogy of David versus Goliath. Even though Americans spend trillions on health care, the author states that America is ranked 37th in the world in terms of its health care delivery system. The author uses the methods used to manage the health care system in discussing how such a system could impact higher education and offers some solutions to same. PMID:17252876

Drayton-Brooks, Shirlee



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. PMID:22390510

Stöver, Heino; Wolff, Hans



Improving access to health care for uninsured elderly patients.  


The purpose of this article is to explore the barriers that the uninsured elderly population encounter when accessing health care in the United States. These barriers include, but are not limited to lack of transportation, insurance, or family support; the daunting complexity of the health care system; poverty; culture; poor patient-health care provider communications; race/ethnicity; and lack of health care professionals such as nurses and doctors with adequate geriatric preparation, or generalists who are undereducated in geriatrics. The number of health care professionals currently available to treat elderly persons in the United States is inadequate. The Federal government should take steps to develop solutions to improve access to health care and decrease health disparities for older adults. As a nation, we should be proactive in addressing these concerns instead of waiting for new barriers to arise that further limit access to health care for elderly patients and their families. In this article, we provide an assessment of the barriers that limit access to health care in the uninsured elderly population and suggest recommendations and possible solutions to eliminate or reduce these barriers. PMID:20626837

Horton, Shalonda; Johnson, Regina J



The US health care system: On a road to nowhere?  

PubMed Central

THIS ARTICLE REVIEWS THE CURRENT STATE AND FUTURE PROSPECTS of the health care system in the United States. The 1990s were a decade of reform and change in US medical care, with the debate over the Clinton plan for universal insurance and, after its defeat, the spread of managed care. In particular, managed care had a profound impact on the delivery of medical services, transforming traditional insurance arrangements. However, after all of the changes, the United States appears to be no closer to solving the problems that have characterized its health care system for the past 3 decades. Over 40 million Americans lack health insurance, universal coverage is nowhere in sight, and medical care costs are rising again after a period of moderation. It is doubtful that incremental health reforms will significantly ameliorate these problems. PMID:12160126

Oberlander, Jonathan



Federal Involvement in Mental Health Care for the Aged: Past and Future Directions.  

ERIC Educational Resources Information Center

This article is concerned with the aged and looks briefly at the history of federal involvement in mental health care, discusses current trends, and examines the future of mental health care in the United States. (CMG)

Roybal, Edward R.



Transforming Your Care A Review of Health and Social Care  

E-print Network

MENTAL HEALTH SERVICES ......................................... 89 14. PEOPLE WITH A LEARNING DISABILITY history in NI, particularly in the mental well being of the citizenry; and the very powerful affinityTransforming Your Care A Review of Health and Social Care in Northern Ireland #12

Paxton, Anthony T.


Peripheral health workers are central to primary health care: Lessons from Papua New Guinea's aid posts  

Microsoft Academic Search

This paper examines the nature of the service offered by Papua New Guinea's primary health workers and analyses the factors that influence their performance. The structural position of these peripheral health workers in the health care system sets limits to the effectiveness of current Health Department policy in determining the quality and availability of local services. Instead a variety of

Stephen Frankel



Selective primary health care: the counter revolution  

Microsoft Academic Search

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

Kenneth W. Newell



Predictors of Adolescent Health Care Utilization  

ERIC Educational Resources Information Center

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

Vingilis, Evelyn; Wade, Terrance; Seeley, Jane



Mental Health Consultation in Child Care and  

E-print Network

Mental Health Consultation in Child Care and Early Childhood Settings Opportunities to Expand Department of Children & Families Children's Mental Health Program June 30, 2006 Florida State University-922-1300 · #12;Mental Health Consultation in Child Care and Early Childhood Settings

McQuade, D. Tyler


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.



Background Briefing: The Canadian Health Care System  

Microsoft Academic Search

Canada's version of national public health insurance is characterised by local control, doctor autonomy and consumer choice - patients theoretically have a free choice of physician and hospital. (Kraker, 2002). The ten provincial governments are the key providers of health care, having the constitutional responsibility for planning, financing, and evaluating the provision of hospital care, negotiating salaries of health professionals

Benedict Irvine; Shannon Ferguson; Ben Cackett


Paying for Health Care: The Unequal Burdens  

ERIC Educational Resources Information Center

This article addresses the issue of national health care. Neither Medicare nor Medicaid equitably meet the health needs of the entire population. The author suggests criteria which must be met by a national health program if it is to eliminate inequalities in costs, access to services and quality of care. (GC)

Myers, Beverlee A.



Health care: economic impact of caring for geriatric patients.  


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

Rich, Preston B; Adams, Sasha D



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


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

Goldberg, L G



Health Care System Distrust in the Intensive Care Unit  

PubMed Central

Purpose To examine the performance and properties of the revised Health Care System Distrust scale among surrogates in the intensive care unit. Materials and Methods Pilot, prospective cohort study of 50 surrogates of adult, mechanically-ventilated patients surveyed on days 1, 3 and 7 of ICU admission. Results Responses on the Health Care System Distrust scale on day 1 ranged from 9 to 34 (possible range 9–45 with higher scores indicating more distrust), with a mean and standard deviation of 20.3 ± 6.9. Factor analysis demonstrated a 2-factor structure, corresponding to the domains of values and competence. Cronbach’s alpha for the overall scale was 0.83, for the competence subscale 0.76 and for the values subscale 0.74. Health care system distrust was inversely correlated with trust in ICU physicians (Pearson coefficient: ?0.63). When evaluated over the course of each patient’s ICU stay, health care system distrust ratings decreased by 0.31 per patient-day (95% CI .55-.06; p=.015). Correlation between health care system distrust and trust in ICU physicians decreased slightly over time. Conclusions Among surrogates in the ICU, the Health Care System Distrust scale has high internal consistency and convergent validity. There was substantial variability in surrogates’ trust in the health care system. PMID:21715134

Schenker, Yael; White, Douglas B.; Asch, David A.; Kahn, Jeremy M.



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

PubMed Central

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

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



Distance education for the health care supervisor.  


Health care supervisors are being driven by the rapid changes in health care today. One demand is to complete their undergraduate degree or even a graduate degree. Few of us are able to devote the many hours required to attend on-campus classes full time. Now there is an alternative. Busy health care supervisors can now complete their undergraduate or graduate degrees from the comfort of their home--maintaining a job and family life. PMID:10174445

Brownson, K



States' embrace of managed mental health care.  


Historically, state mental health authorities have dominated public mental health services, operating with fixed resources and responsible for a large population. A good public mental health system has many of the attributes of a well-managed private mental health system. Unfortunately, public systems are not flexible enough to contract creatively with multiple providers; they lack many of the tools of modern managed care. As a consequence, state mental health authorities have begun to contract with private managed care firms to assist them in managing their health care reform efforts, particularly reform of Medicaid. This paper examines the forces shaping managed behavioral health care in the public sector and describes strategies for managing care, such as contracting, utilization review, and monitoring. PMID:7498902

Essock, S M; Goldman, H H



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


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

Orlando, Rocco; Haytaian, Marcia



Current UK dental sedation practice and the 'National Institute for Health and Care Excellence' (NICE) guideline 112: sedation in children and young people.  


Aim Describe current dental sedation practice for under 19-year-olds in the UK and compare it with the recommendations of NICE guidance 112.Method Members of the Society for the Advancement of Anaesthesia in Dentistry and members of the Dental Sedation Teachers Group were invited to participate in an online survey.Results Two hundred and sixty-six dentists and doctors completed the survey. Eighty-two percent were operator and sedationist (operator-sedationist). Ninety-five percent provided written information and 94% obtained written consent. Eighty-four percent kept a written or electronic sedation record. Eighty-six percent complied with life support training expectations. Eighty-six percent had immediate access to resuscitation equipment. Sixty-seven percent of sedationists reported that treatment could not be completed under sedation for <10% of cases during the previous year. When sedation was unsuccessful, 61% said they would schedule general anaesthesia and 54.5% would schedule advanced sedation care. Forty-nine percent believed that a dentist was an appropriate person to provide advanced sedation for 12-18 years. Only 24% thought a dentist should provide advanced sedation for children <12 years, with 75% preferring an anaesthetist. The appropriate setting for advanced sedation was thought to be primary care by 33% and secondary care by 68%.Conclusions We found good agreement between the current practice of sedation and the recommendations of the NICE guidance 112. PMID:25908383

Coulthard, P; Craig, D; Holden, C; Robb, N D; Sury, M; Chopra, S; Holroyd, I



Attending unintended transformations of health care infrastructure  

PubMed Central

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

Wentzer, Helle; Bygholm, Ann



Health Care–Acquired Viral Respiratory Diseases  

PubMed Central

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

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



Skin Diseases: Questions for Your Health Care Provider  


Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Questions for Your Health Care Provider Past Issues / Fall 2008 Table of Contents For an enhanced version of this page please turn Javascript on. Photo: iStock Acne How should I care for my skin if I have acne? What will make my ...


Health Care Recommendations University Committee on Faculty Affairs  

E-print Network

, 2010 of the Blue Care Network as the base faculty health care plan. This would replace the current PHP and subsequently reviewed and approved by Faculty Council. Based on this report, and subsequent discussions, in the institution's prescription drug policy. The following additional recommendations are based upon the task


Cultural context, health and health care decision making. 1994.  


Decisions about health promotion and illness prevention occur within a cultural context that is influenced by the contemporary context of community and family in addition to the ethnohistorical and language contexts, worldview and sociocultural factors of the particular culture and the available folk and professional health care resources. Using information about the health and care beliefs and values and health care decision making process in negotiating culturally congruent nursing and health care interventions is imperative, especially in a world with limited health care resources and an increasing demand for recognition of cultural diversity. This article uses data on health and health care decision-making from an ethnonursing study of the Old Order Amish to demonstrate the role of cultural context in health care practices and decision making. Leininger's cultural care theory and Hall's conceptualization of high context culture were used to investigate these phenomena. High context features of the Old Order Amish culture are used to explain how Amish are actively involved in decisions and actions taken to promote health and prevent and treat illness using a broad array of folk, alternative and professional services simultaneously. As nurses learn to involve clients in decisions and actions using the guiding principles of cultural care preservation, accommodation and repatterning they will provide culturally congruent care for Amish and other culture-specific groups. PMID:8716100

Wenger, A F



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



Managing the quality of health care.  


This article reviews quality of health care initiatives beginning with the quality assessment/quality assurance movement of the 1970s. Conceptually, modern quality of care management is rooted in the intellectual work of Avedis Donabedian who defined quality of care as a combination of structure, process, and outcome. Donabedian's model is presented and some limitations are pointed out. In the late 1980s and 1990s. the health care industry adopted total quality management (TQM). More recently, the pursuit of health care quality has led to substantial performance measurement initiatives such as ORYX by the Joint Commission on Accreditation of Healthcare Organizations and MEDIS by the National Commission of Quality Assurance. The importance of CONQUEST, a freely available performance measurement database developed at the Harvard School of Public Health, is noted and discussed. The article concludes with a list of challenges facing public and private parties interests in health care quality improvement. PMID:15188996

Larson, James S; Muller, Andreas



Social networks of professionals in health care organizations: a review.  


In this article, we provide an overview of social network research in health care, with a focus on social interactions between professionals in organizations. We begin by introducing key concepts defining the social network approach, including network density, centrality, and brokerage. We then review past and current research on the antecedents of health care professionals' social networks-including demographic attributes, professional groups, and organizational arrangements-and their consequences-including satisfaction at work, leadership, behaviors, knowledge transfer, diffusion of innovation, and performance. Finally, we examine future directions for social network research in health care, focusing on micro-macro linkages and network dynamics. PMID:25380607

Tasselli, Stefano



Emotional intelligence: a core competency for health care administrators.  


The contemporary concept of emotional intelligence (EI) as a critical set of management skills is traced through time to its current application for health care administration. EI is defined as proficiencies in intrapersonal and interpersonal skills in the areas of self-awareness, self-regulation, self-motivation, social awareness, and social skills. The contributions of EI to effective management are supported by empirical research in the field. The importance of developing these skills in health care organizations is further clarified with examples familiar to health care administrators. Training suggestions and assessment resources are provided. PMID:12083173

Freshman, Brenda; Rubino, Louis




E-print Network

include, but is not limited to, emergency health care, sick call, access to medication, dental and mental may sign up for medical, dental, and mental health care, using one form for each request. All services MENTAL HEALTH SERVICES DENTAL SERVICES A completed inmate request form, placed in the "Medical" box

Oliver, Douglas L.


Health Services and Health Care Providers  


... First Aid Supplies Alcohol and Drugs Health Services Sexual Health How to Stay Healthy Abusive Relationships Common Health ... disabilities, nutrition issues or eating disorders, relationship problems, sexual health issues, alcohol or drug problems, or sports injuries. ...


Pivoting: leveraging opportunities in a turbulent health care environment*  

PubMed Central

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

Bandy, Margaret Moylan



[Access to child's health care in primary care services].  


It was conducted a qualitative study based on the methodological framework of dialectical hermeneutics, aiming to identify the attribute access from primary care to solve the health problems of children under one year old from the reports of parents and caregivers. Sixteen caregivers of children were involved, all of them seen in the emergency units of Cascavel-PR, in 2010. Four thematic categories were recognized: Family counselling in seeking health care for the child; Absence of reception on the first contact; Presence of risk classification to the child´s health attention; Barriers that block the access to health care. It was conclude that, families showed difficulties to reach the solution for their children´s health, because of the lack of access to primary care services. PMID:25517675

da Silva, Rosane Meire Munhak; Viera, Cláudia Silveira



Scalable office-based health care.  


The goal of health care is to provide high-quality care at an affordable cost for its patients. However, the population it serves has changed dramatically since the popularization of hospital-based health care. With available new technology, alternative health care delivery methods can be designed and tested. This study examines scalable office-based health care for small business, where health care is delivered to the office floor. This delivery was tested in 18 individuals at a small business in Minneapolis, Minnesota. The goal was to deliver modular health care and mitigate conditions such as diabetes, hyperlipidaemia, obesity, sedentariness and metabolic disease. The modular health care system was welcomed by employees - 70% of those eligible enrolled. The findings showed that the modular health care deliverable was feasible and effective. The data demonstrated significant improvements in weight loss, fat loss and blood variables for at risk participants. This study leaves room for improvement and further innovation. Expansion to include offerings such as physicals, diabetes management, smoking cessation and prenatal treatment would improve its utility. Future studies could include testing the adaptability of delivery method, as it should adapt to reach rural and under-served populations. PMID:21471576

Koepp, Gabriel A; Manohar, Chinmay U; McCrady-Spitzer, Shelly K; Levine, James A



Health Care Costing: Data, Methods, Future Directions

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


Health care librarians and information literacy: an investigation.  


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

Kelham, Charlotte



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 ( 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



Challenges for the German Health Care System.  


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

Dietrich, C F; Riemer-Hommel, P



Factors Associated with Health Care Access for Mississippi Children with Special Health Care Needs  

Microsoft Academic Search

Objectives: This purpose of the study was to examine the factors associated with access to routine care and to specialty care for Mississippi children with special health care needs (CSHCN). Methods: We analyzed data for Mississippi CSHCN from the 2001 National Survey of Children with Special Health Care Needs. Using a modified version of Andersen and Aday’s Behavioral Model of

Debra J. Kane; Marianne E. Zotti; Deborah Rosenberg



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

E-print Network

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

Oxford, University of


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.



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


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

Ung, Brian L; Mullins, C Daniel



Perspectives on HealthCare Resource Management Problems  

Microsoft Academic Search

\\u000a Research devoted to health-care applications has grown increasingly within operations research over the past 30 years, with\\u000a over 200 presentations at the 2008 INFORMS conference. Resource management is of particular importance within healthcare because\\u000a of the system’s unique objectives and challenges. We provide a perspective of the current health-care literature, focusing\\u000a on recent papers in planning and scheduling and reviewing

Jonathan Turner; Sanjay Mehrotra; Mark S. Daskin


The impact of changes in Finland's health care system.  


The most important reform in Finnish health care in the last decade occurred at the beginning of 1993 as part of a broader change to the entire state subsidy system. This reform reduced central government control and increased the freedom of the municipalities in the provision of health services. In addition, an unusually severe economic recession in the early 1990s affected Finnish health care. Currently, the most important economic decisions in the health care system are made by the 432 municipalities, which decide annually the amount of money to be devoted to health care as well as dividing resources in different sectors within the area of health. The changes in measures of productivity (based on activity-based measures in output) in the system are more closely associated with direct economic constraints (of municipalities) than with changes in financial incentive structures. Studies on equity in utilisation indicate that the Finnish health care system met the challenges of the 1991--1994 recession. Inequity in utilisation still prevails, however, and can be partly explained by the specific characteristics of the Finnish health care system. In future one needs to take more careful account of the rather unusual incentives that affect the behaviour of political decision-makers, providers and patients. PMID:16161191

Häkkinen, Unto



Insights From Health Care in Germany  

PubMed Central

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

Altenstetter, Christa



A Conversation on Rural Health Care.  

ERIC Educational Resources Information Center

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

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



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.



Disseminating best-evidence health-care to Indigenous health-care settings and programs in Australia: identifying the gaps.  


Indigenous Australians experience a disproportionately greater burden of harm from smoking, poor nutrition, alcohol misuse and physical inactivity (SNAP risk factors) than the general Australian population. A critical step in further improving efforts to reduce this harm is to review existing efforts aimed at increasing the uptake of evidence-based interventions in Indigenous-specific health-care settings and programs. This study systematically identifies and reviews published Indigenous-specific dissemination studies targeting SNAP interventions. An electronic search of eight databases and a manual search of reference lists of previous literature reviews were undertaken. Eleven dissemination studies were identified for review: six for nutrition and physical activity as a component of diabetes care, three for alcohol and two for smoking. The majority of studies employed continuing medical education (n = 9 studies), suggesting that improving health-care providers' knowledge and skills is a focus of current efforts to disseminate best-evidence SNAP interventions in Indigenous health-care settings. Only two studies evaluated reminder systems, despite their widespread use in Indigenous-specific health-care services, and only one study employed academic detailing, despite its cost-effectiveness at modifying health-care provider behavior. There is a clear need for more Indigenous-specific dissemination research targeting the uptake of secondary prevention and to establish reliable and valid measures of Indigenous-specific health-care delivery, in order to determine which dissemination strategies are most likely to be effective in Indigenous health-care settings and programs. PMID:19887577

Clifford, A; Jackson Pulver, L; Richmond, R; Shakeshaft, A; Ivers, R



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




Viewing health care as a war theater.  


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

Kessler, D M




E-print Network

FIXING THE FLOW OF HEALTH CARE IN TURBULENT TIMES INNOVATION REPORT 2014 #12;Since 2012, Algorithms, resources, people, data, even money to solve the impossible problems we face in health care today. Having, and an estimated 30 percent of that is wasted. Figure out how to carve that out, and we'd have an easy $840 billion

Feschotte, Cedric


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



Financial management in leading health care systems.  


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

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



A Guide to Adolescent Health Care EPSDT.  

ERIC Educational Resources Information Center

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

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


Health Care Provider Physical Activity Prescription Intervention  

ERIC Educational Resources Information Center

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

Josyula, Lakshmi; Lyle, Roseann



Lactose Intolerance: Information for Health Care Providers  

E-print Network

Lactose Intolerance: Information for Health Care are at or above their adequate intake of calcium.1 And adolescents who may be lactose intolerant are even less of their adult bone mass is established. As a health care provider, you can help your patients get the calcium

Rau, Don C.


Discrimination Against Older Women in Health Care  

Microsoft Academic Search

Growing awareness of apparent gaps in health care received by women and men raises concern over possible discrimination. This literature review examines this issue for elderly women, whose health care is obtained in a system that also may be permeated with age discrimination. Physicians tend to spend more time with women and older patients, suggesting that discrimination may not be

Linda Liska Belgrave



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



Applying economic principles to health care.  

PubMed Central

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

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



Changing trends in health care tourism.  


Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers. PMID:21045588

Karuppan, Corinne M; Karuppan, Muthu



Challenges to equity in health and health care: A Zimbabwean case study  

Microsoft Academic Search

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 \\

Rene Loewenson; David Sanders; Rob Davies



Home Health Care: What It Is and What to Expect  


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


[French national health insurance. The current situation].  


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

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



Protecting the health of employees caring for family members with special health care needs.  


Over half of American workers are holding a paid job while also providing unpaid assistance and support to a family member. Research shows that family members who provide care to children or adults with special health care needs are themselves at risk of physical and mental health problems. Yet, little research has explored how the work environment mediates the effects of caregiving on caregivers' mental and physical health. With a sample of 2455 currently employed U.S. adults from the Work, Family, Community Nexus (WFCN) survey, a random-digit dial, nationally representative survey of Americans aged 18-69, we examine whether paid leave and flexibility policies mediate the relationship between caregiving and health. In Ordinary Least Squares regression models, we find that paid leave to address family members' health was associated with better mental health status as measured by the 5-item Mental Health Inventory and paid sick leave with better physical health status as measured by self-rated overall health status. A supportive supervisor was also associated with improvements in mental and physical health. For both men and women, paid leave and a supervisor's support offset some or all of the negative effects of caregiving, but for women, the buffering effects of working conditions are slightly larger. Enhancing the unpaid leave guaranteed in the U.S. Family and Medical Leave Act so that it is paid and passing national paid sick days legislation will help ensure that employed caregivers can retain their jobs, receive needed income, and meet their own mental and physical health needs. PMID:21669484

Earle, Alison; Heymann, Jody



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



"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



Allied health care in Parkinson's disease: referral, consultation, and professional expertise  

Microsoft Academic Search

There is evidence for the efficacy of allied health care in Parkinson's disease (PD). However, barriers exist that hamper implementation of evidence into daily practice. We conducted a survey to investigate: (1) to what extent PD patients currently utilize allied health care for relevant problems in the core areas of allied health care and (2) the level of PD-specific expertise

Maarten J. Nijkrake; Samyra H. J. Keus; Rob A. B. Oostendorp; Sebastiaan Overeem; Wim Mulleners; Bastiaan R. Bloem; Marten Munneke



Patient Data Confidentiality Issues of the Dutch Electronic Health Care Record  

E-print Network

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

Groot, Perry


Bursaries, writing grants and fellowships: a strategy to develop research capacity in primary health care  

Microsoft Academic Search

BACKGROUND: General practitioners and other primary health care professionals are often the first point of contact for patients requiring health care. Identifying, understanding and linking current evidence to best practice can be challenging and requires at least a basic understanding of research principles and methodologies. However, not all primary health care professionals are trained in research or have research experience.

Karin Ried; Elizabeth A Farmer; Kathryn M Weston



Home health care: the dietitian's role.  


Nutritional services are an important part of the home care program. Medicare, Medicaid, and other third-party mechanisms do not reimburse providers for such services, even though the cost for home care is lower than for institutional care. Recognizing the need for nutritional services, the Veterans Administration has included the dietitian as a member of the home care team. Skills and guidelines developed by The American Dietetic Association for home and ambulatory care were adapted and utilized in developing a dietetic home care procedure which helps to avoid institutional care and provides a better quality of life at home. Nutritional services should be an integral part of all home health care programs. Because most home care programs do not have funds for a dietitian's service, legislative and/or regulatory action is needed to provide reimbursement for nutritional home care services. PMID:368104

Birge, K R; Maxwell, D R



Technology in health care: forensic implications.  


Technology continues to evolve and improve making our everyday tasks appear sometimes routine and mundane. The health care industry has embraced technological advances to improve on its daily operations in an effort to run more efficiently. Health care providers must be aware that these technologies collect data, lots of data, which is discoverable and may be used to defend or refute your actions as a nurse. This article will take a closer look at health care technology, cell phones, medical equipment, social media, telematics, and Health Insurance Portability and Accountability Act requirements, so that you will become familiar with the information and electronic fingerprint left behind. PMID:25463007

Quail, M Thomas



Oregon's Experiment in Health Care Delivery and Payment Reform: Coordinated Care Organizations Replacing Managed Care.  


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

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



41TREE CARE INDUSTRY -DECEMBER 2001 Plant Health Care  

E-print Network

41TREE CARE INDUSTRY - DECEMBER 2001 Plant Health Care Why Do Trees Vary in Suitability to Insects relationships among tree food quality to in- sects and pathogens, the environment and tree growth rates. The articles are based on a paper presented at "Trees 2000: Challenges for the future," a conference or


Health care employee perceptions of patient-centered care.  


Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L



Exchange of experience on primary health care.  


Objectives of the interregional Conference on Primary Health Care, organized by the World Health Organization (WHO) Regional Office for Southeast Asis together with the government of the Democratic People's Republic of Korea, were as follows: to exchange country experiences in the organization and implementation of primary health care; to assess primary health care development vis-a-vis national socioeconomic development and national health systems; to define alternative approaches to the development of the health infrastructure for inntegrated implementation of the 8 essential elements of primary health care; and to define the coordinating role of governments and international organizations in supporting and mobilizing resources in support of primary health care to to formulate recommendations for the organization and furthr development of primary care. The conference was attended by 35 participants from 18 countries in all 6 WHO regions and by representatives of 5 UN agencies. Conference recommendations include: a program of public information and health education should be launched to create and strengthen the desired awareness and commitment among the people and their representatives; the national health policy on primary health care should be broadly disseminated among all professional groups and functionaries involved in community development activities both in the health sector and outside it; concerted action by all health related development sectors should be initiated and strengthened to support the health sector in acheiving the goal of health for all; appropriate mechanisms relevant to the local situation should be evolved to give suitable training, orientation, and motivation to the community and opinion leaders in order to ensure their total involvement in the implementation and management of their own health care; governments should ensure the allocation of adequate funds for the smooth implementation of the program and that preferential allocation of resources be made for activities in the underserved areas; more rapid measures should be taken to extend primary health care services to all segments of the community that are still not covered; and the shortage of personnel available for providing primary care should be made up by reorienting existing personnel, accelerating the pace of basic training for primary health workers, and possibly also by inducting the health manpower available under traditional systems of medicine. PMID:6506669



Quality assurance in health care: past, present and future.  


Quality of health care delivery is a growing concern globally given current budget restraints and increasing demands on health care providers. The variety of quality assurance and quality management activities equals the numerous ways health care practitioners of all genres provide health care. Dental hygienists around the world must be knowledgeable about quality assurance and management in health care as it is a significant factor in the evolution of the dental hygiene profession and the quality of oral health care provided by dental hygienists. The objective of this research was to conduct a literature review on quality assurance and quality management. A MEDLINE search from 1966 to 2002 was conducted. The search resulted in approximately 145 articles. Additional references from works generated by the search were also obtained. The literature revealed information on the background and history of quality assurance and quality management. Much of the literature was devoted to discussions of the validity, reliability and effectiveness of most prominent quality management activities being utilised in health care today. The investigation revealed numerous issues and barriers surrounding quality management. This article concludes with suggestions for future directions of quality assurance and quality management. PMID:16451516

Bilawka, E; Craig, B J



Commodifying the polyvalent good of health care.  


This essay serves as an introduction to this issue of the Journal of Medicine and Philosophy on commodification and health care. The essay attempts to sharpen the articulation of generally expressed worries about the commodification of health care. It does so by defining commodification, analyzing three components of the good of health care, and attempting to assess how commodification might distort the shape of each of those components. Next, it explores how the good of health care might be distorted by the market-based principle of distributive justice, "to each according to ability to pay." Finally, it identifies two basic questions about the relationship of medicine and the market that merit further exploration. (1) How does the market-based language of "incentives" so pervasive in the world of managed care distort the complex patterns of virtue and vice that motivate actors in the health care arena? (2) If we recognize that we cannot eliminate the influence of money from the health care system, how can we insure that the good of health care remains, in Radin's terms, "incompletely commodified"? PMID:10472812

Kaveny, M C



Strategic service quality management for health care.  


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

Anderson, E A; Zwelling, L A



An introduction to oral health care reform.  


Oral health care reform is made up of several components, but access to care is central. Health care reform will occur in some fashion at some point, and how it will impact the entire dental sector is unclear. In the short term, there is likely to be a dental component during the reauthorization of State Children's Health Insurance Program in early 2009, and several federal oral health bills are expected to be reintroduced as well. Additional public funding for new programs and program expansions remains questionable, as federal funding will be tight. Fiscal conservancy will be occurring in the states as well; however, various proposals to expand dental hygienists' duties are likely, as are proposals related to student grants for dental schools. Regardless of one's political stance, the profile of oral health care has been elevated, offering countless opportunities for improvement in the oral health of the nation. PMID:19482130

Hathaway, Kristen L



Vaccine perceptions among Oregon health care providers.  


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

Bean, Sandra J; Catania, Joseph A



Health care technology and quality of care.  


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



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. PMID:21778473

Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica



Socioeconomic inequality in health and health care among children  

Microsoft Academic Search

Objective: There is evidence of a steepening socioeconomic gradient in health as children age in the US. Building on this research, this study examines the association between socioeconomic inequality in health and access to health care in the context of a universal health system. The objectives of this research are twofold: first, to estimate the extent of socioeconomic inequality in

Sara Allin; Mark Stabile



Community health workers in primary care practice: redesigning health care delivery systems to extend and improve diabetes care in underserved populations.  


New, comprehensive, approaches for chronic disease management are needed to ensure that patients, particularly those more likely to experience health disparities, have access to the clinical care, self-management resources, and support necessary for the prevention and control of diabetes. Community health workers (CHWs) have worked in community settings to reduce health care disparities and are currently being deployed in some clinical settings as a means of improving access to and quality of care. Guided by the chronic care model, Baylor Health Care System embedded CHWs within clinical teams in community clinics with the goal of reducing observed disparities in diabetes care and outcomes. This study examines findings from interviews with patients, CHWs, and primary care providers (PCPs) to understand how health care delivery systems can be redesigned to effectively incorporate CHWs and how embedding CHWs in primary care teams can produce informed, activated patients and prepared, proactive practice teams who can work together to achieve improved patient outcomes. Respondents indicated that the PCPs continued to provide clinical exams and manage patient care, but the roles of diabetes education, nutritional counseling, and patient activation were shifted to the CHWs. CHWs also provided patients with social support and connection to community resources. Integration of CHWs into clinical care teams improved patient knowledge and activation levels, the ability of PCPs to identify and proactively address specific patient needs, and patient outcomes. PMID:25359249

Collinsworth, Ashley; Vulimiri, Madhulika; Snead, Christine; Walton, James



Cooperative health care clinics: a group approach to individual care.  


In cooperative health care clinics (CHCC), health care is provided to older patients in a group setting. The CHCC concept, which was developed under a research grant by Kaiser Permanente in Colorado in 1991, showed improvement in patient and provider satisfaction, as well as improved quality of care and cost effectiveness. CHCC are being replicated in other sites under a research grant from the Robert Wood Johnson Foundation. In addition to formal findings from research studies, much has been learned about factors that have promoted the success of the program. PMID:9597981

Scott, J; Gade, G; McKenzie, M; Venohr, I



[Primary care in maternal-child health].  


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



Lean methodology in health care.  


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

Kimsey, Diane B



Medical informatics and health care organizations.  


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

Holden, F M



Using Electronic Health Records to Help Coordinate Care  

PubMed Central

The use of electronic health records that can securely transmit patient data among physicians will help coordinate the care of 60 million Americans with multiple chronic conditions. This article summarizes the different organizations in the United States that are developing this technology. It discusses some of the problems encountered and the current initiatives to resolve them. The article concludes with three recommendations for enhancing care coordination: (1) a common health record, such as the Continuity of Care Record, to facilitate the exchange of clinical information among health providers; (2) regional governance structures to encourage the exchange of clinical data; and (3) payment by purchasers of care, both public and private, to physicians for using electronic health records. PMID:15330973

Burton, Lynda C; Anderson, Gerard F; Kues, Irvin W



Baylor Health Care System's journey to provide equitable care.  


Baylor Health Care System* has a long history of addressing health disparities at its hospitals and clinics and in the communities it serves. The organization's definition of health equity has evolved from simply providing care that looks the same for all patients to providing care that is tailored to and effective at producing equitable outcomes for the highly diverse populations of North Texas. Baylor's overarching framework for achieving health equity requires work in three dimensions: improving access to care, improving care delivery, and ultimately producing equitable outcomes for patients. The strategies and tactics used by Baylor have also evolved over time and range from initiatives supporting volunteerism and community service to the operation of a network of clinics tailored to meet the needs of uninsured and underinsured patients. The factors contributing to disparities among different populations include a broad range of health system, medical, and societal issues, many of which are outside the direct scope of influence of hospitals and other healthcare organizations. We share how Baylor has proactively addressed disparities within the organization and its community in the hope of encouraging other hospitals and providers to engage in similar efforts to improve care for all patients. PMID:25291890

Allison, Joel T; Fullerton, Cliff; Chabira, Adam



Analysis of Senate Bill 890: Basic Health Care Services  

E-print Network

Affordable Care Act (P.L.111-148), which was amended by the Health Care and Education Reconciliation Act (Affordable Care Act (P.L.111-148), which was amended by the Health Care and Education Reconciliation Act (

California Health Benefits Review Program (CHBRP)



Antiretroviral therapy: effects on orofacial health and health care.  


This study summarizes the adverse effects of antiretroviral therapy (ART) agents against HIV on orofacial health and health care. Current antiretroviral agents fall mainly into three major classes: nucleoside reverse-transcriptase inhibitors (NRTIs), non-nucleoside reverse-transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) - now with the new classes of fusion inhibitors, entry inhibitors--CCR5 co-receptor antagonists and HIV integrase strand transfer inhibitors. Many of the ART agents can have adverse orofacial effects, or can give rise to allergies or drug interactions--the optimum anti-HIV drug has yet to be found. There are few orofacial adverse effects that characterize a particular ART class, but erythema multiforme (EM), ulcers and xerostomia may be associated with reverse-transcriptase inhibitors (RTI); parotid lipomatosis, taste disturbance, xerostomia and perioral paraesthesia mainly related to PIs. Facial lipoatrophy is a common adverse effect of NRTIs; EM is more frequently associated with NNRTIs. Thus, although most of the more recent ART drugs and combinations of them show improved safety profiles, some may give rise to orofacial adverse effects, and may affect oral health care. PMID:23530806

Diz Dios, P; Scully, C



Health care reform and rural mental health: Severe mental illness  

Microsoft Academic Search

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

Catherine F. Kane; Jacqueline M. Ennis




Microsoft Academic Search

Organizations are held accountable to multiple stakeholders. New systems to manage the changing face of organizational processes are continually being created necessitating constant change in the way we work together in the healthcare workplace. Today's health care manager requires a clear understanding of the complexity in which health care organizations function and a commensurate stable of knowledge, skills and abilities

Diana W. Hilberman


Introducing a fresh approach to health care.  

E-print Network

health plan gives you access to quality care and the tools and resources you need to manage your health to manage your plan, your money and your health Your terms · Definitions of key terms 3 #12;innovative {in offers a wide range of benefits that provide the protection you need. You're covered for everything from


Home Health and Informal Care Utilization  

E-print Network

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


Young People's Experiences of Mental Health Care  

ERIC Educational Resources Information Center

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

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



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.



Planning Campus Health Care Services 1.  

ERIC Educational Resources Information Center

New trends in campus health care delivery were discussed at a workshop in Chicago sponsored by the Society for College and University Planning on January 30-31, 1975. Consideration was given to the repercussions of strong consumer demands for broader and more accessible health services, the emergence of health maintenance organizations, and…

Hazard, Sprague W.



Voice Care Jewels: Nurturing Singers' Vocal Health.  

ERIC Educational Resources Information Center

Focuses on the importance of vocal health for students. Discusses learning about vocal health care and the techniques used to educate music students about it. Includes an annotated bibliography of resources on vocal health, a survey to administer to students, and "Jewels of Wisdom" useful to music teachers. (CMK)

Cooper, Cynthia



Reflections on curative health care in Nicaragua.  


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

Slater, R G



47 CFR 54.633 - Health care provider contribution.  

Code of Federal Regulations, 2014 CFR

...2014-10-01 2014-10-01 false Health care provider contribution. 54.633...SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a)...



47 CFR 54.633 - Health care provider contribution.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Health care provider contribution. 54.633...SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a)...



76 FR 37307 - Rural Health Care Support Mechanism  

Federal Register 2010, 2011, 2012, 2013, 2014

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



77 FR 42185 - Rural Health Care Support Mechanism  

Federal Register 2010, 2011, 2012, 2013, 2014

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



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

Federal Register 2010, 2011, 2012, 2013, 2014

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



[Informatics in the Croatian health care system].  


Informatization process of the Croatian health care system started relatively early. Computer processing of data of persons not covered by health insurance started in 1968 in Zagreb. Remetinec Health Center served as a model of computer data processing (CDP) in primary health care and Sveti Duh General Hospital in inpatient CDP, whereas hospital administration and health service were first introduced to Zagreb University Hospital Center and Sestre Milosrdnice University Hospital. At Varazdin Medical Center CDP for health care services started in 1970. Several registries of chronic diseases have been established: cancer, psychosis, alcoholism, and hospital registries as well as pilot registries of lung tuberculosis patients and diabetics. Health statistics reports on healthcare services, work accidents and sick-leaves as well as on hospital mortality started to be produced by CDP in 1977. Besides alphanumeric data, the modern information technology (IT) can give digital images and signals. Communication in health care system demands a standardized format of all information, especially for telemedicine. In 2000, Technical Committee for Standardization in Medical Informatics was founded in Croatia, in order to monitor the activities of the International Standardization Organization (ISO) and Comite Européen de Normalisation (CEN), and to implement their international standards in the Croatian standardization procedure. The HL7 Croatia has also been founded to monitor developments in the communication standard HL7. So far, the Republic of Croatia has a number of acts regulating informatization in general and consequently the informatization of the health care system (Act on Personal Data Confidentiality, Act on Digital Signature, Act of Standardization) enacted. The ethical aspect of data security and data protection has been covered by the Code of Ethics for medical informaticians. It has been established by the International Medical Informatics Association (IMIA), and the Croatian Society of Medical Informatics (CSMI) has translated it into Croatian and published it on its website. Based on a survey of medical staff attitudes toward health care system informatization, the Croatian health system appears to be ready for informatization. The only requirement is that the present and future health care providers have appropriate medical informatics education, proper computer equipment at their workplace, and an opportunity to participate in the development and/or improvement of the health information system. One of the EU health strategy priorities is the improvement of health information and knowledge. It means that integrated health information systems are required, i.e. systems able to provide key information on health and health care system to the politicians, health professionals and public in general. PMID:16095187

Kern, Josipa; Strnad, Marija



The Ottawa Charter and acute health care.  


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



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


Robots and service innovation in health care.  


Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation. PMID:20729249

Oborn, Eivor; Barrett, Michael; Darzi, Ara



Future developments in health care performance management  

PubMed Central

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

Crema, Maria; Verbano, Chiara



Health Care Robotics: A Progress Report  

NASA Technical Reports Server (NTRS)

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

Fiorini, Paolo; Ali, Khaled; Seraji, Homayoun



Health care evaluation, utilitarianism and distortionary taxes.  


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

Calcott, P



Simulation modeling for the health care manager.  


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

Kennedy, Michael H



Mercy health promoter: A paradigm for just health care  

PubMed Central

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

Clark, Peter A.; Schadt, Sam



Integration: the firm and the health care sector.  


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

Laugesen, Miriam J; France, George



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

PubMed Central

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



Health care – an everlasting challenge in temporal and spatial domains  

PubMed Central

Health care is an everlasting challenge that requires effort at all levels, from national and organizational to individual domains, over a long-term period. This article reviews the historical development of health care-related issues worldwide and accentuates the necessity of health care in the current era. Through investigating the historical background in both the occidental and the oriental worlds and the latest achievements from academic and industrial endeavors, many lessons can be learnt, and as a result, an integrative strategy is proposed to meet today’s pressing needs. A government-funded project, “Challenge to 100 years of age”, which involved more than 600 residents in west Aizu village, lasted over 15 years. After reviewing its outcomes, a metrology of health based upon the three-dimensional phase space, which integrates with social well-being, mental status, and physical condition for a lifelong span, is advocated as a measure of the holistic view of health state. PMID:21197368

Chen, Wenxi



Transforming nursing care through health literacy ACTS.  


Limited patient literacy contributes to poorer health status, increased emergency room and hospital use, higher morbidity and mortality rates, and less use of preventive health services. All patients, however, need health information that is accurate, accessible, and actionable to make informed decisions about their health. A universal health literacy precautions approach is recommended to empower patients through shared decision-making interactions. Consistent use of evidence-based health literacy practices by front-line nurses offers the potential for transformations in nursing care through stronger patient-nurse interactions and health system partnerships. PMID:25680489

French, Kempa S



Access to Health Care: Health Insurance Considerations for Young Adults With Special Health Care Needs\\/Disabilities  

Microsoft Academic Search

Youth with special health care needs\\/dis- abilities want what all youth in America want: indepen- dence, health, friends, and jobs. Yet, between 19 and 23 years of age (depending on the state), youth with special health care needs\\/disabilities often find little availability of health insurance or health providers that were an essential part of why they survived and now are

Patience H. White



Policy dilemmas in latino health care and implementation of the affordable care act.  


The changing Latino demographic in the United States presents a number of challenges to health care policy makers, clinicians, organizations, and other stakeholders. Studies have demonstrated that Latinos tend to have worse patterns of access to, and utilization of, health care than other ethnic and racial groups. The implementation of the Affordable Care Act (ACA) of 2010 may ameliorate some of these disparities. However, even with the ACA, it is expected that Latinos will continue to have problems accessing and using high-quality health care, especially in states that are not expanding Medicaid eligibility as provided by the ACA. We identify four current policy dilemmas relevant to Latinos' health and ACA implementation: (a) the need to extend coverage to the undocumented; (b) the growth of Latino populations in states with limited insurance expansion; PMID:25581154

Ortega, Alexander N; Rodriguez, Hector P; Vargas Bustamante, Arturo



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



Challenges to Native American health care.  

PubMed Central

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

Noren, J; Kindig, D; Sprenger, A



[Health insurance in Africa: a straw for the health care system].  


Health Care Systems Clutch at a Straw: The health care systems of sub-Saharan Africa are facing a global crisis which is severely challenging their survival. Currently, alternatives to the traditional financing of health care by government grants and/or "fee for service" are sought. Otherwise the vast majority of poor rural inhabitants of these countries will lose access to Western medicine at the end of this century, making appropriate medical care a privilege of a small number of rich urbans. One approach to solving this crisis is the introduction of a health insurance system. However, the culture of African people must also be considered if one attempts to design and implement an insurance scheme. This paper reflects some of the problems of health insurance in an African context. Since the author contributed to the design of a "Community Based Health Insurance" of the Evangelical Lutheran Church in Tansania, this scheme is used here as an example. PMID:9522564

Flessa, S



Managing County Employee Health Care Costs The Problem  

E-print Network

.pdf Health Fair Planning Guide planning_guide/index.php HealthManaging County Employee Health Care Costs The Problem If food costs increased at same rate as health care, one dozen eggs would cost $80.20! 87.5% of health-care claims are due to employees


Should Health Care Providers be Accountable for Patients' Care Experiences?  


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

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



The case for integrating oral health into primary health care  

Microsoft Academic Search

Severe disparities in oral health and inequities in access to oral health care exist globally. In New Zealand, the cost of oral health services is high. Physician services and medicines are heavily subsidised by the government—however, in contrast, private financing, either as out-of-pocket payments or as private insurance, dominates dental care. Consequently, the use of services is often prompted by

Santosh Jatrana; Peter Crampton; Sara Filoche



Mental health services of the future: Managed care, unmanaged care, mismanaged care  

Microsoft Academic Search

Rising costs. Treatable disorders. No treatment for many. High indirect expenses. The response to this contemporary set of circumstances has been managed mental health care. The transition from fee?for?service to managed behavioral health services has meant the industrialization of mental health care, an entirely new culture for providers, and a melding of the traditional public and private sectors. This article

Jeffrey L. Geller



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


Health and Health Care Disparities among Homeless Women  

PubMed Central

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

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



Health and health care disparities among homeless women.  


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

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



The Promise Of Health Care Cost Containment  

Microsoft Academic Search

ABSTRACT: Today the United States may be on the cusp of changing,from a cost-uncon- scious health care system to one that seeks value. The consequences,of adopting a value- based approach to coverage have not been well studied; however, several broad strands of the health literature suggest that spending,could be reduced,by as much,as 30 percent without adversely affecting health. [Health Affairs

Alan Garber; Dana P. goldman; Anupam B. Jena



Operationalizing knowledge management in health care.  


Being able to leverage the collective clinical knowledge that a health system acquires on a daily basis and then apply that knowledge to elevate productivity and maintain clinical quality would be nirvana for health system executives. Although it is difficult to bring knowledge management to health care, it is not impossible. Architects of knowledge management solutions in health care will need to balance what an organization hopes to achieve in its market (business strategy); how they hope to achieve it (operating strategy); and where information technology is needed to enable what they hope to achieve and how they hope to achieve it (information strategy). PMID:11234728

Zazzara, P



Market forces and efficient health care systems.  


The "market forces" to which economists ascribe the ability to motivate improvement in quality and efficiency are largely nonexistent in U.S. health care. One thus might ask, "Could market forces be made strong enough to deliver efficient health care systems?" There is some evidence to suggest that the answer is "Yes." This paper offers a short list of some changes that would be needed to create such a health care economy. Continued increases in costs and in the numbers of uninsured people will likely make a universal coverage model based on Medicare a politically popular choice, but such a model would not deliver efficient health care systems because it lacks sufficient incentives for consumers to choose less costly options. PMID:15046128

Enthoven, Alain C



Children with Special Health Care Needs  


... Prevention Travel & Motor Vehicle Safety En Español Childhood Student Emergencies Children With Special Health Care Needs Parents ... teachers, and school nurses. FYI Related links Childhood Student Emergencies Symptoms of Childhood Emergencies When Your Child ...


Panel: Trends in Health Care Information Systems  

PubMed Central

The panel presents significant trends in demographic and economic forces that are driving healthcare delivery systems, how health care providers are responding to these driving forces, and how information systems are being developed using new technology to help health care providers and consumers. An aging population and rapidly increasing government and business health care expenditures are forcing hospitals and other health care providers to consolidate, compete, become more efficient, and diversify and market their services. Emerging computer technology will facilitate the development of information systems that utilize integrated data bases, communication networks, appropriate input/output devices, and cost effective computing power to provide the financial, management, and medical information required by these evolving provider systems.

Grams, Stanley; Dvorak, Robert M.; Pryor, T. Allan; Childs, Bill W.



The valuation of health care intangible assets.  


Health care entities (and especially medical practices) are valued for a number of reasons: sale transaction pricing and structuring, merger formation and dissolution, taxation and regulatory compliance, and litigation support and dispute resolution. The identification and quantification of the entity's intangible assets are often the most important aspects of the valuation. This article illustrates the generally accepted methods for valuing health care-related intangible assets. PMID:9143902

Reilly, R F; Rabe, J R



Emerging trends in health care finance.  


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

Sterns, J B



Agent-Based Health Care Systems  

Microsoft Academic Search

In this paper we introduce the main issues related to the deployment of agent-based systems in health care. First, we comment on the characteristics of health care problems and we argue that multi-agent systems are a good choice to tackle problems with these features. This belief is supported with a number of exemplar applications of agent-based systems in medical domains.

John L. Nealon; Antonio Moreno


Agent-Based Applications in Health Care  

Microsoft Academic Search

In this paper we introduce the main issues related to the deployment of agent-based systems in health care. First, we comment on the characteristics of health care problems and we argue that multi-agent systems are a good choice to tackle problems with these features. This be- lief is supported with a number of exemplar applications of agent-based systems in medical

John Nealon; Antonio Moreno



Health Care Cost Containment In Connecticut  

Microsoft Academic Search

\\u000a In 1993, the state legislature, through its chief oversight committee—the Legislative Program Review and Investigations Committee—undertook\\u000a a study of Connecticut’s health care delivery system. The goal of the Committee’s study was to create a regulatory environment\\u000a that encourages cooperative efforts for controlling costs while setting boundaries for an emerging competitive health care\\u000a market. This paper summarizes some of the findings

L. Spencer Cain


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.


Transforming IT University Health Care System  

E-print Network

-- Improved access to archived cardiology studies provides a competitive advantage for UHCS in the community to help improve healthcare GMAS delivers three important capabilities to ensure UHCS cliniciansTransforming IT University Health Care System improves patient care with enterprise grid storage


Risk contracts in managed mental health care  

Microsoft Academic Search

Prologue: The term risk contracting has become a familiar part of the vocabulary and the landscape of managed care. Risk contracting refers to an arrangement whereby the cost or claims risk for an insured population is borne by the entity that is desig- nated to bear risk: a prepaid plan or, as is increasingly the case for mental health care,

Richard G. Frank; Thomas G. McGuire; Joseph P. Newhouse



The Health Care Dilemma. Second Edition.  

ERIC Educational Resources Information Center

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

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


Medical returns: Seeking health care in Mexico  

Microsoft Academic Search

Despite the growing prevalence of transnational medical travel among immigrant groups in industrialized nations, relatively little scholarship has explored the diverse reasons immigrants return home for care. To date, most research suggests that cost, lack of insurance and convenience propel US Latinos to seek health care along the Mexican border. Yet medical returns are common even among Latinos who do

Sarah Horton; Stephanie Cole



[Quality of health care and its evaluation].  


The focus on quality improvement of health care has been emerging in last decade, due to rapidly increasing competition, cost containment by governmental and private health financing corporations (including health insurance), and high costs structure of health care providing institutions. Accordingly, necessity of evaluation on results of care/outcome (discharge and discontinuation) of care has been drawn prompt attention of decision makers and administrators in health care institutions. However, since, original motive of quality care has been generated from the aspect of care providers' oriented (in US: Market and costs oriented, in Europe: Legislation oriented) bases and directions, in terms of cost performance, downsizing operation, improvement of competing capability and creating new profit making opportunity, evaluation approach, prioritization, itemization, setting goal, and standards were forced to set as forth to meet the providers' objective, in stead of patient's benefit and maximization of patient's satisfaction. Therefore, effective evaluation structure of quality balance management in operation must be built and consisted of four major 1)-4) cores to maintain patient oriented quality and optimal level of quality obligation to community. 1) In process 2) In Services 3) In Inhabitant Benefits 4) In Producing Assured Results. Through the efforts, it is proposed to urge "Evaluation Effectiveness Initiative (EEI) by Japan's leadership" to achieve sustainable safety and effective quality in balance of process through whole operations. PMID:9423195

Tsubo, T



Status of simulation in health care education: an international survey  

PubMed Central

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

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




E-print Network

with fluid retention due to heart failure, renal failure, or hepatic failure. 4. Mechanically Soft Diet concepts related to preventive health maintenance, including health education services and training in self-care skills as a part of inmate health service. Printed education materials shall be made available to all

Oliver, Douglas L.


Applying business management models in health care.  


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

Trisolini, Michael G



Implementing health information technology to improve the process of health care delivery: a case study.  


Integration of health information is critical to the provision of effective, quality care in today's fragmented health care system. The increasing prevalence of chronic conditions and the demand for a comprehensive understanding of patient health on the part of providers are driving the need for the integration of health information through electronic health information systems. Two distinct health information systems currently utilized in the health care field include electronic medical records (EMR) and chronic disease management systems (CDMS). The integration of these systems is likely to enable the efficient management of health information and improve the quality of health care as it would provide real-time patient information in a coordinated manner. The lack of real-time information may result in delayed treatment, uninformed decisions, inefficient resource use, and medical errors. Despite their importance and widespread support, these systems have slow provider adoption rates. Our understanding of how health information technology may be used to improve health care is limited by the relative paucity of research on the adoption, integration, and implementation of these 2 types of systems. This paper documents the use of an EMR at Marshfield Clinic, a multidisciplinary group practice in the United States. We review the concomitant use of an EMR for clinical data capture and the implementation of a proprietary CDMS, InformaCare, for care management of chronic diseases. These 2 systems allow providers to deliver health care using evidence-based guidelines that meet the Institute of Medicine's aim of providing safe, efficient, patient-centered, and timely care. PMID:17718659

Follen, Marilyn; Castaneda, Rachel; Mikelson, Melissa; Johnson, Debrah; Wilson, Alisa; Higuchi, Keiko



Corporate social responsibility and the future health care manager.  


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



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

PubMed Central

This regular feature of the journal includes a discussion of recent trends in health care spending, employment, and prices. The statistics presented in this article are valuable in their own right and for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data. PMID:25372024

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



Mental health stigma and primary health care decisions.  


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

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



Role of primary health care in ensuring access to medicines.  


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



Economic analysis of health care interventions.  


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

Konski, Andre



Informatics and Pediatric Health Care  

Microsoft Academic Search

The incorporation of information technology (IT) to improve the quality, safety, and efficiency of medical care has gained\\u000a popularity among the public, policymakers, and clinicians. The application of IT tools to address the special vulnerabilities\\u000a of children, to meet the data needs of their care and to avert medical errors and their consequences, is natural if not compelling.\\u000a However, the

Kevin B. Johnson; George R. Kim


[Measuring health literacy can improve communication in health care.  


A tool for measuring health literacy is desirable when tailoring health care services to individual patients. Existing tools measure the functional aspects of health literacy whereas newly developed tools have a broader scope and measure people's knowledge, motivation and competences to access, understand, appraise and apply health information. Two novel, international health literacy questionnaires have been translated and are being validated in a Danish context. The final questionnaires may assist Danish health professionals in shaping communication with patients and reduce health disparities. PMID:24629605

Nørgaard, Ole; Sørensen, Kristine; Maindal, Helle Terkildsen; Kayser, Lars



Overview of current pediatric burn care.  


Burn injuries affect approximately a million children in the United States on an annual basis. Moderate to severe burns require hospitalization, usually under the direction of a Pediatric Surgical service. Despite advancements in burn treatment, pediatric burn injuries account for approximately 2500 deaths annually. This article provides an overview of the initial evaluation and resuscitative measures for pediatric burn patients, most current wound care, indications for grafting, and the role of nutrition, including use of pharmacologic adjuncts. Use of colloid solutions, indications for use of skin substitutes, and transfer criteria will also be addressed. PMID:25639810

Gonzalez, Raquel; Shanti, Christina M



Sensible compromise: will there be health care reform?  


Three significant challenges to the passage of health care legislation bear watching as they have the potential to make sensible compromise between the House and Senate unlikely. The first threat is the continuing exposure of the public to misinformation from media commentary and interest groups. If health care delivery issues weren't complex enough, another growing issue is the misuse of the filibuster, further obscuring change and clarity in legislative discussion. The third threat is a move by opponents of current health care reform to engage the Supreme Court and challenge the constitutionality of the legislation. If substantive health reform legislation fails to pass, nursing will have received a deep wound along with the rest of this country. Our voice as patient advocates must be stronger in these final days. PMID:20306879

Gardner, Deborah



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.


SIU Student Health Initiative Working for quality and affordable student heath care at Southern.  

E-print Network

SIU Student Health Initiative Working for quality and affordable student heath care at Southern. Benefit Comparison Current SIUC self-funded student insurance plan* Affordable Care Act (ACA) compliant,000 lifetime benefits cap) No limits on mental health care appointments Limited number of therapy appointments

Nickrent, Daniel L.


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


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

Ono, N



Suicides in Users of Mental Health Care Services: Treatment Characteristics and Hindsight Reflections  

ERIC Educational Resources Information Center

The current study aims to describe the patient and treatment characteristics of a sample of 505 suicides by mental health care patients, and to determine how clinicians view the care provided and what they learned. The results indicate that the quality of mental health care for suicidal patients could be improved by focusing on communication among…

Huisman, Annemiek; Kerkhof, Ad J. F. M.; Robben, Paul B. M.



Women and access to health care  

Microsoft Academic Search

This paper is concerned with access to health care for women in developing countries, with specific reference to Latin American and Caribbean countries. It reviews the available literature on the concept of access as it relates to other variables such as accountability, affordability and acceptability of health services, taking into consideration the effects of the generalized socio-economic crisis that has

Cristina Puentes-Markides



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



Wireless Sensor Networks for Home Health Care  

Microsoft Academic Search

Abstract— Sophisticated electronics are within reach of average users. Cooperation between wireless sensor networks and existing consumer electronic infrastructures can assist in the areas of health care and patient monitoring. This will improve the quality of life of patients, provide early detection for certain ailments, and improve doctor-patient efficiency. The goal of our work is to focus on health-related applications

Chris R. Baker; Kenneth Armijo; Simon Belka; Merwan Benhabib; Vikas Bhargava; Nathan Burkhart; Artin Der Minassians; Gunes Dervisoglu; Lilia Gutnik; M. Brent Haick; Christine Ho; Mike Koplow; Jennifer Mangold; Stefanie Robinson; Matt Rosa; Miclas Schwartz; Christo Sims; Hanns Stoffregen; Andrew Waterbury; Eli S. Leland; Trevor Pering; Paul K. Wright



Twenty-first century health care.  


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

Pearson, M



Reforming the Military Health Care System.  

ERIC Educational Resources Information Center

Serious problems beset the military's extensive system of health care: rising budgetary costs, dissatisfaction among its beneficiaries, and inadequate readiness for war. This report was written at the request of the House Committee on Armed Services to examine some of these issues. It looks at a range of possible reforms in the military health

Slackman, Joel


New Developments Concerning Health Care Fitness  

Microsoft Academic Search

In this report we discuss some of the new developments in the health care fitness industry catering to the needs of a healthy lifestyle, and their pros and cons. Such solutions have become very popular among health-conscious people, and these developments help enhance one's appearance, make one feel good, and give more control over one's body and lifestyle. We have

Vibhuti Singhal; Brian Kleiner



Health and Safety in Day Care.  

ERIC Educational Resources Information Center

Basic health and day care policies and procedures should be implemented and closely monitored with the help of a health consultant, particularly in terms of respiratory tract, enteric, skin, invasive bacterial, and multiple system infections; Acquired Immune Deficiency Syndrome; vaccine preventable diseases; and general safety procedures.…

Sells, Clifford J.; Paeth, Susan



Securing Health or Just Health Care? The Effect of the Health Care System on the Health of America  

Microsoft Academic Search

The author first analyzes why the prevention of illness and promotion of health provide the leading justification for the government to act for the welfare of the population. His analysis focuses principally on the foundational importance of health for human happiness, the exercise of rights and privileges, and the formation of family and social relationships. He explains why health care,

Lawrence O. Gostin



DRGs: the counterrevolution in financing health care.  


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

Dolenc, D A; Dougherty, C J



The South African national health insurance: a revolution in health-care delivery!  


A brief overview of the Green Paper on the National Health Insurance (NHI) policy of South Africa is presented. It describes the intention of the NHI to ensure equity, address the inequalities presented by the current private and public health system and present an ambitious plan to change the face of the South African health care system over the next fourteen years. It provides the context of the currents system that provides the case for the change. It also provides some detail on the structure of the proposed new Re-engineered Primary Health Care system as well as the future financing of this bold new health care system for South Africa. The challenge will be in its implementation. PMID:22362968

Naidoo, Shan



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. PMID:23722861

Weinehall, Lars; Jerdén, Lars; Nyström, Monica E.; Johansson, Helene



Who pays for health care in Ghana?  

PubMed Central

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



Income-related inequalities of health and health care utilization  

Microsoft Academic Search

By utilizing the China Health and Nutrition Survey (CHNS) data, this paper examines the extent of deviations in terms of horizontal\\u000a equity in the field of China’s health and medical community, i.e., that those in equal demand ought to be treated equally,\\u000a and computes the contribution of income in health inequality and utilization inequality of health care. The main conclusions

E. Xie



Health care reform: a short summary.  


The Health Care Reform legislation has many provisions of importance to the nuclear medicine community. This article is not a complete summary of the thousands of pages in the legislation, but emphasizes some relevant aspects of the bills. When the plan is fully implemented, about 32 million more Americans will have health insurance. Pre-existing medical conditions will no longer result in insurance denials. There are many initiatives to slow the growth of spending on health care in various ways, such as by setting up the new Medicare Advisory Board. There are also new fees, taxes, penalties, subsidies, and tax deduction changes. PMID:20706044

Harolds, Jay



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



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

PubMed Central

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

Beacham, Barbara L.; Deatrick, Janet A.



Reliability assessment of home health care services.  


In this paper, a model of reliability assessment of services in Home Health Care Delivery is presented. Reliability is an important quality dimension for services and is included in non-functional requirements of a system. A stochastic Markov model for reliability assessment is applied to patient communication services, in the field of home health care delivery. The methodology includes the specification of scenarios, the definition of failures in scenarios as well as the application of the analytical model. The results of the methodology reveal the critical states of the Home Health Care System and recommendations for improvement of the services are proposed. The model gives valuable results in predicting service reliability and, independently of the error types, it can be applied to all fields of Regional Health Network (RHN). PMID:17911722

Spyrou, Stergiani; Bamidis, Panagiotis; Kilintzis, Vassilis; Lekka, Irini; Maglaveras, Nicos; Pappas, Costas



[Health promotion of lesbian woman: nursing care].  


The aim of this study was to analyze national and international scientific literature on nursing care for lesbian women. An integrative approach was adopted to review studies from MEDLINE, LILACS, BDENF and SCOPUS databases and SciELO and Cochrane libraries using the keywords: female homosexuality, nursing care, health promotion and women's health. Studies published between 1990 and 2013 in English, Portuguese or Spanish were considered for analysis. After analyzing data, four international studies were selected, being that three were from the United States and one was from Canada. This study revealed a scarcity of Brazilian and international studies and the importance of increasing scientific literature on this topic. Descriptors: Homosexuality, female. Nursing care. Health promotion. Women's health. PMID:25842788

Sousa, Josueida de Carvalho; Mallmann, Danielli Gavibo; Galindo Neto, Nelson Miguel; de Freitas, Natália Oliveira; de Vasconcelos, Eliane Maria Ribeiro; de Araújo, Ednaldo Cavalcante




PubMed Central

This study aims to measure the causal effect of informal caregiving on the health and health care use of women who are caregivers, using instrumental variables. We use data from South Korea, where daughters and daughters-in-law are the prevalent source of caregivers for frail elderly parents and parents-in-law. A key insight of our instrumental variable approach is that having a parent-in-law with functional limitations increases the probability of providing informal care to that parent-in-law, but a parent-in-law’s functional limitation does not directly affect the daughter-in-law’s health. We compare results for the daughter-in-law and daughter samples to check the assumption of the excludability of the instruments for the daughter sample. Our results show that providing informal care has significant adverse effects along multiple dimensions of health for daughter-in-law and daughter caregivers in South Korea. PMID:24753386




The health care market: can hospitals survive?  


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

Goldsmith, J C



Virtual health care center in Georgia.  


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



Current trends and challenges in health informatics  

Microsoft Academic Search

This paper outlines the roles of health informatics in modern health planning and delivery and defines the key challenges and opportunities for promoting high-quality and cost-effective care. It describes the main information management and technology drivers that improve the generation, use and flow of health information, categorizing these drivers under the headings of healthcare complexity, policy and priorities, clinical support

A. C. Norris



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


Care Coordination: A Case Study Linking Primary Health Care  

Microsoft Academic Search

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

Monica M. Lancaster; David P. Thow



Rapid Business Transformations in Health Care: A Systems Approach  

ERIC Educational Resources Information Center

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

Shulaiba, Refaat A.



Inequities in Mental Health Care After Health Care System Reform in Chile  

Microsoft Academic Search

Objectives. We compared differences in mental health needs and provision of mental health services among residents of Santiago, Chile, with private and pub- lic health insurance coverage. Methods. We conducted a cross-sectional survey of a random sample of adults. Presence of mental disorders and use of health care services were assessed via structured interviews. Individuals were classified as having public,

Ricardo Araya; Graciela Rojas; Rosemarie Fritsch; Richard Frank; Glyn Lewis


Choosing the right health care provider for pregnancy and childbirth  


... have to decide about is what kind of health care provider you would like to care for you ... or a certified nurse-midwife. Each of these health care providers is described below. Each one has different ...


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



How Do Health Care Providers Diagnose Klinefelter Syndrome?  


... Information Clinical Trials Resources and Publications How do health care providers diagnose Klinefelter syndrome (KS)? Skip sharing on ... karyotype (pronounced care-EE-oh-type ) test. A health care provider will take a small blood or skin ...


Spirituality and health care in Iran: time to reconsider.  


Spirituality is increasingly recognized as an essential element of care. This article investigates the role of spirituality in Iranian health care system and provides some guidelines to integrate spirituality in routine health care practice in Iran. PMID:24912827

Jafari, Najmeh; Loghmani, Amir; Puchalski, Christina M



Palliative care and pain treatment in the global health agenda.  


The Global Atlas of Palliative Care at the End of Life, published by the Worldwide Palliative Care Alliance (WPCA) jointly with the World Health Organization (WHO) estimated that every year >20 million patients need palliative care (PC) at the end of life. Six percent of these are children. According to the Atlas, in 2011, approximately 3 million patients received PC and only 1 in 10 people in need is currently receiving it. Although most PC is provided in high-income countries (HIC), almost 80% of the global need is in low- and middle-income countries (LMIC). Only 20 countries have PC well integrated into their health-care systems. In regards to opioids, >5 billion people (83% of the world's population) live in countries with low to nonexistent access, 250 million (4%) have moderate access, and only 460 million (7%) have adequate access. In order for PC and pain treatment strategies to be effective, they must be incorporated by governments into all levels of their health care systems. In 1990, the WHO pioneered a public health strategy to integrate PC into existing health care systems which includes four components: (1) appropriate policies, (2) adequate availability of medications, (3) education of health care workers and the public, and (4) implementation of PC services at all levels throughout the society. This topical review describes the current status of the field, and presents several initiatives by United Nations (UN) organizations and the civil society to improve access to PC and to pain treatment for patients in need. PMID:25789428

De Lima, Liliana



Staying alive: strategies for accountable health care.  


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

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



Prevention of health care-associated infections.  


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

Hsu, Vincent



Mental Health Care: Who's Who  


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


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.



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

ERIC Educational Resources Information Center

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

Fitch, Sandra F.


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.



The Inextricable Nature of Mental and Physical Health: Implications for Integrative Care  

Microsoft Academic Search

There is growing evidence that physical health problems are caused and exacerbated by psychological factors. Research indicates that psychological distress leads to physical disease through impairment of the neuroendocrine system and its interface with the body’s immune response. However, the current health care delivery system splinters care into “psychiatric” and “physical” health silos. New approaches are needed to assure adequate

Sandra J. Weiss; Judith Haber; June Andrews Horowitz; Gail W. Stuart; Barbara Wolfe



Models of psychological service provision under Australia's Better Outcomes in Mental Health Care program  

Microsoft Academic Search

The Access to Allied Psychological Services com- ponent of Australia's Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based men- tal health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular

Jane Pirkis; Philip Burgess; Fay Kohn; Belinda Morley; Grant Blashki; Lucio Naccarella



Vaccination campaigns in postsocialist Ukraine: health care providers navigating uncertainty.  


Vaccination anxieties grew into a public health issue during the 2008 failed measles and rubella immunization campaign in Ukraine. Here I explore how health care providers bend official immunization policies as they navigate media scares about vaccines, parents' anxieties, public health officials' insistence on the need for vaccination, and their own sense of expertise and authority. New hierarchies are currently being renegotiated, and I follow health care providers as they attempt to parcel out their new position in the Ukrainian society and beyond. Public health control is reframed in a postsocialist context as a condition of acceptance into the European community as a sanitary democracy, and a contestation point between citizens and state. I untangle how relationships between citizens and states shape the construction of medical risk. PMID:22338289

Bazylevych, Maryna



Measles in health-care settings.  


Despite the availability of an effective and safe vaccine for almost half a century, measles is re-emerging in several developed countries because of the insufficient vaccination coverage among specific subpopulations, the emerging anti-vaccination movement, and the increasing movement of humans across borders. In this context, health-care settings play a critical role in the transmission of infection and generation of numerous cases. Health-care-associated outbreaks may be associated with severe morbidity and mortality among specific groups of patients, disruption of health-care services, and considerable costs. Misdiagnosis or delayed diagnosis of a measles case and inadequate implementation of infection control measures are common in almost all events of nosocomial spread. Measles vaccination of health-care workers is an effective means of prevention of nosocomial measles outbreaks. Eliminating measles by 2010 has not been accomplished. Stronger recommendations and higher vaccination coverage against measles in health-care workers could contribute to eliminate measles in the general population. PMID:23352075

Maltezou, Helena C; Wicker, Sabine



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. PMID:22844644



Conditional shared confidentiality in mental health care.  


Because of the development towards community care, care providers not only exchange information in a team, but increasingly also in networks. This is a challenge to confidentiality. The ethical question is how care providers can keep information about the care receiver confidential, whilst at the same time exchanging information about that care receiver in a team or network? Can shared confidentiality be extended from a team to a network? To clarify this question, the article refers to the advice of an expert ethics committee in mental health care. The advice regards exchange of information in a network as a further step in enhancing collaboration among care providers. Therefore, the good and evident practice of shared confidentiality in a team can be extended to a network if the same conditions are met. First, the care providers participate in a clearly defined and identifiable team or network. Secondly, they have a shared care responsibility. Thirdly, they have a duty of confidentiality. Fourth, they dialogue with the care receiver and obtain his or her consent. Finally, they apply the filter of relevance. Hence, conditional shared confidentiality is an ethical justification for the exchange of information in a team or network. PMID:25209901

Liégeois, Axel; Eneman, Marc



Maternal interaction style, reported experiences of care, and pediatric health care utilization  

Microsoft Academic Search

U.S. immunization and well child-care rates are below desired levels with lower income individuals being at higher risk for receiving inadequate care. To enhance the understanding of motivating factors to health care utilization, this study explored relationships between a mother's interaction style (secure, anxious, avoidant), her reported experiences with pediatric health care and her child's utilization of pediatric health care.

Wendy Lauran Struchen Shellhorn



Perceived Impacts of Health Care Reform on Large Urban Health Departments  

PubMed Central

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

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



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


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

Wörz, M; Wismar, M



Space technology in remote health care  

NASA Technical Reports Server (NTRS)

Crews and passengers on future long-duration Earth orbital and interplanetary missions must be provided quality health services - to combat illnesses and accidental injuries, and for routine preventive care. People on Earth-orbital missions can be returned relatively easily to Earth, but those on interplanetary missions cannot. Accordingly, crews on long-duration missions will likely include at least one specially trained person, perhaps a physician's assistant, hospital corpsman, nurse, or physician who will be responsible for providing onboard health services. Specifically, we must determine the most effective way to administer health care to a remotely located population. NASA with the cooperation of the Department of Health, Education, and Welfare is pursuing a program for providing health services to remote locations on Earth as a necessary step to developing and verifying this capability on a spacecraft. The STARPAHC program is described.

Pool, Sam L.



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



Use of Mental Health Services and Barriers to Care for Individuals on Probation or Parole  

Microsoft Academic Search

Prior research with incarcerated populations and individuals on parole or probation suggests that significant rates of mental health problems and histories of traumatic events exist among these groups. However, limited research has explored mental health treatment-seeking and barriers to accessing mental health care for individuals on parole or probation. The current study assessed mental health symptoms, mental health services use

Gina P. Owens; Shannon M. Rogers; Allison A. Whitesell



Higher Education and Health Care at a Crossroads  

ERIC Educational Resources Information Center

As major providers and consumers of health care, higher-education institutions have an important role to play in improving health and the nation's health-care system. Health care is a complex issue for colleges and universities. Not only do institutions of higher education provide health insurance to faculty members, staff members, and students,…

Kirch, Darrell G.



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

Microsoft Academic Search

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

Rong Hu; Chunli Shen; Heng-fu Zou



Mental Health Care in China: Recent Changes and Future Challenges  

Microsoft Academic Search

fter 1949, the communist govern- ment under Mao Zedong built strong collective health care and public health systems. While mental health care did not receive specialized attention, the overall health of Chinese citizens was improved due to the emphasis on basic health care. Within thirty years, these Chi- nese systems became the envy of many de- veloping (and developed) countries

Zeping Xiao; Jonathan Worth; Jennifer M. Park



Preparing the profession to care for youngsters with special health care needs.  


The complex issues involved in providing dental services to the increasing numbers of youngsters with special health care needs require the preparation of students and practitioners to meet these developments. A review of the changes in dental school requirements, the extent of needed services, the increased costs, and a challenge for current practitioners is presented. PMID:20806633

Waldman, H Barry; Wong, Allen; Perlman, Steven P



Managed Care, Utilization Review, and Financial Risk Shifting: Compensating Patients for Health Care Cost Containment Injuries  

Microsoft Academic Search

This Article examines current tort remedies for personal injury claims and explores the problems that arise when these remedies are applied to physicians' actions that are directed by third-party payers. Part II of this Article explores the organization and historical development of managed health care products. Part III considers the past and present uses of the utilization review process and

Vernellia R. Randall



[Health care systems and impossibility theorems].  


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

Penchas, Shmuel




Microsoft Academic Search

The medical savings account (MSA) model of health care financing is viewed as a health care cost containment strategy. Yet, health care expenditure in Shanghai has increased sharply since the adoption of the MSA system. This paper looks into the health care reforms in Shanghai, especially since the introduction of the MSA scheme.From the Labor Insurance Scheme and Government Insurance




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

ERIC Educational Resources Information Center

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

Risley-Curtiss, Christina; Kronenfeld, Jennie Jacobs



Antimicrobial resistance: the threat to health and health care  

Microsoft Academic Search

This article addresses antimicrobial resistance and the threat it poses to an individual’s health and the health care system. Diseases, such as pneumococcus have gained an overabundance of antimicrobial resistance. In addition, previously unknown diseases are surging and sounding alarm bells worldwide. The history and causes of this surge are examined globally. One such cause is the overuse of antibiotics

Kathleen Granitto



Pediatric Mental Health Emergencies and Special Health Care Needs  

PubMed Central

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

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



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

ERIC Educational Resources Information Center

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

Institute of Medicine (NAS), Washington, DC.


Talking with Your Health Care Professionals about Kidney Disease  


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


How Do Health Care Providers Diagnose Birth Defects?  


... Trials Resources and Publications En Español How do health care providers diagnose birth defects? Skip sharing on social ... to begin before health problems occur. Prenatal Screening Health care providers recommend that certain pregnant women, including those ...


Direct measurement of health care costs.  


Cost identification is fundamental to many economic analyses of health care. Health care costs are often derived from administrative databases. Unit costs may also be obtained from published studies. When these sources will not suffice (e.g., in evaluating interventions or programs), data may be gathered directly through observation and surveys. This article describes how to use direct measurement to estimate the cost of an intervention. The authors review the elements of cost determination, including study perspective, the range of elements to measure, and short-run versus long-run costs. They then discuss the advantages and drawbacks of alternative direct measurement methods such as time-and-motion studies, activity logs, and surveys of patients and managers. A parsimonious data collection effort is desirable, although study hypotheses and perspective should guide the endeavor. Special reference is made to data sources within the Department of Veterans Affairs (VA) health care system. PMID:15095547

Smith, Mark W; Barnett, Paul G



ERP implementation in rural health care.  


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



Reforming health care in the Republic of Kazakstan.  


Kazakstan, as in other former communist countries, is currently replacing the soviet system of health care financing for a model based on medical insurance. The main initial purpose has been to generate additional revenue for a sector suffering considerably from reductions in state funding induced by economic transition. Two key issues need to be addressed if the new system is to produce genuine reform. First, the rural areas have suffered disproportionately from the changes. There is an urgent need to adapt the existing system so that adequate funding goes to redress this imbalance. Second, although the fund has concentrated on raising revenue, it will only induce real reform if it begins to exercise its role as an independent purchaser of health care. There is a need for the future roles of both health ministry and insurance fund to be clearly defined to ensure that wide access to medical care is preserved. PMID:10175305

Ensor, T; Rittmann, J



Role of pediatric nurse practitioners in oral health care.  


Dental caries remain the most prevalent unmet health need in US children. Access to care is particularly problematic for poor children and is compounded by the shortage of dentists to meet the needs of this patient population. Expanding the roles of pediatricians, family physicians, and pediatric nurse practitioners (PNPs) who provide primary care services to children may be a strategy to address in this issue. Enhancements in current PNP education and certification processes are needed to support the expansion of oral health-related clinical responsibilities. Although oral health is included in the published curriculum for PNPs and certification exams require specific oral health knowledge, gaps in postgraduate training persist and few data document the extent to which current oral health-related educational goals are being achieved. We recommend enhancements in oral health education and research to evaluate curriculum innovations, the development of partnerships between stakeholder groups to leverage existing resources, and ongoing surveillance of oral health-related practice patterns among PNPs. Leadership at the national level is needed to develop policies that support curriculum changes and the implementation of oral health practice guidelines for PNPs that will improve access and reduce health disparities. PMID:19945081

Hallas, Donna; Shelley, Donna



Enhancing Health-Care Services with Mixed Reality Systems  

NASA Astrophysics Data System (ADS)

This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

Stantchev, Vladimir


Health Care Costs Workshop Agenda

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Digital health care: cementing centralisation?  


This article reviews large-scale digital developments in the National Health Service in England in recent years and argues that there is a mismatch between digital and organisational thinking and practice. The arguments are based on new institutional thinking, where the digital infrastructure is taken to be an institution, which has been shaped over a long period, and which in turn shapes the behaviour of health professionals, managers and others. Many digital services are still being designed in line with a bureaucratic data processing model. Yet health services are increasingly based on a network model, where health professionals and service managers require information systems that allow them to manage risks proactively and to coordinate multiple services on behalf of patients. This article further argues that the data processing model is being reinforced by Open Data policies and by related developments in the acquisition of genomic and telehealth data, suggesting that the mismatch will persist. There is, therefore, an ongoing tension between frontline and central objectives for digital services. It may be that the tension can only be resolved when--or if--there is trust between the interested parties. PMID:25183607

Keen, Justin



Utilization of performance appraisal systems in health care organizations and improvement strategies for supervisors.  


Performance appraisal systems that are designed to objectively evaluate an employee's performance and then outline measures to be taken for improvements are essential for an organization to move ahead. These systems are often organization specific and health care organizations are no exception. However, health care managers seem to be more vocal and have often expressed dissatisfaction with the use of their company's performance appraisal system. This article is based on a case study of a health care organization's current performance appraisal techniques. This organization's current use of performance appraisals are discussed in brief, and strategies for health care organizations to improve their performance appraisal system have also been identified. PMID:15035345

Chandra, Ashish; Frank, Zachary D



Budget crisis, entitlement crisis, health care financing problem--which is it?  


Many budget analysts allege that growing expenditures on entitlements will necessitate a reexamination of all public spending and taxes. In fact, anticipated budget problems are fully explained by projected growth of Medicare and Medicaid. But the same forces driving public-sector health care spending are also driving private spending. Sensible reforms of publicly financed health care require a systemwide approach. Apart from health care, currently legislated federal revenues suffice to cover all currently projected spending, including all Social Security and other entitlements. The United States confronts a public and private health care spending problem, not an entitlement crisis. PMID:17978382

Aaron, Henry J



Health care policy and cancer survivorship.  


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

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



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

Microsoft Academic Search

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

Susan J. Shaw; Julie Armin



Differentiating Subgroups of Children with Special Health Care Needs by Health Status and Complexity of Health Care Needs  

Microsoft Academic Search

Objectives Our objective is to use the Children with Special Health Care Needs (CSHCN) Screener to identify subgroups of CSHCN differentiated\\u000a by health status and complexity of need. Methods Data are from the National Survey of Children with Special Health Care Needs, 2001 and the National Survey of Children’s Health,\\u000a 2003 (conducted by the Maternal and Child Health Bureau and

Matthew D. Bramlett; Debra Read; Christina Bethell; Stephen J. Blumberg



Megamarketing strategies for health care services.  


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



TQM in health care: mistaken identity?  


Total Quality Management is a powerful tool in health care today. The definition of quality improvement in the medical literature focuses on improving patient outcomes. However, most quality initiatives in the health care field focus on improving productivity, cost-effectiveness, market share, employee morale, and efficiencies of processes. This disparity between the medical definition of quality and the actual application of quality improvement may have the effect of alienating many physicians, the very people who must be involved. The semantics are important to address in a TQM initiative. PMID:10184762

Rose, E A



The role of branding in health care.  


Branding has been successfully practiced by consumer packaged goods companies for decades. But only recently have managed health care organizations begun to embrace the concept, and hence, few well developed brands exist. For health care organizations, the rewards of branding can be great as it provides an opportunity to truly assess the needs of their members, develop capabilities to meet those needs, and more effectively communicate the ability to meet those needs. A summary of seven steps to building a strong brand is also included. PMID:10185773

Acton, V



Energy conservation in health-care facilities  

SciTech Connect

As energy expenditures continue their dramatic rise in the health-care industry, they absorb a larger portion of hospital budgets and prompt managers to seek ways to conserve energy and reduce consumption. Hospital managers, however, may be forced by capital constraints to choose between medical and energy conservation investments. The author examines some of the issues (including fairness, legal and financial impediments, and medical practices) involved in reducing health care costs. He makes practical suggestions for improving facility efficiency that include a strategy for energy management and a checklist of ideas. The case histories of 25 medical facilities illustrate conservation opportunities. 18 references, 34 figures, 3 tables. (DCK)

Hunt, V.D. (comp.)



[Evolution of primary health care in Spain].  


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



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

NASA Astrophysics Data System (ADS)

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

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



Medicaid managed care and public health data.  


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. PMID:10476991

Rutherford, G W; Backer, H D



Organizational economics and health care markets.  

PubMed Central

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

Robinson, J C



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. PMID:20429901



Gender, social roles and health care utilization  

E-print Network

multiple role involvement with the greater probability of being more satisfied with life, less depressed and being physically healthier. Explanations for the positive relationship between mental health and role acquisition have been linked to greater...GENDER, SOCIAL ROLES AND HEALTH CARE UTILIZATION A Thesis by JENNIFER LOUISE DAVID Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE December...

David, Jennifer Louise



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



Cross-cultural training in mental health care--challenges and experiences from Sweden and Germany.  


Globalization and cultural diversity challenge mental health care in Europe. Sensitivity to culture in mental health care benefits effective delivery of care to the individual patient and can be a contribution to the larger project of building a tolerant multicultural society. Pivotal for improving cultural sensitivity in mental health care is knowledge in cross-cultural psychiatry, psychology, nursing and related fields among professionals and accordingly training of students and mental health professionals. This paper will give an overview, and a critical examination, of current conceptualisation of cross-cultural mental health training. From German and Swedish experiences the need for crosscultural training and clinical research on evaluation will be presented. PMID:22863254

Bäärnhielm, S; Mösko, M



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

PubMed Central

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

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



Health insurance in India: need for managed care expertise.  


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

Thomas, Thomas K



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



Changes in Patterns of Health Care: Plus Forty Years  

ERIC Educational Resources Information Center

In this article, the author presents an update of Herman's article ["Changes in Patterns of Health Care," "School Health Review," 1(9-14)1969] that focuses on the changes in patterns of health care. He discusses the poverty, insurance, and access to medical care as well as the quality of medical care for adults and minors. He stresses that…

Sofalvi, Alan J.



Reason for Visit: Is Migrant Health Care that Different?  

ERIC Educational Resources Information Center

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

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



Michigan Health Care Costs Review. Personal Health Care Expenditures, 1966-1981. Number 1.  

ERIC Educational Resources Information Center

Data are presented describing expenditures for personal health services in Michigan from 1977 to 1981. The rapid growth in expenditures is illustrated, as well as the rates of growth in expenditures, for major categories of health services. Personal health expenditures are defined as payments for care directly provided to patients: specifically,…

Michigan State Office of Health and Medical Affairs, Lansing.


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


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

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



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


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.



Child day care arrangements and employee health.  


With the changing demographics of the work force and predictions that two thirds of new job entrants will be female, it is vital that occupational health nurses develop programs to meet these changes to ensure the health and safety of the work force. Workers and their families can no longer be viewed as separate from the workplace. There is an interactive relationship between workers, their families, and their work. Child day care arrangements can positively or negatively affect all three domains. Available, affordable, accessible, and dependable child day care are only part of the answer for the child care crisis facing today's workers. The perception of the quality of the day care center seems to be a major factor affecting mothers in the work force. Occupational health nurses are in a pivotal position to assist workers in meeting the unique demands and challenges of the dual career family--including child day care--thus promoting a more productive, healthier, and safer work force. PMID:1536688

Mastroianni, K



Exposure of health workers in primary health care to glutaraldehyde  

PubMed Central

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



The ethical self-fashioning of physicians and health care systems in culturally appropriate health care.  


Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace. PMID:21553151

Shaw, Susan J; Armin, Julie



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

ERIC Educational Resources Information Center

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

Jecklin, Robert