Science.gov

Sample records for private pay patients

  1. Private Schools and the Willingness to Pay for Public Schooling

    ERIC Educational Resources Information Center

    Brasington, David M.

    2007-01-01

    Households pay a premium to live in houses assigned to high quality public schools, and the housing market yields information about the demand for public school quality. The current study estimates a two-stage house price hedonic emphasizing the role that private schools play in the willingness to pay for public school quality. The elasticity of…

  2. Private Pay Progression. Research Brief. Edition 6

    ERIC Educational Resources Information Center

    Anders, Jake

    2015-01-01

    While the issue of access to the professions is relatively well understood, there is limited understanding of the impact of entrants' backgrounds on success once in graduate employment. The research looks at the way social background continues to influence graduate pay and career progression once in professional employment. Key findings include:…

  3. Ramos` private-power policies pay off

    SciTech Connect

    1995-11-01

    This article reports that political stability, government incentives attract foreign capital for new generating plants and T and D facilities. Teams of multinational lenders, developers, equipment vendors, engineering contractors erect critical plants in record time. As recently as the summer of 1993, the Republic of the Philippines was teetering on the brink of bankruptcy--mainly because of electricity shortages. Brownouts averaging seven hours a day were common nationwide, and Manila`s business districts were frequently blacked out for most of the day. With the nation of 67-million facing economic losses estimated at several billion dollars a year, President Fidel V. Ramos took swift, decisive action. Ramos, elected the previous year, accelerated power-sector reforms initiated by his predecessor, Corazon C. Aquino, that sought to augment the aging, unreliable generating capacity of the state-owned electric utility with private power development.

  4. Beyond price: individuals' accounts of deciding to pay for private healthcare treatment in the UK

    PubMed Central

    2012-01-01

    Background Delivering appropriate and affordable healthcare is a concern across the globe. As countries grapple with the issue of delivering healthcare with finite resources and populations continue to age, more health-related care services or treatments may become an optional 'extra' to be purchased privately. It is timely to consider how, and to what extent, the individual can act as both a 'patient' and a 'consumer'. In the UK the majority of healthcare treatments are free at the point of delivery. However, increasingly some healthcare treatments are being made available via the private healthcare market. Drawing from insights from healthcare policy and social sciences, this paper uses the exemplar of private dental implant treatment provision in the UK to examine what factors people considered when deciding whether or not to pay for a costly healthcare treatment for a non-fatal condition. Methods Qualitative interviews with people (n = 27) who considered paying for dental implants treatments in the UK. Data collection and analysis processes followed the principles of the constant comparative methods, and thematic analysis was facilitated through the use of NVivo qualitative data software. Results Decisions to pay for private healthcare treatments are not simply determined by price. Decisions are mediated by: the perceived 'status' of the healthcare treatment as either functional or aesthetic; how the individual determines and values their 'need' for the treatment; and, the impact the expenditure may have on themselves and others. Choosing a private healthcare provider is sometimes determined simply by personal rapport or extant clinical relationship, or based on the recommendation of others. Conclusions As private healthcare markets expand to provide more 'non-essential' services, patients need to develop new skills and to be supported in their new role as consumers. PMID:22397733

  5. 32 CFR 728.14 - Pay patients.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Pay patients. 728.14 Section 728.14 National... § 728.14 Pay patients. Care is provided on a reimbursable basis to: Coast Guard active duty officers, enlisted personnel, and academy cadets; Public Health Service Commissioned Corps active duty officers;...

  6. 32 CFR 728.36 - Pay patients.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Pay patients. 728.36 Section 728.36 National... Services § 728.36 Pay patients. Care is provided on a reimbursable basis to retired Coast Guard officers and enlisted personnel, retired Public Health Service Commissioned Corps officers,...

  7. 32 CFR 728.14 - Pay patients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Pay patients. 728.14 Section 728.14 National... § 728.14 Pay patients. Care is provided on a reimbursable basis to: Coast Guard active duty officers, enlisted personnel, and academy cadets; Public Health Service Commissioned Corps active duty officers;...

  8. 32 CFR 728.36 - Pay patients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Pay patients. 728.36 Section 728.36 National... Services § 728.36 Pay patients. Care is provided on a reimbursable basis to retired Coast Guard officers and enlisted personnel, retired Public Health Service Commissioned Corps officers,...

  9. Gender Differences in Pay among Recent Graduates: Private Sector Employees in Ireland

    ERIC Educational Resources Information Center

    Russell, Helen; Smyth, Emer; O'Connell, Philip J.

    2010-01-01

    In this paper we seek to investigate the role of different factors in accounting for the differences in earnings among recent graduates working in the private sector in Ireland. Three years after graduation there is a pay gap of 8 per cent in hourly wages between male and female graduates in the private sector and a 4 per cent non-significant gap…

  10. Willingness To Pay and Preference for Private Institutions.

    ERIC Educational Resources Information Center

    Hu, Shouping; Hossler, Don

    2000-01-01

    This study focuses on the correlates of student preference for private institutions over public institutions in their senior year in high school. Results indicate that students' subjective responses to tuition costs and to financial aid availability are directly related to student preference for a certain type of postsecondary institution. (JM)

  11. Pay and Perks Creep Up for Private-College Presidents

    ERIC Educational Resources Information Center

    Stripling, Jack

    2012-01-01

    Private-college presidents often draw scrutiny for their hefty compensation packages, but most of them have a ready comeback: I could make a lot more money in the corporate world. While this statement is surely sometimes true, it is also true that some of the nation's top-paid presidents continue to receive perks that their corporate counterparts…

  12. 32 CFR 728.14 - Pay patients.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Pay patients. 728.14 Section 728.14 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of the Uniformed Services on Active...

  13. Paying pharmacists for patient care

    PubMed Central

    Houle, Sherilyn K. D.; Grindrod, Kelly A.; Chatterley, Trish; Tsuyuki, Ross T.

    2014-01-01

    Background: Expansion of scope of practice and diminishing revenues from dispensing are requiring pharmacists to increasingly adopt clinical care services into their practices. Pharmacists must be able to receive payment in order for provision of clinical care to be sustainable. The objective of this study is to update a previous systematic review by identifying remunerated pharmacist clinical care programs worldwide and reporting on uptake and patient care outcomes observed as a result. Methods: Literature searches were performed in several databases, including MEDLINE, Embase and International Pharmaceutical Abstracts, for papers referencing remuneration, pharmacy and cognitive services. Searches of the grey literature and Internet were also conducted. Papers and programs were identified up to December 2012 and were included if they were not reported in our previous review. One author performed data abstraction, which was independently reviewed by a second author. All results are presented descriptively. Results: Sixty new remunerated programs were identified across Canada, the United States, Europe, Australia and New Zealand, ranging in complexity from emergency contraception counseling to minor ailments schemes and comprehensive medication management. In North America, the average fee provided for a medication review is $68.86 (all figures are given in Canadian dollars), with $23.37 offered for a follow-up visit and $15.16 for prescription adaptations. Time-dependent fees were reimbursed at $93.60 per hour on average. Few programs evaluated uptake and outcomes of these services but, when available, indicated slow uptake but improved chronic disease markers and cost savings. Discussion: Remuneration for pharmacists’ clinical care services is highly variable, with few programs reporting program outcomes. Programs and pharmacists are encouraged to examine the time required to perform these activities and the outcomes achieved to ensure that fees are adequate to

  14. Faculty and Administrator Perspectives of Merit Pay Compensation Systems in Private Higher Education: A Mixed Methods Analysis

    ERIC Educational Resources Information Center

    Power, Anne L.

    2013-01-01

    The purpose of this explanatory sequential mixed methods study is to explore faculty and administrator perspectives of faculty merit pay compensation systems in private, higher education institutions. The study focuses on 10 small, private, four-year institutions which are religiously affiliated. All institutions are located in Nebraska, Iowa, and…

  15. A longitudinal study of Medicaid payment, private-pay price and nursing home quality.

    PubMed

    Grabowski, David C

    2004-03-01

    Quality of care problems have persisted for decades within U.S. nursing homes. A potential state-level policy towards addressing this concern is the level of Medicaid payment. However, a number of studies have found that an increase in Medicaid payment is associated with lower quality in the presence of certificate-of-need (CON) laws and bed construction moratorium regulations, which serve as barriers to entry within the nursing home industry. Instead of relying on potentially confounded cross-sectional comparisons, this study presents novel, panel-based evidence that incorporates aggregate private-pay price data. These estimates almost uniformly indicate that an increase in the Medicaid payment rate raises nursing home quality. When compared to the earlier literature, these new findings are attributed to changes over time in the market for nursing home care related to the growth in nursing home substitutes. PMID:15170962

  16. 41 CFR 303-70.702 - Must we pay transportation costs to return the deceased employee's privately owned vehicle (POV...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Contracts and Property Management Federal Travel Regulation System PAYMENT OF EXPENSES CONNECTED WITH THE... 41 Public Contracts and Property Management 4 2012-07-01 2012-07-01 false Must we pay transportation costs to return the deceased employee's privately owned vehicle (POV) from the temporary duty...

  17. 41 CFR 303-70.702 - Must we pay transportation costs to return the deceased employee's privately owned vehicle (POV...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Contracts and Property Management Federal Travel Regulation System PAYMENT OF EXPENSES CONNECTED WITH THE... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true Must we pay transportation costs to return the deceased employee's privately owned vehicle (POV) from the temporary duty...

  18. 41 CFR 303-70.702 - Must we pay transportation costs to return the deceased employee's privately owned vehicle (POV...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Contracts and Property Management Federal Travel Regulation System PAYMENT OF EXPENSES CONNECTED WITH THE... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false Must we pay transportation costs to return the deceased employee's privately owned vehicle (POV) from the temporary duty...

  19. Patient preference and willingness to pay for knee osteoarthritis treatments

    PubMed Central

    Posnett, John; Dixit, Sanjeev; Oppenheimer, Brooks; Kili, Sven; Mehin, Nazanin

    2015-01-01

    Purpose To review treatments for osteoarthritis of the knee (OAK) received by patients across five European countries, and to obtain patients’ perceptions and willingness to pay for current treatments. Patients and methods A prospective, internet-based, double-blind survey of adults with OAK was conducted in France, Germany, Italy, Spain, and the United Kingdom. The questionnaire included questions about diagnosis, treatment history, and perceptions of OAK treatments, followed by a discrete choice-based conjoint exercise to identify preferred attributes of OAK treatments, evaluating 14 sets of four unbranded products. Results Two thousand and seventy-three patients with self-reported OAK completed the survey; 17.4% of patients rated their knee pain as drastically affecting their ability to perform normal daily activities, and 39.3% of employed patients reported that they had lost work time because of OAK. The most common treatments were exercise (69.7%), physical therapy (68.2%), and nonprescription oral pain medication (73.9%). Treatments perceived as most effective were: viscosupplement injections (74.1%), narcotics (67.8%), and steroid injection (67.6%). Patient co-pay, duration of pain relief, and type of therapy exhibited the largest impact on patient preference for OAK treatments. The average patient was willing to pay €35 and €64 more in co-pay for steroid and viscosupplement injections, respectively, over the cost of oral over-the-counter painkillers (per treatment course, per knee) (each P<0.05). Conclusion OAK is a debilitating condition that affects normal daily activities. In general, treatments most commonly offered to patients are not those perceived as being the most effective. Patients are willing to pay a premium for treatments that they perceive as being more effective and result in longer-lasting pain relief, and those that can be administered with fewer visits to a physician. PMID:26089650

  20. Willingness to pay for private primary care services in Hong Kong: are elderly ready to move from the public sector?

    PubMed

    Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M

    2013-10-01

    How to provide better primary care and achieve the right level of public-private balance in doing so is at the centre of many healthcare reforms around the world. In a healthcare system like Hong Kong, where inpatient services are largely funded through general taxation and ambulatory services out of pocket, the family doctor model of primary care is underdeveloped. Since 2008, the Government has taken forward various initiatives to promote primary care and encourage more use of private services. However, little is known in Hong Kong or elsewhere about consumers' willingness to pay (WTP) for private services when care is available in the public sector. This study assessed willingness of the Hong Kong elderly to pay for specific primary care and preventive services in the private sector, through a cross-sectional in-person questionnaire survey and focus group discussions among respondents. The survey revealed that the WTP for private services in general was low among the elderly; particularly, reported WTP for chronic conditions and preventive care both fell below the current market prices. Sub-group analysis showed higher WTP among healthier and more affluent elderly. Among other things, concerns over affordability and uncertainty (of price and quality) in the private sector were associated with this low level of WTP. These results suggest that most elderly, who are heavy users of public health services but with limited income, may not use more private services without seeing significant reduction in price. Financial incentives for consumers alone may not be enough to promote primary care or public-private partnership. Public education on the value of prevention and primary care, as well as supply-side interventions should both be considered. Hong Kong's policy-making process of the initiative studied here may also provide lessons for other countries with ongoing healthcare reforms. PMID:23161587

  1. Amniotic fluid infection syndrome in private and non-private patients.

    PubMed

    Möller, G H; Woods, D L; Malan, A F; Sinclair-Smith, C C

    1987-11-01

    The incidence of placental histological evidence of amniotic fluid infection syndrome (AFIS) was studied in two groups of patients delivered at term. One group received private medical care during pregnancy, while the other patients were delivered at a midwife obstetric unit. There was no significant difference in histological evidence of AFIS in the private patient (22%) and non-private patient (28%) groups. PMID:3686296

  2. Are the affluent prepared to pay for the planet? Explaining willingness to pay for public and quasi-private environmental goods in Switzerland.

    PubMed

    Meyer, Reto; Liebe, Ulf

    2010-09-01

    A large number of 'environmental justice' studies show that wealthier people are less affected by environmental burdens and also consume more resources than poorer people. Given this double inequity, we ask, to what extent are affluent people prepared to pay to protect the environment? The analyses are couched within the compensation/affluence hypothesis, which states that wealthier persons are able to spend more for environmental protection than their poorer counterparts. Further, we take into account various competing economic, psychological and sociological determinants of individuals' willingness to pay (WTP) for both public environmental goods (e.g., general environmental protection) and quasi-private environmental goods (e.g., CO(2)-neutral cars). Such a comprehensive approach contrasts with most other studies in this field that focus on a limited number of determinants and goods. Multivariate analyses are based on a general population survey in Switzerland (N = 3,369). Although income has a positive and significant effect on WTP supporting the compensation hypothesis, determinants such as generalized interpersonal trust that is assumed to be positively associated with civic engagement and environmental concern prove to be equally important. Moreover, we demonstrate for the first time that time preferences can considerably influence survey-based WTP for environmental goods; since investments in the environment typically pay off in the distant future, persons with a high subjective discount rate are less likely to commit. PMID:20835384

  3. Are the affluent prepared to pay for the planet? Explaining willingness to pay for public and quasi-private environmental goods in Switzerland

    PubMed Central

    Liebe, Ulf

    2010-01-01

    A large number of ‘environmental justice’ studies show that wealthier people are less affected by environmental burdens and also consume more resources than poorer people. Given this double inequity, we ask, to what extent are affluent people prepared to pay to protect the environment? The analyses are couched within the compensation/affluence hypothesis, which states that wealthier persons are able to spend more for environmental protection than their poorer counterparts. Further, we take into account various competing economic, psychological and sociological determinants of individuals’ willingness to pay (WTP) for both public environmental goods (e.g., general environmental protection) and quasi-private environmental goods (e.g., CO2-neutral cars). Such a comprehensive approach contrasts with most other studies in this field that focus on a limited number of determinants and goods. Multivariate analyses are based on a general population survey in Switzerland (N = 3,369). Although income has a positive and significant effect on WTP supporting the compensation hypothesis, determinants such as generalized interpersonal trust that is assumed to be positively associated with civic engagement and environmental concern prove to be equally important. Moreover, we demonstrate for the first time that time preferences can considerably influence survey-based WTP for environmental goods; since investments in the environment typically pay off in the distant future, persons with a high subjective discount rate are less likely to commit. PMID:20835384

  4. Paying for Quality? Associations between Private School Income, Performance and Use of Resources

    ERIC Educational Resources Information Center

    Davies, Peter; Davies, Neil M.

    2014-01-01

    Education policy in England has explicitly aimed to remodel state schools in the image of independent, private, schools. However, the body of research evidence on the operation of private schools is very small. Critics have frequently argued that, in contrast to state schools, private schools use resources efficiently because their autonomy gives…

  5. The Price of Admission: Who Gets into Private School, and How Much Do They Pay?

    ERIC Educational Resources Information Center

    Walton, Nina

    2010-01-01

    I analyze how elementary and secondary private schools decide which students to admit from their applicant pool using mechanism design theory. The problem for an individual private school of who to admit and how much to charge in tuition, is complicated by the existence of peer-effects: the value students place on attending school is increasing…

  6. High and varying prices for privately insured patients underscore hospital market power.

    PubMed

    White, Chapin; Bond, Amelia M; Reschovsky, James D

    2013-09-01

    Across 13 selected U.S. metropolitan areas, hospital prices for privately insured patients are much higher than Medicare payment rates and vary widely across and within markets, according to a study by the Center for Studying Health System Change (HSC) based on claims data for about 590,000 active and retired nonelderly autoworkers and their dependents. Across the 13 communities, aver­age hospital prices for privately insured patients are about one-and-a-half times Medicare rates for inpatient care and two times what Medicare pays for outpa­tient care. Within individual communities, prices vary widely, with the highest-priced hospital typically paid 60 percent more for inpatient services than the lowest-priced hospital. The price gap within markets is even greater for hospital outpatient care, with the highest-priced hospital typically paid nearly double the lowest-priced hospital. In contrast to the wide variation in hospital prices for pri­vately insured patients across and within markets, prices for primary care physi­cian services generally are close to Medicare rates and vary little within markets. Prices for specialist physician services, however, are higher relative to Medicare and vary more across and within markets. Of the 13 markets, five are in Michigan, which has an unusually concentrated private insurance market, with one insurer commanding a 70-percent market share. Despite the presence of a dominant insurer, almost all Michigan hospi­tals command prices that are higher than Medicare, and some hospitals com­mand prices that are twice what Medicare pays. In the eight markets outside of Michigan, private insurers generally pay even higher hospital prices, with even wider gaps between high- and low-priced hospitals. The variation in hospital and specialist physician prices within communities underscores that some hospitals and physicians have significant market power to command high prices, even in markets with a dominant insurer. PMID:24073466

  7. Robbing Public to Pay Private? Two Cases of Refinancing Education Infrastructure in Australia

    ERIC Educational Resources Information Center

    Crump, Stephen; Slee, Roger

    2005-01-01

    This paper will explore private sector participation in public sector education in the Australian context, focusing on case studies of Queensland and New South Wales, with reference to developments in other states and territories and internationally. In Australia, most states and territories have PPP policies and key projects include the Southbank…

  8. Wildfire Risk Management on a Landscape with Public and Private Ownership: Who Pays for Protection?

    NASA Astrophysics Data System (ADS)

    Busby, Gwenlyn; Albers, Heidi J.

    2010-02-01

    Wildfire, like many natural hazards, affects large landscapes with many landowners and the risk individual owners face depends on both individual and collective protective actions. In this study, we develop a spatially explicit game theoretic model to examine the strategic interaction between landowners’ hazard mitigation decisions on a landscape with public and private ownership. We find that in areas where ownership is mixed, the private landowner performs too little fuel treatment as they “free ride”—capture benefits without incurring the costs—on public protection, while areas with public land only are under-protected. Our central result is that this pattern of fuel treatment comes at a cost to society because public resources focus in areas with mixed ownership, where local residents capture the benefits, and are not available for publicly managed land areas that create benefits for society at large. We also find that policies that encourage public expenditures in areas with mixed ownership, such as the Healthy Forest Restoration Act of 2003 and public liability for private values, subsidize the residents who choose to locate in the high-risk areas at the cost of lost natural resource benefits for others.

  9. Wildfire risk management on a landscape with public and private ownership: who pays for protection?

    PubMed

    Busby, Gwenlyn; Albers, Heidi J

    2010-02-01

    Wildfire, like many natural hazards, affects large landscapes with many landowners and the risk individual owners face depends on both individual and collective protective actions. In this study, we develop a spatially explicit game theoretic model to examine the strategic interaction between landowners' hazard mitigation decisions on a landscape with public and private ownership. We find that in areas where ownership is mixed, the private landowner performs too little fuel treatment as they "free ride"-capture benefits without incurring the costs-on public protection, while areas with public land only are under-protected. Our central result is that this pattern of fuel treatment comes at a cost to society because public resources focus in areas with mixed ownership, where local residents capture the benefits, and are not available for publicly managed land areas that create benefits for society at large. We also find that policies that encourage public expenditures in areas with mixed ownership, such as the Healthy Forest Restoration Act of 2003 and public liability for private values, subsidize the residents who choose to locate in the high-risk areas at the cost of lost natural resource benefits for others. PMID:20087585

  10. Understanding patient preferences and willingness to pay for hemophilia therapies

    PubMed Central

    Chaugule, Shraddha S; Hay, Joel W; Young, Guy

    2015-01-01

    Background Despite clearly improved clinical outcomes for prophylaxis compared to on-demand therapy, on average only 56% of patients diagnosed with severe hemophilia receive prophylactic factor replacement therapy in the US. Prophylaxis rates generally drop as patients transition from childhood to adulthood, partly due to patients becoming less adherent when they reach adulthood. Assessment of patient preferences is important because these are likely to translate into increased treatment satisfaction and adherence. In this study, we assessed preferences and willingness to pay (WTP) for on-demand, prophylaxis, and longer acting prophylaxis therapies in a sample of US hemophilia patients. Methods Adult US hemophilia patients and caregivers (N=79) completed a discrete-choice survey that presented a series of trade-off questions, each including a pair of hypothetical treatment profiles. Using a mixed logit model for analysis, we compared the relative importance of five treatment characteristics: 1) out-of-pocket treatment costs (paid by patients), 2) factor dose adjustment, 3) treatment side effects, 4) availability of premixed factor, and 5) treatment effectiveness and dosing frequency. Based on these attribute estimates, we calculated patients’ WTP. Results Out-of-pocket treatment costs (P<0.001), side effects (P<0.001), and treatment effectiveness and dosing frequency (P<0.001) were found to be statistically significant in the model. Patients were willing to pay US $410 (95% confidence interval: $164–$656) out of pocket per month for thrice-weekly prophylaxis therapy compared to on-demand therapy and $360 (95% confidence interval: $145–$575) for a switch from thrice-weekly to once-weekly prophylaxis therapy. Conclusion Improvements in treatment effectiveness and dosing frequency, treatment side effects, and out-of-pocket costs per month were the greatest determinants of hemophilia treatment choice and WTP. The positive preferences and WTP for longer acting

  11. 34 CFR 303.520 - Policies related to use of public benefits or insurance or private insurance to pay for Part C...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... insurance policy; (ii) The use of private health insurance to pay for part C services cannot negatively... the child's family members who are covered under that health insurance policy, and health insurance... disability, the parent, or the child's family members covered under that health insurance policy. (3) If...

  12. 34 CFR 303.520 - Policies related to use of public benefits or insurance or private insurance to pay for Part C...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... insurance policy; (ii) The use of private health insurance to pay for part C services cannot negatively... the child's family members who are covered under that health insurance policy, and health insurance... disability, the parent, or the child's family members covered under that health insurance policy. (3) If...

  13. 34 CFR 303.520 - Policies related to use of public benefits or insurance or private insurance to pay for Part C...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... insurance policy; (ii) The use of private health insurance to pay for part C services cannot negatively... the child's family members who are covered under that health insurance policy, and health insurance... disability, the parent, or the child's family members covered under that health insurance policy. (3) If...

  14. Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK

    PubMed Central

    2011-01-01

    Background The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences. Methods Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Results Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. Conclusions Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had

  15. Patient education: a potential marketing tool for the private physician.

    PubMed

    Van Doren, D C; Blank, K M

    1992-03-01

    To keep pace with increasing competition, the private physician is encouraged to consider a patient education program as a marketing tool. Meeting the educational needs of patients is presented as an opportunity to create a trusting environment in the practice, enhance the doctor-patient relationship, and increase the active role of the patient in the health care process. A management model is proposed for successfully planning, organizing, staffing, leading, and controlling the patient education program. PMID:10145615

  16. Private and public in the lives of chronic schizophrenic patients.

    PubMed

    Leferink, K

    1998-01-01

    This article argues that both the private and public spheres must be taken into account when analyzing the development and everyday reality of the mentally ill. Private and public are two poles whose reciprocal relationship constitutes the form taken by a person's life. The interplay of both areas expresses how a person uses his thinking, feeling, and acting to relate to a real or imaginary audience. The psychosocial reality of a person is based on cooperation of the public and private selves. According to a central thesis of this essay, a loss of public presence leads in equal measure to a loss, rather than an increase, of private reality. An empirical study based on a sample of patients with chronic schizophrenia confirms this assumption by showing that such patients, under today's social conditions, develop lives characterized by a high degree of private reclusiveness. This is linked with an external and internal loss of life reality. Many patients, however, look for indirect and socially noncommittal forms of participating in public life without having to deny their private reality. PMID:9706102

  17. Service quality of private hospitals: The Iranian Patients' perspective

    PubMed Central

    2012-01-01

    Background Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. Methods A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. Results The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2) and 4.02(SD = 0.6), respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p < 0.001). There was a significant difference between the expectations scores based on gender, education level, and previous hospitalization in that same hospital. Also, there was a significant difference between the perception scores based on insurance coverage, average length of stay, and patients' health conditions on discharge. Conclusion The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients. PMID:22299830

  18. Private in-patient psychiatry in the USA

    PubMed Central

    Russakoff, L. Mark

    2014-01-01

    The US healthcare system is in the midst of major changes driven by four forces: the growing consensus in the country that the current system is financially unsustainable; managed care and parity legislation; the Affordable Care Act 2010; and the ageing of the ‘baby boomer’ generation. How these forces will combine and interact is unclear. The current state of in-patient psychiatric care and trends affecting the private practice of in-patient psychiatry over the next few years will be described. PMID:25285222

  19. College CFO's Outpace Other Leaders in Pay Raises: Business Leaders Got 13.8% Median Increase at Private Institutions

    ERIC Educational Resources Information Center

    June, Audrey Williams

    2007-01-01

    Chief financial officers at the nation's private colleges have bigger workloads than ever before, and in return, many are taking home much larger paychecks. A "Chronicle" survey of 103 private doctoral institutions shows that between 2003 and 2005, the median compensation package for the top financial position, which includes such titles as vice…

  20. “It’s easier in pharmacy”: why some patients prefer to pay for flu jabs rather than use the National Health Service

    PubMed Central

    2014-01-01

    Background There is a need to increase flu vaccination rates in England particularly among those under 65 years of age and at risk because of other conditions and treatments. Patients in at risk groups are eligible for free vaccination on the National Health Service (NHS) in England, but despite this, some choose to pay privately. This paper explores how prevalent this is and why people choose to do it. There is moderate to good evidence from several countries that community pharmacies can safely provide a range of vaccinations, largely seasonal influenza Immunisation. Pharmacy-based services can extend the reach of immunisation programmes. User, doctor and pharmacist satisfaction with these services is high. Method Data were collected during the 2012–13 flu season as part of a community pharmacy private flu vaccination service to help identify whether patients were eligible to have their vaccination free of charge on the NHS. Additional data were collected from a sample of patients accessing the private service within 13 pharmacies to help identify the reasons patients paid when they were eligible for free vaccination. Results Data were captured from 89,011 privately paying patients across 479 pharmacies in England, of whom 6% were eligible to get the vaccination free. 921 patients completed a survey in the 13 pharmacies selected. Of these, 199 (22%) were eligible to get their flu vaccination for free. 131 (66%) were female. Average age was 54 years. Of the 199 patients who were eligible for free treatment, 100 (50%) had been contacted by their GP surgery to go for their vaccination, but had chosen not to go. Reasons given include accessibility, convenience and preference for pharmacy environment. Conclusions While people at risk can access flu vaccinations free via the NHS, some choose to pay privately because they perceive that community pharmacy access is easier. There are opportunities for pharmacy to support the NHS in delivering free flu vaccinations to

  1. Motivational Factors of Pay-for-Performance Plans in Educational Institutions: A Study of Select Private, Faith-Based Schools

    ERIC Educational Resources Information Center

    Wrobbel, Paul H.

    2009-01-01

    In the United States there is considerable focus on the need for continuous improvement in the quality of schools, including student achievement and teacher performance. Performance-based pay has been repeatedly suggested as a way to improve teaching in school systems. Therefore, a more thorough understanding of the differences in the perceptions…

  2. Targeting low literacy patients pays off for health system.

    PubMed

    2015-11-01

    Ochsner Health, with headquarters in New Orleans, targets patients with low health literacy, along with other readmission reduction programs. When patients are readmitted, the case managers administer the Rapid Estimate of Adult Literacy in Medicine (REALM) tool, developed by the Agency for Healthcare Research and Quality (AHRQ) to identify patients who need extra help in understanding their discharge instructions. When case managers make post-discharge follow-up calls to at-risk patients, they ask a series of questions that determine if the patient can understand written instructions. - The staff uses pictographs and videos to educate patients identified as having low literacy and make sure the caregivers understand the discharge instructions. PMID:26521642

  3. Pay for Performance.

    ERIC Educational Resources Information Center

    LaFee, Scott

    1999-01-01

    Top school administrators and school boards across the country are increasingly employing a private-sector incentive: bonus pay for improved (school) performance. Connecticut, Texas, and North Carolina have merit-pay clauses in superintendents' contracts. This article discusses pay-for-performance criteria, increased job expectations, and ethical…

  4. Colchicine toxicity in renal patients - Are we paying attention?

    PubMed

    Medani, Samar; Wall, Catherine

    2016-08-01

    Colchicine is an approved agent in the management and prophylaxis of gout and familial Mediterranean fever but its therapeutic value is limited by its narrow therapeutic index. Multisystem toxicity is uncommonly reported; and is often associated with renal impairment and/or specific drug interactions. We report two cases of colchicine toxicity marked by severe neuromyopathy in a diabetic with stage 4 chronic kidney disease (CKD) and a renal transplant recipient. Both patients presented with diarrhea, acute on chronic kidney injury and progressive muscle weakness while on colchicine for several weeks or longer. In addition to kidney disease, risk factors for colchicine toxicity included maintenance therapy with simvastatin in the first patient and cyclosporine in the second. Creatine phosphokinase (CPK) was elevated in both cases at presentation and neurophysiologic studies showed a pattern of severe myopathy with axonal sensorimotor neuropathy. The first patient recovered from neurological weakness in a few weeks, but the second patient suffered an extraordinarily protracted and severe neuromuscular disability for a year. The two cases reinforce the need for extra vigilance in prescribing and monitoring colchicine therapy in renal patients with specific attention to drug interactions known to increase the risk of toxicity, thus avoiding such combinations in patients with renal impairment. PMID:26249546

  5. Private Mitochondrial DNA Variants in Danish Patients with Hypertrophic Cardiomyopathy

    PubMed Central

    Hagen, Christian M.; Aidt, Frederik H.; Havndrup, Ole; Hedley, Paula L.; Jensen, Morten K.; Kanters, Jørgen K.; Pham, Tam T.; Bundgaard, Henning; Christiansen, Michael

    2015-01-01

    Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease primarily caused by mutations in genes coding for sarcomeric proteins. A molecular-genetic etiology can be established in ~60% of cases. Evolutionarily conserved mitochondrial DNA (mtDNA) haplogroups are susceptibility factors for HCM. Several polymorphic mtDNA variants are associated with a variety of late-onset degenerative diseases and affect mitochondrial function. We examined the role of private, non-haplogroup associated, mitochondrial variants in the etiology of HCM. In 87 Danish HCM patients, full mtDNA sequencing revealed 446 variants. After elimination of 312 (69.9%) non-coding and synonymous variants, a further 109 (24.4%) with a global prevalence > 0.1%, three (0.7%) haplogroup associated and 19 (2.0%) variants with a low predicted in silico likelihood of pathogenicity, three variants: MT-TC: m.5772G>A, MT-TF: m.644A>G, and MT-CYB: m.15024G>A, p.C93Y remained. A detailed analysis of these variants indicated that none of them are likely to cause HCM. In conclusion, private mtDNA mutations are frequent, but they are rarely, if ever, associated with HCM. PMID:25923817

  6. Are patients willing to pay for total shoulder arthroplasty? Evidence from a discrete choice experiment

    PubMed Central

    O’Hara, Nathan N.; Slobogean, Gerard P.; Mohammadi, Tima; Marra, Carlo A.; Vicente, Milena R.; Khakban, Amir; McKee, Michael D.

    2016-01-01

    Background Total shoulder arthroplasty (TSA) is a common treatment to decrease pain and improve shoulder function in patients with severe osteoarthritis (OA). In Canada, patients requiring this procedure often wait a year or more. Our objective was to determine patient preferences related to accessing TSA, specifically comparing out-of-pocket payments for treatment, travel time to hospital, the surgeon’s level of experience and wait times. Methods We administered a discrete choice experiment among patients with end-stage shoulder OA currently waiting for TSA. Respondents were presented with 14 different choice sets, each with 3 options, and they were asked to choose their preferred scenario. A conditional logit regression model was used to estimate the relative preference and willingness to pay for each attribute. Results Sixty-two respondents completed the questionnaire. Three of the 4 attributes significantly influenced treatment preferences. Respondents had a strong preference for an experienced surgeon (mean 0.89 ± standard error [SE] 0.11), while reductions in travel time (−0.07 ± 0.04) or wait time (−0.04 ± 0.01) were of less importance. Respondents were found to be strongly averse (−1.44 ± 0.18) to surgical treatment by a less experienced surgeon and to paying out-of-pocket for their surgical treatment (−0.56 ± 0.05). Conclusion Our results suggest that patients waiting for TSA to treat severe shoulder OA have minimal willingness to pay for a reduction in wait time or travel time for surgery, yet will pay higher amounts for treatment by an experienced surgeon. PMID:27007091

  7. Factors influencing patients' willingness to pay for new technologies in hip and knee implants.

    PubMed

    Schwarzkopf, Ran; Sagebin, Fabio M; Karia, Raj; Koenig, Karl M; Bosco, Joseph A; Slover, James D

    2013-03-01

    Rising implant prices and evolving technologies are important factors contributing to the increased cost of arthroplasty. Assessing how patients value arthroplasty, new technologies, and their perceived outcomes is critical in planning cost-effective care, as well as evaluating new-technologies. One hundred one patients undergoing arthroplasty took part in the survey. We captured demographics, spending practices, knowledge of implants, patient willingness to pay for implants, and preferences related to implant attributes. When patients were asked if they would be satisfied with "standard of care" prosthesis, 80% replied "no". When asked if they would pay for a higher than "standard of care" prosthesis, 86% replied "yes". The study demonstrated that patients, regardless of their socio-economic status, are not satisfied with standard of care implants when newer technologies are available, and they may be willing to share in the cost of their prosthesis. Patients also prefer the option to choose what they perceive to be a higher quality or innovative implant even if the "out of pocket" cost is higher. PMID:23142436

  8. Meet the challenge of discharging patients with no way to pay.

    PubMed

    2014-04-01

    Case managers and social workers have to look for creative solutions as hospitals struggle with finding a safe discharge for uninsured, undocumented, and homeless patients. It's often more cost-effective for hospitals to pay for post-discharge care rather than keeping unfunded patients as inpatients after they no longer meet acute care criteria. Undocumented patients sometimes want to go back to their home country for post-discharge care, but many have families in this country who are willing to care for them. Some homeless patients have families who are looking for them, but some have been on the street for many years and want to be discharged to the only living situation they know. PMID:24697135

  9. Private Prayer and Optimism in Middle-Aged and Older Patients Awaiting Cardiac Surgery

    ERIC Educational Resources Information Center

    Ai, Amy L.; Peterson, Christopher; Bolling, Steven F.; Koenig, Harold

    2002-01-01

    Purpose: This study investigated the use of private prayer among middle-aged and older patients as a way of coping with cardiac surgery and prayer's relationship to optimism. Design and Methods: The measure of prayer included three aspects: (a) belief in the importance of private prayer, (b) faith in the efficacy of prayer on the basis of previous…

  10. Patients' appraisals of public and private healthcare: a qualitative study of physiotherapy and osteopathy.

    PubMed

    Bradbury, Katherine J; Bishop, Felicity L; Yardley, Lucy; Lewith, George

    2013-10-01

    Patients have previously reported differences in their experiences of treatments received in the public and private sectors; it remains unclear whether such perceived differences are particular to or shared across different interventions. This study explored whether patients' appraisals of public and private treatments are similar when appraising a complementary therapy (osteopathy) compared to a mainstream therapy (physiotherapy). Thirty-five qualitative interviews were analysed thematically. Patients' appraisals varied by health-care sector and therapy type: physiotherapy was appraised more negatively in the National Health Service than the private sector but osteopathy was appraised similarly within both health-care sectors. Potential reasons for this are discussed. PMID:23180877

  11. Pay for Performance: Are Hospitals Becoming More Efficient in Improving Their Patient Experience?

    PubMed

    Stanowski, Anthony Charles; Simpson, Kit; White, Andrea

    2015-01-01

    The Centers for Medicare & Medicaid Services (CMS) changed the way hospitals interact with patients when it implemented a pay-for-performance (P4P) system. Under this system, a financial reward or penalty is based in part on measures of patient experience. The program seeks to reward healthcare providers who expand their focus from solely delivering a highly technical set of services that improves the patient's health to creating an atmosphere that makes hospitalization more humane and respectful of patients' values and preferences. Refocusing priorities requires capital investment in more "patient-friendly" facilities or funding staff training programs. This study seeks to determine whether a relationship exists between inpatient costs and the score for "overall rating of hospital" (ORH) on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) hospital version survey. Second, if a relationship exists, the study examines how that relationship changed during the time of CMS' implementation of its P4P program. The study's findings suggest that higher-cost hospitals have higher levels of positive patient experiences, after controlling for other variables. Importantly, the research findings indicate that hospitals are becoming more efficient in delivering care associated with higher levels of patient experience, coinciding with implementation of the P4P program. PMID:26364350

  12. DELIBERATE SELF-HARM PATIENTS VISITING PUBLIC AND PRIVATE EMERGENCY DEPARTMENTS OF KARACHI

    PubMed Central

    SHAHID, MUHAMMAD; KHAN, MUHAMMAD ZAMAN; AFZAL, BADAR; KHAN, SUMAIYA TAUSEEQ; NAKEER, ROOHAM

    2015-01-01

    OBJECTIVE To study the mode of attempted deliberate self-harm (DSH) in patients presenting to the Emergency Departments (ED) of public and private hospitals of Karachi, Pakistan. DESIGN A cross sectional study. PLACE AND DURATION OF STUDY Aga Khan University Hospital Karachi, Jinnah Post Graduate Medical Centre Karachi and Civil Hospital Karachi; March 2011 to February 2012. SUBJECTS AND METHODS One hundred DSH cases from ED of a private sector hospital were compared with 101 patients from two public sector hospitals. RESULTS DSH patients in the private hospital were mostly females (70%), had higher level of education (32%), did not share their problems (67%) with someone and had more mental disorders (28%). Patients from public hospitals were treated more for physical illnesses compared to private facility. Organophosphorus poisoning (90%) was a common mode of DSH in patients presenting to public hospitals; however significant number of organophosphorus poisoning (40%) was also seen in private hospital besides the benzodiazepine overdose (32%). CONCLUSION Emergency Physicians working in the EDs, both public and private sector hospitals of Karachi, should have adequate knowledge of managing organophosphorus poisoning. As more and more cases are presenting to the EDs, there should be a public health initiative to control the illegal sale and availability of such compounds in Pakistan. PMID:26985203

  13. Patients' with type 2 diabetes willingness to pay for insulin therapy and clinical outcomes

    PubMed Central

    Feher, Michael D; Brazier, John; Schaper, Nicolaas; Vega-Hernandez, Gabriela; Bøgelund, Mette

    2016-01-01

    Objectives This study assessed patient preferences, using willingness to pay as a method to measure different treatment characteristics or attributes associated with injectable insulin therapy in patients with type 2 diabetes. Research design and methods Adults with type 2 diabetes in 12 countries, diagnosed >6 months prior and receiving insulin for >3 months, were recruited through a representative online panel. Data were collected via online questionnaire and analyzed using a standard choice model for discrete choice experiment. Results A total of 3758 patients from North America (n=646), South America (n=1537), and Europe (n=1575) completed the study. Mean glycated hemoglobin (HbA1c) levels in North America, South America, and Europe were 63 mmol/mol (7.9%), 75 mmol/mol (9.0%), and 64 mmol/mol (8.0%), respectively. In the three regions, monthly willingness to pay was US$116, US$74, and US$92, respectively, for a 1%-point decrease in HbA1c; US$99, US$80, and US$104 for one less major hypoglycemic event per year; and US$64, US$37 and US$60 for a 3 kg weight decrease. To avoid preinjection preparation of insulin, the respective values were US$47, US$18, and US$37, and US$25, US$25, and US$24 for one less injection per day. Among respondents on basal-only insulin who had previously tried a more intensive regimen, reasons for switching back included difficulty in handling multiple injections and risk of hypoglycemic events. Conclusions Reducing HbA1c, frequency of major hypoglycemic events and weight decrease were the highest valued outcomes in each region. The administrative burden of injections was also considered important. PMID:27158518

  14. Should we pay the patient? Review of financial incentives to enhance patient compliance.

    PubMed Central

    Giuffrida, A.; Torgerson, D. J.

    1997-01-01

    OBJECTIVE: To determine whether financial incentives increase patients' compliance with healthcare treatments. DATA SOURCES: Systematic literature review of computer databases--Medline, Embase, PsychLit, EconLit, and the Cochrane Database of Clinical Trials. In addition, the reference list of each retrieved article was reviewed and relevant citations retrieved. STUDY SELECTION: Only randomised trials with quantitative data concerning the effect, of financial incentives (cash, vouchers, lottery tickets, or gifts) on compliance with medication, medical advice, or medical appointments were included in the review. Eleven papers were identified as meeting the selection criteria. DATA EXTRACTION: Data on study populations, interventions, and outcomes were extracted and analysed using odds ratios and the number of patients needed to be treated to improve compliance by one patient. RESULTS: 10 of the 11 studies showed improvements in patient compliance with the use of financial incentives. CONCLUSIONS: Financial incentives can improve patient compliance. PMID:9314754

  15. 42 CFR 22.1 - Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... care of Hansen's disease patients; additional pay. 22.1 Section 22.1 Public Health PUBLIC HEALTH... Hansen's Disease Duty by Personnel Other Than Commissioned Officers § 22.1 Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay. (a) Non-commissioned...

  16. 42 CFR 22.1 - Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... care of Hansen's disease patients; additional pay. 22.1 Section 22.1 Public Health PUBLIC HEALTH... Hansen's Disease Duty by Personnel Other Than Commissioned Officers § 22.1 Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay. (a) Non-commissioned...

  17. 42 CFR 22.1 - Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... care of Hansen's disease patients; additional pay. 22.1 Section 22.1 Public Health PUBLIC HEALTH... Hansen's Disease Duty by Personnel Other Than Commissioned Officers § 22.1 Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay. (a) Non-commissioned...

  18. 42 CFR 22.1 - Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... care of Hansen's disease patients; additional pay. 22.1 Section 22.1 Public Health PUBLIC HEALTH... Hansen's Disease Duty by Personnel Other Than Commissioned Officers § 22.1 Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay. (a) Non-commissioned...

  19. 42 CFR 22.1 - Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... care of Hansen's disease patients; additional pay. 22.1 Section 22.1 Public Health PUBLIC HEALTH... Hansen's Disease Duty by Personnel Other Than Commissioned Officers § 22.1 Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay. (a) Non-commissioned...

  20. Patients Are Paying Too Much for Tuberculosis: A Direct Cost-Burden Evaluation in Burkina Faso

    PubMed Central

    Laokri, Samia; Drabo, Maxime Koiné; Weil, Olivier; Kafando, Benoît; Dembélé, Sary Mathurin; Dujardin, Bruno

    2013-01-01

    Background Paying for health care may exclude poor people. Burkina Faso adopted the DOTS strategy implementing “free care” for Tuberculosis (TB) diagnosis and treatment. This should increase universal health coverage and help to overcome social and economic barriers to health access. Methods Straddling 2007 and 2008, in-depth interviews were conducted over a year among smear-positive pulmonary tuberculosis patients in six rural districts of Burkina Faso. Out-of-pocket expenses (direct costs) associated with TB were collected according to the different stages of their healthcare pathway. Results Median direct cost associated with TB was US$101 (n = 229) (i.e. 2.8 months of household income). Respectively 72% of patients incurred direct costs during the pre-diagnosis stage (i.e. self-medication, travel, traditional healers' services), 95% during the diagnosis process (i.e. user fees, travel costs to various providers, extra sputum smears microscopy and chest radiology), 68% during the intensive treatment (i.e. medical and travel costs) and 50% during the continuation treatment (i.e. medical and travel costs). For the diagnosis stage, median direct costs already amounted to 35% of overall direct costs. Conclusions The patient care pathway analysis in rural Burkina Faso showed substantial direct costs and healthcare system delay within a “free care” policy for TB diagnosis and treatment. Whether in terms of redefining the free TB package or rationalizing the care pathway, serious efforts must be undertaken to make “free” health care more affordable for the patients. Locally relevant for TB, this case-study in Burkina Faso has a real potential to document how health programs' weaknesses can be identified and solved. PMID:23451079

  1. Direct Pay/Concierge/Blended Care: Where Is The Sweet Spot? Part II--Seen from Your Patients' Perspective.

    PubMed

    Childs, Susan

    2015-01-01

    Physicians are actively considering the direct pay and concierge models as plausible options in providing more patient-oriented care. What are the major considerations and how do we obtain accurate data that may help in sophisticated decision-making? Part I of this article introduced the models, typical patient contract configurations, physician/provider considerations, and commercial payers. In Part II, we discuss the access, cost, and value from a patient's point of view. We also consider patient loyalty and self-care, approaches for introducing and inviting patients, and how to work with other providers and in community relations. Lastly, we share some creative concierge models that are evolving. PMID:26399038

  2. Patients of internists in hospital outpatient departments and in private practice.

    PubMed Central

    Rudd, P.; Carrier, A. C.

    1978-01-01

    To test the contention that patients in outpatient departments and private practices differ, variables were assessed that might affect both the process and the outcome of medical care. Two groups of 60 patients consulting nine Montreal internists who worked in both private practice and in an outpatient department of a university teaching hospital were surveyed. The internists served as their own controls. The two groups of patients were compared for 57 demographic, socioeconomic, access, utilization, attitudinal and current medical status variables. Financial factors were minimized by the existence of universal health insurance. The outpatient group was found to be older, less fluent in English, less likely to be employed, less educated, less wealthy, more dependent on public transportation, more disabled, more likely to use ambulatory services, more anxious about health, and more sceptical about physicians, yet more dependent on them than the private practice group. The outpatient group tended to have more active, significant medical conditions and to receive more prescriptions for medication than the private practice group, in contrast to the national patterns in the practice of internal medicine in the United States. Medical educators, researchers, administrators and providers of health care who have assumed that these two groups of patients are comparable must re-evaluate their practices. PMID:737639

  3. When should managed care firms terminate private benefits for chronically mentally ill patients?

    PubMed

    Gerson, S N

    1994-01-01

    Corporate America's healthcare cost crisis and the country's budget deficit are forcing limits on the resources used to finance healthcare, including mental healthcare. At the same time, the 1990 Americans with Disabilities Act bars discrimination against patients with chronic illnesses, including chronic mental illness. Therefore, corporate benefits managers need guidance on how to ethically and rationally allocate scarce clinical resources to those high-morbidity insureds who utilize disproportionate amounts of these resources. In particular, how should we define the public/private interface: When do patients who repeatedly fail to respond to treatment fall out of the private sector's responsibility? The author, medical director for a leading behavioral healthcare utilization management company, offers the following guidelines recommending reasonable and practical limitations on trials of treatment for seven common categories of difficult psychiatric patients. PMID:10141406

  4. Comparing the probability of stroke by the Framingham risk score in hypertensive Korean patients visiting private clinics and tertiary hospitals

    PubMed Central

    2010-01-01

    Background The purpose of this study was to investigate the pattern of distribution of risk factors for stroke and the 10-year probability of stroke by the Framingham risk score in hypertensive patients visiting private clinics vs. tertiary hospitals. Methods A total of 2,490 hypertensive patients who attended 61 private clinics (1088 patients) and 37 tertiary hospitals (1402 patients) were enrolled. The risk factors for stroke were evaluated using a series of laboratory tests and physical examinations, and the 10-year probability of stroke was determined by applying the Framingham stroke risk equation. Results The proportion of patients who had uncontrolled hypertension despite the use of antihypertensive agents was 49% (66 and 36% of patients cared for at private clinics and tertiary hospitals, respectively; p < 0.001). The average 10-year probability of stroke by the Framingham risk score in hypertensive patients was 21% (approximately 2.2 times higher than of the risk of stroke in the Korean Cancer Prevention Study [KCPS] cohort) and was higher in patients attending tertiary hospitals compared to private clinics (16 and 24% of patients attending private clinics and tertiary hospitals, respectively; p < 0.001). Conclusions Since the 10-year probability of stroke by the Framingham risk score in hypertensive patients attending tertiary hospitals was higher than the risk for patients attending private clinics. We suggest that the more aggressive interventions are needed to prevent and early detect an attack of stroke in hypertensive patients attending tertiary hospitals. PMID:20822544

  5. Use of an interactive tool to assess patients' willingness-to-pay.

    PubMed

    Matthews, D; Rocchi, A; Wang, E C; Gafni, A

    2001-10-01

    Assessment of willingness to pay (WTP) has become an important issue in health care technology assessment and in providing insight into the risks and benefits of treatment options. We have accordingly explored the use of an interactive method for assessment of WTP. To illustrate our methodology, we describe the development and testing of an interactive tool to administer a WTP survey in a dental setting. The tool was developed to measure patient preference and strength of preference for three dental anesthetic options in a research setting. It delivered written and verbal formats simultaneously, including information about the risks and benefits of treatment options, insurance, and user-based WTP scenarios and questions on previous dental experience. Clinical information was presented using a modified decision aid. Subjects could request additional clinical information and review this information throughout the survey. Information and question algorithms were individualized, depending on the subject's reported clinical status and previous responses. Initial pretesting resulted in substantial modifications to the initial tool: shortening the clinical information (by making more of it optional reading) and personalizing the text to more fully engage the user. In terms of results 196 general population subjects were recruited using random-digit dialing in southwestern Ontario, Canada. Comprehension was tested to ensure the instrument clearly conveyed the clinical information; the average score was 97%. Subjects rated the instrument as easy/very easy to use (99%), interesting/very interesting (91%), and neither long nor short (72.4%). Most subjects were comfortable/very comfortable with a computer (84%). Indirect evaluation revealed most subjects completed the survey in the expected time (30 min). Additional information was requested by 50% of subjects, an average of 2.9 times each. Most subjects wanted this type of information available in the provider's office for

  6. Patient satisfaction with HIV/AIDS care at private clinics in Dar es Salaam, Tanzania.

    PubMed

    Miller, James S; Mhalu, Aisa; Chalamilla, Guerino; Siril, Hellen; Kaaya, Silvia; Tito, Justina; Aris, Eric; Hirschhorn, Lisa R

    2014-01-01

    Health system responsiveness (HSR) measures quality of care from the patient's perspective, an important component of ensuring adherence to medication and care among HIV patients. We examined HSR in private clinics serving HIV patients in Dar es Salaam, Tanzania. We surveyed 640 patients, 18 or older receiving care at one of 10 participating clinics, examining socioeconomic factors, HIV regimen, and self-reported experience with access and care at the clinic. Ordered logistic regression, adjusted for clustering of the clinic sites, was used to measure the relationships between age, gender, education, site size, and overall quality of care rating, as well as between the different HSR domains and overall rating. Overall, patients reported high levels of satisfaction with care received. Confidentiality, communication, and respect were particularly highly rated, while timeliness received lower ratings despite relatively short wait times, perhaps indicating high expectations when receiving care at a private clinic. Respect, confidentiality, and promptness were significantly associated with overall rating of health care, while provider skills and communication were not significantly associated. Patients reported that quality of service and confidentiality, rather than convenience of location, were the most important factors in their choice of a clinic. Site size (patient volume) was also positively correlated with patient satisfaction. Our findings suggest that, in the setting of urban private-sector clinics, flexible clinics hours, prompt services, and efforts to improve respect, privacy and confidentiality may prove more helpful in increasing visit adherence than geographic accessibility. While a responsive health system is valuable in its own right, more work is needed to confirm that improvements in HSR in fact lead to improved adherence to care. PMID:24499337

  7. An Empirical Study of the Impact of Service Quality on Patient Satisfaction in Private Hospitals, Iran

    PubMed Central

    Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

    2015-01-01

    Objective: Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. Method: This cross-sectional study was conducted in the year 2010. The study’s sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. Result: this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Conclusions: Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers. PMID:25560338

  8. Psychiatric Patients Tracking Through a Private Social Network for Relatives: Development and Pilot Study.

    PubMed

    García-Peñalvo, Francisco J; Martín, Manuel Franco; García-Holgado, Alicia; Guzmán, José Miguel Toribio; Antón, Jesús Largo; Sánchez-Gómez, Ma Cruz

    2016-07-01

    The treatment of psychiatric patients requires different health care from that of patients from other medical specialties. In particular, in the case of Department of Psychiatry from the Zamora Hospital (Spain), the period of time which patients require institutionalized care is a tiny part of their treatment. A large part of health care provided to the patient is aimed at his/her rehabilitation and social integration through day-care centres, supervised flats or activities. Conversely, several reports reveal that approximately 50 % of Internet users use the network as a source of health information, which has led to the emergence of virtual communities where patients, relatives or health professionals share their knowledge concerning an illness, health problem or specific health condition. In this context, we have identified that the relatives have a lack of information regarding the daily activities of patients under psychiatric treatment. The social networks or the virtual communities regarding health problems do not provide a private space where relatives can follow the patient's progress, despite being in different places. The goal of the study was to use technologies to develop a private social network for being used by severe mental patients (mainly schizophrenic patients). SocialNet is a pioneer social network in the health sector because it provides a social interaction context restricted to persons authorized by the patient or his/her legal guardian in such a way that they can track his/her daily activity. Each patient has a private area only accessible to authorized persons and their caregivers, where they can share pictures, videos or texts regarding his/her progress. A preliminary study of usability of the system has been made for increasing the usefulness and usability of SocialNet. SocialNet is the first system for promoting personal interactions among formal caregivers, family, close friends and patient, promoting the recovery of schizophrenic

  9. Doctor-Patient Relationship Between Individuals With Fibromyalgia and Rheumatologists in Public and Private Health Care in Mexico.

    PubMed

    Colmenares-Roa, Tirsa; Huerta-Sil, Gabriela; Infante-Castañeda, Claudia; Lino-Pérez, Leticia; Alvarez-Hernández, Everardo; Peláez-Ballestas, Ingris

    2016-10-01

    The aim of this article was to describe and analyze the doctor-patient relationship between fibromyalgia patients and rheumatologists in public and private health care contexts within the Mexican health care system. This medical anthropological study drew on hospital ethnography and patients' illness narratives, as well as the experiences of rheumatologists from both types of health care services. The findings show how each type of medical care subsystem shape different relationships between patients and doctors. Patient stigmatization, overt rejection, and denial of the disease's existence were identified. In this doctor-patient-with-fibromyalgia relationship, there are difficult encounters, rather than difficult patients. These encounters are more fluid in private consultations compared with public hospitals. The doctor-centered health care model is prevalent in public institutions. In the private sector, we find the characteristics of the patient-centered model coexisting with the traditional physician-centered approach. PMID:27578852

  10. Examining Adherence Among Challenging Patients in Public and Private HIV Care in Argentina.

    PubMed

    Jones, Deborah; Cook, Ryan; Cecchini, Diego; Sued, Omar; Bofill, Lina; Weiss, Stephen; Waldrop-Valverde, Drenna; Lopez, Maria R; Spence, Andrew

    2015-09-01

    Treatment engagement, retention and adherence to care are required for optimal HIV outcomes. Yet, patients may fall below the treatment recommendations for achieving undetectable viral load or not be retained in care. This study examined the most challenging patients in Buenos Aires, Argentina, those non-adherent to HIV care. Men (n = 61) and women (n = 59) prescribed antiretrovirals (ARVs) and non-adherent to treatment in the prior 3-6 months were enrolled and assessed regarding adherence, knowledge, motivation and attitudes regarding treatment. Private clinic patients had lower viral load and higher self-reported adherence than public clinic patients. Motivations to be adherent and positive beliefs regarding ARVs were associated with increased adherence in public clinic participants. Increased self-efficacy was associated with increased adherence among participants from both clinics. Results support patient and provider interventions that strengthen the characteristics supporting adherence, engagement and retention in public and private clinic settings. PMID:25777507

  11. Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono District, Uganda.

    PubMed

    Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

    2013-03-01

    In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures. PMID:22589226

  12. Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono district, Uganda

    PubMed Central

    Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

    2013-01-01

    In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures. PMID:22589226

  13. SOEMPI: A Secure Open Enterprise Master Patient Index Software Toolkit for Private Record Linkage

    PubMed Central

    Toth, Csaba; Durham, Elizabeth; Kantarcioglu, Murat; Xue, Yuan; Malin, Bradley

    2014-01-01

    To mitigate bias in multi-institutional research studies, healthcare organizations need to integrate patient records. However, this process must be accomplished without disclosing the identities of the corresponding patients. Various private record linkage (PRL) techniques have been proposed, but there is a lack of translation into practice because no software suite supports the entire PRL lifecycle. This paper addresses this issue with the introduction of the Secure Open Enterprise Master Patient Index (SOEMPI). We show how SOEMPI covers the PRL lifecycle, illustrate the implementation of several PRL protocols, and provide a runtime analysis for the integration of two datasets consisting of 10,000 records. While the PRL process is slower than a non-secure setting, our analysis shows the majority of processes in a PRL protocol require several seconds or less and that SOEMPI completes the process in approximately two minutes, which is a practical amount of time for integration. PMID:25954421

  14. Pay scheme preferences and health policy objectives.

    PubMed

    Abelsen, Birgit

    2011-04-01

    This paper studies the preferences among healthcare workers towards pay schemes involving different levels of risk. It identifies which pay scheme individuals would prefer for themselves, and which they think is best in furthering health policy objectives. The paper adds, methodologically, a way of defining pay schemes that include different levels of risk. A questionnaire was mailed to a random sample of 1111 dentists. Respondents provided information about their current and preferred pay schemes, and indicated which pay scheme, in their opinion, would best further overall health policy objectives. A total of 504 dentists (45%) returned the questionnaire, and there was no indication of systematic non-response bias. All public dentists had a current pay scheme based on a fixed salary and the majority of individuals preferred a pay scheme with more income risk. Their preferred pay schemes coincided with the ones believed to further stabilise healthcare personnel. The predominant current pay scheme among private dentists was based solely on individual output, and the majority of respondents preferred this pay scheme. In addition, their preferred pay schemes coincided with the ones believed to further efficiency objectives. Both public and private dentists believed that pay schemes, furthering efficiency objectives, had to include more performance-related pay than the ones believed to further stability and quality objectives. PMID:20565995

  15. The Effect of Service Quality on Patient loyalty: a Study of Private Hospitals in Tehran, Iran

    PubMed Central

    Arab, M; Tabatabaei, SM Ghazi; Rashidian, A; Forushani, A Rahimi; Zarei, E

    2012-01-01

    Background: Service quality is perceived as an important factor for developing patient’s loyalty. The aim of this study was to determine the hospital service quality from the patients’ viewpoints and the relative importance of quality dimensions in predicting the patient’s loyalty. Methods: A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 items about the service quality and 3 items about the patient’s loyalty. Exploratory factor analysis was employed to extracting the dimensions of service quality. Also, regression analysis was performed to determining the relative importance of the service quality dimensions in predicting the patient’s loyalty. Result: The mean score of service quality and patient’s loyalty was 3.99 and 4.16 out of 5, respectively. About 29% of the loyalty variance was explained by the service quality dimensions. Four quality dimensions (Costing, Process Quality, Interaction Quality and Environment Quality) were found to be key determinants of the patient’s loyalty in the private hospitals of Tehran. Conclusion: The patients’ experience in relation to the private hospitals’ services has strong impact on the outcome variables like willingness to return to the same hospital and reuse its services or recommend them to others. The relationship between the service quality and patient’s loyalty proves the strategic importance of improving the service quality for dragging and retaining patients and expanding the market share. PMID:23193509

  16. [Anxiety disorders in private practice psychiatric out-patients: prevalence, comorbidity and burden (DELTA study)].

    PubMed

    Pélissolo, A; André, C; Chignon, J-M; Dutoit, D; Martin, P; Richard-Berthe, C; Tignol, J

    2002-01-01

    Few data are currently available on the prevalence and associated characteristics of anxiety disorders in psychiatric out-patients in France, in particular in the private health-care. However, this represents one of the principal systems of care for patients suffering from anxiety disorders, with a possible direct access and several types of treatments available (pharmacotherapy but also different kinds of psychotherapy). The aim of our study was to describe the prevalence of anxiety disorders in a large sample of patients consulting in the private sector, and in addition to study the comorbidity, the severity of the disorders, their consequences on quality of life and health care consumption. The studied patients were included and assessed by 501 psychiatrists from all the country, at the time of a first visit. Inclusions were to be made in a consecutive way, but with the exclusion of psychotic disorders and dementia. A sample of 1 955 patients was obtained, and all subjects had a standardized diagnostic assessment with the Mini International Neuropsychiatric Interview (MINI) and with various dimensional scales of symptomatology severity, quality of life, and health care consumption. On the whole, at least one current anxiety disorder was found in 64.3% of the patients, while 55% had a depressive disorder. Individually, the prevalence rates are 29.4% for generalized anxiety disorder, 25.9% for agoraphobia, 19.2% for panic disorder, 15.3% for social phobia, 11.4% for obsessive-compulsive disorder, and 5.4% for post-traumatic stress disorder (PTSD). A history of suicide attempts was found in 12-20% of patients, and an elevated suicide risk was found for example in 25% of PTSD patients. The scores of the symptomatic scales, adaptation and quality of life measure show a very significant anxious symptomatology, with serious functional consequences. Approximately 75% of patients had another medical consultation during the three previous months, and 9% have been

  17. Examining adherence among challenging patients in public and private HIV care in Argentina

    PubMed Central

    Jones, Deborah; Cook, Ryan; Cecchini, Diego; Sued, Omar; Bofill, Lina; Weiss, Stephen; Waldrop-Valverde, Drenna; Lopez, Maria R; Spence, Andrew

    2015-01-01

    Treatment engagement, retention and adherence to care are required for optimal HIV outcomes. Yet, patients may fall below the treatment recommendations for achieving undetectable viral load or not be retained in care. This study examined the most challenging patients in Buenos Aires, Argentina, those non-adherent to HIV care. Men (n = 61) and women (n = 59) prescribed antiretrovirals (ARVs) and non-adherent to treatment in the prior 3 to 6 months were enrolled and assessed regarding adherence, knowledge, motivation and attitudes regarding treatment. Private clinic patients had lower viral load and higher self-reported adherence than public clinic patients. Motivations to be adherent and positive beliefs regarding ARVs were associated with increased adherence in public clinic participants. Increased self-efficacy was associated with increased adherence among participants from both clinics. Results support patient and provider interventions that strengthen the characteristics supporting adherence, engagement and retention in public and private clinic settings. Resumen El compromiso, la retención en el cuidado y adherencia al tratamiento son esenciales para el manejo óptimo del paciente con VIH. Sin embargo, muchos pacientes con VIH no siguen las el tratamiento para lograr tener una carga viral indetectable, o no permanecen bajo cuidado médico. Este estudio examina los pacientes más difíciles de retener en el cuidado médico en Buenos Aires, Argentina. Hombres (n = 61) y mujeres (n = 59) a los que se les habían recetado antiretrovirales pero seguían el tratamiento en los últimos 3 - 6 meses participaron en el estudio. Adherencia, conocimiento, motivación y actitudes frente al tratamiento fueron evaluados. Los pacientes en la clínica privada tenían menor carga viral y mejor adherencia que los de la clínica pública. Motivación y pensamientos positivos con respecto a antiretrovirales estaban asociados con mejor adherencia en los pacientes de la clínica p

  18. A case of collegial communication and a patient who does not pay.

    PubMed

    Peltier, Bruce; Rosenblum, Alvin; Bebeau, Muriel J; Koerber, Anne

    2011-01-01

    Four individuals who teach ethics in dental schools comment on a case in which negative financial information is revealed by one dentist when transferring records of a potential patient to another dentist. All commentators find varying degrees of ethical problem with disclosing such information. Professional codes discourage this practice. All commentators stress the importance of the potential new dentist developing a relationship based on professional standards, with the greatest emphasis placed on the patient's health needs. Several of the commentators discuss positive ways of conducting a patient interview, including specific useful language. PMID:21739869

  19. Patient-focused care pays hospital-wide dividends. Interview by Donald E. L. Johnson..

    PubMed

    Bernd, D L

    1992-12-01

    By decentralizing ancillary services, streamlining processes and cross training professional and paraprofessional employees, hospitals can improve patient satisfaction and staff efficiency, says David L. Bernd, executive vice president and chief operating officer of Sentara Health Systems, Norfolk, Virginia, in the following interview with Donald E. L. Johnson, editor and publisher of Health Care Strategic Management. But hospitals should not convert to patient-focused care primarily to cut costs, he warned. Cost savings could result, but only on a hospital-wide basis, as a result of new efficiencies and reduced lengths-of-stay. At the unit level, costs are likely to go up as ancillary services are moved to patient-focused units and more resources are devoted directly at each patient. PMID:10123251

  20. Justification for conducting neurological clinical trials as part of patient care within private practice.

    PubMed

    Beran, R G; Stepanova, D; Beran, M E

    2016-05-01

    The aim of this review was to assess the benefits and drawbacks of conducting neurological clinical trials and research in private practice for the patients, clinician, Practice Manager, sponsors/Clinical Research Organisations (CROs) and Clinical Trial Coordinator (CTC) to determine if this is justified for all involved. A combination of literature reviews, original research articles and books were selected from 2005 to 2015. Provided that the practice has sufficient number of active trials to prevent financial loss, support staff, adequate facilities and equipment and time, the benefits outweigh the drawbacks. Clinical trials provide patients with more thorough monitoring, re-imbursement of trial-related expenses and the opportunity to try an innovative treatment at no charge when other options have failed. For the clinician, clinical trials provide more information to ensure better care for their patients and improved treatment methods, technical experience and global recognition. Trials collect detailed and up-to-date information on the benefits and risks of drugs, improving society's confidence in clinical research and pharmaceuticals, allow trial sponsors to explore new scientific questions and accelerate innovation. For the CTC, industry-sponsored clinical trials allow potential entry for a career in clinical research giving CTCs the opportunity to become Clinical Research Associates (CRAs), Study Start-Up Managers or Drug Safety Associates. PMID:27040457

  1. Patients' Perspectives on Stigma of Mental Illness (an Egyptian Study in a Private Hospital).

    PubMed

    Sidhom, Emad; Abdelfattah, Ahmed; Carter, Julie M; El-Dosoky, Ahmed; El-Islam, Mohamed Fakhr

    2014-01-01

    The present study is concerned with the stigma of mental illness. It examines the subjective element of the experience of stigma among a sample of in-patients with different mental disorders. The sample was taken from consecutive admissions of in-patients meeting International Classification of Diseases, 10th revision (ICD-10) criteria for mental disorders who had capacity to decide on participation in the study and were willing to respond to the structured interview. The study was undertaken in an Egyptian private psychiatric hospital. The structured clinical interview included aspects of the emotional, behavioral, and cognitive effects of having a psychiatric diagnosis on in-patients with various diagnostic labels in an Egyptian psychiatric hospital. It also studied whether this effect changes with specific disorders, total duration of illness, or sociodemographic variables as gender, age, or educational level. The study illustrated the core items of stigmatization attached to the diagnosis of mental illness (1), which more than half of the participants responded affirmatively. The study aimed to explore the most prevailing aspects of stigma or social disadvantage; hoping that this may offer a preliminary guide for clinicians to address these issues in their practice. PMID:25505426

  2. Determinants of patient satisfaction with outpatient health services at public and private hospitals in Addis Ababa, Ethiopia

    PubMed Central

    Woldie, Mirkuzie; Ololo, Shimeles

    2012-01-01

    Abstract Background Patients have explicit desires or requests for services when they visit hospitals. However, inadequate discovery of their needs may result in patient dissatisfaction. This study aimed to determine the levels and determinants of patient satisfaction with outpatient health services provided at public and private hospitals in Addis Ababa, Central Ethiopia. Methods A comparative cross-sectional study was conducted from 27 March to 30 April 2010. The study included 5 private and 5 public hospitals. Participants were selected using systematic random sampling. A pre-tested and contextually prepared structured questionnaire was used to conduct interviews. Descriptive statistics, analysis of variance, factor analysis and multiple linear regressions were performed using computer software (SPSS 16.0). Results About 18.0% of the patients at the public hospitals were very satisfied whilst 47.9% were just satisfied with the corresponding proportions a bit higher at private hospitals. Self-judged health status, expectation about the services, perceived adequacy of consultation duration, perceived providers’ technical competency, perceived welcoming approach and perceived body signalling were determinants of satisfaction at both public and private hospitals. Conclusions Although patients at the private hospitals were more satisfied than those at the public hospitals with the health care they received, five of the predictors of patient satisfaction in this study were common to both settings. Thus, hospitals in both categories should work to improve the competencies of their employees, particularly health professionals, to win the interests of the clients and have a physical structure that better fits the expectations of the patients.

  3. Individual and social concerns in American surgical education: paying patients, prepaid health insurance, Medicare and Medicaid.

    PubMed

    O'Shea, John S

    2010-05-01

    The education of the U.S. surgeon was traditionally based on a system in which surgeons-in-training cared for a population of largely indigent patients in a setting of graded responsibility. To ensure an ethically appropriate bargain, senior surgeons served as mentors, assumed ultimate responsibility for the patient, and supervised the surgical care of the ward patient by the surgical trainee. During the 20th century, changes in health care financing challenged this comfortable accommodation between charity care and medical education. As others have also written, the introduction of prepaid health insurance plans such as Blue Cross/Blue Shield in the early third of the century, the rapid expansion of employment-based health benefits during World War II, and the enactment of the Medicare and Medicaid legislation under Titles XVIII and XIX of the Social Security Act all contributed to a dramatic reduction in hospital ward (i.e., service) populations. The tension between education and patient care remains incompletely resolved; the proper balance between supervision and graded responsibility for the resident is ultimately worked out on an individual basis. Newer issues facing U.S. surgical education, including the justifiable demand for greater transparency, are likely to upset this suspended truce and lead to renewed discussions about such fundamental concepts as the definition of the resident and the role of the patient in the education of future surgeons. PMID:20520042

  4. P4P4P: An Agenda for Research on Pay for Performance for Patients

    PubMed Central

    Volpp, Kevin G.; Pauly, Mark V.; Loewenstein, George; Bangsberg, David

    2012-01-01

    Unhealthy behaviors are a major cause of poor health outcomes and high health care costs. In this Commentary, we describe an agenda for research to guide broader use of patient-targeted financial incentives either in conjunction with provider-targeted financial incentives (P4P) or in clinical contexts where provider-targeted approaches are unlikely to be effective. We discuss evidence of proven effectiveness and limitations of the existing evidence, reasons for underutilization of these approaches, and options for operationalizing wider use. Patient-targeted incentives have great potential, and systematic testing will help determine how they can best be used to improve population health. PMID:19124872

  5. Association between the Value-Based Purchasing pay for performance program and patient mortality in US hospitals: observational study

    PubMed Central

    Figueroa, Jose F; Tsugawa, Yusuke; Zheng, Jie; Orav, E John

    2016-01-01

    Objective To determine the impact of the Hospital Value-Based Purchasing (HVBP) program—the US pay for performance program introduced by Medicare to incentivize higher quality care—on 30 day mortality for three incentivized conditions: acute myocardial infarction, heart failure, and pneumonia. Design Observational study. Setting 4267 acute care hospitals in the United States: 2919 participated in the HVBP program and 1348 were ineligible and used as controls (44 in general hospitals in Maryland and 1304 critical access hospitals across the United States). Participants 2 430 618 patients admitted to US hospitals from 2008 through 2013. Main outcome measures 30 day risk adjusted mortality for acute myocardial infarction, heart failure, and pneumonia using a patient level linear spline analysis to examine the association between the introduction of the HVBP program and 30 day mortality. Non-incentivized, medical conditions were the comparators. A secondary outcome measure was to determine whether the introduction of the HVBP program was particularly beneficial for a subgroup of hospital—poor performers at baseline—that may benefit the most. Results Mortality rates of incentivized conditions in hospitals participating in the HVBP program declined at −0.13% for each quarter during the preintervention period and −0.03% point difference for each quarter during the post-intervention period. For non-HVBP hospitals, mortality rates declined at −0.14% point difference for each quarter during the preintervention period and −0.01% point difference for each quarter during the post-intervention period. The difference in the mortality trends between the two groups was small and non-significant (difference in difference in trends −0.03% point difference for each quarter, 95% confidence interval −0.08% to 0.13% point difference, P=0.35). In no subgroups of hospitals was HVBP associated with better outcomes, including poor performers at baseline

  6. Does the Planetree patient-centered approach to care pay off?: a cost-benefit analysis.

    PubMed

    Coulmont, Michel; Roy, Chantale; Dumas, Lucie

    2013-01-01

    Although the Planetree patient-centered approach to care is being implemented in many institutions around the world, its impact is still the subject of some debate. On the one hand, it is viewed as the most cost-effective way to provide care and create a positive work environment that reduces staff burnout. On the other hand, it is argued that it requires higher staffing ratios and a substantial infusion of financial resources and is time consuming, which in turn results in more work. The present study addresses the economic agenda of the Planetree patient-centered approach to care and has been designed to answer the following question: do the advantages of the Planetree patient-centered approach outweigh its costs? This question is of considerable interest for health care administrators and managers because the relevant authorities the world over have limited resources to allocate to health care organizations. Using a trend analysis approach to cost-benefit in a rehabilitation center, this study shows that the revenues the model generates are greater than the costs of implementing it. Fewer grievances and vacant positions, an improved employee retention rate, a better working atmosphere, and a high level of employee satisfaction (higher than in similar establishments) were also noted. PMID:23364422

  7. Predictors of chlamydial infection and gonorrhea among patients seen by private practitioners.

    PubMed Central

    Vincelette, J; Baril, J G; Allard, R

    1991-01-01

    OBJECTIVE: To identify the predictors of chlamydial infection and gonorrhea among patients tested by general practitioners. DESIGN: Prospective study. SETTING: General private practice, family planning and abortion clinic, adolescent clinic, sexually transmitted disease (STD) clinic and community health clinic in downtown Montreal. PATIENTS: The 2856 patients were included because of symptoms compatible with an STD, a history of sexual contact with a person known or suspected to have chlamydial infection, a history of a nonexclusive sexual relationship or presentation for an abortion. MEASURES: Patient information was obtained by the attending physician on a standard form. Enzyme immunoassay (EIA) for Chlamydia trachomatis and culture for Neisseria gonorrhoeae were performed on cervical (female) or urethral (male) samples. Stepwise logistic regression was used to identify the predictors of infection. RESULTS: The EIA results were positive in 11.1% of the cases and the culture results in 2.3%. Among the males chlamydial infection was independently associated with low age (odds ratio [OR] = 0.88 per year), heterosexuality (OR = 4.99), urethral discharge (OR = 3.74) and the absence of a history of gonorrhea (OR = 0.51). Gonorrhea was associated with urethral discharge (OR = 24.3) and homosexuality (OR = 3.68). Among the females chlamydial infection was associated with low age (OR = 0.79 per year), a history of sexual contact with a person known to have chlamydial infection (OR = 2.30), multiple sexual partners in the previous 12 months (OR = 1.60) and a reason for the test other than screening purposes (OR = 0.60). Gonorrhea was associated with a reason other than screening (OR = 0.24) and low age (OR = 0.74 per year). Among the patients tested for screening purposes age was the only significant predictor of chlamydial infection (OR = 0.79 per year), and the prevalence of gonorrhea was 0.4%. The actual rate of chlamydial infection was 11.8% among the patients younger

  8. Who Pays? Coverage Challenges for Cardiovascular Genetic Testing in U.S. Patients

    PubMed Central

    Spoonamore, Katherine G.; Johnson, Nicole M.

    2016-01-01

    Inherited cardiovascular (CV) conditions are common, and comprehensive care of affected families often involves genetic testing. When the clinical presentations of these conditions overlap, genetic testing may clarify diagnoses, etiologies, and treatments in symptomatic individuals and facilitate the identification of asymptomatic, at-risk relatives, allowing for often life-saving preventative care. Although some professional society guidelines on inherited cardiac conditions include genetic testing recommendations, they quickly become outdated owing to the rapid expansion and use of such testing. Currently, these guidelines primarily discuss the benefits of targeted genetic testing for identifying at-risk relatives. Although most insurance policies acknowledge the benefit and the necessity of this testing, many exclude coverage for testing altogether or are vague about coverage for testing in probands, which is imperative if clinicians are to have the best chance of accurately identifying pathogenic variant(s) in a family. In response to uncertainties about coverage, many commercial CV genetic testing laboratories have shouldered the burden of working directly with commercial payers and protecting patients/institutions from out-of-pocket costs. As a result, many clinicians are unaware that payer coverage policies may not match professional recommendations for CV genetic testing. This conundrum has left patients, clinicians, payers, and laboratories at an impasse when determining the best path forward for meaningful and sustainable testing. Herein, we discuss the need for all involved parties to recognize their common goals in this process, which should motivate collaboration in changing existing frameworks and creating more sustainable access to genetic information for families with inherited CV conditions. PMID:27303673

  9. Redistribution of Emergency Department Patients After Disaster-Related Closures of a Public Versus Private Hospital in New York City.

    PubMed

    Lee, David C; Smith, Silas W; Carr, Brendan G; Goldfrank, Lewis R; Polsky, Daniel

    2015-06-01

    Sudden hospital closures displace patients from usual sources of care and force them to access facilities that lack their prior medical records. For patients with complex needs and for nearby hospitals already strained by high volume, disaster-related hospital closures induce a public health emergency. Our objective was to analyze responses of patients from public versus private emergency departments after closure of their usual hospital after Hurricane Sandy. Using a statewide database of emergency visits, we followed patients with an established pattern of accessing 1 of 2 hospitals that closed after Hurricane Sandy: Bellevue Hospital Center and NYU Langone Medical Center. We determined how these patients redistributed for emergency care after the storm. We found that proximity strongly predicted patient redistribution to nearby open hospitals. However, for patients from the closed public hospital, this redistribution was also influenced by hospital ownership, because patients redistributed to other public hospitals at rates higher than expected by proximity alone. This differential response to hospital closures demonstrates significant differences in how public and private patients respond to changes in health care access during disasters. Public health response must consider these differences to meet the needs of all patients affected by disasters and other public health emergencies. PMID:25777992

  10. Aesthetic surgical training in the UK independent sector--the clients' view: Results of a survey on 155 private patients.

    PubMed

    Schenker, M; Lees, V C; McGeorge, D D; Orton, C I; Hancock, K

    2006-01-01

    As training opportunities in cosmetic surgery become less frequent in teaching hospitals, this survey set out to examine the attitudes of patients towards extending this training into the independent health sector. We questioned 155 private patients, 95% of who were happy for trainees to sit in during their consultations. Of these, 85% were comfortable with the presence of the trainee throughout their appointments and 92% said they saw advantages in having such trainees present. However, patients were less enthusiastic about trainees carrying out procedures, under consultant supervision and for a reduced fee. The survey found that while 49% felt it was a good idea, only 32% would consider it for themselves. Seventeen percent of patients thought this offer alone was inappropriate. This survey has shown that while the vast majority of private patients supported and were happy to participate in higher surgical training during private consultations, fewer would consider the possibility of cosmetic surgery performed by supervised trainees for reduced fees. The implications of these findings for higher surgical training in Plastic Surgery in the UK are discussed. PMID:17046628

  11. Mortality, Length of Stay, and Inpatient Charges for Heart Failure Patients at Public versus Private Hospitals in South Korea

    PubMed Central

    Kim, Sun Jung; Park, Eun-Cheol; Kim, Tae Hyun; Yoo, Ji Won

    2015-01-01

    Purpose This study compared in-hospital mortality within 30 days of admission, lengths of stay, and inpatient charges among patients with heart failure admitted to public and private hospitals in South Korea. Materials and Methods We obtained health insurance claims data for all heart failure inpatients nationwide between November 1, 2011 and May 31, 2012. These data were then matched with hospital-level data, and multi-level regression models were examined. A total of 8406 patients from 253 hospitals, including 31 public hospitals, were analyzed. Results The in-hospital mortality rate within 30 days of admission was 0.92% greater and the mean length of stay was 1.94 days longer at public hospitals than at private hospitals (mortality: 5.18% and 4.26%, respectively; LOS: 12.08 and 10.14 days, respectively). The inpatient charges were 11.4% lower per case and 24.5% lower per day at public hospitals than at private hospitals. After adjusting for patient- and hospital-level confounders, public hospitals had a 1.62-fold higher in-hospital mortality rate, a 16.5% longer length of stay, and an 11.7% higher inpatient charge per case than private hospitals, although the charges of private hospitals were greater in univariate analysis. Conclusion We recommend that government agencies and policy makers continue to monitor quality of care, lengths of stay in the hospital, and expenditures according to type of hospital ownership to improve healthcare outcomes and reduce spending. PMID:25837196

  12. Religiosity/spirituality of German doctors in private practice and likelihood of addressing R/S issues with patients.

    PubMed

    Voltmer, Edgar; Bussing, Arndt; Koenig, Harold G; Al Zaben, Faten

    2014-12-01

    This study examined the self-assessed religiosity and spirituality (R/S) of a representative sample of German physicians in private practice (n = 414) and how this related to their addressing R/S issues with patients. The majority of physicians (49.3 %)reported a Protestant denomination, with the remainder indicating mainly either Catholic(12.5 %) or none (31.9 %). A significant proportion perceived themselves as either religious(42.8 %) or spiritual (29.0 %). Women were more likely to rate themselves R/S than did men. Women (compared to men) were also somewhat more likely to attend religious services (7.4 vs. 2.1 % at least once a week) and participate in private religious activities(14.9 vs. 13.7 % at least daily), although these differences were not statistically significant.The majority of physicians (67.2 %) never/seldom addressed R/S issues with a typical patient. Physicians with higher self-perceived R/S and more frequent public and private religious activity were much more likely to address R/S issues with patients. Implications for patient care and future research are discussed. PMID:24077926

  13. Cancer patients' willingness to pay for blood transfusions at home: results from a contingent valuation study in a French cancer network.

    PubMed

    Havet, Nathalie; Morelle, Magali; Remonnay, Raphaël; Carrere, Marie-Odile

    2012-06-01

    Home blood transfusion may be an interesting alternative to hospital transfusion, especially when given with curative or palliative intent or for terminal care in advanced-stage cancer patients. However, there is limited information about patients' attitude toward this type of care. The purpose of this study was to measure French cancer patients' willingness to pay (WTP) for home blood transfusion and to analyze determinants of their choice. A contingent valuation survey was administered to 139 patients receiving transfusions in the framework of a regional home care network or in the hospital outpatient department. Participation was high (90%). Most patients (65%) had received home care, including 43% blood transfusions. Just under half of the patients gave a zero WTP, among which we identified 8 protest bidders. The median WTP for home blood transfusion was 26.5 per patient. In multivariate analysis, long home-hospital distance, poor quality of life, and previous experience of home care were identified as important factors in determining how much more patients would be willing to pay for transfusion at home. These results demonstrate the benefits of developing domiciliary services to improve patient well-being, notably for the weakest among them. The significant impact of previous home care experience on WTP is probably related to the strong involvement of physicians from the blood center and to their active contribution to a high-level homecare network. Some of our findings could be useful for policy decision-making regarding home care. PMID:21660563

  14. Identification of best practices in the delivery of patient food services through public/private sector partnerships.

    PubMed

    Marshall, L

    2000-01-01

    This article describes the evolution of public/private sector partnership in patient food service delivery and identifies skills required by executives to manage partnerships effectively, features that may be generalized to other areas; and the importance of labour relations. Site visits conducted across Canada demonstrate that when partners understand each other's objectives, commit to providing strong leadership, and create meaningful labour relations and communications strategies, partnerships can be successful. PMID:15892317

  15. South Ocean International School: Private Education in China.

    ERIC Educational Resources Information Center

    Krebs, Sylvia

    1997-01-01

    Offers a brief report on a private elementary and middle school located in northwest China. Discusses opportunities and dilemmas of private education in China, including access, teacher hiring/firing and pay, tuition, and class size. (SR)

  16. Comparative Investigation of Health Literacy Level of Cardiovascular Patients Hospitalized in Private and Educational Hospitals of Kerman City, Iran

    PubMed Central

    Malekzadeh, Sajedeh; Azami, Mohammad; Mirzaei, Moghadameh; Motamedi, Fatemeh

    2016-01-01

    Introduction: literacy involves a complex set of abilities to understand and use symbolic systems of a culture for personal development and social development in a diverse set of skills required as an adult to exercise behavior are considered in society Objectives: The aim of this study was to evaluate Comparative investigation of health literacy level of cardiovascular patients hospitalized in private and public educational hospitals of Kerman city Methods: This study used survey methods, analytical and cross-sectional manner. Data was collected through questionnaires distributed among 200 patients of cardiovascular-hospitalization took place in the city of Kerman. To analyze the data in the description of the mean, standard deviation and frequency distribution tables and the level of analysis to determine the relationship between gender and marital status of health literacy test or nonparametric test Mann-Whitney T-Test and, for the relationship between group employment and residence, a one-way analysis of variance or Kruskal-Wallis test, to evaluate the relationship between age and income, Pearson and Spearman correlation to investigate the relationship between level of education and health literacy of SPPS software version 21 was used. Results: The results showed that 10% of patients at educational hospitals in Kerman adequate health literacy, and 48% of patients in private hospitals had adequate health literacy. As a result, there is a significant difference of health literacy between the two types of hospital (p-value <0/0001). Conclusions: The results showed that most patients had inadequate and border health literacy have been. Health plans, preparation of simple educational system and understanding, spending more time and have a discussion with the lower speed In connection with the patient’s doctor and medical staff, Including ways to help patients with low health literacy and improve their health literacy is. PMID:27041812

  17. Therapy Preferences in Melanoma Treatment - Willingness to Pay and Preference of Quality versus Length of Life of Patients, Physicians and Healthy Controls

    PubMed Central

    Krammer, Ramona; Heinzerling, Lucie

    2014-01-01

    Background New melanoma therapies, like e.g. ipilimumab, improve survival. However, only a small subset of patients benefits while 60% encounter side effects. Furthermore, these marginal benefits come at a very high price of €110’000 per treatment. This study examines attitudes towards melanoma therapy options of physicians, healthy individuals and patients, their willingness to pay and preference of quality versus length of life. Methods Based on findings from a focus group questionnaires were developed and pretested. After obtaining ethical approval and informed consent surveys were conducted in a total of 90 participants (n = 30 for each group). Statistical analyses were conducted using R. Findings Attitudes vastly differed between healthy participants, physicians and melanoma patients. Whereas melanoma patients show a high willingness to endure side effects despite very small survival gains (down to 1 extra week) or even only hope with no survival benefit, healthy controls are more critical, while physicians are the most therapy adverse. Consequently, if given €100’000 and the free decision what to spend the money on the willingness to pay for therapy was much higher in the patient group (68%) compared to 28% of healthy controls and only 43% of the physicians, respectively. When lowering the amount of cash that could be received instead of ipilimumab to €50’000 or €10’000 to test price sensitivity 69% (+1%) and 76% (+8%) of melanoma patients, respectively, preferred ipilimumab over cash. When judging on societal spending even melanoma patients opted for spending on ipilimumab in only 21%. Conclusion The judgment about the benefits of new treatment options largely differs between groups, physicians being the most critical against therapy. Price elasticity was low. PMID:25369124

  18. A Discrete Choice Experiment to Elicit Patient Willingness to Pay for Attributes of Treatment-Induced Symptom Relief in Comorbid Insomnia

    PubMed Central

    Roy, Anuja N.; Madhavan, S. Suresh; Lloyd, Andrew

    2016-01-01

    Purpose Insomnia is a burdensome, commonly comorbid condition. How patients value various aspects of the safety and efficacy of available drugs has not been studied. The aim of the present study was to quantify patient-rated utility by studying willingness to pay (WTP) for attributes of symptom relief via a discrete choice experiment (DCE). Methodology Adult primary care patients (West Virginia University Hospital) with comorbid insomnia were enrolled. The attributes and levels examined were sleep onset latency (SOL; 10, 20, 30 minutes), awakenings (1, 2, 3), wake time after sleep onset (WASO; 15, 45, 60 minutes), total sleep time (TST; 6, 7, 8 hours), hangover (none, mild, moderate), FDA-approved duration of use (short term, not restricted to short term, no restrictions), and out-of-pocket cost per month ($20, $35, $50). Willingness to pay (WTP) data were analyzed using a random effects binary logistic regression model. Results A total of 82 patients completed the DCE (74 analyzed). SOL, WASO, TST, and cost were all found to predict treatment choice. Higher values of SOL, WASO, and cost resulted in decreased preference for a particular treatment, while higher TST predicted increased preference. Modeling revealed an estimated marginal WTP of $66.69 for an example product that improved SOL by 10 minutes, reduced WASO by 15 minutes, and improved TST by 1 hour. Conclusion Patient WTP for symptomatic relief in insomnia can help clinicians fine-tune interventions based on patient preferences, provide evidence for drug formulary and reimbursement decisions, and potentially guide the development of novel drugs. PMID:26489177

  19. Behind the Pay Gap

    ERIC Educational Resources Information Center

    Dey, Judy Goldberg; Hill, Catherine

    2007-01-01

    Women have made remarkable gains in education during the past three decades, yet these achievements have resulted in only modest improvements in pay equity. The gender pay gap has become a fixture of the U.S. workplace and is so ubiquitous that many simply view it as normal. "Behind the Pay Gap" examines the gender pay gap for college graduates.…

  20. Both Patient and Facility Contribute to Achieving the Centers for Medicare and Medicaid Services' Pay-for-Performance Target for Dialysis Adequacy

    PubMed Central

    Tighiouart, Hocine; Meyer, Klemens B.; Miskulin, Dana C.

    2011-01-01

    The Centers for Medicare and Medicaid Services (CMS) designated the achieved urea reduction ratio (URR) as a pay-for-performance measure, but to what extent this measure reflects patient characteristics and adherence instead of its intent to reflect facility performance is unknown. Here, we quantified the contributions of patient case-mix and adherence to the variability in achieving URR targets across dialysis facilities. We found that 92% of 10,069 hemodialysis patients treated at 173 facilities during the last quarter of 2004 achieved the target URR ≥65%. Mixed-effect models with random intercept for dialysis facility revealed a significant facility effect: 11.5% of the variation in achievement of target URR was attributable to the facility level. Adjusting for patient case-mix reduced the proportion of variation attributable to the facility level to 6.7%. Patient gender, body surface area, dialysis access, and adherence with treatment strongly associated with achievement of the URR target. We could not identify specific facility characteristics that explained the remaining variation between facilities. These data suggest that if adherence is not a modifiable patient characteristic, providers could be unfairly penalized for caring for these patients under current CMS policy. These penalties may have unintended consequences. PMID:22025629

  1. What Predicts Patients’ Willingness to Undergo Online Treatment and Pay for Online Treatment? Results from a Web-Based Survey to Investigate the Changing Patient-Physician Relationship

    PubMed Central

    Bidmon, Sonja; Terlutter, Ralf

    2016-01-01

    Background Substantial research has focused on patients’ health information–seeking behavior on the Internet, but little is known about the variables that may predict patients’ willingness to undergo online treatment and willingness to pay additionally for online treatment. Objective This study analyzed sociodemographic variables, psychosocial variables, and variables of Internet usage to predict willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the general practitioner (GP). Methods An online survey of 1006 randomly selected German patients was conducted. The sample was drawn from an e-panel maintained by GfK HealthCare. Missing values were imputed; 958 usable questionnaires were analyzed. Variables with multi-item measurement were factor analyzed. Willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the GP were predicted using 2 multiple regression models. Results Exploratory factor analyses revealed that the disposition of patients’ personality to engage in information-searching behavior on the Internet was unidimensional. Exploratory factor analysis with the variables measuring the motives for Internet usage led to 2 separate factors: perceived usefulness (PU) of the Internet for health-related information searching and social motives for information searching on the Internet. Sociodemographic variables did not serve as significant predictors for willingness to undergo online treatment offered by the GP, whereas PU (B=.092, P=.08), willingness to communicate with the GP more often in the future (B=.495, P<.001), health-related information–seeking personality (B=.369, P<.001), actual use of online communication with the GP (B=.198, P<.001), and social motive (B=.178, P=.002) were significant predictors. Age, gender, satisfaction with the GP, social motive, and trust in the GP had no significant impact on the willingness to pay additionally

  2. Privatizing Libraries

    ERIC Educational Resources Information Center

    Jerrard, Jane; Bolt, Nancy; Strege, Karen

    2012-01-01

    This timely special report from ALA Editions provides a succinct but comprehensive overview of the "privatization" of public libraries. It provides a history of the trend of local and state governments privatizing public services and assets, and then examines the history of public library privatization right up to the California legislation…

  3. Time to Insurance Approval in Private and Public Payers Does Not Influence Survival in Patients Who Undergo Hematopoietic Cell Transplantation.

    PubMed

    Bhatt, Vijaya Raj; Loberiza, Fausto R; Schmit-Pokorny, Kim; Lee, Stephanie J

    2016-06-01

    In the United States, insurance status has been implicated as a barrier to obtaining timely treatment. In this retrospective cohort study of 521 patients who underwent first hematopoietic cell transplantation (HCT), we investigated the association between timeliness of HCT and overall survival. Timeliness was operationally defined in the following 3 ways: (1) payer approval, from request for approval to actual payer approval; (2) transplantation speed, from payer approval to time of actual HCT; and (3) total time, from request for approval to HCT. Patients with private insurance had longer time to payer approval (P < .0001) than those with public payers but shorter time from approval to actual HCT (P < .0001) and total time to HCT (P < .0001). Multivariate Cox regression showed no significant differences in risk of death between slow and fast times in the 3 indices of timeliness in the models that used all patients (n = 509), autologous HCT in lymphoma (n = 278), and autologous HCT in multiple myeloma (n = 121). Additional studies to evaluate the effect of insurance timeliness on all patients for whom HCT is recommended, not just those who undergo HCT, should be conducted. PMID:26988742

  4. What Midlife Women Want from Gynecologists: A Survey of Patients in Specialty and Private Practices

    PubMed Central

    Klein-Patel, Marcia; Lee, MinJae; Wisner, Katherine L.; Balk, Judith L.

    2014-01-01

    Abstract Background: This study characterized the self-reported reason for a gynecology visit among midlife women in three different practice settings. We hypothesized that women seeking specialty care were more likely to report nonvasomotor symptoms potentially related to the menopausal transition. Methods: Participants were 625 women aged 40–60 seen by gynecologists at three sites: an urban, academic, gynecologic menopause practice (Midlife Practice, or MLP) and urban (site A) and suburban (site B) locations of a general, nonacademic obstetrics and gynecology practice. Participants completed a self-report questionnaire asking them to choose and weigh the reason for their visit as “very much,” “somewhat,” or “not at all” for 15 common gynecologic and menopausal concerns. Demographic questions included age, self-rated health status, race/ethnicity, difficulty of paying for basics, and education. Comparisons between the three groups were made using parametric and nonparametric tests as appropriate. The main outcome measure was the response to the reason for participants' visit compared across the three sites. Results: Women presenting to the MLP were significantly older and more likely to report vasomotor symptoms (VMS), moodiness, sexual problems, sleep problems, and weight and to learn more about menopause. When “very much” and “somewhat” reasons were combined, nearly 80% of the MLP responses listed sleep problems, 60% listed vaginal dryness or low desire, 34% listed weight gain, and 30.7% listed mood. Conclusions: Midlife women seeking care in a menopause gynecology practice had significantly more visits for vasomotor and nonvasomotor concerns than did women seeing general gynecologists. Women sought care for a broad range of concerns that are not typically in gynecologists' scope of practice, including sleep disturbances, moodiness, and weight management. PMID:24405312

  5. MULTISCREEN SERUM ANALYSIS OF HIGHLY SENSITIZED RENAL DIALYSIS PATIENTS FOR ANTIBODIES TOWARD PUBLIC AND PRIVATE CLASS I HLA DETERMINANTS

    PubMed Central

    Duquesnoy, Rene J.; White, Linda T.; Fierst, Janet W.; Vanek, Marian; Banner, Barbara F.; Iwaki, Yuichi; Starzl, Thomas E.

    2010-01-01

    A multi screen serum analysis program has been developed that permits a determination of antibody specificity for the vast majority of highly sensitized patients awaiting transplantation. This program is based on a 2 × 2 table analysis of correlations between serum reactivity with an HLA-typed cell panel and incorporates two modifications. One implements the concept of public HLA determinants based on the serologic crossreactivity among class I HLA antigens. The other modification derives from the premise that most highly sensitized patients maintain the same PRA and antibody profiles over many months and even years. Monthly screening results for patients with persistent PRA values can therefore be combined for analysis. For 132 of 150 highly sensitized patients with >50% PRA, this multiscreen serum analysis program yielded information about antibody specificity toward public and private class I HLA determinants. The vast majority of patients (108 of 112) with PRA values between 50 and 89% showed antibody specificity generally toward one, two, or three public markers and/or the more common private HLA-A, B antigens. For 24 of 38 patients with >90% PRA, it was possible to define one or few HLA-specific antibodies. The primary objective of the multiscreen program was to develop an algorithm about computer-predicted acceptable and unacceptable donor HLA-A, B antigens for patients with preformed antibodies. A retrospective analysis of kidney transplants into 89 highly sensitized patients has demonstrated that allografts with unacceptable HLA-A, B mismatches had significantly lower actuarial survival rates than those with acceptable mismatches (P = 0.01). This was shown for both groups of 32 primary transplants (44% vs. 67% after 1 year) and 60 retransplants (50% vs. 68%). Also, serum creatinine levels were significantly higher in patients with unacceptable class I mismatches (3.0 vs. 8.4 mg% [P = 0.007] after 2 weeks; 3.9 vs. 9.1 mg% [P = 0.014] after 4 weeks

  6. Patient adherence to three dose completion of the quadrivalent human papillomavirus (HPV) vaccine in a private practice.

    PubMed

    Rubin, Rochelle F; Kuttab, Huda-Marie; Rihani, Rami S; Reutzel, Thomas J

    2012-12-01

    The human papillomavirus quadrivalent (types 6, 11, 16, and 18) recombinant vaccine is effective in preventing cervical, vulvar, vaginal and anal cancer. Maximal protection is achieved with completion of all three recommended doses. A retrospective chart review was performed to (1) assess the current vaccine series completion rates in a private practice multispecialty suburban setting and (2) identify factors associated with failure to complete the vaccine series. Chi-square and independent samples t test were used for data analysis. A total of 4,117 patients out of 10,821 eligible patients received at least one dose of the HPV vaccine between October 1, 2006 and April 30, 2010. Overall, 69.5 % (n = 2,863) of patients who received one dose of the HPV vaccine completed all three doses in a valid time frame, representing 26.5 % of all eligible patients. Patients who completed the series were younger (16.8 vs. 18.2, p < 0.05), less likely to have a sexually transmitted disease diagnosis prior to initiation of the series (57.7 vs. 69.8 %, p < 0.05), and more likely to have visited the pediatrics department compared to family medicine, internal medicine, and OB/GYN departments (75.9, 65.7, 57.0, 60.9 %, respectively, p < 0.05). Deaths, pregnancies, and adverse drug reactions were not identified as independent factors impacting completion rates. The results indicate that adolescents, patients visiting the pediatrics department and those without a prior STD diagnosis completed the vaccination series more frequently than adults managed in family medicine, internal medicine, and OB/GYN departments. PMID:22752532

  7. Investigation of privatization by level crossing approach

    NASA Astrophysics Data System (ADS)

    Vahabi, M.; Jafari, G. R.

    2009-09-01

    Privatization - a political as well as an economic policy - is generally defined as the transfer of a property or the responsibility for it from the public to the private sector. But privatization is not merely the transfer of the ownership and efficiency of the market should be considered. A successful privatization program induces better profitability and efficiency, higher output, more investment, etc. The main method of privatization is through introducing new stocks to the market to motivate competition. However, for a successful privatization the capability of a market for absorbing the new stock should also be considered. Without paying attention to this aspect, privatization through the introduction of new stocks may lead to reduced market efficiency. We study, based on the complexity theory and in particular the concept of Level Crossing, the effect of the stages of the development, activity, risk, and the waiting times for special events on the privatization.

  8. 31 CFR 256.50 - How does FMS process back pay awards?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false How does FMS process back pay awards... JUDGMENT FUND AND UNDER PRIVATE RELIEF BILLS Additional Provisions § 256.50 How does FMS process back pay... attorney fees, which is sent directly to the attorney. (b) Under the second method, FMS pays the...

  9. 31 CFR 256.50 - How does FMS process back pay awards?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false How does FMS process back pay awards... JUDGMENT FUND AND UNDER PRIVATE RELIEF BILLS Additional Provisions § 256.50 How does FMS process back pay... attorney fees, which is sent directly to the attorney. (b) Under the second method, FMS pays the...

  10. 31 CFR 256.50 - How does FMS process back pay awards?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false How does FMS process back pay awards... JUDGMENT FUND AND UNDER PRIVATE RELIEF BILLS Additional Provisions § 256.50 How does FMS process back pay... attorney fees, which is sent directly to the attorney. (b) Under the second method, FMS pays the...

  11. 31 CFR 256.50 - How does FMS process back pay awards?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false How does FMS process back pay awards... JUDGMENT FUND AND UNDER PRIVATE RELIEF BILLS Additional Provisions § 256.50 How does FMS process back pay... attorney fees, which is sent directly to the attorney. (b) Under the second method, FMS pays the...

  12. 34 CFR 76.660 - Use of private school personnel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Use of private school personnel. 76.660 Section 76.660....660 Use of private school personnel. A subgrantee may use program funds to pay for the services of an employee of a private school if: (a) The employee performs the services outside of his or her regular...

  13. 34 CFR 76.660 - Use of private school personnel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Use of private school personnel. 76.660 Section 76.660....660 Use of private school personnel. A subgrantee may use program funds to pay for the services of an employee of a private school if: (a) The employee performs the services outside of his or her regular...

  14. 34 CFR 76.660 - Use of private school personnel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Use of private school personnel. 76.660 Section 76.660... Be Met by the State and Its Subgrantees? Participation of Students Enrolled in Private Schools § 76.660 Use of private school personnel. A subgrantee may use program funds to pay for the services of...

  15. The impact of total quality service (TQS) on healthcare and patient satisfaction: an empirical study of Turkish private and public hospitals.

    PubMed

    Bakan, Ismail; Buyukbese, Tuba; Ersahan, Burcu

    2014-01-01

    This paper attempts to measure patients' perceptions of the quality of services in public and private healthcare centers in Turkey. The main aim was to examine the impact of the dimensions of patient-perceived total quality service (TQS) on patients' satisfaction. The research framework and hypotheses are derived from a literature review of service quality and quality in the healthcare industry. The research data were collected through questionnaires and then statistically analyzed using descriptive statistics, Pearson product moment correlation and linear regression. The results suggest that service quality perceptions positively influence patient satisfaction with overall hospital care (SOHC). The most important factors identified in the regression model regarding patient SOHC are the quality of the hospital's social responsibility, administrative processes and overall experience of medical care received. These factors explain 74% of the variance in SOHC. The findings of the study can be used to improve TQS in both private and public hospitals. PMID:23494819

  16. Treatment outcomes of HIV-positive patients on first-line antiretroviral therapy in private versus public HIV clinics in Johannesburg, South Africa

    PubMed Central

    Moyo, Faith; Chasela, Charles; Brennan, Alana T; Ebrahim, Osman; Sanne, Ian M; Long, Lawrence; Evans, Denise

    2016-01-01

    Background Despite the widely documented success of antiretroviral therapy (ART), stakeholders continue to face the challenges of poor HIV treatment outcomes. While many studies have investigated patient-level causes of poor treatment outcomes, data on the effect of health systems on ART outcomes are scarce. Objective We compare treatment outcomes among patients receiving HIV care and treatment at a public and private HIV clinic in Johannesburg, South Africa. Patients and methods This was a retrospective cohort analysis of ART naïve adults (≥18.0 years), initiating ART at a public or private clinic in Johannesburg between July 01, 2007 and December 31, 2012. Cox proportional-hazards regression was used to identify baseline predictors of mortality and loss to follow-up (>3 months late for the last scheduled visit). Generalized estimating equations were used to determine predictors of failure to suppress viral load (≥400 copies/mL) while the Wilcoxon rank-sum test was used to compare the median absolute change in CD4 count from baseline to 12 months post-ART initiation. Results 12,865 patients initiated ART at the public clinic compared to 610 at the private clinic. The patients were similar in terms of sex and age at initiation. Compared to public clinic patients, private clinic patients initiated ART at higher median CD4 counts (159 vs 113 cells/mm3) and World Health Organization stage I/II (76.1% vs 58.5%). Adjusted hazard models showed that compared to public clinic patients, private clinic patients were less likely to die (adjusted hazard ratio [aHR] 0.50; 95% confidence interval [CI] 0.35–0.70) but were at increased risk of loss to follow-up (aHR 1.80; 95% CI 1.59–2.03). By 12 months post-ART initiation, private clinic patients were less likely to have a detectable viral load (adjusted relative risk 0.65; 95% CI 0.49–0.88) and recorded higher median CD4 change from baseline (184 cells/mm3 interquartile range 101–300 vs 158 cells/mm3 interquartile

  17. Balancing the interests of patient data protection and medication safety monitoring in a public-private partnership.

    PubMed

    Dreyer, Nancy A; Blackburn, Stella; Hliva, Valerie; Mt-Isa, Shahrul; Richardson, Jonathan; Jamry-Dziurla, Anna; Bourke, Alison; Johnson, Rebecca

    2015-01-01

    Obtaining data without the intervention of a health care provider represents an opportunity to expand understanding of the safety of medications used in difficult-to-study situations, like the first trimester of pregnancy when women may not present for medical care. While it is widely agreed that personal data, and in particular medical data, needs to be protected from unauthorized use, data protection requirements for population-based studies vary substantially by country. For public-private partnerships, the complexities are enhanced. The objective of this viewpoint paper is to illustrate the challenges related to data protection based on our experiences when performing relatively straightforward direct-to-patient noninterventional research via the Internet or telephone in four European countries. Pregnant women were invited to participate via the Internet or using an automated telephone response system in Denmark, the Netherlands, Poland, and the United Kingdom. Information was sought on medications, other factors that may cause birth defects, and pregnancy outcome. Issues relating to legal controllership of data were most problematic; assuring compliance with data protection requirements took about two years. There were also inconsistencies in the willingness to accept nonwritten informed consent. Nonetheless, enrollment and data collection have been completed, and analysis is in progress. Using direct reporting from consumers to study the safety of medicinal products allows researchers to address a myriad of research questions relating to everyday clinical practice, including treatment heterogeneity in population subgroups not traditionally included in clinical trials, like pregnant women, children, and the elderly. Nonetheless, there are a variety of administrative barriers relating to data protection and informed consent, particularly within the structure of a public-private partnership. PMID:25881627

  18. Adherence to Antidepressant Treatment Among Privately Insured Patients Diagnosed With Depression

    PubMed Central

    Akincigil, Ayse; Bowblis, John R.; Levin, Carrie; Walkup, James T.; Jan, Saira; Crystal, Stephen

    2008-01-01

    Background Antidepressants are effective in treatment of depression, but poor adherence to medication is a major obstacle to effective care. Objective We sought to describe patient and provider level factors associated with treatment adherence. Methods This was a retrospective, observational study using medical and pharmacy claims from a large health plan, for services provided between January 2003 and January 2005. We studied a total of 4312 subjects ages 18 or older who were continuously enrolled in the health plan with a new episode of major depression and who initiated antidepressant treatment. Treatment adherence was measured by using pharmacy refill records during the first 16 weeks (acute phase) and the 17–33 weeks after initiation of antidepressant therapy (continuation phase). Measures were based on Health Plan Employer Data and Information Set (HEDIS) quality measures for outpatient depression care. Results Fifty-one percent of patients were adherent through the acute phase; of those, 42% remained adherent in the continuation phase. Receipt of follow-up care from a psychiatrist and higher general pharmacy utilization (excluding psychotropics) were associated with better adherence in both phases. Younger age, comorbid alcohol or other substance abuse, comorbid cardiovascular/metabolic conditions, use of older generation antidepressants, and residence in lower-income neighborhoods were associated with lower acute-phase adherence. Continuation-phase adherence was lower for HMO participants than for others. Conclusion In an insured population, many patients fall short of adherence to guideline recommended therapy for depression. Information from existing administrative data can be used to predict patients at highest risk of nonadherence, such as those with substance abuse, and to target interventions. PMID:17496721

  19. Comparing demographics, clinical presentation, treatments and outcome between systemic lupus erythematosus patients treated in a public and private health system in Santa Fe, Argentina.

    PubMed

    Schmid, María Marcela; Roverano, Susana Graciela; Paira, Sergio Oscar

    2014-01-01

    The study includes 159 SLE patients seen between 1987 and 2011, of whom 116 were treated in the public health system and 43 in private practice. In the comparison between both groups, it was shown that patients in the public health system were younger at first consultation and at the onset of SLE, and that the mean duration of their disease prior to nephropathy was statistically significantly shorter. They also presented with more SLE activity (measured by Systemic Lupus Erythematosus Activity Index) such as fever, lower levels of C4, and elevated erythrocyte sedimentation rate. Although cyclophosphamide was administered more frequently to patients in the public health system group, there were no statistically significant differences in renal histological findings. A second renal biopsy was performed on 20 patients due to the presence of persistent proteinuria, peripheral edema, urinary casts, or because of previous defective renal specimens. The overall 10-year survival of the patients in the public health system was 78% compared to a survival rate of 91% for the patients in private practices. When survival was evaluated at 15 years, however, no differences were found (log rank test: 0.65). Patients from both public and private groups attended medical specialist practices and received early diagnoses and close follow-ups. PMID:24984924

  20. Privatizing Australia

    SciTech Connect

    Burr, M.T.

    1995-07-01

    The sun is setting on Australia`s long tradition of state involvement in business. As part of efforts begun in the late-1980`s to stem the tide of debt rising within Australian federal and state treasuries, government-owned entities are being corporatized and privatized, and private companies are sponsoring a large share of the country`s new infrastructure projects.

  1. Privatizing Maintenance.

    ERIC Educational Resources Information Center

    Hounsell, Dan

    1996-01-01

    Schools and other government facilities want to see whether privatization of maintenance can provide services as efficiently and at less cost than inhouse workers. Privatization proponents say that everyone will benefit the most if the bidding process involves competition. Offers examples from the Memphis City Schools and the Union Public Schools…

  2. The impact of erlotinib use in non-small-cell lung cancer patients treated in a private reference general hospital and in a private cancer clinic from 2005 to 2011

    PubMed Central

    Bognar, Cinthia Leite Frizzera Borges; Simon, Sergio Daniel; Gansl, Rene Claudio; Abramoff, Roberto; Aisen, Marcelo; Lopes, Gilberto de Lima; Smaletz, Oren; Peres, Stela Verzinhasse; Tabacof, Jacques

    2015-01-01

    ABSTRACT Objective: To report the demographic data and clinical outcomes of non-small-cell lung cancer patients exposed to erlotinib in any line of treatment. Methods: This was a retrospective cohort study of nonsmall-cell lung cancer patients from a reference general hospital and a private oncology clinic, who received erlotinib from 2005 to 2011. Statistical analysis was performed and we evaluated demographic data and response to treatment, by correlating the results of this first cohort published in Brazil with results of current literature. Results: A total of 44 patients were included; 65.9% were diagnosed with adenocarcinoma, and 63.6% had metastatic disease. The mean age was 63.3 years. The median follow-up was 47.9 months. Epidermal growth factor receptor mutation screening was performed in 22.7% of patients (n=10), with mutation present in 30% of patients. The median overall survival was 46.3 months, and there was a higher probability of survival at 60 months for females compared to males (29.4% versus 15.8%; p=0.042). The other variables did not present significant statistical difference. Conclusion: We collected the largest cohort of patients with non-small-cell lung cancer who have used erlotinib in Brazil to date, and demonstrated that outcomes of patients treated at our clinic during the study period were consistent with the results of current literature in similar patients. PMID:26154542

  3. A Retrospective Analysis of Direct Medical Cost and Cost of Drug Therapy in Hospitalized Patients at Private Hospital in Western India

    PubMed Central

    Kumbar, Shivaprasad Kalakappa

    2015-01-01

    Background Pharmacoeconomics is analytical tool to know cost of hospitalization and its effect on health care system and society. In India, apart from the government health services, private sector also play big role to provide health care services. Objective To study the direct medical cost and cost of drug therapy in hospitalized patients at private hospital. Materials and Methods A retrospective study was conducted at private hospital in a metro city of Western India. Total 400 patients’ billing records were selected randomly for a period from 01/01/2013 to 31/12/2014. Data were collected from medical record of hospital with permission of medical director of hospital. Patients’ demographic profile age, sex, diagnosis and various costs like ICU charge, ventilator charge, diagnostic charge, etc. were noted in previously formed case record form. Data were analysed by Z, x2 and unpaired t-test. Result Patients were divided into less than 45 years and more than 45 year age group. They were divided into medical and surgical patients according to their admission in medical or surgical ward. Mortality, Intensive Care Unit (ICU) admission, patients on ventilator were significantly (p<0.05) higher in medical patients. Direct medical cost, ward bed charge, ICU bed charge, ventilator charge and cost of drug therapy per patient were significantly (p<0.05) higher in medical patients while operation theatre and procedural charge were significantly (p<0.05) higher in surgical patients. Cost of fibrinolytics, anticoagulants, cardiovascular drugs were significantly (p<0.05) higher in medical patients. Cost of antimicrobials, proton pump inhibitors (PPIs), antiemetics, analgesics, were significantly (p<0.05) higher in surgical patients. Conclusion Ward bed charge, ICU bed charge, ventilator charge accounted more than one third cost of direct medical cost in all the patients. Cost of drug therapy was one fourth of direct medical cost. Antimicrobials cost accounted 33% of cost

  4. Initial care and outcome of glioblastoma multiforme patients in 2 diverse health care scenarios in Brazil: does public versus private health care matter?

    PubMed Central

    Loureiro, Luiz Victor Maia; Pontes, Lucíola de Barros; Callegaro-Filho, Donato; Koch, Ludmila de Oliveira; Weltman, Eduardo; Victor, Elivane da Silva; Santos, Adrialdo José; Borges, Lia Raquel Rodrigues; Segreto, Roberto Araújo; Malheiros, Suzana Maria Fleury

    2014-01-01

    Background The aim of this study was to describe the epidemiological and survival features of patients with glioblastoma multiforme treated in 2 health care scenarios—public and private—in Brazil. Methods We retrospectively analyzed clinical, treatment, and outcome characteristics of glioblastoma multiforme patients from 2003 to 2011 at 2 institutions. Results The median age of the 171 patients (117 public and 54 private) was 59.3 years (range, 18–84). The median survival for patients treated in private institutions was 17.4 months (95% confidence interval, 11.1–23.7) compared with 7.1 months (95% confidence interval, 3.8–10.4) for patients treated in public institutions (P < .001). The time from the first symptom to surgery was longer in the public setting (median of 64 days for the public hospital and 31 days for the private institution; P = .003). The patients at the private hospital received radiotherapy concurrent with chemotherapy in 59.3% of cases; at the public hospital, only 21.4% (P < .001). Despite these differences, the institution of treatment was not found to be an independent predictor of outcome (hazard ratio, 1.675; 95% confidence interval, 0.951–2.949; P = .074). The Karnofsky performance status and any additional treatment after surgery were predictors of survival. A hazard ratio of 0.010 (95% confidence interval, 0.003–0.033; P < .001) was observed for gross total tumor resection followed by radiotherapy concurrent with chemotherapy. Conclusions Despite obvious disparities between the hospitals, the medical assistance scenario was not an independent predictor of survival. However, survival was directly influenced by additional treatment after surgery. Therefore, increasing access to resources in developing countries like Brazil is critical. PMID:24463356

  5. Are prescribing doctors sensitive to the price that their patients have to pay in the Spanish National Health System?

    PubMed Central

    2011-01-01

    Background This study aims to design an empirical test on the sensitivity of the prescribing doctors to the price afforded for the patient, and to apply it to the population data of primary care dispensations for cardiovascular disease and mental illness in the Spanish National Health System (NHS). Implications for drug policies are discussed. Methods We used population data of 17 therapeutic groups of cardiovascular and mental illness drugs aggregated by health areas to obtain 1424 observations ((8 cardiovascular groups * 70 areas) + (9 psychotropics groups * 96 areas)). All drugs are free for pensioners. For non-pensioner patients 10 of the 17 therapeutic groups have a reduced copayment (RC) status of only 10% of the price with a ceiling of €2.64 per pack, while the remaining 7 groups have a full copayment (FC) rate of 40%. Differences in the average price among dispensations for pensioners and non-pensioners were modelled with multilevel regression models to test the following hypothesis: 1) in FC drugs there is a significant positive difference between the average prices of drugs prescribed to pensioners and non-pensioners; 2) in RC drugs there is no significant price differential between pensioner and non-pensioner patients; 3) the price differential of FC drugs prescribed to pensioners and non-pensioners is greater the higher the price of the drugs. Results The average monthly price of dispensations to pensioners and non-pensioners does not differ for RC drugs, but for FC drugs pensioners get more expensive dispensations than non-pensioners (estimated difference of €9.74 by DDD and month). There is a positive and significant effect of the drug price on the differential price between pensioners and non-pensioners. For FC drugs, each additional euro of the drug price increases the differential by nearly half a euro (0.492). We did not find any significant differences in the intensity of the price effect among FC therapeutic groups. Conclusions Doctors

  6. Long-Term and Interactive Effects of Pay-For-Performance Interventions among Diabetic Nephropathy Patients at the Early Chronic Kidney Disease Stage.

    PubMed

    Liao, Pei-Ju; Lin, Tzu-Yu; Wang, Tzu-Ching; Ting, Ming-Kuo; Wu, I-Wen; Huang, Hsin-Tsung; Wang, Fu-Chung; Chang, Huan-Cheng; Hsu, Kuang-Hung

    2016-04-01

    Chronic kidney disease (CKD) is a major health problem worldwide because of the aging population and lifestyle changes. One of the important etiologies of CKD is diabetes mellitus (DM). The long-term effects of pay-for-performance (P4P) on disease progression have not been thoroughly examined.This study is a retrospective population-based patient cohort design to examine the continuous effects of diabetes and CKD P4P interventions. This study used the health insurance claims database to conduct a longitudinal analysis. A total of 32,084 early CKD patients with diabetes were extracted from the outpatient claims database from January 2011 to December 2012, and the follow-up period was extended to August 2014. A 4-group matching design, including both diabetes and early CKD P4P interventions, with only diabetes P4P intervention, with only early CKD P4P intervention, and without any P4P interventions, was performed according to their descending intensity. The primary outcome of this study was all-cause mortality and the causes of death. The statistical methods included a Chi-squared test, ANOVA, and multi-variable Cox regression models.A dose-response relationship between the intervention groups and all-cause mortality was observed as follows: comparing to both diabetes and early CKD P4P interventions (reference), hazard ratio (HR) was 1.22 (95% confidence interval [CI], 1.00-1.50) for patients with only a diabetes P4P intervention; HR was 2.00 (95% CI, 1.66-2.42) for patients with only an early CKD P4P intervention; and HR was 2.42 (95% CI, 2.02-2.91) for patients without any P4P interventions. The leading cause of death of the total diabetic nephropathy patient cohort was infectious diseases (34.32%) followed by cardiovascular diseases (17.12%), acute renal failure (1.50%), and malignant neoplasm of liver (1.40%).Because the earlier interventions have lasting long-term effects on the patient's prognosis regardless of disease course, an integrated early intervention

  7. Pragmatic privatization

    SciTech Connect

    Bernstein, S.

    1995-10-01

    Chile was probably the first country in the world to privatize under a decentralized and competitive framework a former state-owned power sector. Power sector privatization was conducted with pragmatism, particularly in terms of the speed with which the changes occurred. In fact, the earliest privatization did not occur until 1980 and the process was not completed until early 1990. The privatized Chilean electric industry has performed fairly well in terms of the investments carried out not only in the power sector, but also in other economic activities and in foreign countries. The diversification of ownership and the competitive framework have been an incentive to reach efficiency and a guaranty for the stability of the rules of the game in the long run.

  8. Patient Preferences and Willingness-To-Pay for a Home or Clinic Based Program of Chronic Heart Failure Management: Findings from the Which? Trial

    PubMed Central

    Whitty, Jennifer A.; Stewart, Simon; Carrington, Melinda J.; Calderone, Alicia; Marwick, Thomas; Horowitz, John D.; Krum, Henry; Davidson, Patricia M.; Macdonald, Peter S.; Reid, Christopher; Scuffham, Paul A.

    2013-01-01

    Background Beyond examining their overall cost-effectiveness and mechanisms of effect, it is important to understand patient preferences for the delivery of different modes of chronic heart failure management programs (CHF-MPs). We elicited patient preferences around the characteristics and willingness-to-pay (WTP) for a clinic or home-based CHF-MP. Methodology/Principal Findings A Discrete Choice Experiment was completed by a sub-set of patients (n = 91) enrolled in the WHICH? trial comparing home versus clinic-based CHF-MP. Participants provided 5 choices between hypothetical clinic and home-based programs varying by frequency of nurse consultations, nurse continuity, patient costs, and availability of telephone or education support. Participants (aged 71±13 yrs, 72.5% male, 25.3% NYHA class III/IV) displayed two distinct preference classes. A latent class model of the choice data indicated 56% of participants preferred clinic delivery, access to group CHF education classes, and lower cost programs (p<0.05). The remainder preferred home-based CHF-MPs, monthly rather than weekly visits, and access to a phone advice service (p<0.05). Continuity of nurse contact was consistently important. No significant association was observed between program preference and participant allocation in the parent trial. WTP was estimated from the model and a dichotomous bidding technique. For those preferring clinic, estimated WTP was ≈AU$9-20 per visit; however for those preferring home-based programs, WTP varied widely (AU$15-105). Conclusions/Significance Patient preferences for CHF-MPs were dichotomised between a home-based model which is more likely to suit older patients, those who live alone, and those with a lower household income; and a clinic-based model which is more likely to suit those who are more socially active and wealthier. To optimise the delivery of CHF-MPs, health care services should consider their patients’ preferences when designing CHF-MPs. PMID

  9. Health literacy, health information seeking behaviors and internet use among patients attending a private and public clinic in the same geographic area.

    PubMed

    Gutierrez, Natalia; Kindratt, Tiffany B; Pagels, Patti; Foster, Barbara; Gimpel, Nora E

    2014-02-01

    Despite the growing body of health information available online, patients with limited health literacy may lack either internet access or skills necessary to utilize this information. Nonetheless, patients at all health literacy levels may prefer other primary sources to obtain health information. We conducted a cross-sectional study to measure health literacy of patients attending two clinics in Dallas, TX and determine associations between health literacy, health information access and internet usage before and after controlling for confounders. Patients from both clinics (county N = 265; private N = 233) completed a brief survey which included sociodemographics, internet patterns, confidence in filling out medical forms and a self-administered Newest Vital Sign to measure health literacy. In the county clinic, most patients (61.5 %) were Hispanic, had low income (<$19,000/year), limited education (<11th grade) and a high likelihood or possibility of limited health literacy (68.5 %). In the private clinic, participants were mostly black (40.4 %) or white (38.6 %), had higher incomes (≥$46,000), higher education (technical college or college) and adequate health literacy (75.1 %). The primary source of obtaining health information in both clinics was their health care professional (50.6 % county; 40.1 % private). In multivariate analyses to determine differences by health literacy level, there were no statistically significant differences between patients with limited and adequate health literacy and their primary information source. Regardless of health literacy, patients rely on their health care providers to obtain health information. These results showcase the importance of providers' effective communication with patients to make shared decisions about their health regardless of other factors. PMID:23900880

  10. Financial Advice: Who Pays

    ERIC Educational Resources Information Center

    Finke, Michael S.; Huston, Sandra J.; Winchester, Danielle D.

    2011-01-01

    Using a cost-benefit framework for financial planning services and proprietary data collected in the summer of 2008, the client characteristics that are associated with the likelihood of paying for professional financial advice, as well as the type of financial services purchased, are identified. Results indicate that respondents who pay for…

  11. Reforming Teacher Pay

    ERIC Educational Resources Information Center

    Burns, Susan Freeman; Gardner, Catherine D.

    2010-01-01

    A recent Google search for information regarding performance pay in education produced 6.1 million results. This number should come as no surprise given the current level of interest in incentives as a popular reform option in public education. Supporters believe pay-for-performance programs encourage less effective teachers to improve and will…

  12. High Pay Makes Headlines

    ERIC Educational Resources Information Center

    Fain, Paul

    2006-01-01

    The skyrocketing pay and benefits of corporate executives have kept reporters and, sometimes, prosecutors busy in recent years. The resulting public outrage over these tales of excess has contributed to a backlash. Now the news media, in searching for excessive pay in places where there seems to be no cap on costs, have increasingly focused their…

  13. Merit Pay and Developmental Composition.

    ERIC Educational Resources Information Center

    Klink, William

    Five areas are considered with respect to the relationship of merit pay and developmental composition: (1) the kinds of merit pay; (2) the sources of merit pay funds; (3) the combinations of developmental writing programs, types of merit pay, and the sources of funding; (4) the evaluation of teachers for the purposes of merit pay; and (5) the…

  14. Assessment of Economic Impact Among In-Patients with Non-Communicable Diseases in a Private Tertiary Care Hospital in Southern India

    PubMed Central

    Gupta, Shilpa

    2016-01-01

    Introduction Non-communicable diseases (NCDs) are currently responsible for tremendous economic impact on households. Aim This study was done to estimate the direct, indirect and total costs incurred by households of in-patients with non-communicable diseases admitted in a Private tertiary care hospital. Materials and Methods It was a cross-sectional study conducted in a private tertiary care hospital of Mangalore city in June 2012 by interviewing 30 patients and their attenders using a validated interview schedule. Results Direct cost constituted 58.6% of the total expenses during the course of stay in the hospital. Mean direct cost was more among patients with cancers (p=0.049). Indirect cost was associated with educational status (p=0.04), occupational status (p<0.001) and socio economic status (ses) (p<0.001) of patients. Total cost was more among patients from upper middle ses households (p=0.012). Direct and indirect cost constituted 5-10% each and total cost > 20% of the annual income of majority of households. Medical insurance scheme was not availed by 26 (86.7%) patients due to ignorance. Conclusion Economic burden imposed by a single admission among inpatients with NCDs was tremendous on their households. Hence, information on various medical insurance schemes needs to be popularized among people to improve its utilization. Health care providers need to introduce more financial schemes to minimize health care costs among poor households. PMID:27504316

  15. Private advantage

    SciTech Connect

    Marier, D.; Stoiaken, L.

    1988-03-01

    At least a half dozen independent power producers put out initial public offerings in 1985-86 and the experts were projecting more to come. Most executives of private development companies admitted that they had at least taken a hard look at going public. Several quarters worth of disappointing earnings and the October market crash have brought attention back to the activities of private companies. Fortunately for the industry, at about the same time public-equity markets were closing down, new sources of debt and equity were entering the field in a big way-including insurance companies, pension funds, and utilities. While the development should be good news for all companies in the field (private equity is not necessarily earmarked for private companies), the impact of the crash has made it more difficult for public companies to make their case to the new equity players. The newest players, the unregulated utility subsidiaries, the fastest growing segment in the industry, are probably in a position to put a major dent in the business.

  16. Are Selective Private and Public Colleges Affordable?

    ERIC Educational Resources Information Center

    Karikari, John A.; Dezhbakhsh, Hashem

    2013-01-01

    We examine college affordability under the existing pricing and financial aid system that awards both non need-based and need-based aid. Using data of freshmen attending a large number of selective private and public colleges in the USA, we find that the prices students actually pay for college have increased over time. Need-based grant aid has…

  17. Private and Nonpublic Schools: Elementary Enrollments, 2003-04.

    ERIC Educational Resources Information Center

    Bobek, Joanne R., Comp.

    2004-01-01

    This listing contains 2003-04 elementary enrollments for private and nonpublic schools that reported to the Division of Data Services. Listed are the school name, location address and affiliation of each reporting school having elementary enrollments. These enrollments reflect private-pay students only. An asterisk (*) preceding the school name…

  18. Private and Nonpublic Schools: Secondary Enrollments, 2003-04.

    ERIC Educational Resources Information Center

    Bobek, Joanne R., Comp.

    2004-01-01

    This listing contains 2003-04 secondary enrollments for private and nonpublic schools that reported to the Division of Data Services. Listed are the school name, location address and affiliation of each reporting school having secondary enrollments. These enrollments reflect private-pay students only. An asterisk (*) preceding the school name…

  19. Medicare Pays for Chronic Care Management.

    PubMed

    Sorrel, Amy Lynn

    2015-09-01

    As of January, the Centers for Medicare & Medicaid Services began paying for chronic care management of patients with two or more conditions under its Chronic Care Management program. The payment applies to patients in traditional fee-for-service and noncapitated Medicare Advantage plan arrangements. Texas Medical Association leaders caution the program has some hefty requirements. PMID:26360339

  20. Reputation Effects in Public and Private Interactions

    PubMed Central

    Ohtsuki, Hisashi; Iwasa, Yoh; Nowak, Martin A.

    2015-01-01

    We study the evolution of cooperation in a model of indirect reciprocity where people interact in public and private situations. Public interactions have a high chance to be observed by others and always affect reputation. Private interactions have a lower chance to be observed and only occasionally affect reputation. We explore all second order social norms and study conditions for evolutionary stability of action rules. We observe the competition between “honest” and “hypocritical” strategies. The former cooperate both in public and in private. The later cooperate in public, where many others are watching, but try to get away with defection in private situations. The hypocritical idea is that in private situations it does not pay-off to cooperate, because there is a good chance that nobody will notice it. We find simple and intuitive conditions for the evolution of honest strategies. PMID:26606239

  1. Medicaid Nursing Home Pay for Performance: Where Do We Stand?

    ERIC Educational Resources Information Center

    Arling, Greg; Job, Carol; Cooke, Valerie

    2009-01-01

    Purpose: Nursing home pay-for-performance (P4P) programs are intended to maximize the value obtained from public and private expenditures by measuring and rewarding better nursing home performance. We surveyed the 6 states with operational P4P systems in 2007. We describe key features of six Medicaid nursing home P4P systems and make…

  2. Making Failure Pay: For-Profit Tutoring, High-Stakes Testing, and Public Schools

    ERIC Educational Resources Information Center

    Koyama, Jill P.

    2010-01-01

    A little-discussed aspect of the No Child Left Behind Act (NCLB) is a mandate that requires failing schools to hire after-school tutoring companies--the largest of which are private, for-profit corporations--and to pay them with federal funds. "Making Failure Pay" takes a hard look at the implications of this new blurring of the boundaries between…

  3. 42 CFR 22.5 - Leave without pay while on detail.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Leave without pay while on detail. 22.5 Section 22... OTHER THAN COMMISSIONED OFFICERS Special Consultants § 22.5 Leave without pay while on detail. The... the period of a detail to a State, a subdivision thereof, or a private non-profit institution and...

  4. Engaging Stakeholders in Teacher Pay Reform. Emerging Issues. Report No. 1

    ERIC Educational Resources Information Center

    Max, Jeffrey; Koppich, Julia E.

    2009-01-01

    A growing number of states and school districts are experimenting with new approaches to paying teachers. These efforts to reform teacher pay can involve a range of state and local actors, including governors, state education officials, superintendents, local school boards, teacher unions, private foundations, community organizations, and local…

  5. Patient satisfaction and uptake of private-sector run malaria diagnosis clinics in a post-conflict district in Sri Lanka

    PubMed Central

    2014-01-01

    Background With the incidence of malaria in Sri Lanka declining, intensive parasitological surveillance has been identified as a key strategy to achieve elimination by end 2014. Tropical and Environmental Diseases and Health Associates Private Limited (TEDHA) in collaboration with the Anti-Malaria Campaign established 43 malaria diagnostic laboratories (MDL) in four post-conflict districts of the Northern and Eastern Provinces. This study assesses the patterns of referral of patients with fever for malaria diagnosis by health care providers (HCPs) in four government hospitals in one of the districts of the Northern Province, and patient satisfaction with the laboratory services offered. Methods In this prospective descriptive study, data was collected on the proportion of fever patients being referred by the HCP in hospitals for malaria screening, and the proportion thereof who underwent screening. An interviewer-administered questionnaire was also used to assess patient satisfaction among those attending MDL, which was graded on a scale of 0–4. Results Of patients presenting to the hospitals with fever, only 44.3% were referred for malaria screening; 81.7% of them underwent screening. Referral depended largely on the presence of a permanent staff HCP. Satisfaction levels were high, with 86.55% giving an overall rating of 4. Comfort within the laboratory was rated satisfactory in three of the four hospitals. Conclusions This study demonstrates the success of a public-private partnership in the malaria control programme in Sri Lanka. Malaria is considered low on the differential diagnosis in patients with fever even in previously malaria-endemic areas, due to the declining incidence of malaria and the increase in other febrile illnesses in these areas during the recent past. Private sector run malaria diagnostic services provided free of charge within government hospitals are viable and effective, and had good patient satisfaction ratings. In a country on the

  6. Adolescents with co-occurring substance use and mental conditions in a private managed care health plan: prevalence, patient characteristics, and treatment initiation and engagement.

    PubMed

    Chi, Felicia W; Sterling, Stacy; Weisner, Constance

    2006-01-01

    This study examined the prevalence, patient characteristics, and treatment initiation and engagement of adolescents with co-occurring substance use (SU) and serious mental health (MH) diagnoses in a private, managed care health plan. We identified 2,005 adolescents aged 12-17, who received both SU and MH diagnoses within a 1-year window between 1/1/2000 and 12/31/2002; 57% were girls. Gender variations were found in diagnoses received and point of identification. Being dually diagnosed in specialty departments (rather than Primary Care and Emergency) and receiving both diagnoses within a shorter time period were associated with treatment initiation and engagement. PMID:17182422

  7. Peru privatizes

    SciTech Connect

    Suttil, K.R.

    1993-02-01

    Peru has been undergoing a revolution since the election of Alberto Fujimori as president in 1990. A revolution that is reversing many of the policies of the past 25 years and one which aims to bring Peru back into the mainstream of the world economy. All the enterprises nationalized in the heady days of the early 1970s are set up for privatization. The most important are the three mining companies: Hierro-Peru, Centromin, and Mineroo-Peru. It will not be easy to attract foreign investment after such a long period of political and economic instability but the rewards are there for the intrepid.

  8. Excellent long-term survival of 170 patients with Waldenström's macroglobulinemia treated in private oncology practices and a university hospital.

    PubMed

    Hensel, M; Brust, J; Plöger, C; Schuster, D; Memmer, M L; Franz-Werner, J; Feustel, H-P; Karcher, A; Fuxius, S; Mosthaf, F A; Rieger, M; Ho, A D; Witzens-Harig, M

    2012-12-01

    The purpose of this study was to compare treatment and outcome of patients with Waldenström's macroglobulinemia (WM) in four private oncology practices (PP) and a university hospital (UH) in southwest Germany. We retrospectively reviewed the charts of all patients with WM of the last two decades of four PP in Mannheim, Heidelberg, Karlsruhe, and Speyer and the Department of Hematology of the University of Heidelberg. One hundred seventy patients could be identified, 74 from PP, 96 from the UH. Median age was 63.3 years. Patients from PP were older (median 65.3 vs. 62.5 years, p = 0.01). Only 54 % of patients from PP have received treatment during the observation time, as compared to 78.1 % of the UH (p < 0.001). In PP, 35 % of treated patients have received rituximab, as compared to 62.6 % of the patients of the UH (p < 0.001). Sixty percent of treated patients of PP have received bendamustine, as compared to only 8 % of the patients of the UH (p < 0.001). Time to first treatment was significantly shorter in patients from the UH compared to PP (median 13.7 vs. 52.9 months, p = 0.05). A trend towards a better overall survival was observed for patients treated with a rituximab-containing first-line regimen. The International Prognostic Scoring System for WM had significant prognostic value. Median overall survival was 25.0 years and did not differ between PP and UH. Despite different treatment strategies between PP and UH today overall survival of patients with WM is excellent, and better than previously reported. PMID:22895554

  9. Merit Pay Misfires

    ERIC Educational Resources Information Center

    Ramirez, Al

    2011-01-01

    Critics argue that the uniform salary schedule is unfair because it promotes mediocrity by rewarding poor performers while failing to recognize outstanding achievement on the job. Advocates for merit pay systems for preK-12 education also contend that the uniform salary schedule ignores the basic purpose of education--student learning. Although…

  10. 20 CFR 404.1242 - Back pay.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Back pay. 404.1242 Section 404.1242 Employees... Prior to 1987 § 404.1242 Back pay. (a) Back pay defined. Back pay is pay received in one period of time... to wages. (b) Back pay under a statute. Back pay under a statute is a payment by an...

  11. Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey

    PubMed Central

    2013-01-01

    Introduction Since 2004, the Sun Quality Health (SQH) franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor. Methods The study uses data from two sources: 1) Myanmar’s first nationally representative TB prevalence study conducted in 2009, and 2) client exit interviews from TB patients from SQH clinics. In total, 1,114 TB-positive individuals were included in the study, including 739 from the national sample and 375 from the SQH sample. Results TB patients at SQH clinics were poorer than TB-positive individuals in the overall population, though not at a statistically significant level (p > 0.05). After stratification we found that in urban areas, TB patients at SQH clinics were more likely to be in the poorest quartile compared to general TB positive population (16.8% vs. 8.6%, respectively; p < 0.05). In rural areas, there was no statistically significant difference between the wealth distribution of SQH clinic patients and general TB positive individuals (p > 0.05). Conclusion Franchised clinics in Myanmar are reaching poor populations of TB patients in urban areas; more efforts are needed in order to reach the most vulnerable in rural areas. PMID:23305063

  12. The development of outpatient prospective payment systems and the use of ambulatory patient groups by private insurers.

    PubMed

    Miller, H

    1993-04-01

    Private insurers will likely move to APGs rapidly because of the key advantages that APGs provide. Not only is it necessary to have an outpatient classification system to make utilization review, quality assurance, and customer reporting more meaningful, outpatient prospective payment provides a foundation for the controls on outpatient payments that insurers have been seeking. Because of outpatient volume increases and constraints on inpatient payments that have led hospitals to increase outpatient charges more rapidly, most insurers believe that outpatient payment levels are currently beyond their control. Introduction of an outpatient prospective payment system will shift control over outpatient payment increases from providers to insurers, as has been the case for many insurers who have adopted DRG payment for inpatient services. Once APGs are in place, annual increases in payment amounts will be determined through insurer-provider negotiation or through contractual approaches that limit payment increases to changes in a price index. PMID:10125064

  13. Role of the private sector in elective surgery in England and Wales, 1986.

    PubMed Central

    Nicholl, J. P.; Beeby, N. R.; Williams, B. T.

    1989-01-01

    From a sample of 19,000 treatment episodes at 183 of the 193 independent hospitals with operating facilities in England and Wales that were open in 1986 it is estimated that 287,000 residents of England and Wales had elective surgery as inpatients in 1986 (an increase of 77% since 1981) and 72,000 as day cases. From 1985 Hospital In-Patient Enquiry data it was estimated that a further 36,000 similar elective inpatient treatments were undertaken in NHS pay beds (a decrease of 38%) and 21,000 as day cases. Overall, an estimated 16.7% of all residents of England and Wales who had non-abortion elective surgery as inpatients were treated in the private sector, as were 10.5% of all day cases. An estimated 28% of all total hip joint replacements were done privately, and in both the North West and South West Thames regions the proportion of inpatients treated privately for elective surgery was 31%. It is concluded that mainly for reasons of available manpower private sector activity may not be able to grow much more without arresting or reversing the growth of the NHS, in which case some method of calculating NHS resource allocation which takes account of the local strength of the private sector will be needed. PMID:2493874

  14. Value-Added Merit Pay.

    ERIC Educational Resources Information Center

    Twomey, Daniel F.

    The purpose of merit pay is to reward employees for their accomplishments and motivate them to continue improving. Critics of merit pay say the increased extrinsic motivation that it prompts is more than offset by the decrease in intrinsic motivation. Supporters of performance-based pay claim several benefits of the practice. This study addressed…

  15. Pattern of linkage and retention in HIV care continuum among patients attending referral HIV care clinic in private sector in India.

    PubMed

    Parchure, Ritu; Kulkarni, Vinay; Kulkarni, Sanjeevani; Gangakhedkar, Raman

    2015-01-01

    Continued engagement throughout the HIV care continuum, from HIV diagnosis through retention on antiretroviral therapy (ART), is crucial for enhancing impact of HIV care programs. We assessed linkage and retention in HIV care among people living with HIV (PLHIV) enrolled at a private HIV care clinic in Pune, India. Of 1220 patients, 28% delayed linkage after HIV diagnosis with a median delay of 24 months (IQR = 8-43). Younger people, women, low socioeconomic status, and those diagnosed at facilities other than the study clinic were more likely to delay linkage. Those with advanced HIV disease at diagnosis and testing for HIV due to HIV-related illness were linked to care immediately. Of a total of 629 patients eligible for ART at first CD4 count, 68% initiated ART within 3 months. Among those not eligible for ART, only 46% of patients sought subsequent CD4 count in time. Multivariate logistic regression analysis revealed that patients with initial CD4 count of 350-500 cells/cu mm (OR: 2, 95% CI: 1.1-3.5) and >500 cells/cu mm (OR: 2.1, 95% CI: 1.2-3.7) were less likely to do subsequent CD4 test on time as compared to those with CD4 < 50 cells/cu mm. Among patients not eligible for ART, those having >12 years of education (OR: 0.4, 95% CI: 0.2-0.9) were more likely to have timely uptake of subsequent CD4 count. Among ART eligible patients, being an unskilled laborer (OR: 2.2, 95% CI: 1.1-4.2) predicted lower uptake. The study highlights a long delay from HIV diagnosis to linkage and further attrition during pre-ART and ART phases. It identifies need for newer approaches aimed at timely linkage and continued retention for patients with low education, unskilled laborers, and importantly, asymptomatic patients. PMID:25559639

  16. Patient punctuality and clinic performance: observations from an academic-based private practice pain centre: a prospective quality improvement study

    PubMed Central

    Williams, Kayode A; Chambers, Chester G; Dada, Maqbool; McLeod, Julia C; Ulatowski, John A

    2014-01-01

    Objectives The aim of this study was to examine the effects of an intervention to alter patient unpunctuality. The major hypothesis was that the intervention will change the distribution of patient unpunctuality by decreasing patient tardiness and increasing patient earliness. Design Prospective Quality Improvement. Setting Specialty Pain Clinic in suburban Baltimore, Maryland, USA. Participants The patient population ranged in age from 18 to 93 years. All patients presenting to the clinic during the study period were included in the study. The average monthly volume was 86.2 (SD=13) patients. A total of 1500 patient visits were included in this study. Interventions We tracked appointment times and patient arrival times at an ambulatory pain clinic. An intervention was made in which patients were informed that tardy patients would not be seen and would be rescheduled. This policy was enforced over a 12-month period. Primary and secondary outcome measures The distribution of patient unpunctuality was developed preintervention and at 12 months after implementation. Distribution parameters were used as inputs to a discrete event simulation to determine effects of the change in patient unpunctuality on clinic delay. Results Data regarding patient unpunctuality were gathered by direct observation before and after implementation of the intervention. The mean unpunctuality changed from −20.5 min (110 observations, SD=1.7) preintervention to −23.2 (169, 1.2) at 1 month after the intervention, −23.8 min (69, 1.8) at 6 months and −25.0 min (71, 1.2) after 1 year. The unpunctuality 12 months after initiation of the intervention was significantly different from that prior to the intervention (p<0.05). Conclusions Physicians and staff are able to alter patient arrival patterns to reduce patient unpunctuality. Reducing tardiness improves some measures of clinic performance, but may not always improve waiting times. Accommodating early arriving patients

  17. Medicaid patients seen at federally qualified health centers use hospital services less than those seen by private providers.

    PubMed

    Rothkopf, Jennifer; Brookler, Katie; Wadhwa, Sandeep; Sajovetz, Michael

    2011-07-01

    Federally qualified health centers, also known as community health centers, play an essential role in providing health care to millions of Americans. In return for providing primary care to underserved, homeless, and migrant populations, these centers are reimbursed at a higher rate than other providers by public programs such as Medicaid. Under the Affordable Care Act of 2010, the role of the centers is expected to grow. To examine the quality of care that the centers provide, the Colorado Department of Health Care Policy and Financing compared the use of costly hospital-related services by Medicaid clients whose usual source of care was a community health center with the use by clients whose usual source of care was a private, fee-for-service provider. The study found that community health center users were about one-third less likely than the other group to have emergency department visits, inpatient hospitalizations, or preventable hospital admissions. Public funders such as states should work with community health centers to improve the quality and reduce the cost of care even further. PMID:21734208

  18. Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

    PubMed Central

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

    2016-01-01

    Objectives The main objective of this study was to assess practices of antibiotic prescription at registered drug shops with a focus on upper respiratory tract infections among children in order to provide data for policy discussions aimed at improving quality of care and patient safety in the private health sector in Uganda. Methods A survey was conducted within 57 parishes from August to October 2014 in Mukono District, Uganda. Data was captured on the following variables: drug shop characteristics, training of staff in management of pneumonia, availability of guidelines and basic equipment, available antibiotics, knowledge on treatment of pneumonia in children aged <5 years. The main study outcome was the proportion of private health facilities prescribing an antibiotic. Results A total of 170 registered drug shops were surveyed between August and October 2014. The majority of drug shops, 93.5% were prescribing antibiotics, especially amoxicillin and trimethoprim-sulfamethoxazole (septrin). The professional qualification of a provider was significantly associated with this practice, p=0.04; where lower cadre staff (nursing assistants and enrolled nurses) overprescribed antibiotics. A third, 29.4% of drug shop providers reported that antibiotics were the first-line treatment for children with diarrhoea; yet the standard guideline is to give oral rehydration salts and zinc tablets. Only few providers, 8.2%, had training on antibiotics, with 10.6% on pneumonia case management. Further to this, 7.1% drug shops had WHO-Integrated Management of Childhood Illness guidelines, and a negligible proportion (<1%) had respiratory timers and baby weighing scales. Although the majority of providers, 82.4%, knew severe signs and symptoms of pneumonia, few, 17.6%, knew that amoxicillin was the first-line drug for treatment of pneumonia in children according to the guidelines. Conclusions There is urgent need to regulate drug shop practices of prescribing and selling

  19. P2Y12 receptor inhibition and effect of morphine in patients undergoing primary PCI for ST-segment elevation myocardial infarction. The PRIVATE-ATLANTIC study.

    PubMed

    Silvain, Johanne; Storey, Robert F; Cayla, Guillaume; Esteve, Jean-Baptiste; Dillinger, Jean-Guillaume; Rousseau, Hélène; Tsatsaris, Anne; Baradat, Caroline; Salhi, Néjoua; Hamm, Christian W; Lapostolle, Frédéric; Lassen, Jens Flensted; Collet, Jean-Philippe; Ten Berg, Jurriën M; Van't Hof, Arnoud W; Montalescot, Gilles

    2016-08-01

    PRIVATE-ATLANTIC (P2Y12 Receptor Inhibition with VASP Testing using Elisa kit during the ATLANTIC study) is a pre-specified substudy of the randomised, double-blind ATLANTIC trial in patients with ST-segment elevation myocardial infarction, designed to help interpret the main trial results. The primary objective of ATLANTIC was to assess coronary reperfusion prior to percutaneous coronary intervention (PCI) with pre- vs in-hospital ticagrelor 180 mg loading dose (LD). PRIVATE-ATLANTIC assessed platelet inhibition in 37 patients by measurement of vasodilator-associated stimulated phosphoprotein (VASP) platelet reactivity index (PRI) and VerifyNow platelet reactivity units (PRU) before angiogram (T1), immediately after PCI (T2), 1 (T3), and 6 (T4) hours (h) after PCI, and before next study drug administration (T5). The median time difference between the two ticagrelor LD was 41 minutes. Platelet reactivity was unaffected at T1 when measured by VASP-PRI (89.8 vs 93.9 % for pre- and in-hospital ticagrelor, respectively; p = 0.18) or PRU (239 vs 241; p = 0.82). Numerical differences were apparent at T2 and maximal at T3. Morphine administration significantly delayed onset of platelet inhibition at T3 (VASP-PRI 78.2 vs 23.4 % without morphine; p = 0.0116) and T4 (33.1 vs 11.0 %; p = 0.0057). In conclusion, platelet inhibition in ATLANTIC was unaffected by pre-hospital ticagrelor administration at the time of initial angiogram due to the short transfer delay. The maximum difference in platelet inhibition was detected 1 h after PCI (T3). Morphine administration was associated with delayed onset of action of ticagrelor and appeared more important than timing of ticagrelor administration. PMID:27196998

  20. The Evolution of Privatization at Hanford Tank Waste Treatment Complex

    SciTech Connect

    BROWN, N.R.

    2001-02-01

    Privatization acquisition strategies embody substantial contract reform principles-private financing and ownership, competition, fixed prices, and payment only upon delivery of services-which in time became the recipe for privatization of Department of Energy (DOE) Environmental Management (EM) cleanup projects. Privatization changes the federal government's approach from traditional cost-plus contracting, where the federal government pays the contractor as the project progresses, to a strategy where the federal government pays for products or services as they are delivered. To be successful, the privatization requires additional risk taking by the contractor. This paper focuses on why the Tank Waste Remediation System (TWRS) pursued privatization, how the TWRS Privatization Project matured, and why the privatization project moved to an alternate path. The paper is organized as follows: a description of the TWRS-Privatization framework, how the project changed from the original request for proposal through the decision not to proceed to Part B-2, and the lessons learned during evolution of the effort, including what worked as well as what went wrong and how such negative outcomes might be prevented in the future.

  1. Prescribing patterns of non-steroidal anti-inflammatory drugs in chronic kidney disease patients in the South African private sector.

    PubMed

    Meuwesen, Willem P; du Plessis, Jesslee M; Burger, Johanita R; Lubbe, Martie S; Cockeran, Marike

    2016-08-01

    Background Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used pharmaceutical agents worldwide. NSAIDs are considered nephrotoxic and should therefore be used with caution or be avoided completely in high risk patients, such as chronic kidney disease (CKD) patients. Objective This study aimed to investigate the prescribing of NSAIDs in CKD patients in order to generate awareness and improve the outcome of these patients. Setting The study was conducted using medicine claims data in the private health sector of South Africa. Method A descriptive, quantitative study was performed, using retrospective data obtained from a Pharmaceutical Benefit Management company. Data from 1 January 2009 to 31 December 2013 were analysed. The study population consisted of all patients with an ICD-10 code for a CKD (N18), in association with a paid claim for an NSAID. Main outcome measure The stratification of NSAID prescribing volume among the CKD population in terms of gender, age, NSAID type, dosage and prescriber type. Results The prescribing of NSAIDs in CKD patients varied between 26 and 40 % over the 5 year study period. No association between gender and CKD patients who received NSAIDs versus those who did not was found, with p > 0.05 and Cramer's V < 0.1 for each year of the study. The association between age groups and CKD patients who received NSAIDs versus those who did not was statistically significant, but practically weak (p < 0.05; Cramer's V ≥ 0.1). Most NSAID prescriptions (52-63 %) were for patients aged 35-64 years. Diclofenac (34.25 %) was the single most frequently prescribed NSAID, but the COX-2-inhibitors (celecoxib, meloxicam and etoricoxib) were the preferred NSAID class to be prescribed. The majority (61.6 %) of the NSAIDs were prescribed by general medical practitioners in dosages meeting and even exceeding the recommended daily dosage of patients with normal kidney function. Conclusions Even though NSAIDs are

  2. 41 CFR 302-9.11 - For what POV emergency or temporary storage expenses will my agency pay?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... or temporary storage expenses will my agency pay? 302-9.11 Section 302-9.11 Public Contracts and... PROPERTY 9-ALLOWANCES FOR TRANSPORTATION AND EMERGENCY OR TEMPORARY STORAGE OF A PRIVATELY OWNED VEHICLE General Rules § 302-9.11 For what POV emergency or temporary storage expenses will my agency pay?...

  3. Using School Scholarships to Estimate the Effect of Private Education on the Academic Achievement of Low Income Students in Chile

    ERIC Educational Resources Information Center

    Anand, Priyanka; Mizala, Alejandra; Repetto, Andrea

    2008-01-01

    This paper estimates the impact of private education on the academic achievement of low-income students in Chile. To deal with selection bias, we use propensity score matching to compare the test scores of reduced-fee paying, low-income students in private voucher schools to those of similar students in public schools and free private voucher…

  4. Privatization and Education

    ERIC Educational Resources Information Center

    Dash, Neena

    2009-01-01

    This paper highlights emerging trends, programmes and policies in privatization of education in Western countries. These trends are educational vouchers, choice of private schools, private school liberalization, private contracting of specific services, tuition tax credits and deductions for parents ,subsidies and assistance grants to private…

  5. Automating The Work at The Skin and Allergy Private Clinic : A Case Study on Using an Imaging Database to Manage Patients Records

    NASA Astrophysics Data System (ADS)

    Alghalayini, Mohammad Abdulrahman

    Today, many institutions and organizations are facing serious problem due to the tremendously increasing size of documents, and this problem is further triggering the storage and retrieval problems due to the continuously growing space and efficiency requirements. This problem is becoming more complex with time and the increase in the size and number of documents in an organization; therefore, there is a world wide growing demand to address this problem. This demand and challenge can be met by converting the tremendous amount of paper documents to images using a process to enable specialized document imaging people to select the most suitable image type and scanning resolution to use when there is a need for storing documents images. This documents management process, if applied, attempts to solve the problem of the image storage type and size to some extent. In this paper, we present a case study resembling an applied process to manage the registration of new patients in a private clinic and to optimize following up the registered patients after having their information records stored in an imaging database system; therefore, through this automation approach, we optimize the work process and maximize the efficiency of the Skin and Allergy Clinic tasks.

  6. Setting Up Private Practice in Psychiatry*

    PubMed Central

    De Sousa, Alan; De Sousa, Avinash

    2015-01-01

    Setting up a private practice in Mumbai is an onerous task. The present paper looks at the difficulties face by young psychiatrists when starting a private practice in psychiatry. It suggests certain guidelines to be followed to ensure the development of a successful practice. It also suggests methods to gain popularity among patients and society along with the ethics to be followed, knowledge base to be garnered, and the role of using multiple therapies and versatility in private practice. PMID:25838718

  7. Financing Higher Education Worldwide: Who Pays? Who Should Pay?

    ERIC Educational Resources Information Center

    Johnstone, D. Bruce; Marcucci, Pamela N.

    2010-01-01

    No issue in higher education is as salient, or as controversial, as finance. As demand for higher education around the world grows, so do the costs associated with it, especially as governments shoulder less of the burden. Tuition fees rise and student loan debt grows. Who pays for these surging costs? Who "should" pay? D. Bruce Johnstone and…

  8. Pay as you throw

    SciTech Connect

    Dahlen, Lisa; Lagerkvist, Anders

    2010-01-15

    Householders' response to weight-based billing for the collection of household waste was investigated with the aim of providing decision support for waste management policies. Three questions were addressed: How much and what kind of information on weight-based billing is discernible in generic Swedish waste collection statistics? Why do local authorities implement weight-based billing, and how do they perceive the results? and, Which strengths and weaknesses of weight-based billing have been observed on the local level? The study showed that municipalities with pay-by-weight schemes collected 20% less household waste per capita than other municipalities. Surprisingly, no part of this difference could be explained by higher recycling rates. Nevertheless, the majority of waste management professionals were convinced that recycling had increased as a result of the billing system. A number of contradicting strengths and weaknesses of weight-based billing were revealed.

  9. Teachers' Perceptions of Merit Pay

    ERIC Educational Resources Information Center

    Jackson, Vanessa; Langheinrich, Cornelia; Loth, Dan

    2012-01-01

    The purpose of the study is to show the various perceptions teachers have on merit pay. This research was designed to examine the perceptions and attitudes of teachers towards the idea of performance based pay. This topic has been an ongoing battle within school systems since the 1800s. The participants in this study were teachers from the state…

  10. The Determinants of Pay Satisfaction

    ERIC Educational Resources Information Center

    Dyer, Lee; Theriault, Roland

    1976-01-01

    Through a study of American and Canadian managers, tested the utility of Lawler's model of the determinants of pay satisfaction and the value of adding to Lawler's model a category of variables for perceptions of pay-system administration. The study findings are then used to develop a modified model. For availability see EA 507 670. (Author/JG)

  11. Teacher Pay and Teacher Aptitude

    ERIC Educational Resources Information Center

    Leigh, Andrew

    2012-01-01

    Can changes in teacher pay encourage more able individuals to enter the teaching profession? So far, studies of the impact of pay on the aptitude distribution of teachers have provided mixed evidence on the extent to which altering teacher salaries represents a feasible solution to the teacher quality problem. One possible reason is that these…

  12. 5 CFR 534.604 - Pay administration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Pay administration. 534.604 Section 534.604 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Administrative Appeals Judge Positions § 534.604 Pay administration. (a) The head of each agency must fix the rate of basic pay...

  13. 5 CFR 534.604 - Pay administration.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Pay administration. 534.604 Section 534.604 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Administrative Appeals Judge Positions § 534.604 Pay administration. (a) The head of each agency must fix the rate of basic pay...

  14. 5 CFR 534.604 - Pay administration.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Pay administration. 534.604 Section 534.604 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Administrative Appeals Judge Positions § 534.604 Pay administration. (a) The head of each agency must fix the rate of basic pay...

  15. 28 CFR 345.51 - Inmate pay.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmate pay. 345.51 Section 345.51... (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.51 Inmate pay. (a) Grade levels. Inmate workers in FPI locations receive pay at five levels ranging from 5th grade pay (lowest) to 1st grade...

  16. 4 CFR 5.1 - Pay.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...). (c) Pay adjustments. Except as provided in regulations for the GAO Senior Executive Service and the... 4 Accounts 1 2011-01-01 2011-01-01 false Pay. 5.1 Section 5.1 Accounts GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL SYSTEM COMPENSATION § 5.1 Pay. (a) Pay principles. Pay of the employees of GAO shall...

  17. 5 CFR 534.502 - Pay range.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Pay range. 534.502 Section 534.502 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.502 Pay range. A pay rate fixed under this subpart shall be— (a) Not less...

  18. 5 CFR 534.502 - Pay range.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Pay range. 534.502 Section 534.502 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.502 Pay range. A pay rate fixed under...

  19. 5 CFR 534.502 - Pay range.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Pay range. 534.502 Section 534.502 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.502 Pay range. A pay rate fixed under...

  20. 5 CFR 534.502 - Pay range.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Pay range. 534.502 Section 534.502 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.502 Pay range. A pay rate fixed under...

  1. Quantum data locking for high-rate private communication

    NASA Astrophysics Data System (ADS)

    Lupo, Cosmo; Lloyd, Seth

    2015-03-01

    We show that, if the accessible information is used as a security quantifier, quantum channels with a certain symmetry can convey private messages at a tremendously high rate, as high as less than one bit below the rate of non-private classical communication. This result is obtained by exploiting the quantum data locking effect. The price to pay to achieve such a high private communication rate is that accessible information security is in general not composable. However, composable security holds against an eavesdropper who is forced to measure her share of the quantum system within a finite time after she gets it.

  2. Quantifying the Impact of Autism Coverage on Private Insurance Premiums

    ERIC Educational Resources Information Center

    Bouder, James N.; Spielman, Stuart; Mandell, David S.

    2009-01-01

    Many states are considering legislation requiring private insurance companies to pay for autism-related services. Arguments against mandates include that they will result in higher premiums. Using Pennsylvania legislation as an example, which proposed covering services up to $36,000 per year for individuals less than 21 years of age, this paper…

  3. Private-College Presidents Enjoy Another Lucrative Year.

    ERIC Educational Resources Information Center

    Nicklin, Julie L.

    2001-01-01

    A survey by "The Chronicle of Higher Education" of the pay of private-college presidents found increases at the top levels, with especially lucrative packages going to some executives on their way out of office. Includes several data tables. (EV)

  4. Wage Differentials Between Federal Government and Private Sector Workers.

    ERIC Educational Resources Information Center

    Smith, Sharon Patricia

    This study examined the earnings and wage rate differentials between Federal government and private sector workers in 1960 and 1970 to consider the comparability of these workers and the application of the Comparability Doctrine in Federal pay policy during that period. Two types of earnings and wage rate equations were estimated by ordinary least…

  5. Private health insurance: an international overview and considerations for Canada.

    PubMed

    Dhalla, Irfan

    2007-01-01

    Since the passage of the Canada Health Act in 1984 and its prohibition of extra-billing, there has been an extremely limited role for private health insurance in Canada as a mechanism to pay for medically necessary physician or hospital services. In the aftermath of the landmark Supreme Court decision Chaoulli v. Québec, this may change. PMID:18274001

  6. Gap Persists between Faculty Salaries at Public and Private Institutions

    ERIC Educational Resources Information Center

    Byrne, Richard

    2008-01-01

    Gaps in faculty pay between private and public colleges and universities continue to widen, warned the American Association of University Professors in its annual report on the economic status of the profession. It is a divide, the group argues, that threatens the ability of public institutions to recruit and retain faculty members at all levels.…

  7. Patterns of Compensation of Public and Private School Teachers.

    ERIC Educational Resources Information Center

    Chambers, Jay G.

    1985-01-01

    Public school teachers earn more money, and possess more of the characteristics valued in the teaching market, than do private school teachers. Organizational and ownership structure of schools appears to make a difference in teacher salaries. Profit-making schools are among the lowest paying, second only to parochial schools. (Author/MD)

  8. Special Education Private Placements: Financial Responsibility Under the Law.

    ERIC Educational Resources Information Center

    McQuain, Sandra

    1982-01-01

    Reviews cases involving school districts' obligation to pay tuition or reimburse parents for placing children in private special education programs. Discusses state constitutions and statutes, tuition payment ceilings, limiting of options for services, unilateral placements by parents, and placements made before administrative or judicial…

  9. 77 FR 36566 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... SECURITY Federal Emergency Management Agency National Flood Insurance Program (NFIP); Assistance to Private..., 2012) private sector property insurers sell flood insurance policies and adjust flood insurance claims... the remaining premium to the Federal Government. The Federal Government pays flood losses and...

  10. Public-Private Partnership in Higher Education: Central Queensland University Meets Campus Management Services

    ERIC Educational Resources Information Center

    Rodan, Paul

    2016-01-01

    Massive growth in the numbers of fee-paying international students and an increasing private sector role are two of the most salient features of Australian higher education in the past quarter century. Both these trends were evident in a little known partnership, involving a public regional university and a private entrepreneur, which had its…

  11. Private Loan Counseling for Undergraduate Students: The Role of College Financial Aid Counselors

    ERIC Educational Resources Information Center

    Jensen, Carol A.

    2008-01-01

    The cost of attending college has surpassed federal financial aid limits and fewer parents are paying the balance. As private lenders have been targeting undergraduate students to obtain private (alternative) loans to fill the financial gap, many students do not have parents or other adults to help them navigate one of the largest financial…

  12. Paying for water.

    PubMed

    Middleton, J; Saunders, P

    1997-03-01

    Water has been taken for granted as an essential public health need since the Victorian sanitary revolution. Water has come back on to the public health agenda in the United Kingdom because of recent policy changes and their untoward environmental and social impacts; along with water privatization and tough new environmental directives, there have been serious water pollution incidents, water shortages, water debt and disconnection. Along with concern about protecting individual rights to a clean safe water supply, there is concern about the ability of national water resources to meet all our communities' needs, without unacceptable environmental damage. A national plan is needed for the conservation of water and protection of water resources and the environment; adequate central funds are needed to see that this happens. There should be greater emphasis on local water management and a key role for local authorities; there should be fair pricing, protection of water supplies for the poorest and most vulnerable, and a ban on water disconnection to domestic users, on public health grounds. More research is needed into the potential adverse health impact of people on prepayment meters disconnecting themselves. There is a place for water metering as the most rapidly deliverable means of controlling peak demand, reducing overall consumption and avoiding a large-scale environmentally damaging solution to supply more water. However, control of leakage offers the largest potential saving and is the most cost-effective means to protect existing water supply. We question whether private water companies, geared to maximizing profit and share dividends, can deliver a national plan for the protection and management of water resources, for the good of the environment and future generations. The public health lobby must become more actively engaged in the debate about the supply, protection and price of our most precious public health asset-water. PMID:9138226

  13. The Private Language Argument.

    ERIC Educational Resources Information Center

    Baker, Gordon

    1998-01-01

    Discusses the private language argument (PLA)--the argument against the possibility of a private language. Raises questions about the PLA, suggesting there are a number of problems that PLA interpretation generates and fails to resolve. (Author/JL)

  14. [Treatment of constipation in palliative care patients is a challenge].

    PubMed

    Jarlbæk, Lene; Johnsen, Berit; Hansen, Ole Bo; Hedal, Birte

    2016-08-15

    The evidence for treatment of constipation in palliative care patients is poor. The condition of these patients is often complex, and results from studies performed in other patient groups cannot be extrapolated unconditionally. However, macrogol (polyethylene glycol), lactulose and sodium picosulphate seem to be well tolerated, and methylnaltrexone could be used in opioid-induced constipation, if the patients are not at risk from gastrointestinal perforation. The patients should be offered quiet and private surroundings, and attention should be payed to securing an optimal body position for defecation. PMID:27550785

  15. Getting Real Performance Out of Pay-for-Performance

    PubMed Central

    Nicholson, Sean; Pauly, Mark V; Wu, Anita Ya Jung; Murray, James F; Teutsch, Steven M; Berger, Marc L

    2008-01-01

    Context Most private and public health insurers are implementing pay-for-performance (P4P) programs in an effort to improve the quality of medical care. This article offers a paradigm for evaluating how P4P programs should be structured and how effective they are likely to be. Methods This article assesses the current comprehensiveness of evidence-based medicine by estimating the percentage of outpatient medical spending for eighteen medical processes recommended by the Institute of Medicine. Findings Three conditions must be in place for outcomes-based P4P programs to improve the quality of care: (1) health insurers must not fully understand what medical processes improve health (i.e., the health production function); (2) providers must know more about the health production function than insurers do; and (3) health insurers must be able to measure a patient's risk-adjusted health. Only two of these conditions currently exist. Payers appear to have incomplete knowledge of the health production function, and providers appear to know more about the health production function than payers do, but accurate methods of adjusting the risk of a patient's health status are still being developed. Conclusions This article concludes that in three general situations, P4P will have a different impact on quality and costs and so should be structured differently. When information about patients’ health and the health production function is incomplete, as is currently the case, P4P payments should be kept small, should be based on outcomes rather than processes, and should target physicians’ practices and health systems. As information improves, P4P incentive payments could be increased, and P4P may become more powerful. Ironically, once information becomes complete, P4P can be replaced entirely by “optimal fee-for-service.” PMID:18798885

  16. Privatization in Education.

    ERIC Educational Resources Information Center

    Rehfuss, John

    1995-01-01

    Privatization calls for substantially trimming the scope and breadth of government services, replacing them with private or other nongovernmental operators. The attraction of privatization is reduced costs and increased management flexibility. To date, the arrangement has received substantial support from students and parents in situations that…

  17. The self-pay problem.

    PubMed

    DeSoto, Richard

    2015-09-01

    Development of a self-pay plan is key to improving collections. The five opportunities for providers to do this include: Pre-registration/scheduling. Admissions, time of service, discharge, post-billing. PMID:26548165

  18. New activity-based funding model for Australian private sector overnight rehabilitation cases: the rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model.

    PubMed

    Hanning, Brian; Predl, Nicolle

    2015-09-01

    Traditional overnight rehabilitation payment models in the private sector are not based on a rigorous classification system and vary greatly between contracts with no consideration of patient complexity. The payment rates are not based on relative cost and the length-of-stay (LOS) point at which a reduced rate applies (step downs) varies markedly. The rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model (RAM), which has been in place for over 2 years in some private hospitals, bases payment on a rigorous classification system, relative cost and industry LOS. RAM is in the process of being rolled out more widely. This paper compares and contrasts RAM with traditional overnight rehabilitation payment models. It considers the advantages of RAM for hospitals and Australian Health Service Alliance. It also considers payment model changes in the context of maintaining industry consistency with Electronic Claims Lodgement and Information Processing System Environment (ECLIPSE) and health reform generally. PMID:25725655

  19. 38 CFR 1.514a - Disclosure to private psychologists.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... psychologists. 1.514a Section 1.514a Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Disclosure to private psychologists. When a beneficiary elects to obtain therapy or analysis as a private patient from a private psychologist, such information in the medical record as may be pertinent may...

  20. 38 CFR 1.514a - Disclosure to private psychologists.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... psychologists. 1.514a Section 1.514a Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Disclosure to private psychologists. When a beneficiary elects to obtain therapy or analysis as a private patient from a private psychologist, such information in the medical record as may be pertinent may...

  1. 38 CFR 1.514a - Disclosure to private psychologists.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... psychologists. 1.514a Section 1.514a Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Disclosure to private psychologists. When a beneficiary elects to obtain therapy or analysis as a private patient from a private psychologist, such information in the medical record as may be pertinent may...

  2. 38 CFR 1.514a - Disclosure to private psychologists.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... psychologists. 1.514a Section 1.514a Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Disclosure to private psychologists. When a beneficiary elects to obtain therapy or analysis as a private patient from a private psychologist, such information in the medical record as may be pertinent may...

  3. Glycemic Control Outcomes by Gender in the Pay-for-Performance System: A Retrospective Database Analysis in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Yuan, Shao-Ping; Huang, Chien-Ning; Liao, Hung-Chang; Lin, Yu-Tzu; Wang, Ya-huei

    2014-01-01

    Background. The purpose of this study was to investigate how the degree of glycemic control in patients with type 2 diabetes associated with lifestyle interventions as well as sociodemographic factors and further examine the differences by gender. Methods. This was a retrospective study using data collected from a diabetes quality improvement plan that began in 2002 in a medical center in Taiwan. Statistic analysis was used to determine the associations of sociodemographic data, lifestyle intervention, and treatment regimens with changes in HbA1c levels (between the initial visit and the latest follow-up measured level), and the differences were then sorted by the sex of the patients. Results. Our results showed that HbA1c averaged 7.50% for males and 7.80% for females at the initial visit, compared to levels averaging 7.50% for males and 7.70% for females at the most recent follow-up visit. There was no significant change (P = 0.541) in HbA1c in males, but there was a 0.10% (P = 0.384) reduction in females. The duration of the diabetes and medication regimen was associated with the decrease seen in the females. Conclusions. The results of these analyses provide important insights for policy makers to formulate healthcare policies related to chronic diseases or illnesses. PMID:25202328

  4. 28 CFR 345.52 - Premium pay.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Premium pay. 345.52 Section 345.52 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.52 Premium pay. Payment of premium pay...

  5. 28 CFR 345.52 - Premium pay.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Premium pay. 345.52 Section 345.52 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.52 Premium pay. Payment of premium pay...

  6. 28 CFR 345.52 - Premium pay.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Premium pay. 345.52 Section 345.52 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.52 Premium pay. Payment of premium pay...

  7. 28 CFR 345.52 - Premium pay.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Premium pay. 345.52 Section 345.52 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.52 Premium pay. Payment of premium pay...

  8. 5 CFR 9701.356 - Pay retention.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Pay Administration § 9701.356 Pay retention. (a) Subject to...

  9. 5 CFR 9701.356 - Pay retention.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Pay Administration § 9701.356 Pay retention. (a) Subject to...

  10. 5 CFR 9701.356 - Pay retention.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Pay Administration § 9701.356 Pay retention. (a) Subject to...

  11. 4 CFR 5.1 - Pay.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... OFFICE PERSONNEL SYSTEM COMPENSATION § 5.1 Pay. (a) Pay principles. Pay of the employees of GAO shall be... a schedule of pay rates which shall apply to GAO employees. Except as provided in paragraph (b) (2) of this section, and regulations for the GAO Senior Executive Service, the highest rate under...

  12. 5 CFR 551.501 - Overtime pay.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Overtime pay. 551.501 Section 551.501 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Overtime Pay Provisions Basic Provisions § 551.501 Overtime pay. (a) An...

  13. 28 CFR 345.56 - Vacation pay.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Vacation pay. 345.56 Section 345.56 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.56 Vacation pay. Inmate workers are granted FPI vacation pay by the SOI when their...

  14. 75 FR 18133 - Pay for Sunday Work

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-09

    ... OF PERSONNEL MANAGEMENT 5 CFR Part 550 RIN 3206-AM08 Pay for Sunday Work AGENCY: Office of Personnel... of Sunday premium pay for work performed on Sundays. The revised Sunday premium pay regulations would... are regularly scheduled to perform work on a Sunday are entitled to Sunday premium pay for the...

  15. 5 CFR 534.503 - Pay setting.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Pay setting. 534.503 Section 534.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.503 Pay setting. (a) Each agency with positions subject to this subpart...

  16. 28 CFR 345.55 - Longevity pay.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Longevity pay. 345.55 Section 345.55... (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.55 Longevity pay. (a) Except as provided in paragraph (b) of this section, an inmate earns longevity pay raises after 18 months spent in FPI work...

  17. 28 CFR 345.55 - Longevity pay.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Longevity pay. 345.55 Section 345.55... (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.55 Longevity pay. (a) Except as provided in paragraph (b) of this section, an inmate earns longevity pay raises after 18 months spent in FPI work...

  18. 28 CFR 345.55 - Longevity pay.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Longevity pay. 345.55 Section 345.55... (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.55 Longevity pay. (a) Except as provided in paragraph (b) of this section, an inmate earns longevity pay raises after 18 months spent in FPI work...

  19. 28 CFR 345.55 - Longevity pay.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Longevity pay. 345.55 Section 345.55... (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.55 Longevity pay. (a) Except as provided in paragraph (b) of this section, an inmate earns longevity pay raises after 18 months spent in FPI work...

  20. 28 CFR 345.55 - Longevity pay.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Longevity pay. 345.55 Section 345.55... (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.55 Longevity pay. (a) Except as provided in paragraph (b) of this section, an inmate earns longevity pay raises after 18 months spent in FPI work...

  1. 28 CFR 345.60 - Training pay.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Training pay. 345.60 Section 345.60... (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.60 Training pay. Inmates directed by the SOI to take a particular type of training in connection with a FPI job are to receive FPI pay if...

  2. An Update on the 2006-7 Pay of Presidents at Public Institutions

    ERIC Educational Resources Information Center

    Fain, Paul

    2007-01-01

    Over the past decade, an increasing number of public institutions have raised the pay and benefits of presidents with contributions from private sources, including foundations. This article presents the findings of a survey conducted by "The Chronicle" that reflected this trend. The median compensation for public-university presidents included in…

  3. 5 CFR 550.604 - Biweekly pay periods and computation of pay.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Biweekly pay periods and computation of pay. 550.604 Section 550.604 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Computation of Pay for Biweekly Pay Periods § 550.604 Biweekly...

  4. 5 CFR 550.604 - Biweekly pay periods and computation of pay.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Biweekly pay periods and computation of pay. 550.604 Section 550.604 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Computation of Pay for Biweekly Pay Periods § 550.604 Biweekly...

  5. 5 CFR 534.305 - Pay periods and computation of pay.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Pay periods and computation of pay. 534.305 Section 534.305 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Basic Pay for Employees of Temporary Organizations § 534.305 Pay periods...

  6. 5 CFR 534.305 - Pay periods and computation of pay.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Pay periods and computation of pay. 534.305 Section 534.305 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Basic Pay for Employees of Temporary Organizations § 534.305 Pay periods...

  7. Pay modernisation and healthcare governance.

    PubMed

    Benton, David C

    Policies interact and have direct and indirect consequences resulting in both short-term and longer-term effects on the working lives of professionals, the care they offer and the education needed by future generations of staff. This article explores how pay modernisation could result in benefits and risks for corporate, clinical and staff governance. It is argued that if pay modernisation as a major enabler of service redesign is to succeed then far greater understanding of how various policies interact and their potential consequences is required. PMID:15473207

  8. Willingness to pay for improvements in drinking water quality

    NASA Astrophysics Data System (ADS)

    Jordan, Jeffrey L.; Elnagheeb, Abdelmoneim H.

    1993-02-01

    In this paper, data from a 1991 survey of Georgia residents were used to study people's willingness to pay (WTP) for improvements in drinking water quality and people's perceptions of potential groundwater contamination. Results showed that 27% of the respondents served by public water supplies rated drinking water quality as poor, and 23% were uncertain about their drinking water quality. The contingent valuation method was used to estimate WTP using a checklist format. The median estimated WTP was 5.49 per month above their current water bills for people on public systems and 7.38 for those using private wells, after rejecting outliers and using the maximum likelihood method. The aggregate WTP for all of Georgia was estimated to be about 111.5 million per year for public water users and 42.3 million per year for private well owners. This aggregate WTP can serve as an estimate of benefits to consumers from improvements in drinking water quality statewide.

  9. Private expenditure and the role of private health insurance in Greece: status quo and future trends.

    PubMed

    Siskou, Olga; Kaitelidou, Daphne; Economou, Charalampos; Kostagiolas, Peter; Liaropoulos, Lycourgos

    2009-10-01

    The health care system in Greece is financed in almost equal proportions by public and private sources. Private expenditure, consists mostly of out-of-pocket and under-the-table payments. Such payments strongly suggest dissatisfaction with the public system, due to under financing during the last 25 years. This gap has been filled rapidly by the private sector. From this point of view, one might suggest that the flourishing development of private provision may lead in turn to a corresponding growth in private health insurance (PHI). This paper aims to examine the role of PHI in Greece, to identify the factors influencing its development, and to make some suggestions about future policies and trends. In the decade of 1985-1995 PHI show increasing activity, reflecting the intention of some citizens to seek health insurance solutions in the form of supplementary cover in order to ensure faster access, better quality of services, and increased consumer choice. The benefits include programs covering hospital expenses, cash benefits, outpatient care expenses, disability income insurance, as well as limited managed care programs. However, despite recent interest, PHI coverage remains low in Greece compared to other EU countries. Economic, social and cultural factors such as low average household income, high unemployment, obligatory and full coverage by social insurance, lead to reluctance to pay for second-tier insurance. Instead, there is a preference to pay a doctor or hospital directly even in the form of under-the-table payments (which are remarkably high in Greece), when the need arises. There are also factors endogenous to the PHI industry, related to market policies, low organisational capacity, cream skimming, and the absence of insurance products meeting consumer requirements, which explain the relatively low state of development of PHI in Greece. PMID:19593628

  10. Public private partnership in vascular surgery

    PubMed Central

    Mendes, Cynthia de Almeida; Martins, Alexandre de Arruda; Teivelis, Marcelo Passos; Kuzniec, Sérgio; Wolosker, Nelson

    2014-01-01

    Objective To describe and analyze the results of a public-private partnership between the Ministry of Health and a private hospital in a project of assistance and scientific research in the field of endovascular surgery. Methods: The flows, costs and clinical outcomes of patients treated in a the public-private partnership between April 2012 and July 2013 were analyzed. All patients underwent surgery and stayed at least one day at the intensive care unit of the private hospital. They also participated in a research protocol to compare two intravenous contrast media used in endovascular surgery (iodinated contrast and carbon dioxide). Results A total of 62 endovascular procedures were performed in 57 patients from the public healthcare system. Hospital and endovascular supplies expenses were significantly higher as compared to the amount paid by the Unified Health System (SUS - Sistema Único de Saúde) in two out of three disease groups studied. Among outpatients, the average interval between appointment and surgery was 15 days and, in hospitalized patients 7 days. All procedures were successful with no conversion to open surgery. The new contrast medium studied - carbon dioxide – was effective and cheaper. Conclusion The waiting time for patients between indication and accomplishment of surgery was significantly reduced. Public-private partnerships can speed up care of patients from public health services, and generate and improve scientific knowledge. PMID:25295457

  11. Public Values, Private Schools.

    ERIC Educational Resources Information Center

    Devins, Neal E.

    Controversy surrounding private education involves questions of compulsory education's role in inculcating values, how much alike public and private schools should be, and the duty of educational institutions to conform to constitutional norms. This book examines government regulation and resistance, legislative and judicial approaches, and issues…

  12. Private Speech in Ballet

    ERIC Educational Resources Information Center

    Johnston, Dale

    2006-01-01

    Authoritarian teaching practices in ballet inhibit the use of private speech. This paper highlights the critical importance of private speech in the cognitive development of young ballet students, within what is largely a non-verbal art form. It draws upon research by Russian psychologist Lev Vygotsky and contemporary socioculturalists, to…

  13. The Limits of Privatization.

    ERIC Educational Resources Information Center

    Starr, Paul

    Transferring public services and public assets to private ownership is not an entirely new idea. Governments at all levels in the United States have for years contracted out many services. However, under the recently coined label "privatization," such policies now come recommended as a more comprehensive approach to the problems of modern…

  14. Women and Private Pensions.

    ERIC Educational Resources Information Center

    Benson, Helene A.

    This speech focuses on women and private pension plans, such as private pension coverage and smaller benefit amounts. Pension issues affecting women as employees include participation in plans, vesting, break-in service, benefit accruals, integration with Social Security, sex-based actuarial tables, portability, inflation, and individual…

  15. Dialogue on private events

    PubMed Central

    Palmer, David C.; Eshleman, John; Brandon, Paul; Layng, T. V. Joe; McDonough, Christopher; Michael, Jack; Schoneberger, Ted; Stemmer, Nathan; Weitzman, Ray; Normand, Matthew

    2004-01-01

    In the fall of 2003, the authors corresponded on the topic of private events on the listserv of the Verbal Behavior Special Interest Group. Extracts from that correspondence raised questions about the role of response amplitude in determining units of analysis, whether private events can be investigated directly, and whether covert behavior differs from other behavior except in amplitude. Most participants took a cautious stance, noting not only conceptual pitfalls and empirical difficulties in the study of private events, but doubting the value of interpretive exercises about them. Others argued that despite such obstacles, in domains where experimental analyses cannot be done, interpretation of private events in the light of laboratory principles is the best that science can offer. One participant suggested that the notion that private events can be behavioral in nature be abandoned entirely; as an alternative, the phenomena should be reinterpreted only as physiological events. PMID:22477293

  16. 26 CFR 301.6685-1 - Assessable penalties with respect to private foundations' failure to comply with section 6104(d).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... foundations' failure to comply with section 6104(d). 301.6685-1 Section 301.6685-1 Internal Revenue INTERNAL... Additional Amounts § 301.6685-1 Assessable penalties with respect to private foundations' failure to comply... private foundations' annual returns, and who fails so to comply, if such failure is willful, shall pay...

  17. 26 CFR 301.6685-1 - Assessable penalties with respect to private foundations' failure to comply with section 6104(d).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... foundations' failure to comply with section 6104(d). 301.6685-1 Section 301.6685-1 Internal Revenue INTERNAL... Additional Amounts § 301.6685-1 Assessable penalties with respect to private foundations' failure to comply... private foundations' annual returns, and who fails so to comply, if such failure is willful, shall pay...

  18. 26 CFR 301.6685-1 - Assessable penalties with respect to private foundations' failure to comply with section 6104(d).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... foundations' failure to comply with section 6104(d). 301.6685-1 Section 301.6685-1 Internal Revenue INTERNAL... Additional Amounts § 301.6685-1 Assessable penalties with respect to private foundations' failure to comply... private foundations' annual returns, and who fails so to comply, if such failure is willful, shall pay...

  19. 26 CFR 301.6685-1 - Assessable penalties with respect to private foundations' failure to comply with section 6104(d).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... foundations' failure to comply with section 6104(d). 301.6685-1 Section 301.6685-1 Internal Revenue INTERNAL... Additional Amounts § 301.6685-1 Assessable penalties with respect to private foundations' failure to comply... private foundations' annual returns, and who fails so to comply, if such failure is willful, shall pay...

  20. 26 CFR 301.6685-1 - Assessable penalties with respect to private foundations' failure to comply with section 6104(d).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... foundations' failure to comply with section 6104(d). 301.6685-1 Section 301.6685-1 Internal Revenue INTERNAL... Additional Amounts § 301.6685-1 Assessable penalties with respect to private foundations' failure to comply... private foundations' annual returns, and who fails so to comply, if such failure is willful, shall pay...

  1. Donating the Voucher: An Alternative Tax Treatment of Private School Enrollment. Research Briefs in Economic Policy, Number 1

    ERIC Educational Resources Information Center

    Samwick, Andrew

    2014-01-01

    In the United States, parents send about 10 percent of elementary and secondary school-age children to private schools, which through their accreditation meet the requirement that students receive an adequate education. By paying out of pocket for their children's private education, these families relieve a financial burden on local, state, and…

  2. The Problem with Performance Pay

    ERIC Educational Resources Information Center

    Gratz, Donald B.

    2009-01-01

    Although today's performance pay plans take many forms, the most commonly proposed version--in which teachers are rewarded on the basis of their students' standardized test scores--flows from flawed logic and several troublesome assumptions: that teachers lack motivation and supposedly need financial awards to give students what they need; that…

  3. How Universities Pay Their Presidents

    ERIC Educational Resources Information Center

    Langbert, Mitchell

    2006-01-01

    Statistics show that university presidents at nondenominational and public institutions in the north make a lot more money. Presidents generally also seem to be rewarded for increasing the spending per student. Such indices of quality as "U.S. News" ranking and high SAT scores do relate to presidential pay, but not robustly, and Mitchell Langbert…

  4. Looming Questions in Performance Pay

    ERIC Educational Resources Information Center

    Gratz, Donald B.

    2010-01-01

    When proposing performance pay for teachers, reformers first must answer three questions: What is the definition of teacher performance? What is the definition of student performance? and What are the goals of schooling? Reformers also need to examine the assumptions that guide their proposals and prepare to deal with the implementation issues…

  5. Performance Pay Path to Improvement

    ERIC Educational Resources Information Center

    Gratz, Donald B.

    2011-01-01

    The primary goal of performance pay for the past decade has been higher test scores, and the most prominent strategy has been to increase teacher performance through financial incentives. If teachers are rewarded for success, according to this logic, they will try harder. If they try harder, more children will achieve higher test scores. The…

  6. History of Pay Equity Studies.

    ERIC Educational Resources Information Center

    Barbezat, Debra A.

    2002-01-01

    Traces the evolution of salary-equity studies over time, and how the findings have changed with regard to pay differences by gender and race/ethnicity. Reviews the literature on salary equity for both faculty and nonfaculty academic employees. (EV)

  7. Pay for Performance: Whose Performance?

    ERIC Educational Resources Information Center

    Tienken, Christopher H.

    2011-01-01

    Education reform proposals are not in short supply. Recent issues of the "Kappa Delta Pi Record" examined two of these: Common Core State Standards (Winter 2011) and Charter Schools (Spring 2011). Teacher pay for performance is another policy gaining traction in state legislatures and at the federal level. The Race to the Top (RTTT) federal grant…

  8. Pay-for-Performance Incentives: Holy Grail or Sippy Cup?

    PubMed

    Caveney, Brian J

    2016-01-01

    The health care system is slowly evolving from fee-for-service care to other forms of payment. Pay-for-performance contracts based on quality, patient satisfaction, and utilization are an important development along the continuum. The metrics are not perfect and do not always nudge clinicians to improve their performance, but many outcomes are likely to improve. PMID:27422948

  9. Medicare Pays for End-of-Life Consults.

    PubMed

    Sorrel, Amy Lynn

    2016-01-01

    As of January, Medicare pays physicians for advance care planning as a separate service, a long-sought victory that promotes educating patients and physicians on the issue. The Centers for Medicare & Medicaid Services created two new payment codes that cover it as a separate service in physician practices and facilities, including hospitals. PMID:27295289

  10. Willingness to pay for genetic testing for inherited retinal disease

    PubMed Central

    Tubeuf, Sandy; Willis, Thomas A; Potrata, Barbara; Grant, Hilary; Allsop, Matthew J; Ahmed, Mushtaq; Hewison, Jenny; McKibbin, Martin

    2015-01-01

    This paper investigates the willingness of adults with inherited retinal disease to undergo and pay for diagnostic genetic testing in three hypothetical scenarios and to explore the factors that influence decision making. Fifty patients were presented with three scenarios whereby genetic testing provided increasing information: confirming the diagnosis and inheritance pattern alone, providing additional information on future visual function, and identifying in addition a new treatment which could stabilise their condition. Willingness to pay (WTP) was elicited using an iterative bidding game. Regression analysis was used to investigate the probability of agreeing to and paying for testing. Qualitative data were also reviewed to provide a comprehensive understanding of WTP and decision making. The majority of participants agreed to undergo genetic testing in each of the three scenarios. Scenario 2 was the least acceptable with 78% of participants agreeing to genetic testing. The probability of agreeing to genetic testing decreased with age. Between 72 and 96% of participants reported a WTP for genetic testing. Average WTP was £539, £1516, and £6895 for scenarios 1, 2, and 3 respectively. Older participants and participants with higher incomes were willing to pay more for testing. Qualitative data provided additional detail about the rationale behind participants' decisions. The study suggests that patients with inherited retinal disease were willing to undergo and to pay for diagnostic genetic testing, suggesting that they valued the information it may provide. However, several patients preferred not to receive prognostic information and were less willing to pay for genetic testing that yielded such detail. PMID:24916649