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Sample records for administrative health care

  1. Grading the Clinton administration's health care team.

    PubMed

    1994-01-01

    Where health reform ends up this year--or next--is anyone's guess. But no one can dispute the enormous role the Clinton White House has played in getting the ball rolling. Even the Clintons' most ardent foes (and there are more than a few) acknowledge that the President and First Lady Hillary Rodham Clinton deserve enormous credit for putting the complex issue high on the public and political agenda. With those extra-credit points safely assured, the editorial staff of the Journal of American Health Policy is grading the efforts of 10 top health officials in the Clinton Administration. Our 1994 report card reflects individuals' leadership ability, credibility in dealing with the public, willingness to compromise, and role in improving health care for all Americans. PMID:10136683

  2. The Potential Use of Health Care Financing Administration Data Sets for Health Care Services Research

    PubMed Central

    Lave, Judith; Dobson, Allen; Walton, Carol

    1983-01-01

    Administrative Record Systems may be an overlooked source of data for health services researchers. Through its administration of the Medicare and Medicaid Programs, the Health Care Financing Administration (HCFA) routinely receives data on items such as its beneficiary population, providers certified to deliver care to its beneficiary population, providers certified to deliver care to the beneficiaries, the use of services and reimbursements to providers. This article introduces the reader to the HCFA data, it describes the most important data bases that are useful for research, their relative strengths and weaknesses and the extent to which they are available to outside users. PMID:10310280

  3. The paradox of physicians and administrators in health care organizations.

    PubMed

    Peirce, J C

    2000-01-01

    Rapidly changing times in health care challenge both physicians and health care administrators to manage the paradox of providing orderly, high quality, and efficient care while bringing forth innovations to address present unmet problems and surprises that emerge. Health care has grown throughout the past several centuries through differentiation and integration, becoming a highly complex biological system with the hospital as the central attractive force--or "strange attractor"--during this century. The theoretical model of complex adaptive systems promises more effective strategic direction in addressing these chaotic times where the new strange attractor moves beyond the hospital. PMID:10710724

  4. Teaching Health Care Administration in Athletic Training: A Unique Approach

    ERIC Educational Resources Information Center

    Sage, Bradley W.

    2013-01-01

    Health care administration is a challenging topic to teach due to the inability for students to directly engage in many of the activities such as insurance billing, inventory, and ordering equipment and supplies. The objective of this article is to describe how a discussion-based meeting format can be used to engage students in health care…

  5. Expectations and outcome skills of a generalist health care administrator.

    PubMed

    Jones, V B; Taylor, L C

    1990-01-01

    The question of the degree of technical versus managerial competence to be found in future graduates from health administration programs is not easily resolved. In the HIMSS 1988 survey of CIOs the attributes needed for success are listed in descending rank order as follows: leadership ability, vision/imagination, knowledge of hospital systems, business acumen, decisiveness, and technical competence. CIOs ranked technical competence as less important than other attributes associated with general management success. The expectations for attitudes, knowledge, and skills presented in this article support the greater importance of management abilities relative to pure technical competence. However, it is vital that an appropriate level of technical knowledge and skill be maintained to enable future alumni of health administration programs to function effectively as administrators. Depending on their role in a health care organization, greater or lesser technical knowledge may be needed. Those pursuing a career path toward CIO must, of necessity, have greater technical knowledge and skill. We have discussed necessary and expected attitudes, knowledge, and skills that will be needed by the generalist health administration graduate in the future. It will be important to develop and maintain an attitude that MIS is a strategic tool, that health care technology is a corporate asset, and that information is power. Graduates must recognize the necessity of maintaining and enhancing their knowledge and skills through continuing education. The knowledge base of MIS education should focus on determining information needs to support strategic goals, understanding of general systems theory, principles of systems analysis, design, implementation and maintenance, awareness and exposure to standard application software, and an awareness of external sources of data.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10106375

  6. HIPAA administrative simplification: standard unique health identifier for health care providers. Final rule.

    PubMed

    2004-01-23

    This final rule establishes the standard for a unique health identifier for health care providers for use in the health care system and announces the adoption of the National Provider Identifier (NPI) as that standard. It also establishes the implementation specifications for obtaining and using the standard unique health identifier for health care providers. The implementation specifications set the requirements that must be met by "covered entities": Health plans, health care clearinghouses, and those health care providers who transmit any health information in electronic form in connection with a transaction for which the Secretary has adopted a standard (known as "covered health care providers"). Covered entities must use the identifier in connection with standard transactions. The use of the NPI will improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the health care system and enabling the efficient electronic transmission of certain health information. This final rule implements some of the requirements of the Administrative Simplification subtitle F of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). PMID:14968800

  7. Interest in Long-Term Care among Health Services Administration Students

    ERIC Educational Resources Information Center

    Temple, April; Thompson, Jon M.

    2011-01-01

    The aging of the population has created increased opportunities for health administrators in long-term care. This study consisted of a cross-sectional survey of 68 undergraduate health services administration students to explore factors related to interest in a career in long-term care administration. One third expressed interest working in the…

  8. The impact of decentralization of health care administration on equity in health and health care in Canada.

    PubMed

    Zhong, Hai

    2010-09-01

    In this paper, we examine the impact of decentralization of health care administration on inequity in health care access in Canada. We extend previous studies in two ways. First, to explore the spatial dimension of inequity, we adopt a perfect decomposable inequality measure--the Theil index--in our analysis. Secondly, we conduct a before and after comparison of a change in the degree of decentralization in Canada--the introduction of the CHST in 1996/1997. This may shed some lights on the casual relationship between decentralization and health-related inequity. The results of our analysis show that the overall inequity in health care utilization is mostly explained by variations within provinces in Canada. The increase in the degree of decentralization is related to lower degree of overall and within-province inequity in the use of GP and hospital services, and lower between-province inequity in the use of all the three health care variables examined in this paper. PMID:20217473

  9. Informatics Resources to Support Health Care Quality Improvement in the Veterans Health Administration

    PubMed Central

    Hynes, Denise M.; Perrin, Ruth A.; Rappaport, Steven; Stevens, Joanne M.; Demakis, John G.

    2004-01-01

    Information systems are increasingly important for measuring and improving health care quality. A number of integrated health care delivery systems use advanced information systems and integrated decision support to carry out quality assurance activities, but none as large as the Veterans Health Administration (VHA). The VHA's Quality Enhancement Research Initiative (QUERI) is a large-scale, multidisciplinary quality improvement initiative designed to ensure excellence in all areas where VHA provides health care services, including inpatient, outpatient, and long-term care settings. In this paper, we describe the role of information systems in the VHA QUERI process, highlight the major information systems critical to this quality improvement process, and discuss issues associated with the use of these systems. PMID:15187063

  10. Project TEAMS (Techniques and Education for Achieving Management Skills): Health Care Administrators.

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

    These Project TEAMS (Techniques and Education for Achieving Management Skills) instructional materials consist of five units for use in training health care administrators. Unit 1 contains materials designed to help the health care administrators increase their management skills in regard to self-awareness, time management, problem solving,…

  11. Health Care Reform and Its Implications for the Administrative Sciences.

    ERIC Educational Resources Information Center

    Kolassa, E. M.

    1994-01-01

    It is argued that the discipline of pharmacoeconomics has much to offer the pharmacy field during a period of health care reform but that these specialists must let their colleagues in related fields know how they can assist in facilitating change. (MSE)

  12. Examining Phenomenon of the Administrative Burden in Health Care, Allied Health, and Respiratory Care.

    PubMed

    Heuer, Albert J; Parrott, James S; Percival, Dreina; Kacmarek, Robert M

    2016-01-01

    Documentation expectations for allied health professional appears to have changed dramatically in the past decade. The purpose of this essay is to discuss the literature related to clinician perceptions of these documentation expectations and changes in the workload attributable to such administrative duties, review the results of a recent pilot project surveying respiratory therapists' perception of documentation, and reflect upon the potential ramifications of excessive documentation. This commentary also discusses some recommendations for the future in terms of the design of documentation systems and the need for additional research to further explore this area. PMID:27262474

  13. 77 FR 1555 - Administrative Simplification: Adoption of Standards for Health Care Electronic Funds Transfers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-10

    ... regulatory history, see the August 22, 2008 (73 FR 49742) proposed rule entitled ``Health Insurance Reform..., 2000 Federal Register (65 FR 50312), we published a final rule entitled ``Health Insurance Reform... and 162 Administrative Simplification: Adoption of Standards for Health Care Electronic...

  14. Access to Care for Transgender Veterans in the Veterans Health Administration: 2006–2013

    PubMed Central

    Shipherd, Jillian C.; Lindsay, Jan; Blosnich, John R.; Brown, George R.; Jones, Kenneth T.

    2014-01-01

    A 2011 Veterans Health Administration directive mandated medically necessary care for transgender veterans. Internal education efforts informed staff of the directive and promoted greater access to care. For fiscal years 2006 through 2013, we identified 2662 unique individuals with International Classification of Diseases, Ninth Revision diagnoses related to transgender status in Veterans Health Administration medical records, with 40% of new cases in the 2 years following the directive. A bottom-up push for services by veterans and top-down education likely worked synergistically to speed implementation of the new policy and increase access to care. PMID:25100417

  15. Sustainability in Primary Care and Mental Health Integration Projects in Veterans Health Administration

    PubMed Central

    Ford, James H.; Krahn, Dean; Oliver, Karen Anderson; Kirchner, JoAnn

    2015-01-01

    Objective To explore staff perceptions about sustainability, commitment to change, participation in change process, and information received about the change project within the Veterans Administration Primary Care and Mental Health Integration (PC-MHI) initiative and to examine differences from the Veterans Health Administration Mental Health Systems Redesign (MHSR) initiative. Data Sources Surveys of change team members involved in the Veterans Affairs PC-MHI and MHSR initiatives. Study Design One-way analysis of variance examined the relationship between commitment, participation and information, and sustainability. Differences in PC-MHI sustainability were explored by location and job classification. Staff sustainability perceptions were compared with MHSR results. Principal Findings Sustainability differed by staff discipline. Difference between MHSR and PC-MHI existed by job function and perceptions about the change benefits. Participation in the change process and information received about the change process were positively correlated with sustainability. Staff commitment to change was positively associated with staff perceptions about the benefits of change and staff attitudes toward change. Conclusions Sustainability is an important part of organizational change efforts. Change complexity seems to influence perception about sustainability and impacts staff perceptions about the benefits of change. These perceptions seem to be driven by the information received and opportunities to participate in the change process. Further research is needed to understand how information and participation influence sustainability and affect employee commitment to change. PMID:23011071

  16. Integrating Hospital Administrative Data to Improve Health Care Efficiency and Outcomes: “The Socrates Story”

    PubMed Central

    Lawrence, Justin; Delaney, Conor P.

    2013-01-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes. PMID:24436649

  17. Integrating hospital administrative data to improve health care efficiency and outcomes: "the socrates story".

    PubMed

    Lawrence, Justin; Delaney, Conor P

    2013-03-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes. PMID:24436649

  18. Health Care Administrators. Project TEAMS. (Techniques and Education for Achieving Management Skills).

    ERIC Educational Resources Information Center

    Platte Technical Community Coll., Columbus, NE.

    The result of a project to develop short courses to help health care administrators and supervisors in developing practical, up-to-date management skills, this instructional workbook provides information and exercises applicable to on-the-job situations. Unit I covers the following leadership considerations: self-awareness, time management,…

  19. Physical and Mental Health and Access to Care among Nonmetropolitan Veterans Health Administration Patients Younger than 65 Years

    ERIC Educational Resources Information Center

    West, Alan; Weeks, William B.

    2006-01-01

    Context: The 4.5 million military veterans treated by the Veterans Health Administration (VA) are believed to experience poorer physical and mental health than nonveterans. Furthermore, nonmetropolitan residents have less access to medical services, whether or not they are veterans in VA care. A direct comparison of metropolitan and…

  20. Veterans Health Administration and Medicare Outpatient Health Care Utilization by Older Rural and Urban New England Veterans

    ERIC Educational Resources Information Center

    Weeks, William B.; Bott, David M.; Lamkin, Rebecca P.; Wright, Steven M.

    2005-01-01

    Older veterans often use both the Veterans Health Administration (VHA) and Medicare to obtain health care services. The authors sought to compare outpatient medical service utilization of Medicare-enrolled rural veterans with their urban counterparts in New England. The authors combined VHA and Medicare databases and identified veterans who were…

  1. Implementing a patient centered medical home in the Veterans health administration: Perspectives of primary care providers.

    PubMed

    Solimeo, Samantha L; Stewart, Kenda R; Stewart, Gregory L; Rosenthal, Gary

    2014-12-01

    Implementation of a patient centered medical home challenges primary care providers to change their scheduling practices to enhance patient access to care as well as to learn how to use performance metrics as part of a self-reflective practice redesign culture. As medical homes become more commonplace, health care administrators and primary care providers alike are eager to identify barriers to implementation. The objective of this study was to identify non-technological barriers to medical home implementation from the perspective of primary care providers. We conducted qualitative interviews with providers implementing the medical home model in Department of Veterans Affairs clinics-the most comprehensive rollout to date. Primary care providers reported favorable attitudes towards the model but discussed the importance of data infrastructure for practice redesign and panel management. Respondents emphasized the need for administrative leadership to support practice redesign by facilitating time for panel management and recognizing providers who utilize non-face-to-face ways of delivering clinical care. Health care systems considering adoption of the medical home model should ensure that they support both technological capacities and vertically aligned expectations for provider performance. PMID:26250631

  2. Organizational correlates of implementation of colocation of mental health and primary care in the Veterans Health Administration.

    PubMed

    Guerrero, Erick G; Heslin, Kevin C; Chang, Evelyn; Fenwick, Karissa; Yano, Elizabeth

    2015-07-01

    This study explored the role of organizational factors in the ability of Veterans Health Administration (VHA) clinics to implement colocated mental health care in primary care settings (PC-MH). The study used data from the VHA Clinical Practice Organizational Survey collected in 2007 from 225 clinic administrators across the United States. Clinic degree of implementation of PC-MH was the dependent variable, whereas independent variables included policies and procedures, organizational context, and leaders' perceptions of barriers to change. Pearson bivariate correlations and multivariable linear regression were used to test hypotheses. Results show that depression care training for primary care providers and clinics' flexibility and participation were both positively correlated with implementation of PC-MH. However, after accounting for other factors, regressions show that only training primary care providers in depression care was marginally associated with degree of implementation of PC-MH (p = 0.051). Given the importance of this topic for implementing integrated care as part of health care reform, these null findings underscore the need to improve theory and testing of more proximal measures of colocation in future work. PMID:25096986

  3. Organizational Correlates of Implementation of Colocation of Mental Health and Primary Care in the Veterans Health Administration

    PubMed Central

    Guerrero, Erick G.; Heslin, Kevin C.; Chang, Evelyn; Fenwick, Karissa; Yano, Elizabeth

    2014-01-01

    This study explored the role of organizational factors in the ability of Veterans Health Administration (VHA) clinics to implement colocated mental health care in primary care settings (PC-MH). The study used data from the VHA Clinical Practice Organizational Survey collected in 2007 from 225 clinic administrators across the United States. Clinic degree of implementation of PC-MH was the dependent variable, whereas independent variables included policies and procedures, organizational context, and leaders’ perceptions of barriers to change. Pearson bivariate correlations and multivariable linear regression were used to test hypotheses. Results show that depression care training for primary care providers and clinics’ flexibility and participation were both positively correlated with implementation of PC-MH. However, after accounting for other factors, regressions show that only training primary care providers in depression care was marginally associated with degree of implementation of PC-MH (p = 0.051). Given the importance of this topic for implementing integrated care as part of health care reform, these null findings underscore the need to improve theory and testing of more proximal measures of colocation in future work. PMID:25096986

  4. Exploring the link between ambulatory care and avoidable hospitalizations at the Veteran Health Administration.

    PubMed

    Pracht, Etienne E; Bass, Elizabeth

    2011-01-01

    This paper explores the link between utilization of ambulatory care and the likelihood of rehospitalization for an avoidable reason in veterans served by the Veteran Health Administration (VA). The analysis used administrative data containing healthcare utilization and patient characteristics stored at the national VA data warehouse, the Corporate Franchise Data Center. The study sample consisted of 284 veterans residing in Florida who had been hospitalized at least once for an avoidable reason. A bivariate probit model with instrumental variables was used to estimate the probability of rehospitalization. Veterans who had at least 1 ambulatory care visit per month experienced a significant reduction in the probability of rehospitalization for the same avoidable hospitalization condition. The findings suggest that ambulatory care can serve as an important substitute for more expensive hospitalization for the conditions characterized as avoidable. PMID:21385280

  5. Assisted living facility administrator and direct care staff views of resident mental health concerns and staff training needs.

    PubMed

    Dakin, Emily; Quijano, Louise M; McAlister, Courtney

    2011-01-01

    This community needs assessment surveyed 21 administrators and 75 direct care staff at 9 larger and 12 smaller assisted living facilities (ALFs) regarding perceptions of resident mental health concerns, direct care staff capacity to work with residents with mental illness, and direct care staff training needs. Group differences in these perceptions were also examined. Both administrators and directcare staff indicated that direct care staff would benefit from mental health-related training, and direct care staff perceived themselves as being more comfortable working with residents with mental illness than administrators perceived them to be. Implications for gerontological social work are discussed. PMID:21170779

  6. Using geographic information system tools to improve access to MS specialty care in Veterans Health Administration.

    PubMed

    Culpepper, William J; Cowper-Ripley, Diane; Litt, Eric R; McDowell, Tzu-Yun; Hoffman, Paul M

    2010-01-01

    Access to appropriate and timely healthcare is critical to the overall health and well-being of patients with chronic diseases. In this study, we used geographic information system (GIS) tools to map Veterans Health Administration (VHA) patients with multiple sclerosis (MS) and their access to MS specialty care. We created six travel-time bands around VHA facilities with MS specialty care and calculated the number of VHA patients with MS who resided in each time band and the number of patients who lived more than 2 hours from the nearest specialty clinic in fiscal year 2007. We demonstrate the utility of using GIS tools in decision-making by providing three examples of how patients' access to care is affected when additional specialty clinics are added. The mapping technique used in this study provides a powerful and valuable tool for policy and planning personnel who are evaluating how to address underserved populations and areas within the VHA healthcare system. PMID:20848371

  7. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

    PubMed

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A

    2016-03-01

    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation. PMID:25414376

  8. Health care administration in the year 2000: practitioners' views of future issues and job requirements.

    PubMed

    Hudak, R P; Brooke, P P; Finstuen, K; Riley, P

    1993-01-01

    This research identifies the most important domains in health care administration (HCA) from now to the year 2000 and differentiates job skill, knowledge, and ability requirements necessary for successful management. Fellows of the American College of Healthcare Executives from about half of the United States responded to two iterations of a Delphi mail inquiry. Fellows identified 102 issues that were content-analyzed into nine domains by an HCA expert panel. Domains, in order of ranked importance, were cost/finance, leadership, professional staff interactions, health care delivery concepts, accessibility, ethics, quality/risk management, technology, and marketing. In the second Delphi iteration, Fellows reviewed domain results and rated job requirements on required job importance. Results indicated that while a business orientation is needed for organizational survival, an equal emphasis on person-oriented skills, knowledge, and abilities is required. PMID:10126189

  9. 38 CFR 3.360 - Service-connected health-care eligibility of certain persons administratively discharged under...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Service-connected health-care eligibility of certain persons administratively discharged under other than honorable condition. (a) General. The health-care and related benefits authorized by chapter 17 of title 38... bars listed in § 3.12(c) applies. (c) Eligibility criteria. In making determinations of...

  10. Final Report on the Development of a Baccalaureate External Degree Program in Health Services Administration With a Major in Long Term Care Administration.

    ERIC Educational Resources Information Center

    Kleppick, Annabelle L.; And Others

    A project undertaken at the Graduate School of Public Health of the University of Pittsburgh to develop an undergraduate external degree program in health services administration with a major in long-term care administration is described. Program activities were designed to: develop a work plan, identify the parameters of knowledge and skills…

  11. Ensuring Appropriate Care for LGBT Veterans in the Veterans Health Administration.

    PubMed

    Sharpe, Virginia Ashby; Uchendu, Uchenna S

    2014-09-01

    Within health care systems, negative perceptions of lesbian, gay, bisexual, and transgender persons have often translated into denial of services, denial of visitation rights to same-sex partners, reluctance on the part of LGBT patients to share personal information, and failure of workers to assess and recognize the unique health care needs of these patients. Other bureaucratic forms of exclusion have included documents, forms, and policies that fail to acknowledge a patient's valued relationships because of, for example, a narrow definition of "spouse," "parent," or "family." Bureaucratic exclusion has taken a particularly prominent form in the U.S. military. Until its repeal and termination in 2011, the "Don't Ask, Don't Tell" policy had for eighteen years barred openly gay men and lesbians from serving in the military. Among the effects of DADT is a dearth of information about the number and needs of LGBT service members who transition to the Veterans Health Administration for health care at the end of their military service. The long-standing social stigma against LGBT persons, the silence mandated by DADT, and the often unrecognized bias built into the fabric of bureaucratic systems make the task of creating a welcoming culture in the VHA urgent and challenging. The VHA has accepted a commitment to that task. Its Strategic Plan for fiscal years 2013 through 2018 stipulates that "[v]eterans will receive timely, high quality, personalized, safe, effective and equitable health care irrespective of geography, gender, race, age, culture or sexual orientation." To achieve this goal, the VHA undertook a number of coordinated initiatives to create an environment and culture that is informed, welcoming, positive, and empowering for the LGBT veterans and families whom the agency serves. PMID:25231789

  12. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.

    PubMed

    Sperber, Nina R; Andrews, Sara M; Voils, Corrine I; Green, Gregory L; Provenzale, Dawn; Knight, Sara

    2016-01-01

    We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC), but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines. PMID:27136589

  13. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration

    PubMed Central

    Sperber, Nina R.; Andrews, Sara M.; Voils, Corrine I.; Green, Gregory L.; Provenzale, Dawn; Knight, Sara

    2016-01-01

    We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC), but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines. PMID:27136589

  14. Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care

    PubMed Central

    Brown, George R.; Shipherd, PhD, Jillian C.; Kauth, Michael; Piegari, Rebecca I.; Bossarte, Robert M.

    2013-01-01

    Objectives. We estimated the prevalence and incidence of gender identity disorder (GID) diagnoses among veterans in the Veterans Health Administration (VHA) health care system and examined suicide risk among veterans with a GID diagnosis. Methods. We examined VHA electronic medical records from 2000 through 2011 for 2 official ICD-9 diagnosis codes that indicate transgender status. We generated annual period prevalence estimates and calculated incidence using the prevalence of GID at 2000 as the baseline year. We cross-referenced GID cases with available data (2009–2011) of suicide-related events among all VHA users to examine suicide risk. Results. GID prevalence in the VHA is higher (22.9/100 000 persons) than are previous estimates of GID in the general US population (4.3/100 000 persons). The rate of suicide-related events among GID-diagnosed VHA veterans was more than 20 times higher than were rates for the general VHA population. Conclusions. The prevalence of GID diagnosis nearly doubled over 10 years among VHA veterans. Research is needed to examine suicide risk among transgender veterans and how their VHA utilization may be enhanced by new VA initiatives on transgender care. PMID:23947310

  15. 77 FR 48007 - Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-10

    ... (74 FR 3296), we published a final rule titled, ``Health Insurance Reform; Modifications to the Health... IFC (76 FR 40458). 4. Affordable Care Act: Standards and Operating Rules for Electronic Funds... implements parts of section 1104 of the Affordable Care Act which requires the adoption of operating...

  16. Medical and health administration education in managed care: needs, content and readings.

    PubMed

    Ziegenfuss, J T; Weitekamp, M

    1996-01-01

    With both public and private reform initiatives moving toward managed care, curriculum designs are timely and useful to a diverse audience. This paper discusses the need for and design of education in managed care in medical schools and health services programs. The pressures for offering education regarding managed care are derived from interests of various actors of the health system e.g. regulators, purchasers, providers and consumers. The content of education in managed care is defined in seven areas: (1) managed care and health systems design-history and concepts; (2) environment and governmental policy; (3) models, products, services, outcomes and quality; (4) managed care economics and finance; (5) organization and strategic management; (6) legal issues; and (7) future designs/redesigns. Education in managed care is delivered by universities, professional associations and private training and development corporations. All can benefit from a dialogue on curricular content. PMID:10166710

  17. Health care agents

    MedlinePlus

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

  18. A Case Study of Early Experience with Implementation of Collaborative Care in the Veterans Health Administration

    PubMed Central

    Kunik, Mark E.; Shepherd, Alexandra; Kirchner, JoAnn; Gottumukkala, Aruna

    2010-01-01

    Abstract Primary care remains critically important for those who suffer from mental disorders. Although collaborative care, which integrates mental health services into primary care, has been shown to be more effective than usual care, its implementation has been slow and the experience of providers and patients with collaborative care is less well known. The objective of this case study was to examine the effects of collaborative care on patient and primary care provider (PCP) experiences and communication during clinical encounters. Participating physicians completed a self-administered visit reconstruction questionnaire in which they logged details of patient visits and described their perceptions of the visits and the influence of collaborative care. Audio recordings of visits were analyzed to assess the extent of discussion about colocated mental health services and visit time devoted to mental health topics. The main outcome measures were the extent of discussion and recommendation for collaborative care during clinical visits and providers' experiences based on their responses to the visit reconstruction questionnaire. Providers surveyed expressed enthusiasm about collaborative care and cited the time constraint of office visits and lack of specialty support as the main reasons for limiting their discussion of mental health topics with patients. Despite the availability of mental health providers at the same clinic, PCPs missed many opportunities to address mental health issues with their patients. Ongoing education for PCPs regarding how to conduct a “warm handoff” to colocated providers will need to be an integral part of the implementation of collaborative care. (Population Health Management 2010;13:331–337) PMID:21090989

  19. Battlefield acupuncture: Opening the door for acupuncture in Department of Defense/Veteran's Administration health care.

    PubMed

    Walker, Patricia Hinton; Pock, Arnyce; Ling, Catherine G; Kwon, Kyung Nancy; Vaughan, Megan

    2016-01-01

    Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a number of military medical facilities throughout the Department of Defense (DoD). It has been used with anecdotal published positive impact with warriors experiencing polytrauma, post-traumatic stress disorder, and traumatic brain injury. It has also been effectively used to treat warriors with muscle and back pain from carrying heavy combat equipment in austere environments. This article highlights the history within the DoD related to the need for nonpharmacologic/opioid pain management across the continuum of care from combat situations, during evacuation, and throughout recovery and rehabilitation. The article describes the history of auricular acupuncture and details implementation procedures. Training is necessary and partially funded through DoD and Veteran's Administration (VA) internal Joint Incentive Funds grants between the DoD and the VA for multidisciplinary teams as part of a larger initiative related to the recommendations from the DoD Army Surgeon General's Pain Management Task Force. Finally, Uniformed Services University of the Health Sciences School of Medicine and Graduate School of Nursing faculty members present how this interdisciplinary training is currently being integrated into both schools for physicians and advanced practice nurses at the Uniformed Services University of the Health Sciences. Current and future research challenges and progress related to the use of acupuncture are also presented. PMID:27601311

  20. The measurement of quality of care in the Veterans Health Administration.

    PubMed

    Halpern, J

    1996-03-01

    The Veterans Health Administration (VHA) is committed to continual refinement of its system of quality measurement. The VHA organizational structure for quality measurement has three levels. At the national level, the Associate Chief Medical Director for Quality Management provides leadership, sets policy, furnishes measurement tools, develops and distributes measures of quality, and delivers educational programs. At the intermediate level, VHA has four regional offices with staff responsible for reviewing risk management data, investigating quality problems, and ensuring compliance with accreditation requirements. At the hospital level, staff reporting directly to the chief of staff or the hospital director are responsible for implementing VHA quality management policy. The Veterans Health Administration's philosophy of quality measurement recognizes the agency's moral imperative to provide America's veterans with care that meets accepted standards. Because the repair of faulty systems is more efficient than the identification of poor performers, VHA has integrated the techniques of total quality into a multifaceted improvement program that also includes the accreditation program and traditional quality assurance activities. VHA monitors its performance by maintaining adverse incident databases, conducting patient satisfaction surveys, contracting for external peer review of 50,000 records per year, and comparing process and outcome rates internally and when possible with external benchmarks. The near-term objectives of VHA include providing medical centers with a quality matrix that will permit local development of quality indicators, construction of a report card for VHA's customers, and implementing the Malcolm W. Baldrige system for quality improvement as the road map for systemwide continuous improvement. Other goals include providing greater access to data, creating a patient-centered database, providing real-time clinical decision support, and expanding the

  1. U.S. Army-Baylor University Health Care Administration Program: evidenced-based outcomes in the military health system.

    PubMed

    Mangelsdorff, A David; Rogers, Jody; Finstuen, Kenn; Pryor, Rene

    2004-01-01

    The purpose of this research is to assess the impact of an educational program on the Military Health System on some of the evidence-based educational outcomes for the Individual (student) and the Society (all Army Medical Treatment Facilities). The U.S. Army-Baylor University HCA program provides a unique opportunity to assess the impact of an educational program on the Military Health System (MHS). Since the majority of the graduate students are military officers who serve in military medical treatment facilities (MTFs), tracking their career progression allows assessing the value added of the U.S. Army-Baylor University HCA experience from 1951 to 2001 (n = 2234). The context of Society outcomes includes all the Army MTFs where U.S. Army-Baylor University HCA graduates execute their leadership skills. During the time from 1994 to 2001, all of the Army MTFs in the MHS (n = 38) were examined by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In a similar but shorter time frame (1997-2001), DoD patient satisfaction assessments were conducted. The Individual outcomes (career advancement, increase in status, higher professional association membership) demonstrate that the selection criteria used for program admission appear to be successful. The Society outcomes showed higher JCAHO scores and satisfied consumers in Army facilities with Baylor graduates as the Deputy Commander for Administration (DCA). Continued internal program assessments (curriculum reviews) and external reviews (Accrediting Commission on Education for Health Services Administration accreditations of 5 years in 1987, 8 years in 1993 and 7 years in 2001, and 7 ACHE student chapter awards) attest to the strengths of the U.S. Army-Baylor University HCA program. Educating the MHS shareholders (patients, beneficiaries, professional and support staff, senior leaders) and leveraging technology to. share best practices for all administrators (including non-Baylor graduates) will

  2. Marketers don't wear plaid: marketing and health care administration in the Canadian context.

    PubMed

    Rigby, J M; Backman, A M

    1997-01-01

    Marketing has a bad reputation among Canadian health managers, even though marketing solutions may address many of their problems. This article provides an overview of current understandings of marketing and how they may be applied to health care situations. Marketing should be considered an ongoing process. This is particularly helpful if we understand the root task of health managers as creating and promoting exchanges--with governments, physicians, nurses, other health workers and client groups. Exchanges that are desirable to the health care community will more likely occur if the true costs and benefits of health services are analyzed, understood and imaginatively communicated. The public constantly evaluates the health system. Constant evaluation implies a need for marketing directed internally at staff and those within the health system, and externally at constituents outside the system. Properly understood and practiced, marketing can be part of the innovative solutions health care managers develop and apply as they deal with the difficult challenges facing them in Canada's current health care environment. PMID:10173495

  3. How do hospital administrators perceive cardiac rehabilitation in a publicly-funded health care system?

    PubMed Central

    2013-01-01

    Background Patient and provider-related factors affecting access to cardiac rehabilitation (CR) have been extensively studied, but health-system administration factors have not. The objectives of this study were to investigate hospital administrators’ (HA) awareness and knowledge of cardiac rehabilitation (CR), perceptions regarding resources for and benefit of CR, and attitudes toward and implementation of inpatient transition planning for outpatient CR. Methods A cross-sectional and observational design was used. A survey was administered to 679 HAs through Canadian and Ontario databases. A descriptive examination was performed, and differences in HAs’ perceptions by role, institution type and presence of within-institution CR were compared using t-tests. Results 195 (28.7%) Canadian HAs completed the survey. Respondents reported good knowledge of what CR entails (mean=3.42±1.15/5). Awareness of the closest site was lower among HAs working in community versus academic institutions (3.88±1.24 vs. 4.34±0.90/5 respectively; p=.01). HAs in non-executive roles (4.77±0.46/5) perceived greater CR importance for patients’ care than executives (4.52±0.57; p=.001). HAs perceived CR programs should be situated in both hospitals and community settings (n=134, 71.7%). Conclusions HAs value CR as part of patients’ care, and are supportive of greater CR provision. Those working in community settings and executives may not be as aware of, or less-likely to value, CR services. CR leaders from academic institutions might consider liaising with community hospitals to raise awareness of CR benefits, and advocate for it with the executives in their home institutions. PMID:23537384

  4. Quantifying limitations in chemotherapy data in administrative health databases: implications for measuring the quality of colorectal cancer care.

    PubMed

    Urquhart, Robin; Rayson, Daniel; Porter, Geoffrey A; Grunfeld, Eva

    2011-08-01

    Reliable chemotherapy data are critical to evaluate the quality of care for patients with colorectal cancer who are treated with curative intent. In Canada, limitations in the availability and completeness of chemotherapy data exist in many administrative health databases. In this paper, we discuss these limitations and present findings from a chart review in Nova Scotia that quantifies the completeness of chemotherapy capture in existing databases. The results demonstrate that even basic information on cancer treatment in administrative databases can be insufficient to perform the types of analyses that most decision-makers require for quality-of-care measurement. PMID:22851984

  5. Quantifying Limitations in Chemotherapy Data in Administrative Health Databases: Implications for Measuring the Quality of Colorectal Cancer Care

    PubMed Central

    Rayson, Daniel; Porter, Geoffrey A.; Grunfeld, Eva

    2011-01-01

    Reliable chemotherapy data are critical to evaluate the quality of care for patients with colorectal cancer who are treated with curative intent. In Canada, limitations in the availability and completeness of chemotherapy data exist in many administrative health databases. In this paper, we discuss these limitations and present findings from a chart review in Nova Scotia that quantifies the completeness of chemotherapy capture in existing databases. The results demonstrate that even basic information on cancer treatment in administrative databases can be insufficient to perform the types of analyses that most decision-makers require for quality-of-care measurement. PMID:22851984

  6. Health Ethics Education for Health Administration Chaplains

    ERIC Educational Resources Information Center

    Porter, Russell; Broussard, Amelia; Duckett, Todd

    2008-01-01

    It is imperative for divinity and health administration programs to improve their level of ethics education for their graduates who work as health administration chaplains. With an initial presentation of the variation of ethical dilemmas presented in health care facilities covering social, organizational, and patient levels, we indicate the need…

  7. Preventative care for patients with inflammatory bowel disease in the Veterans Health Administration.

    PubMed

    Pandey, Nivedita; Herrera, Henry H; Johnson, Christopher M; MacCarthy, Andrea A; Copeland, Laurel A

    2016-07-01

    Patients with inflammatory bowel disease (IBD) have underlying immune dysregulation. Immunosuppressive medications put them at risk of infection. This study assessed rates of recommended vaccinations and preventative screening in patients with IBD.Nationwide data on patients diagnosed with IBD in the Veterans Health Administration (VHA) October 2004 to September 2014 were extracted. Variation in vaccination, screenings, and risk of death by demographic factors (age group, gender) were estimated in bivariate and multivariable analyses.During the 10-year study period, 62,002 patients were treated for IBD. Nonmelanoma skin cancer was found in 2.6%, and these patients more commonly accessed dermatology clinic (22.5% vs 15.2%; chi-square = 66.6; df = 1; P < 0.0001). In total, 15% received DEXA scans, especially women (34.7% vs 13.2% men; chi-square = 1415.5; df = 1; P < 0.0001). Eye manifestations were noted in 38.3% yet only 31% were referred to ophthalmology. Abnormal Pap smears were found for 15% of women <65 (compared to 5% among normal patient populations); 34% had no record of Pap smear in VHA data. Vaccination rates were modest: pneumococcal 39%; TDAP 23%; hepatitis B 3%; varicella and PPD <0.5%. In an adjusted logistic regression model, 5-year mortality was lower among those using primary care prior to IBD diagnosis (odds ratio [OR] = 0.61; 95% CI 0.55-0.68).Despite the current IBD guidelines, vaccination and preventative screening rates were unacceptably low among patients diagnosed with IBD. Interventions such as education and increased awareness may be needed to improve these rates. PMID:27399081

  8. The Value of Field Experience in Education for Health Care Administration.

    ERIC Educational Resources Information Center

    Hiller, Marc D.

    A sample of 54 health administration education programs were examined to identify and analyze current practices in field experience programs. The six primary areas investigated include: (1) the prevalence of field experience requirements; (2) the objectives and characteristics of field experience components; (3) the experiences encountered in…

  9. Quality of end-of-life cancer care in Canada: a retrospective four-province study using administrative health care data

    PubMed Central

    Barbera, L.; Seow, H.; Sutradhar, R.; Chu, A.; Burge, F.; Fassbender, K.; McGrail, K.; Lawson, B.; Liu, Y.; Pataky, R.; Potapov, A.

    2015-01-01

    Background The quality of data comparing care at the end of life (eol) in cancer patients across Canada is poor. This project used identical cohorts and definitions to evaluate quality indicators for eol care in British Columbia, Alberta, Ontario, and Nova Scotia. Methods This retrospective cohort study of cancer decedents during fiscal years 2004–2009 used administrative health care data to examine health service quality indicators commonly used and previously identified as important to quality eol care: emergency department use, hospitalizations, intensive care unit admissions, chemotherapy, physician house calls, and home care visits near the eol, as well as death in hospital. Crude and standardized rates were calculated. In each province, two separate multivariable logistic regression models examined factors associated with receiving aggressive or supportive care. Results Overall, among the identified 200,285 cancer patients who died of their disease, 54% died in a hospital, with British Columbia having the lowest standardized rate of such deaths (50.2%). Emergency department use at eol ranged from 30.7% in Nova Scotia to 47.9% in Ontario. Of all patients, 8.7% received aggressive care (similar across all provinces), and 46.3% received supportive care (range: 41.2% in Nova Scotia to 61.8% in British Columbia). Lower neighbourhood income was consistently associated with a decreased likelihood of supportive care receipt. Interpretation We successfully used administrative health care data from four Canadian provinces to create identical cohorts with commonly defined indicators. This work is an important step toward maturing the field of eol care in Canada. Future work in this arena would be facilitated by national-level data-sharing arrangements. PMID:26628867

  10. State child health; implementing regulations for the State Children's Health Insurance Program. Health Care Financing Administration (HCFA), HHS. Final rule.

    PubMed

    2001-01-11

    Section 4901 of the Balanced Budget Act of 1997 (BBA) amended the Social Security Act (the Act) by adding a new title XXI, the State Children's Health Insurance Program (SCHIP). Title XXI provides funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner. To be eligible for funds under this program, States must submit a State plan, which must be approved by the Secretary. This final rule implements provisions related to SCHIP including State plan requirements and plan administration, coverage and benefits, eligibility and enrollment, enrollee financial responsibility, strategic planning, substitution of coverage, program integrity, certain allowable waivers, and applicant and enrollee protections. This final rule also implements the provisions of sections 4911 and 4912 of the BBA, which amended title XIX of the Act to expand State options for coverage of children under the Medicaid program. In addition, this final rule makes technical corrections to subparts B, and F of part 457. PMID:11503759

  11. Administrative simplification: adoption of operating rules for eligibility for a health plan and health care claim status transactions. Interim final rule with comment period.

    PubMed

    2011-07-01

    Section 1104 of the Administrative Simplification provisions of the Patient Protection and Affordable Care Act (hereafter referred to as the Affordable Care Act) establishes new requirements for administrative transactions that will improve the utility of the existing HIPAA transactions and reduce administrative costs. Specifically, in section 1104(b)(2) of the Affordable Care Act, Congress required the adoption of operating rules for the health care industry and directed the Secretary of Health and Human Services to "adopt a single set of operating rules for each transaction * * * with the goal of creating as much uniformity in the implementation of the electronic standards as possible." This interim final rule with comment period adopts operating rules for two Health Insurance Portability and Accountability Act of 1996 (HIPAA) transactions: eligibility for a health plan and health care claim status. This rule also defines the term "operating rules" and explains the role of operating rules in relation to the adopted transaction standards. In general, transaction standards adopted under HIPAA enable electronic data interchange through a common interchange structure, thus minimizing the industry's reliance on multiple formats. Operating rules, in turn, attempt to define the rights and responsibilities of all parties, security requirements, transmission formats, response times, liabilities, exception processing, error resolution and more, in order to facilitate successful interoperability between data systems of different entities. PMID:21739765

  12. [Health care reform in the Obama administration: difficulties of reaching a similar agreement in Argentina].

    PubMed

    Belmartino, Susana

    2014-04-01

    This article presents a comparative analysis of the processes leading to health care reform in Argentina and in the USA. The core of the analysis centers on the ideological references utilized by advocates of the reform and the decision-making processes that support or undercut such proposals. The analysis begins with a historical summary of the issue in each country. The political process that led to the sanction of the Obama reform is then described. The text defends a hypothesis aiming to show that deficiencies in the institutional capacities of Argentina's decision-making bodies are a severe obstacle to attaining substantial changes in this area within the country. PMID:24823603

  13. The medical care programs of the Farm Security Administration, 1932 through 1947: a rehearsal for national health insurance?

    PubMed Central

    Grey, M R

    1994-01-01

    At a time of renewed interest in universal health insurance, an examination of earlier periods when society grappled with the link between socioeconomic status and health is fruitful. Between 1935 and 1947, the federal government sponsored a comprehensive medical care program for low-income farmers, sharecroppers, and migrant workers under the auspices of the Farm Security Administration (FSA). Despite the strong opposition of the American Medical Association, humanitarian and economic concerns at the local level often promoted physicians' participation in the program's group prepayment plans. Many FSA leaders clearly saw the program as a model upon which national health insurance might advance. However, in the wake of World War II, the FSA program declined as physicians' income improved, the rural population declined, and traditional ideological objections to federal intervention in medical care resurfaced. The FSA experience illuminates the complex ideological, economic, and humanitarian motivations of American physicians in the face of health care reform. Images p1680-a p1682-a p1684-a PMID:7943497

  14. Strategic plan for geriatrics and extended care in the veterans health administration: background, plan, and progress to date.

    PubMed

    Shay, Kenneth; Hyduke, Barbara; Burris, James F

    2013-04-01

    The leaders of Geriatrics and Extended Care (GEC) in the Veterans Health Administration (VHA) undertook a strategic planning process that led to approval in 2009 of a multidisciplinary, evidence-guided strategic plan. This article reviews the four goals contained in that plan and describes VHA's progress in addressing them. The goals included transforming the healthcare system to a veteran-centric approach, achieving universal access to a panel of services, ensuring that the Veterans Affair's (VA) healthcare workforce was adequately prepared to manage the needs of the growing elderly veteran population, and integrating continuous improvement into all care enhancements. There has been substantial progress in addressing all four goals. All VHA health care has undergone an extensive transformation to patient-centered care, has enriched the services it can offer caregivers of dependent veterans, and has instituted models to better integrate VA and non-VA cares and services. A range of successful models of geriatric care described in the professional literature has been adapted to VA environments to gauge suitability for broader implementation. An executive-level task force developed a three-pronged approach for enhancing the VA's geriatric workforce. The VHA's performance measurement approaches increasingly include incentives to enhance the quality of management of vulnerable elderly adults in primary care. The GEC strategic plan was intended to serve as a road map for keeping VHA aligned with an ambitious but important long-term vision for GEC services. Although no discrete set of resources was appropriated for fulfillment of the plan's recommendations, this initial report reflects substantial progress in addressing most of its goals. PMID:23527829

  15. Using the Veterans Health Administration inpatient care database: trends in the use of antireflux surgery.

    PubMed

    Finalyson, Samuel R G; Stroupe, Kevin T; Joseph, George J; Fisher, Elliott S

    2002-01-01

    Context. In the private sector, the use of surgery to treat gastroesophageal reflux disease has increased substantially since the development of minimally invasive laparoscopic techniques. However, trends in the use of antireflux surgery in the Veterans Affairs (VA) health care system have not been explored. Objective. To compare secular trends in the use of antireflux surgery in VA hospitals and the private sector. Data Sources. VA data are from the 1991-1999 medical SAS datasets for inpatient care (commonly known as patient treatment files); private sector data are from the 1991-1997 Nationwide Inpatient Sample and the U.S. census. Calculations. We compared secular trends in the use of antireflux surgery in the VA and private sector with each group's baseline rate in 1991. For the VA, we calculated annual rates of antireflux surgery among active users of the VA health care system by dividing the number of procedures (based on the appropriate procedure codes from the International Classification of Diseases, ninth revision, clinical modification) by the number of veterans who had at least two hospital or clinic visits in a given year. For the private sector, we calculated true population rates by dividing procedure counts by the total U.S. population. Results. From 1991 to 1995, the annual rate of antireflux surgery among active users of VA hospitals increased by 64%, then decreased over the next 4 years to almost baseline rates. In contrast, rates of antireflux surgery in the private sector increased 185% from 1991 to 1995, then appeared to reach a plateau thereafter. Among patients undergoing antireflux surgery, those in the VA were less likely than those in the private sector to undergo laparoscopic surgery (29% vs. 65%, respectively, in 1997). Conclusions. With the development of laparoscopic surgery, rates of antireflux surgery in VA hospitals increased only modestly compared with the private sector and have decreased in recent years. Both patient and

  16. 75 FR 69449 - Draft Guidance for Industry and Food and Drug Administration Staff on Dear Health Care Provider...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-12

    ... Staff on Dear Health Care Provider Letters: Improving Communication of Important Safety Information... ``Dear Health Care Provider Letters: Improving Communication of Important Safety Information.'' Dear Health Care Provider (DHCP) Letters are correspondence--usually in the form of a mass mailing from...

  17. The cost of administrative complexity. Administrative intricacies add no value to health care--but the costs keep stacking up.

    PubMed

    Pope, Christina

    2004-01-01

    New MGMA research reports that a 10-physician practice spends almost a quarter of a million dollars a year on unnecessary administrative complexity. MGMA urges public debate on administrative simplification and for industry stakeholders to spread the word. To provide a road map, we outline six basic areas to simplify and describe how a less complicated payment system might operate. PMID:15612214

  18. Home Health Care

    MedlinePlus

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

  19. Course of health care costs before and after psychiatric inpatient treatment: patient-reported vs. administrative records

    PubMed Central

    Zentner, Nadja; Baumgartner, Ildiko; Becker, Thomas; Puschner, Bernd

    2015-01-01

    Background: There is limited evidence on the course of health service costs before and after psychiatric inpatient treatment, which might also be affected by source of cost data. Thus, this study examines: i) differences in health care costs before and after psychiatric inpatient treatment, ii) whether these differences vary by source of cost-data (self-report vs. administrative), and iii) predictors of cost differences over time. Methods: Sixty-one psychiatric inpatients gave informed consent to their statutory health insurance company to provide insurance records and completed assessments at admission and 6-month follow-up. These were compared to the self‐reported treatment costs derived from the "Client Socio-demographic and Service Use Inventory" (CSSRI‐EU) for two 6‐month observation periods before and after admission to inpatient treatment to a large psychiatric hospital in rural Bavaria. Costs were divided into subtypes including costs for inpatient and outpatient treatment as well as for medication. Results: Sixty-one participants completed both assessments. Over one year, the average patient‐reported total monthly treatment costs increased from € 276.91 to € 517.88 (paired Wilcoxon Z = ‐2.27; P = 0.023). Also all subtypes of treatment costs increased according to both data sources. Predictors of changes in costs were duration of the index admission and marital status. Conclusion: Self-reported costs of people with severe mental illness adequately reflect actual service use as recorded in administrative data. The increase in health service use after inpatient treatment can be seen as positive, while the pre-inpatient level of care is a potential problem, raising the question whether more or better outpatient care might have prevented hospital admission. Findings may serve as a basis for future studies aiming at furthering the understanding of what to expect regarding appropriate levels of post-hospital care, and what factors may help or

  20. Clostridium difficile Infections in Veterans Health Administration Long-Term Care Facilities.

    PubMed

    Reeves, Jeffrey S; Evans, Martin E; Simbartl, Loretta A; Kralovic, Stephen M; Kelly, Allison A; Jain, Rajiv; Roselle, Gary A

    2016-03-01

    OBJECTIVE A nationwide initiative was implemented in February 2014 to decrease Clostridium difficile infections (CDI) in Veterans Affairs (VA) long-term care facilities. We report a baseline of national CDI data collected during the 2 years before the Initiative. METHODS Personnel at each of 122 reporting sites entered monthly retrospective CDI case data from February 2012 through January 2014 into a national database using case definitions similar to those used in the National Healthcare Safety Network Multidrug-Resistant Organism/CDI module. The data were evaluated using Poisson regression models to examine infection occurrences over time while accounting for admission prevalence and type of diagnostic test. RESULTS During the 24-month analysis period, there were 100,800 admissions, 6,976,121 resident days, and 1,558 CDI cases. The pooled CDI admission prevalence rate (including recurrent cases) was 0.38 per 100 admissions, and the pooled nonduplicate/nonrecurrent community-onset rate was 0.17 per 100 admissions. The pooled long-term care facility-onset rate and the clinically confirmed (ie, diarrhea or evidence of pseudomembranous colitis) long-term care facility-onset rate were 1.98 and 1.78 per 10,000 resident days, respectively. Accounting for diagnostic test type, the long-term care facility-onset rate declined significantly (P=.05), but the clinically confirmed long-term care facility-onset rate did not. CONCLUSIONS VA long-term care facility CDI rates were comparable to those in recent reports from other long-term care facilities. The significant decline in the long-term care facility-onset rate but not in the clinically confirmed long-term care facility-onset rate may have been due to less testing of asymptomatic patients. Efforts to decrease CDI rates in long-term care facilities are necessary as part of a coordinated approach to decrease healthcare-associated infections. Infect. Control Hosp. Epidemiol. 2016;37(3):295-300. PMID:26686361

  1. Assessing Quality of Diabetes Care by Measuring Longitudinal Changes in Hemoglobin A1c in the Veterans Health Administration

    PubMed Central

    Thompson, Wes; Wang, Hongwei; Xie, Minge; Kolassa, John; Rajan, Mangala; Tseng, Chin-Lin; Crystal, Stephen; Zhang, Quanwu; Vardi, Yehuda; Pogach, Leonard; Safford, Monika M

    2005-01-01

    Context A1c levels are widely used to assess quality of diabetes care provided by health care systems. Currently, cross-sectional measures are commonly used for such assessments. Objective To study within-patient longitudinal changes in A1c levels at Veterans Health Administration (VHA) facilities as an alternative to cross-sectional measures of quality of diabetes care. Design Longitudinal study using institutional data on individual patient A1c level over time (October 1, 1998–September 30, 2000) with time variant and invariant covariates. Setting One hundred and twenty-five VHA facilities nationwide, October 1, 1998–September 30, 2000. Patients Diabetic veteran users with A1c measurement performed using National Glycosylated Hemoglobin Standardization Project certified A1c lab assay methods. Exposures Characteristics unlikely to reflect quality of care, but known to influence A1c levels, demographics, and baseline illness severity. Main Outcome Measure Monthly change in A1c for average patient cared for at each facility. Results The preponderance of facilities showed monthly declines in within-patient A1c over the study period (mean change of −0.0148 A1c units per month, range −0.074 to 0.042). Individual facilities varied in their monthly change, with 105 facilities showing monthly declines (70 significant at .05 level) and 20 showing monthly increases (5 significant at .05 level). Case-mix adjustment resulted in modest changes (mean change of −0.0131 case-mix adjusted A1c units per month, range −0.079 to 0.043). Facilities were ranked from worst to best, with attached 90 percent confidence intervals. Among the bottom 10 ranked facilities, four remained within the bottom decile with 90 percent confidence. Conclusions There is substantial variation in facility-level longitudinal changes in A1c levels. We propose that evaluation of change in A1c levels over time can be used as a new measure to reflect quality of care provided to populations of

  2. Managed health care.

    PubMed

    Curtiss, F R

    1989-04-01

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

  3. Physician Participation in Health Administrator Education

    ERIC Educational Resources Information Center

    Rosen, Harry M.; Rudich, Akiva A.

    1977-01-01

    A seminar in quality of care analysis was developed to: (1) familiarize health administration students with methods for measuring the quality of health care; (2) sensitize students to complexities of the medical care process; and (3) provide a setting where students interact directly with physicians in dealing with a common problem. (Editor/LBH)

  4. Health care reforms in Poland.

    PubMed

    Baginska, Ewa

    2004-01-01

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

  5. Home health care

    MedlinePlus

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

  6. Respiratory Home Health Care

    MedlinePlus

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

  7. Improving Clinical Workflow in Ambulatory Care: Implemented Recommendations in an Innovation Prototype for the Veteran’s Health Administration

    PubMed Central

    Patterson, Emily S.; Lowry, Svetlana Z.; Ramaiah, Mala; Gibbons, Michael C.; Brick, David; Calco, Robert; Matton, Greg; Miller, Anne; Makar, Ellen; Ferrer, Jorge A.

    2015-01-01

    Introduction: Human factors workflow analyses in healthcare settings prior to technology implemented are recommended to improve workflow in ambulatory care settings. In this paper we describe how insights from a workflow analysis conducted by NIST were implemented in a software prototype developed for a Veteran’s Health Administration (VHA) VAi2 innovation project and associated lessons learned. Methods: We organize the original recommendations and associated stages and steps visualized in process maps from NIST and the VA’s lessons learned from implementing the recommendations in the VAi2 prototype according to four stages: 1) before the patient visit, 2) during the visit, 3) discharge, and 4) visit documentation. NIST recommendations to improve workflow in ambulatory care (outpatient) settings and process map representations were based on reflective statements collected during one-hour discussions with three physicians. The development of the VAi2 prototype was conducted initially independently from the NIST recommendations, but at a midpoint in the process development, all of the implementation elements were compared with the NIST recommendations and lessons learned were documented. Findings: Story-based displays and templates with default preliminary order sets were used to support scheduling, time-critical notifications, drafting medication orders, and supporting a diagnosis-based workflow. These templates enabled customization to the level of diagnostic uncertainty. Functionality was designed to support cooperative work across interdisciplinary team members, including shared documentation sessions with tracking of text modifications, medication lists, and patient education features. Displays were customized to the role and included access for consultants and site-defined educator teams. Discussion: Workflow, usability, and patient safety can be enhanced through clinician-centered design of electronic health records. The lessons learned from implementing

  8. I strong administrative buy-in, firm mandates can push flu vaccination rates up to more than 99% among health care workers.

    PubMed

    2014-11-01

    While flu vaccination rates are inching up among health care workers, there is still room for improvement. The Centers for Disease Control and Prevention reports that slightly more than 75% of health care workers received the flu vaccination during the 2013-14 season--an increase of roughly 3% over the 2012-13 season. However, some hospitals have been able to achieve vaccination rates in excess of 99%. The apparent key to these efforts is a firm mandate that all personnel receive a flu shot as a condition of employment. There is always pushback to such policies, but hospitals report that most personnel eventually come around. While flu vaccination rates are on the increase among health, care personnel, data from the Centers for Medicare and Medicaid Services (CMS) note that rates vary widely from state to state. For example, the vaccination rate for health care workers in New Jersey stood at just 62% last year. In contrast, more than 95% of health care workers in Maryland received the shot during the 2013-14 flu season. Both Loyola University Medical Center and Henry Ford Hospital have been able to boost flu vaccination rates among their health care workers to more than 99% with the implementation of policies that require flu shots as a condition of employment. Experts say successful flu vaccination campaigns require strong administration buy-in and physician leadership. PMID:25362750

  9. The future of health care.

    PubMed

    Grossman, J H

    1992-10-01

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

  10. Primary Health Care.

    ERIC Educational Resources Information Center

    Lauffer, Sandra, Ed.

    1979-01-01

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

  11. Medicaid: Determining Cost-Effectiveness of Home and Community-Based Services. Report to the Administrator, Health Care Financing Administration, Department of Health and Human Services.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    To examine alternatives to nursing home care, states have been testing home and community-based services under the Medicaid program. Information on the operations of the state projects will be vital to designing cost-effective alternative services in the future. The General Accounting Office (GAO) reviewed state reports to see if accurate,…

  12. Vacation health care

    MedlinePlus

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

  13. Vacation health care

    MedlinePlus

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

  14. American Health Care Association

    MedlinePlus

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

  15. National Health Care Survey

    Cancer.gov

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

  16. Health care informatics.

    PubMed

    Siau, Keng

    2003-03-01

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

  17. Health Care Indicators

    PubMed Central

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

    1993-01-01

    This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data. PMID:25372246

  18. Health Care Indicators

    PubMed Central

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

    1991-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10114933

  19. Health Care Indicators

    PubMed Central

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

    1991-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10122365

  20. Health Care Indicators

    PubMed Central

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

    1992-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10120177

  1. Health Care Indicators

    PubMed Central

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

    1993-01-01

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

  2. Health care in Brazil.

    PubMed Central

    Haines, A

    1993-01-01

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

  3. HealthCare.gov

    MedlinePlus

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

  4. Effective advocacy for patients with inflammatory bowel disease: communication with insurance companies, school administrators, employers, and other health care overseers.

    PubMed

    Jaff, Jennifer C; Arnold, Janis; Bousvaros, Athos

    2006-08-01

    In addition to their physical challenges, children and adolescents with inflammatory bowel disease (IBD) living in the United States face a number of administrative and regulatory hurdles that affect their quality of life. This article, written by a physician, attorney/patient advocate, and social worker, discusses a number of these challenges and describes how the provider can help his or her patient overcome them. Specifically, the article discusses 4 areas in detail: appeals of denials of coverage from insurance companies and third party payors; assisting children with IBD with classroom and school accommodations; assisting uninsured children in obtaining Social Security benefits; and aiding a parent to care for their child using the Family and Medical Leave Act. Although this article has a pediatric focus, adults have similar advocacy needs. Case examples and sample letters to third-party payors, schools, and employers are included in this article. PMID:16917236

  5. Veterans Health Administration Experience with Data Quality Surveillance of Continuity of Care Documents: Interoperability Challenges for eHealth Exchange Participants

    PubMed Central

    Lyle, Jay; Bouhaddou, Omar; Botts, Nathan; Swall, Marie; Pan, Eric; Cullen, Terry; Donahue, Margaret; Hsing, Nelson

    2015-01-01

    As part of ongoing data quality efforts authors monitored health information retrieved through the United States Department of Veterans Affairs’ (VA) Virtual Lifetime Electronic Record (VLER) Health operation. Health data exchanged through the eHealth Exchange (managed by Healtheway, Inc.) between VA and external care providers was evaluated in order to test methods of data quality surveillance and to identify key quality concerns. Testing evaluated transition of care data from 20 VLER Health partners. Findings indicated operational monitoring discovers issues not addressed during onboarding testing, that many issues result from specification ambiguity, and that many issues require human review. We make recommendations to address these issues, specifically to embed automated testing tools within information exchange transactions and to continuously monitor and improve data quality, which will facilitate adoption and use. PMID:26958223

  6. Reproductive health care delivery.

    PubMed

    Lindgren, Mark C; Ross, Lawrence S

    2014-02-01

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

  7. Achieving health care affordability.

    PubMed

    Payson, Norman C

    2002-10-01

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

  8. Health Care System Accessibility

    PubMed Central

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

    2006-01-01

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

  9. Lean health care.

    PubMed

    Hawthorne, Henry C; Masterson, David J

    2013-01-01

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

  10. Developing primary health care.

    PubMed Central

    Jarman, B; Cumberlege, J

    1987-01-01

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

  11. VA Health Care Facilities Locator

    MedlinePlus

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

  12. 78 FR 46352 - Health Resources and Services Administration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Announcement of Requirements and Registration for ``Care Counts: Educating Women and Families Challenge'' AGENCY: Health Resources and...

  13. Health Care Indicators

    PubMed Central

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

    1991-01-01

    Contained in this regular feature of the journal is a section on each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10112766

  14. Health Care Indicators

    PubMed Central

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

    1991-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10110874

  15. Health care utilisation in India.

    PubMed

    Duggal, R

    1994-02-01

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

  16. Health-Care Hub

    ERIC Educational Resources Information Center

    Bowman, Darcia Harris

    2004-01-01

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

  17. Health care in Africa.

    PubMed

    Brown, M S

    1984-07-01

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

  18. Continuing Trends in Health and Health Care

    ERIC Educational Resources Information Center

    Wilson, Ronald W.; And Others

    1978-01-01

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

  19. Health care automation companies.

    PubMed

    1995-12-01

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

  20. Home health care

    MedlinePlus

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

  1. National Practitioner Data Bank for Adverse Information on Physicians and other Health Care Practitioners: charge for self-queries. Health Resources and Services Administration, HHS. Final rule.

    PubMed

    1999-03-01

    This final rule amends the existing regulations implementing the Health Care Quality Improvement Act of 1986 (the Act), which established the National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners (the Data Bank). The final rule amends the existing fee structure so that the Data Bank can fully recover its costs, as required by law. This rule removes the prohibition against charging for self-queries and, therefore, allows the Data Bank to assess costs in an equitable manner. This is consistent with both the Freedom of Information Act and the Privacy Act which allow the Government to charge fees for the reproduction of records. The Data Bank will continue its current practice of sending to the practitioner in whose name it was submitted--automatically, without a request, and free of charge--a copy of every report received by the Data Bank for purposes of verification and dispute resolution. PMID:10557586

  2. Child Development: Day Care. Administration, Number 7.

    ERIC Educational Resources Information Center

    Host, Malcolm S.; Heller, Pearl B.

    The organizing and administering of day care services are the focus of this handbook. The three parts of the handbook are: (1) Organizing Day Care Services (Starting a Day Care Program, The Board of Directors, and The Staff); (2) Components of Day Care Services (Purpose, Objectives and Evaluation of Day Care Programs; Health and Medical Program;…

  3. 45 CFR 162.1401 - Health care claim status transaction.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Health care claim status transaction. 162.1401 Section 162.1401 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Claim Status § 162.1401 Health care...

  4. 45 CFR 162.1401 - Health care claim status transaction.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Health care claim status transaction. 162.1401 Section 162.1401 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Claim Status § 162.1401 Health care...

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

    ERIC Educational Resources Information Center

    Hildick, Sue; Kohler, Peter O.

    1998-01-01

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

  6. The use of Health Care Financing Administration data for the development of a quality improvement project on the treatment of anemia.

    PubMed

    Eggers, P W; Greer, J; Jencks, S

    1994-08-01

    The Health Care Financing Administration maintains a wide array of data systems that are essential to the functioning of the Medicare program. These data, collected and maintained for the purposes of ensuring entitlements and payment for services, also can be used to monitor programmatic changes and to define potential problem areas. The end-stage renal disease (ESRD) Program Management and Medical Information System (PMMIS) is a subset of the larger Medicare statistical system. It is a historic record of all Medicare ESRD beneficiaries dating back to 1978. Basic Medicare enrollment information on ESRD beneficiaries is enhanced with the addition of information on the cause of renal failure, type of dialysis therapy, transplantation history, and cause of death. The ESRD PMMIS has been put to a number of uses in the past decade or so, ranging from basic descriptive epidemiology to analyses of mortality rates to assessments of programmatic issues such as the composite rate and dialyzer reuse. Because of the limited clinical detail in the PMMIS, there are many specific questions that cannot be adequately addressed. With approval of the Food and Drug Administration and Medicare coverage of erythropoietin, a erythropoietin monitoring system was developed to assess utilization trends of this anemia control drug. Within a few months it became evident that dosing levels for erythropoietin were much lower than expected from the clinical trials. Following a change in the payment method from a fixed amount to one based on dose level, dosing has increased markedly. However, hematocrit levels still remain below optimal levels. This lack of hematocrit response has led the Health Care Financing Administration, in concert with the renal community, to target anemia control as a potential health care quality improvement project. This paper presents an example of the type of data presentation that can be derived from the current PMMIS. The Health Standards and Quality Bureau has made

  7. Administrative simplification: adoption of operating rules for health care electronic funds transfers (EFT) and remittance advice transactions. Interim final rule with comment period.

    PubMed

    2012-08-10

    This interim final rule with comment period implements parts of section 1104 of the Affordable Care Act which requires the adoption of operating rules for the health care electronic funds transfers (EFT) and remittance advice transaction. PMID:22888504

  8. Controlling Health Care Costs

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2009-01-01

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

  9. Health care and AIDS.

    PubMed

    Peck, J; Bezold, C

    1992-07-01

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

  10. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

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

  11. Enhancing transgender health care.

    PubMed Central

    Lombardi, E

    2001-01-01

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

  12. Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP).

    PubMed

    Barry, Catherine N; Abraham, Kristen M; Weaver, Kendra R; Bowersox, Nicholas W

    2016-05-01

    In the past decade, the demand for Veterans Health Administration (VHA) mental health care has increased rapidly. In response to the increased demand, the VHA developed the Behavioral Health Interdisciplinary Program (BHIP) team model as an innovative approach to transform VHA general outpatient mental health delivery. The present formative evaluation gathered information about pilot implementation of BHIP to understand the struggles and successes that staff experienced during facility transitions to the BHIP model. Using a purposive, nonrandom sampling approach, we conducted 1-on-1, semistructured interviews with 37 licensed and nonlicensed clinical providers and 13 clerical support staff assigned to BHIP teams in 21 facilities across the VHA. Interviews revealed that having actively involved facility mental health leaders, obtaining adequate staffing for teams to meet the requirements of the BHIP model, creating clear descriptions and expectations for team member roles within the BHIP framework, and allocating designated time for BHIP team meetings challenged many VHA sites but are crucial for successful BHIP implementation. Despite the challenges, staff reported that the transition to BHIP improved team work and improved patient care. Staff specifically highlighted the potential for the BHIP model to improve staff working relationships and enhance communication, collaboration, morale, and veteran treatment consistency. Future evaluations of the BHIP implementation process and BHIP team functioning focusing on patient outcomes, organizational outcomes, and staff functioning are recommended for fully understanding effects of transitioning to the BHIP model within VHA general mental health clinics and to identify best practices and areas for improvement. (PsycINFO Database Record PMID:27148949

  13. [Quality of health care].

    PubMed

    Medina, J L; De Melo, P C

    2000-01-01

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

  14. Containing Health Care Costs

    PubMed Central

    Derzon, Robert A.

    1980-01-01

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

  15. 75 FR 13595 - Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-22

    ... Benefits Security Administration Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the Consolidated Omnibus Budget Reconciliation Act (COBRA) and Other Health Care... Administration, Department of Labor. ACTION: Notice of the availability of the Model Health Care...

  16. 75 FR 2562 - Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... Benefits Security Administration Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the Consolidated Omnibus Budget Reconciliation Act (COBRA) and Other Health Care... Administration, Department of Labor. ACTION: Notice of the Availability of the Model Health Care...

  17. 75 FR 26276 - Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

    ... Benefits Security Administration Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the Consolidated Omnibus Budget Reconciliation Act (COBRA) and Other Health Care... Administration, Department of Labor. ACTION: Notice of the Availability of the Model Health Care...

  18. Primary care and health reform.

    PubMed

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

    2012-01-01

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

  19. Health care interactional suffering in palliative care.

    PubMed

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

    2014-05-01

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

  20. Values in health care.

    PubMed

    Gish, O

    1984-01-01

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

  1. 38 CFR 3.360 - Service-connected health-care eligibility of certain persons administratively discharged under...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... U.S.C. shall be provided to certain former service persons with administrative discharges under..., or air service in line of duty. (b) Discharge categorization. With certain exceptions such benefits shall be furnished for any disability incurred or aggravated during a period of service terminated by...

  2. 38 CFR 3.360 - Service-connected health-care eligibility of certain persons administratively discharged under...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... U.S.C. shall be provided to certain former service persons with administrative discharges under..., or air service in line of duty. (b) Discharge categorization. With certain exceptions such benefits shall be furnished for any disability incurred or aggravated during a period of service terminated by...

  3. Understanding your health care costs

    MedlinePlus

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

  4. Funding Rural Health Care.

    ERIC Educational Resources Information Center

    Moore, Kim

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

  5. Health Care Reform: Recommendations and Analysis.

    ERIC Educational Resources Information Center

    Lewit, Eugene M.; And Others

    1993-01-01

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

  6. The authoritarian reign in American health care.

    PubMed

    Ballou, Kathryn A; Landreneau, Kandace J

    2010-02-01

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

  7. Have DRG-based prospective payment systems influenced the number of secondary diagnoses in health care administrative data?

    PubMed

    Serdén, Lisbeth; Lindqvist, Rikard; Rosén, Måns

    2003-08-01

    Diagnosis-related groups (DRGs) are secondary patient classification systems based on primary classified medical data, in which single events of care are grouped into larger, economically and medically consistent groups. The main primary classified medical data are diagnoses and surgery codes. In Sweden, the number of secondary diagnoses per case increased during the 1990s. In the early 1990s some county councils introduced DRG systems. The present study investigated whether the introduction of such systems had influenced the number of secondary diagnoses. The nation-wide Hospital Discharge Register from 1988 to 2000 was used for the analyses. All regional hospitals were included, giving a database of 5,355,000 discharges. The hospitals were divided into those that had introduced prospective payment systems during the study period and those that had not. Among all regional hospitals, there was an increase in the number of coded secondary diagnoses, but also in the number of secondary diagnoses per case. Hospitals with prospective payment systems had a larger increase, starting after the system was introduced. Regional hospitals without prospect payment systems had a more constant increase, starting later and coinciding with the introduction of their DRG-based management systems. It is concluded that introduction of DRG-based systems, irrespective of use, focuses on recording diagnoses and therefore increases the number of diagnoses. Other reasons may also have contributed to the increase. It was found that the changes in the speciality mix, during the study period, have impact on the increase of secondary diagnoses. PMID:12849909

  8. Care for the Person, Protection of Health and Respect for the will of the Patient in Italy: Support Administration as a Tool to Jointly Promote Health and Respect for Autonomy in Incompetent Patients

    PubMed Central

    Delbon, Paola; Ricci, Giovanna; Gandolfini, Massimo; Conti1, Adelaide

    2014-01-01

    In Italy, advance health care directives are a subject of considerable debate in both legal theory and practice. This debate focuses in particular not only on the appropriateness of approving ad hoc statutory regulations but also on the extent to which similar advance indications of a person’s wishes are applicable under the existing legal system, albeit in the absence of a law regulating them. The authors of this paper consider, in particular, guidelines relating to the possible use of the mechanism of support administration (amministrazione di sostegno) (Law No. 6/2004) as a procedure to be used for the legal recognition of advance health care directives, particularly in the light of the legal provision for the possible designation in advance of a support administrator by a beneficiary in anticipation of an eventual situation of incapacity. This underlines how the concept of health does not only exist in the abstract, but must be measured in relation to the particular patient in the particular situation and how beneficence and respect for autonomy are both essential elements in the choices aimed at promoting the health and the wellbeing of its citizens. Significance for public health The concept of health includes not only the physical, but also the psychosocial dimension in accordance with the will of people. The reference to the personal concept of quality of life, values, ethical and religious opinions of each subject are key components underlying the decision-making process concerning a given patient in a given clinical condition: the concept of health does not only exist in the abstract, but must be measured in relation to the specific patient in the specific situation. The authors analyse the Italian debate about the possible designation in advance of the support administrator on the part of the beneficiary in anticipation of a potential situation of incapacity, as a tool to enforce advance care directives, to show how beneficence and respect for autonomy

  9. Care for the Health Care Provider.

    PubMed

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

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

  10. Understanding your health care costs

    MedlinePlus

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

  11. Defining quality in health care.

    PubMed

    Buck, A S

    1992-05-01

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

  12. Administrative simplification: adoption of standards for health care electronic funds transfers (EFTs) and remittance advice. Interim final rule with comment period.

    PubMed

    2012-01-10

    This interim final rule with comment period implements parts of section 1104 of the Affordable Care Act which requires the adoption of a standard for electronic funds transfers (EFT). It defines EFT and explains how the adopted standards support and facilitate health care EFT transmissions. PMID:22359791

  13. 42 CFR 488.446 - Administrator sanctions: long-term care facility closures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Administrator sanctions: long-term care facility... PROCEDURES Enforcement of Compliance for Long-Term Care Facilities with Deficiencies § 488.446 Administrator sanctions: long-term care facility closures. Any individual who is or was the administrator of a...

  14. 42 CFR 488.446 - Administrator sanctions: long-term care facility closures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Administrator sanctions: long-term care facility... PROCEDURES Enforcement of Compliance for Long-Term Care Facilities with Deficiencies § 488.446 Administrator sanctions: long-term care facility closures. Any individual who is or was the administrator of a...

  15. 42 CFR 488.446 - Administrator sanctions: long-term care facility closures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Administrator sanctions: long-term care facility... PROCEDURES Enforcement of Compliance for Long-Term Care Facilities with Deficiencies § 488.446 Administrator sanctions: long-term care facility closures. Any individual who is or was the administrator of a...

  16. 42 CFR 488.446 - Administrator sanctions: long-term care facility closures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Administrator sanctions: long-term care facility... PROCEDURES Enforcement of Compliance for Long-Term Care Facilities with Deficiencies § 488.446 Administrator sanctions: long-term care facility closures. Any individual who is or was the administrator of a...

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

    ERIC Educational Resources Information Center

    Fadope, Cece Modupe; And Others

    1994-01-01

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

  18. Child Care Health Connections, 2002.

    ERIC Educational Resources Information Center

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

    2002-01-01

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

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

    PubMed

    Nolin, JoAnn; Killackey, Janet

    2004-01-01

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

  20. Outbreaks in Health Care Settings.

    PubMed

    Sood, Geeta; Perl, Trish M

    2016-09-01

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

  1. Simulation modeling for the health care manager.

    PubMed

    Kennedy, Michael H

    2009-01-01

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

  2. Psychology's Role in Health Care.

    ERIC Educational Resources Information Center

    American Psychological Association, Washington, DC.

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

  3. Betting against health care.

    PubMed

    Appleby, C

    1996-06-20

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

  4. Guidelines for Psychological Practice in Health Care Delivery Systems

    ERIC Educational Resources Information Center

    American Psychologist, 2013

    2013-01-01

    Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These…

  5. Access to health care

    PubMed Central

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

    2005-01-01

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

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

    ERIC Educational Resources Information Center

    Institute of Medicine (NAS), Washington, DC.

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

  7. Migrant health care: creativity in primary care.

    PubMed

    Artemis, L

    1996-01-01

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

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

    ERIC Educational Resources Information Center

    Klemovage, Shirley

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

  9. Nurses cut health care costs.

    PubMed

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

    1993-12-01

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

  10. Transformational leadership in health care.

    PubMed

    Trofino, J

    1995-08-01

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

  11. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

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

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

  12. Community financing of health care.

    PubMed

    Carrin, G

    1988-01-01

    even high-risk individuals no longer find it worthwhile. 2 forms of insurance which may be more successful in sub-Saharan Africa are extended family insurance and compulsory collective insurance organized by an enterprise, cooperative, community, or government. It is necessary to involve the population and to gather in-depth information about a community's socioeconomic status, preferences, and administrative know-how before advice is formulated on policy concerning the financing of drugs and health care. PMID:3252870

  13. Information Technology Outside Health Care

    PubMed Central

    Tuttle, Mark S.

    1999-01-01

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

  14. The health care learning organization.

    PubMed

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

    1996-01-01

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

  15. Gypsies and health care.

    PubMed Central

    Sutherland, A

    1992-01-01

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

  16. Flourishing in Health Care.

    PubMed

    Edgar, Andrew; Pattison, Stephen

    2016-06-01

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

  17. "Cloud" health-care workers.

    PubMed Central

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

    2001-01-01

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

  18. Health and Disability: Partnerships in Health Care

    ERIC Educational Resources Information Center

    Tracy, Jane; McDonald, Rachael

    2015-01-01

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

  19. Managed care and reproductive health.

    PubMed

    Cohen, S S; Williams, D R

    1998-01-01

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

  20. The Employer-Led Health Care Revolution.

    PubMed

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

    2015-01-01

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

  1. Telecommunications, health care, and legal liability

    NASA Astrophysics Data System (ADS)

    Levy, Chris

    1990-06-01

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

  2. Smokers' rights to health care.

    PubMed Central

    Persaud, R

    1995-01-01

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

  3. Space age health care delivery

    NASA Technical Reports Server (NTRS)

    Jones, W. L.

    1977-01-01

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

  4. Incremental health care costs for chronic pain in Ontario, Canada: a population-based matched cohort study of adolescents and adults using administrative data.

    PubMed

    Hogan, Mary-Ellen; Taddio, Anna; Katz, Joel; Shah, Vibhuti; Krahn, Murray

    2016-08-01

    Little is known about the economic burden of chronic pain and how chronic pain affects health care utilization. We aimed to estimate the annual per-person incremental medical cost and health care utilization for chronic pain in the Ontario population from the perspective of the public payer. We performed a retrospective cohort study using Ontario health care databases and the electronically linked Canadian Community Health Survey (CCHS) from 2000 to 2011. We identified subjects aged ≥12 years from the CCHS with chronic pain and closely matched them to individuals without pain using propensity score matching methods. We used linked data to determine mean 1-year per-person health care costs and utilization for each group and mean incremental cost for chronic pain. All costs are reported in 2014 Canadian dollars. After matching, we had 19,138 pairs of CCHS respondents with and without chronic pain. The average age was 55 years (SD = 18) and 61% were female. The incremental cost to manage chronic pain was $1742 per person (95% confidence interval [CI], $1488-$2020), 51% more than the control group. The largest contributor to the incremental cost was hospitalization ($514; 95% CI, $364-$683). Incremental costs were the highest in those with severe pain ($3960; 95% CI, $3186-$4680) and in those with most activity limitation ($4365; 95% CI, $3631-$5147). The per-person cost to manage chronic pain is substantial and more than 50% higher than a comparable patient without chronic pain. Costs are higher in people with more severe pain and activity limitations. PMID:26989805

  5. Congress enacts health care reform.

    PubMed

    2010-03-01

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

  6. Health care for children in foster care.

    PubMed

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

    2004-09-01

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

  7. Foster Care and Child Health.

    PubMed

    McDavid, Lolita M

    2015-10-01

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

  8. Prospects for Health Care Reform.

    ERIC Educational Resources Information Center

    Kastner, Theodore

    1992-01-01

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

  9. Contagious Ideas from Health Care

    ERIC Educational Resources Information Center

    Chaffee, Ellen

    2009-01-01

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

  10. Women Veterans Health Care: Frequently Asked Questions

    MedlinePlus

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

  11. Health care's service fanatics.

    PubMed

    Merlino, James I; Raman, Ananth

    2013-05-01

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

  12. Academic Health Centers and Health Care Reform.

    ERIC Educational Resources Information Center

    Miles, Stephen H.; And Others

    1993-01-01

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

  13. The Veterans Health Administration: an American success story?

    PubMed

    Oliver, Adam

    2007-01-01

    The Veterans Health Administration (VHA) provides health care for U.S. military veterans. By the early 1990s, the VHA had a reputation for delivering limited, poor-quality care, which led to health care reforms. By 2000, the VHA had substantially improved in terms of numerous indicators of process quality, and some evidence shows that its overall performance now exceeds that of the rest of U.S. health care. Recently, however, the VHA has started to become a victim of its own success, with increased demands on the system raising concerns from some that access is becoming overly restricted and from others that its annual budget appropriations are becoming excessive. Nonetheless, the apparent turnaround in the VHA's performance offers encouragement that health care that is both financed and provided by the public sector can be an effective organizational form. PMID:17319805

  14. The Veterans Health Administration: An American Success Story?

    PubMed Central

    Oliver, Adam

    2007-01-01

    The Veterans Health Administration (VHA) provides health care for U.S. military veterans. By the early 1990s, the VHA had a reputation for delivering limited, poor-quality care, which led to health care reforms. By 2000, the VHA had substantially improved in terms of numerous indicators of process quality, and some evidence shows that its overall performance now exceeds that of the rest of U.S. health care. Recently, however, the VHA has started to become a victim of its own success, with increased demands on the system raising concerns from some that access is becoming overly restricted and from others that its annual budget appropriations are becoming excessive. Nonetheless, the apparent turnaround in the VHA's performance offers encouragement that health care that is both financed and provided by the public sector can be an effective organizational form. PMID:17319805

  15. Responding to health care reform: how managed health care providers can manage major change overload.

    PubMed

    Gilmartin, J J

    1994-02-01

    Multiple pressures for clinical, administrative, economical, and political change face providers today. To cope with a changing society and health care delivery system, change management skills have become essential for survival. However, implementing and managing organizational change demands a level of expertise that is, unfortunately, not readily found in many managed health care organizations. In this article, the author addresses the importance for providers to understand the process of change implementation. PMID:10132445

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

    PubMed

    Kern, Josipa; Strnad, Marija

    2005-01-01

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

  17. Soviet health care and perestroika.

    PubMed Central

    Schultz, D S; Rafferty, M P

    1990-01-01

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

  18. Soviet health care and perestroika.

    PubMed

    Schultz, D S; Rafferty, M P

    1990-02-01

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

  19. Health Services Research and Development: the Veterans Administration Program.

    PubMed Central

    Goldschmidt, P G

    1986-01-01

    Health expenditures are rising inexorably; health status shows relatively little gain; technological possibilities are outstripping our ability or willingness to provide a commensurate level of resources. Clinical and administrative managers face increasingly difficult choices among alternative interventions in attempting to resolve these problems. If health services research is to succeed as a tool for assisting these decisions, clinicians, administrators, and researchers must view it as an integral part of management. This paper describes this concept of health services research and its implementation by the VA HSR&D Service, results from 1981 to date, and future directions. Four programs implement the Service's system to make relevant, valid information accessible to VA staff who can use it to improve veterans' health care: Investigator-Initiated Research (IIR) Program; HSR&D Field Program, which implements the Service's mission in various local areas VA-wide; Special Projects Program, responsive to system-wide issues, including technology assessment and transfer; and Resources Program, the Service's own management system. The Service's impact on improving veterans health care is already apparent. However, the true value of the HSR&D system will become apparent only in the 1990s, after the capacity for conducting health services research has been built and integrated fully with clinical and administrative practice. The VA, the nation's largest health care system, has a unique opportunity to demonstrate how health services research can improve health care. PMID:3081467

  20. The context of ethics in the health care industry.

    PubMed

    Wells, B; Spinks, N

    1996-01-01

    Examines ethics in the health care industry from the perspectives of investors, employees, patients, competitors and the environment. Ethical behaviour in the health care industry is essential and desirable; however, determining which behavioural actions are ethical and which are unethical is difficult. Although never will everyone agree on specific ethical standards, everyone should agree that setting ethical standards is vital. Therefore, administrators of health care institutions and health care providers should work together to establish codes of ethics which define boundaries for ethical behaviours in the health care industry. PMID:10157835

  1. 45 CFR 162.414 - Implementation specifications: Health care clearinghouses.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Implementation specifications: Health care clearinghouses. 162.414 Section 162.414 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  2. 45 CFR 162.410 - Implementation specifications: Health care providers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Implementation specifications: Health care providers. 162.410 Section 162.410 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  3. 45 CFR 162.410 - Implementation specifications: Health care providers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Implementation specifications: Health care providers. 162.410 Section 162.410 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  4. 45 CFR 162.414 - Implementation specifications: Health care clearinghouses.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Implementation specifications: Health care clearinghouses. 162.414 Section 162.414 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  5. 45 CFR 162.414 - Implementation specifications: Health care clearinghouses.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Implementation specifications: Health care clearinghouses. 162.414 Section 162.414 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  6. 45 CFR 162.410 - Implementation specifications: Health care providers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Implementation specifications: Health care providers. 162.410 Section 162.410 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  7. 28 CFR 541.32 - Medical and mental health care in the SHU.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Medical and mental health care in the SHU... necessary medical care. Emergency medical care is always available. (b) Mental Health Care. After every 30..., mental health staff will examine you, including a personal interview. Emergency mental health care...

  8. 28 CFR 541.32 - Medical and mental health care in the SHU.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Medical and mental health care in the SHU... necessary medical care. Emergency medical care is always available. (b) Mental Health Care. After every 30..., mental health staff will examine you, including a personal interview. Emergency mental health care...

  9. 28 CFR 541.32 - Medical and mental health care in the SHU.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Medical and mental health care in the SHU... necessary medical care. Emergency medical care is always available. (b) Mental Health Care. After every 30..., mental health staff will examine you, including a personal interview. Emergency mental health care...

  10. 28 CFR 541.32 - Medical and mental health care in the SHU.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Medical and mental health care in the SHU... necessary medical care. Emergency medical care is always available. (b) Mental Health Care. After every 30..., mental health staff will examine you, including a personal interview. Emergency mental health care...

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

    PubMed

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

    2016-02-01

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

  12. Health-care market robust.

    PubMed

    Merkel, Jayne

    2004-01-01

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

  13. Home health care in France.

    PubMed

    Charles, B

    1990-02-23

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

  14. Why are employers prodding health-care providers to adopt new management systems?: reducing the cost of health care.

    PubMed

    De Feo, Joseph A

    2004-01-01

    Increasingly concerned about the escalating costs of health-care insurance coverage, the quality of health-care delivery, and the escalating costs of delivering clinical services, employers are taking action. They are prodding health-care providers and insurers to adopt breakthrough management systems aimed at reducing costs related to poorly performing services and processes--and at the same time improving clinical outcomes. Doing this will require all members of the health-care value chain to work together to improve each and every process and procedure, whether clinical or administrative. This development presents formidable challenges to all health-care providers, insurers, employees, and patients. PMID:15085703

  15. Evidence-based decision-making 6: Utilization of administrative databases for health services research.

    PubMed

    Chowdhury, Tanvir Turin; Hemmelgarn, Brenda

    2015-01-01

    Health-care systems require reliable information on which to base health-care planning and make decisions, as well as to evaluate their policy impact. Administrative data provide important information about health services use, expenditures, clinical outcomes, and may be used to assess quality of care. With increased digitalization and accessibility of administrative databases, these data are more readily available for health service research purposes, aiding evidence-based decision-making. This chapter discusses the utility of administrative data for population-based studies of health and health care. PMID:25694328

  16. Rural health care: redefining access.

    PubMed

    Collins, Chris

    2015-01-01

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

  17. Five Steps to Safer Health Care

    MedlinePlus

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

  18. 45 CFR 162.406 - Standard unique health identifier for health care providers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Standard unique health identifier for health care providers. 162.406 Section 162.406 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  19. 45 CFR 162.406 - Standard unique health identifier for health care providers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standard unique health identifier for health care providers. 162.406 Section 162.406 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  20. 45 CFR 162.406 - Standard unique health identifier for health care providers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Standard unique health identifier for health care providers. 162.406 Section 162.406 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  1. 45 CFR 162.406 - Standard unique health identifier for health care providers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Standard unique health identifier for health care providers. 162.406 Section 162.406 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health...

  2. Will Boeing Change Health Care?

    PubMed

    Stempniak, Marty

    2015-12-01

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

  3. Czechoslovakia's changing health care system.

    PubMed Central

    Raffel, M W; Raffel, N K

    1992-01-01

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

  4. Direct measurement of health care costs.

    PubMed

    Smith, Mark W; Barnett, Paul G

    2003-09-01

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

  5. Model Child Care Health Policies.

    ERIC Educational Resources Information Center

    Aronson, Susan; Smith, Herberta

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

  6. [Corruption and health care system].

    PubMed

    Marasović Šušnjara, Ivana

    2014-06-01

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

  7. The priority of health care.

    PubMed

    Green, R M

    1983-11-01

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

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

    ERIC Educational Resources Information Center

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

    1999-01-01

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

  9. Helping You Choose Quality Behavioral Health Care

    MedlinePlus

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

  10. Competition, gatekeeping, and health care access.

    PubMed

    Godager, Geir; Iversen, Tor; Ma, Ching-to Albert

    2015-01-01

    We study gatekeeping physicians' referrals of patients to specialty care. We derive theoretical results when competition in the physician market intensifies. First, due to competitive pressure, physicians refer patients to specialty care more often. Second, physicians earn more by treating patients themselves, so refer patients to specialty care less often. We assess empirically the overall effect of competition with data from a 2008-2009 Norwegian survey, National Health Insurance Administration, and Statistics Norway. From the data we construct three measures of competition: the number of open primary physician practices with and without population adjustment, and the Herfindahl-Hirschman index. The empirical results suggest that competition has negligible or small positive effects on referrals overall. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care. PMID:25544400

  11. Health care entrepreneurship: financing innovation.

    PubMed

    Grazier, Kyle L; Metzler, Bridget

    2006-01-01

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

  12. Agents of Change for Health Care Reform

    ERIC Educational Resources Information Center

    Buchanan, Larry M.

    2007-01-01

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

  13. Health Care Becomes an Industry

    PubMed Central

    Rastegar, Darius A.

    2004-01-01

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

  14. Health care's 100 most wired.

    PubMed

    Solovy, A; Serb, C

    1999-02-01

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

  15. Help Yourself to Health Care.

    ERIC Educational Resources Information Center

    Snyder, Sarah

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

  16. Using accountability to improve reproductive health care.

    PubMed

    George, Asha

    2003-05-01

    Accountability is best understood as a referee of the dynamics in two-way relationships, often between unequal partners. The literature on accountability distinguishes between political, fiscal, administrative, legal and constitutional accountability. This paper focuses on accountability mechanisms in health care and how they mediate between service providers and communities and between different kinds of health personnel at the primary health care level. It refers to case studies of participatory processes for improving sexual and reproductive health service delivery. Information, dialogue and negotiation are important elements that enable accountability mechanisms to address problems by supporting change and engagement between participants. In order to succeed, however, efforts towards better accountability that broaden the participation of users must take into account the social contexts and the policy and service delivery systems in which they are applied, address power relations and improve the representation of marginalised groups within communities and service delivery systems. PMID:12800713

  17. Optimization of health-care organization and perceived improvement of patient comfort by switching from intra-venous BU four-times-daily infusions to a once-daily administration scheme in adult hematopoietic stem cell recipients.

    PubMed

    Xhaard, A; Rzepecki, P; Valcarcel, D; Santarone, S; Fürst, S; Serrano, D; De Angelis, G; Krüger, W; Scheid, C

    2014-04-01

    Previous studies have shown an equivalent pharmacokinetic profile between four-times-daily (4QD) and once-daily (QD) administration of intra-venous (IV) BU, without increased toxicity. We assess the impact of a switch in IV BU from a 4QD to a QD schedule, in terms of health-care organization, staff working conditions, quality of care dispensed and perceived patient comfort. Clinicians, nurses and pharmacists from nine allogeneic transplantation units in five European countries were interviewed face to face. Overall perception of QD versus 4QD BU was very positive. Both administration schemes were evaluated to be equally efficaciousZ. QD BU was perceived to be safer and more convenient. Clinicians and nurses perceived that patient comfort was improved, due to fewer complications associated with repeated infusions, and avoiding night infusions associated with stress, anxiety and decreased quality of sleep. Switching from 4QD to QD BU had a significant impact on health-care organization, with a better integration in the overall management and usual timelines in the pharmacies and transplantation units. Time spent to prepare and administer BU was significantly reduced, leading to potential financial savings that merit further assessment and would be of particular interest in the current economic climate. PMID:24419513

  18. NATIONAL SURVEY OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS (CSHCN)

    EPA Science Inventory

    The National Survey of Children with Special Health Care Needs (CSHCN) was sponsored and funded by the Maternal and Child Health Bureau of the Health Resources and Services. Administration. The survey was conducted by the National Center for Health Statistics of the Centers for D...

  19. Health care in Armenia today.

    PubMed Central

    Farmer, R G; Chobanian, A V

    1994-01-01

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

  20. Costs and coverage. Pressures toward health care reform.

    PubMed Central

    Lee, P R; Soffel, D; Luft, H S

    1992-01-01

    Signs of discontent with the health care system are growing. Calls for health care reform are largely motivated by the continued increase in health care costs and the large number of people without adequate health insurance. For the past 20 years, health care spending has risen at rates higher than the gross national product. As many as 35 million people are without health insurance. As proposals for health care reform are developed, it is useful to understand the roots of the cost problem. Causes of spiraling health care costs include "market failure" in the health care market, expansion in technology, excessive administrative costs, unnecessary care and defensive medicine, increased patient complexity, excess capacity within the health care system, and low productivity. Attempts to control costs, by the federal government for the Medicare program and then by the private sector, have to date been mostly unsuccessful. New proposals for health care reform are proliferating, and important changes in the health care system are likely. PMID:1441510

  1. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Halfon, Neal; And Others

    1994-01-01

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

  3. 45 CFR 162.1601 - Health care payment and remittance advice transaction.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Health care payment and remittance advice... DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Payment and Remittance Advice § 162.1601 Health care payment and remittance advice transaction. The health care payment...

  4. 5 CFR 9901.363 - Premium pay for health care personnel.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Premium pay for health care personnel... health care personnel. (a) Coverage. (1) This section applies to DoD health care personnel covered under.... For the purpose of this section, health care personnel means employees providing direct patient...

  5. 5 CFR 9901.363 - Premium pay for health care personnel.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Premium pay for health care personnel... health care personnel. (a) Coverage. (1) This section applies to DoD health care personnel covered under.... For the purpose of this section, health care personnel means employees providing direct patient...

  6. Training Health Care Paraprofessionals

    ERIC Educational Resources Information Center

    Linton, Corinne B.

    1977-01-01

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

  7. Phase plane analysis: applying chaos theory in health care.

    PubMed

    Priesmeyer, H R; Sharp, L F

    1995-01-01

    This article applies the new science of nonlinearity to administrative issues and accounts receivable management in health care, and it provides a new perspective on common operating and quality control measures. PMID:10151628

  8. The rise of the bank infomediary in health care.

    PubMed

    Casillas, John

    2008-08-01

    Banks are evolving in four key areas that collectively comprise the rise of a "bank infomediary": Efficient administrative processing; Medical Internet; Health information broker; Community care platform. PMID:18709871

  9. Trends Affecting the U.S. Health Care System. Health Planning Information Series.

    ERIC Educational Resources Information Center

    Cerf, Carol

    This integrated review of national trends affecting the health care system is primarily intended to facilitate the planning efforts of health care providers and consumers, Government agencies, medical school administrators, health insurers, and companies in the medical market. It may also be useful to educators as a textbook to give their students…

  10. reDefined contribution health care.

    PubMed

    Lair, Tamra

    2004-01-01

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

  11. How not to cut health care costs.

    PubMed

    Kaplan, Robert S; Haas, Derek A

    2014-11-01

    Health care providers in much of the world are trying to respond to the tremendous pressure to reduce costs--but evidence suggests that many of their attempts are counterproductive, raising costs and sometimes decreasing the quality of care. Kaplan and Haas reached this conclusion after conducting field research with more than 50 health care provider organizations. Administrators looking for cuts typically work from the line-item expense categories on their P&Ls, they found. This may appear to generate immediate results, but it usually does not reflect the optimal mix of resources needed to efficiently deliver excellent care. The authors describe five common mistakes: (1) Reducing support staff. This often lowers the productivity of clinicians, whose time is far more expensive. (2) Underinvesting in space and equipment. The costs of these are consistently an order of magnitude smaller than personnel costs, so cuts here are short-sighted if they lower people's productivity. (3) Focusing narrowly on procurement prices and neglecting to examine how individual clinicians actually consume supplies. (4) Maximizing patient throughput. Physicians achieve greater overall productivity by spending more time with fewer patients. (5) Failing to benchmark and standardize. Administrators, in collaboration with clinicians, should examine all the costs of treating patients' conditions. This will uncover multiple opportunities to improve processes in ways that lower total costs and deliver better care. PMID:25509507

  12. A right to health care.

    PubMed

    Eleftheriadis, Pavlos

    2012-01-01

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

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

    PubMed

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

    2008-01-01

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

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

    PubMed

    Van Houtven, Courtney Harold; Norton, Edward C

    2004-11-01

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

  15. Knowledge management in health care.

    PubMed

    Guptill, Janet

    2005-01-01

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

  16. Promoting environmentally responsible health care.

    PubMed

    Gaudry, Jacqueline; Skiehar, Kimberly

    2007-01-01

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

  17. Education for primary health care.

    PubMed

    Smith, M; Drickey, R

    1985-07-01

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

  18. Growth of HMOs challenges traditional health care.

    PubMed

    Atkinson, S

    1987-04-01

    Health maintenance organizations (HMOs)--a method of prepaid health care delivery guaranteeing all medical care for a fixed monthly payment--are growing rapidly and presenting traditional medical institutions with increased competition. Hospital must respond with their own HMOs or insurance plans or risk a loss of profits. The basic types of HMOs are structured in three ways: the staff model, in which the HMO owns or leases its facilities and directly employs health care professionals; the independent practice association in which the HMO retains private physicians who maintain their private practices and care for subscribers at their own offices; and the prepaid group health organization, in which the HMO contracts with the physicians to provide services to its subscribers. Although it may be difficult for a hospital to form an HMO because of the capital and expertise required, national hospital alliances can provide developmental assistance in terms of marketing sales, and management experience. For consumers, the major advantage of HMOs is a more reasonable cost, but some have expressed dissatisfaction with access to care and are reluctant to give up their own physician. Physicians benefit from HMOs because they are relieved of some administrative tasks and have better access to ancillary personnel and services. On the other hand, physicians' income may be limited, and HMO participation may adversely affect their relationships with patients and their practice patterns. Financers of HMOs benefit from lower administrative and health insurance costs and the opening of new markets, but this may pose new problems such as a need for expertise in a new area and loss of the insured person's confidence if the venture does not work. PMID:10282278

  19. [Accreditation in health care].

    PubMed

    Fügedi, Gergely; Lám, Judit; Belicza, Éva

    2016-01-24

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

  20. Health care clinics in Cambodia.

    PubMed

    Wollschlaeger, K

    1995-04-01

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

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

    PubMed

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

    2008-12-01

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

  2. Phytotherapy in primary health care

    PubMed Central

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

    2014-01-01

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

  3. Phytotherapy in primary health care.

    PubMed

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

    2014-06-01

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

  4. Health Care Procedure Considerations and Individualized Health Care Plans

    ERIC Educational Resources Information Center

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

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

  5. Sustainable health care for Canada.

    PubMed

    Maxwell, J; Angus, D; Albert, T

    1995-01-01

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

  6. Obama health care for all Americans: practical implications.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2009-01-01

    Rapidly rising health care costs over the decades have prompted the application of business practices to medicine with goals of improving the efficiency, restraining expenses, and increasing quality. Average health insurance premiums and individual contributions for family coverage have increased approximately 120% from 1999 to 2008. Health care spending in the United States is stated to exceed 4 times the national defense, despite the wars in Iraq and Afghanistan. The U.S. health care system has been blamed for inefficiencies, excessive administrative expenses, inflated prices, inappropriate waste, and fraud and abuse. While many people lack health insurance, others who do have health insurance allegedly receive care ranging from superb to inexcusable. In criticism of health care in the United States and the focus on savings, methodologists, policy makers, and the public in general seem to ignore the major disadvantages of other global health care systems and the previous experiences of the United States to reform health care. Health care reform is back with the Obama administration with great expectations. It is also believed that for the first time since 1993, momentum is building for policies that would move the United States towards universal health insurance. President Obama has made health care a central part of his domestic agenda, with spending and investments in Children's Health Insurance Program (CHIP), American Recovery and Reinvestment Act of 2009, and proposed 2010 budget. It is the consensus now that since we have a fiscal emergency, Washington is willing to deal with the health care crisis. Many of the groups long opposed to reform, appear to be coming together to accept a major health care reform. Reducing costs is always at the center of any health care debate in the United States. These have been focused on waste, fraud, and abuse; administrative costs; improving the quality with health technology information dissemination; and excessive

  7. Health disparities among health care workers.

    PubMed

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

    2010-01-01

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

  8. Health Care Reform: A Values Debate.

    ERIC Educational Resources Information Center

    Popko, Kathleen

    1992-01-01

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

  9. The Business Value of Health Care Information Technology

    PubMed Central

    Frisse, Mark C.

    1999-01-01

    The American health care system is one of the world's largest and most complex industries. The Health Care Financing Administration reports that 1997 expenditures for health care exceeded one trillion dollars, or 13.5 percent of the gross domestic product. Despite these expenditures, over 16 percent of the U.S. population remains uninsured, and a large percentage of patients express dissatisfaction with the health care system. Managed care, effective in its ability to attenuate the rate of cost increase, is associated with a concomitant degree of administrative overhead that is often perceived by providers and patients alike as a major source of cost and inconvenience. Both providers and patients sense a great degree of inconvenience and an excessive amount of paperwork associated with both the process of seeking medical care and the subsequent process of paying for medical services. PMID:10495096

  10. The business value of health care information technology.

    PubMed

    Frisse, M C

    1999-01-01

    The American health care system is one of the world's largest and most complex industries. The Health Care Financing Administration reports that 1997 expenditures for health care exceeded one trillion dollars, or 13.5 percent of the gross domestic product. Despite these expenditures, over 16 percent of the U.S. population remains uninsured, and a large percentage of patients express dissatisfaction with the health care system. Managed care, effective in its ability to attenuate the rate of cost increase, is associated with a concomitant degree of administrative overhead that is often perceived by providers and patients alike as a major source of cost and inconvenience. Both providers and patients sense a great degree of inconvenience and an excessive amount of paperwork associated with both the process of seeking medical care and the subsequent process of paying for medical services. PMID:10495096

  11. Good Health Before Pregnancy: Preconception Care

    MedlinePlus

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

  12. Improving Educational Preparation for Transcultural Health Care.

    ERIC Educational Resources Information Center

    Le Var, Rita M. H.

    1998-01-01

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

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

    PubMed

    Hearn, Lydia; Slack-Smith, Linda

    2015-01-01

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

  14. ARTEMIS: a collaborative framework for health care.

    PubMed

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

    1993-01-01

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

  15. The Administrative Control System of Substance Abuse Managed Care

    PubMed Central

    Sosin, Michael R

    2005-01-01

    Objective This article searches for the dimensions of the administrative structures in outpatient substance abuse managed care that control the behavior of agency providers. It also ascertains how these dimensions, and several financial mechanisms, affect key aspects of the providers services: the average number of sessions of care that are delivered, the rate of completion of care, and the (estimated) rate at which clients control their substance use. Data Sources The data were collected in 1999 for this investigation. Study Design These data come from a nationally representative, cross-sectional sample of individual contracts between outpatient drug treatment providers and the Behavioral Health Managed Care Organizations (BHMCOs) that are empowered to regulate the delivery of services. Provider responses are analyzed here. Data Collection Methods Factor analyses at a contract level examine the structural dimensions of the control system. Multivariate analyses at the same level rely on generalized linear models to predict the dependent variables by the structural dimensions and financial mechanisms. Findings The factor analyses suggest that there are six multiple variable structural dimensions. The multivariate analyses suggest that the dimension that mandates follow-up of discharged clients tends to relate to more sessions of care and perhaps a higher rate of service completion. Most other dimensions are found to relate to fewer sessions of care, lower rates of service completion, or lower rates of control of substance abuse. No structural dimension relates to all dependent variables. Financial mechanisms evince varying relations to the sessions of care. They rarely relate to the other dependent variables. Conclusion The results generally suggest that providers, payers, or policymakers might affect service provision by selecting BHMCOs that stress particular structural dimensions and financial mechanisms. However, managed care contracts most heavily rely on

  16. Health care insolvency and bankruptcy.

    PubMed

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

    1998-08-01

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

  17. Mental health care in Cambodia.

    PubMed Central

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

    1999-01-01

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

  18. Reengineering health care materials management.

    PubMed

    Connor, L R

    1998-01-01

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

  19. Where Is Health Care Headed?

    PubMed

    Bland, Jeffrey

    2016-06-01

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

  20. Impact of administrative technology on acute care bed need.

    PubMed Central

    Martin, J B; Dahlstrom, G A; Johnston, C M

    1985-01-01

    This article reports an evaluation of the impact of three administrative technologies--Admission Scheduling (AS) Systems, Outpatient Surgery (OPS) Programs, and Preadmission Testing (PAT) Programs--on the number of acute care beds required by a hospital. The evaluation mechanism reported here is called the ADTECH Computerized Planning Model. ADTECH uses parameters of each technology, identified from previous literature and discussions with health care professionals, to predict the changes in bed requirements resulting from implementation of these programs. Data from eight hospitals of various characteristics and sizes were run to test the ADTECH model. The results from these test runs indicate that the proper implementation of AS, OPS, and PAT can significantly influence a hospital's required bed complement. PMID:3988530

  1. CDC Vital Signs: Making Health Care Safer -- Think Sepsis. Time Matters.

    MedlinePlus

    ... Press Kit Read the MMWR Science Clips Making Health Care Safer Think sepsis. Time matters. Language: English Español ( ... the antibiotic type, dose, and duration are correct. Health care facility CEOs/administrators can Make infection control a ...

  2. Managed consumerism in health care.

    PubMed

    Robinson, James C

    2005-01-01

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

  3. Fostering the coexistence of caring philosophy and economics in today's health care system.

    PubMed

    Cara, Chantal M; Nyberg, Jan J; Brousseau, Sylvain

    2011-01-01

    For the past decade, several health care systems are undergoing continuous administrative restructuring, whose main objective is cost reduction. These changes often result in the patients' needs not being met because nurses are continuously affected by widespread budget cuts and staff downsizing. Have we reached a point, where we are setting aside our prime directive of patient well-being for the sake of finances? If so, are we at risk of forsaking our professional identity as nurses? The authors believe that caring management and economical constraints can coexist while promoting quality patient care. The purpose of this article is to show how nurse managers and administrators can facilitate caring practices while maintaining their financial responsibilities within the health care organization. This article suggests several strategies for assisting nurse managers in promoting caring in the health care environment. PMID:21157259

  4. Preserving community in health care.

    PubMed

    Emanuel, E J; Emanuel, L L

    1997-02-01

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

  5. What is the health care product?

    PubMed

    France, K R; Grover, R

    1992-06-01

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

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

    PubMed

    Guo, Kristina L

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

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

  8. Equity and efficiency in Italian health care.

    PubMed

    Paci, P; Wagstaff, A

    1993-04-01

    Health care finance and provision in Italy is unusual by international standards: public financing relies heavily on both general taxation and social insurance, and although the vast majority of expenditure is publicly financed, the majority of care is provided by the private sector. The system suffers, however, from a chronic failure to control expenditures and its record on perinatal and infant mortality is poor. Hospitals in Italy have a low bed-occupancy rate by international standards and the per diem system of reimbursing private hospitals encourages unduly long stays. Costs per inpatient day are high by international standards, but costs per admission are close to the OECD average. Ambulatory care costs are extremely low, but this appears to be due to the fact that GPs see so many patients that their role is inevitably mainly administrative. Consumption of medicines is extremely high, but because the cost per item is low, expenditure per capita is not unduly high. Despite the emphasis on social insurance, the financing system appears to be progressive. There is evidence of inequalities in health in Italy, and some evidence that health care is not provided equally to those in the same degree of need. PMID:8269044

  9. Providing adolescent sexual health care in the pediatric emergency department: views of health care providers

    PubMed Central

    Miller, Melissa K.; Mollen, Cynthia J.; O’Malley, Donna; Owens, Rhea L.; Maliszewski, Genevieve A.; Goggin, Kathy; Patricia, Kelly

    2014-01-01

    Objective The purpose of this study was to explore health care providers’ (HCPs) attitudes and beliefs about adolescent sexual health care provision in the emergency department (ED) and to identify barriers to a role of a health educator-based intervention. Methods We conducted focused, semi-structured interviews of HCPs from the ED and Adolescent Clinic of a children’s hospital. The interview guide was based on the Theory of Planned Behavior and its constructs: attitudes, subjective norms, perceived behavioral control, and intention to facilitate care. We used purposive sampling and enrollment continued until themes were saturated. Interviews were recorded and transcribed. Transcripts were analyzed using directed content analysis. Results Twenty-nine interviews were required for saturation. Participants were 12 physicians, 12 nurses, 3 nurse practitioners and 2 social workers; the majority (83%) were female. Intention to facilitate care was influenced by HCP perception of 1) their professional role, 2) the role of the ED (focused vs. expanded care), and 3) need for patient safety. HCPs identified three practice referents: patients/families, peers and administrators, and professional organizations. HCPs perceived limited behavioral control over care delivery because of time constraints, confidentiality issues, and comfort level. There was overall support for a health educator and many felt the educator could help overcome barriers to care. Conclusion Despite challenges unique to the ED, HCPs were supportive of the intervention and perceived the health educator as a resource to improve adolescent care and services. Future research should evaluate efficacy and costs of a health educator in this setting. PMID:24457494

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

    PubMed

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

    2009-04-01

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

  11. 42 CFR 433.56 - Classes of health care services and providers defined.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Classes of health care services and providers... Administrative Requirements State Financial Participation § 433.56 Classes of health care services and providers... health care items or services: (1) Inpatient hospital services; (2) Outpatient hospital services;...

  12. 42 CFR 433.56 - Classes of health care services and providers defined.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Classes of health care services and providers... Administrative Requirements State Financial Participation § 433.56 Classes of health care services and providers... health care items or services: (1) Inpatient hospital services; (2) Outpatient hospital services;...

  13. Health care in remote areas.

    PubMed

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

    1995-02-01

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

  14. Many Manly Men Avoid Needed Health Care

    MedlinePlus

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

  15. Savings account for health care costs

    MedlinePlus

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

  16. Passion in today's health care leaders.

    PubMed

    Piper, Llewellyn E

    2005-01-01

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

  17. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

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

  18. 8 ways to cut health care costs

    MedlinePlus

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

  19. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

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

  20. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePlus

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

  1. Job satisfaction in health-care organizations

    PubMed Central

    Bhatnagar, Kavita; Srivastava, Kalpana

    2012-01-01

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

  2. The Cultural Geography of Health Care Delivery.

    ERIC Educational Resources Information Center

    Gesler, Wilbert M.

    1987-01-01

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

  3. Accreditation Association for Ambulatory Health Care

    MedlinePlus

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

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

    PubMed

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

    2014-11-01

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

  5. Tribal Child Care and Development Fund: Guide for New Administrators

    ERIC Educational Resources Information Center

    Child Care Bureau, 2008

    2008-01-01

    Tribal Child Care and Development Fund administrators work each day to ensure that the children and families in tribal communities have the child care services that best meet their needs. The Child Care and Development Fund (CCDF), a federal block grant for States, Tribes, and Territories, is a key resource to help increase the availability,…

  6. The right to preventive health care.

    PubMed

    Conly, Sarah

    2016-08-01

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

  7. Nursing Titles and Health Care Plans.

    ERIC Educational Resources Information Center

    Erceg, Linda

    1996-01-01

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

  8. Communicating in Multicultural Health Care Organizations.

    ERIC Educational Resources Information Center

    Kreps, Gary L.; Kunimoto, Elizabeth

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

  9. Health Care Delivery to Southeast Asian Refugees.

    ERIC Educational Resources Information Center

    Mattson, Susan

    1989-01-01

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

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

    PubMed

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

    2005-01-01

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

  11. Coordinating Mental Health Care across Primary Care and Schools: ADHD as a Case Example

    ERIC Educational Resources Information Center

    Power, Thomas J.; Blum, Nathan J.; Guevara, James P.; Jones, Heather A.; Leslie, Laurel K.

    2013-01-01

    Although primary care practices and schools are major venues for the delivery of mental health services to children, these systems are disconnected, contributing to fragmentation in service delivery. This paper describes barriers to collaboration across the primary care and school systems, including administrative and fiscal pressures, conceptual…

  12. Insights from advanced analytics at the Veterans Health Administration.

    PubMed

    Fihn, Stephan D; Francis, Joseph; Clancy, Carolyn; Nielson, Christopher; Nelson, Karin; Rumsfeld, John; Cullen, Theresa; Bates, Jack; Graham, Gail L

    2014-07-01

    Health care has lagged behind other industries in its use of advanced analytics. The Veterans Health Administration (VHA) has three decades of experience collecting data about the veterans it serves nationwide through locally developed information systems that use a common electronic health record. In 2006 the VHA began to build its Corporate Data Warehouse, a repository for patient-level data aggregated from across the VHA's national health system. This article provides a high-level overview of the VHA's evolution toward "big data," defined as the rapid evolution of applying advanced tools and approaches to large, complex, and rapidly changing data sets. It illustrates how advanced analysis is already supporting the VHA's activities, which range from routine clinical care of individual patients--for example, monitoring medication administration and predicting risk of adverse outcomes--to evaluating a systemwide initiative to bring the principles of the patient-centered medical home to all veterans. The article also shares some of the challenges, concerns, insights, and responses that have emerged along the way, such as the need to smoothly integrate new functions into clinical workflow. While the VHA is unique in many ways, its experience may offer important insights for other health care systems nationwide as they venture into the realm of big data. PMID:25006147

  13. Health care under the Taliban.

    PubMed

    Faiz, A

    1997-04-26

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

  14. Principles of allocation of health care resources.

    PubMed Central

    Knox, E G

    1978-01-01

    The methods and principles of allocating centrally provided health care resources to regions and areas are reviewed using the report of the Resource Allocation Working Party (RAWP) (Department of Health and Social Security, 1976) and the consultative document (Department of Health and Social Security, 1976a) as a basis. A range of practical problems arising from these papers (especially the report of the RAWP) is described and traced to the terms of reference. It is concluded that the RAWP misinterpreted aspects of social and administrative reality, and it failed to recognise clearly that the several principles on which it had to work conflicted with each other and demanded decisions of priority. The consequential errors led to (a) an injudicious imposition of 'objectivity' at all levels of allocation, (b) an unjustified insistence that the same method be used at each administrative level in an additive and transitive manner, (c) the exclusion of general practitioner services from their considerations, (d) a failure to delineate those decisions which are in fact political decisions, thus to concatenate them, inappropriately, with technical and professional issues. The main requirement in a revised system is for a mechanism which allocates different priorities to different principles at each appropriate administrative and distributive level, and adapts the working methods of each tier to meet separately defined objectives. PMID:262585

  15. Intravenous Medication Administration in Intensive Care: Opportunities for Technological Solutions

    PubMed Central

    Moss, Jacqueline; Berner, Eta; Bothe, Olaf; Rymarchuk, Irina

    2008-01-01

    Medication administration errors have been shown to be frequent and serious. Error is particularly prevalent in highly technical specialties such as critical care. The purpose of this study was to describe the characteristics of intravenous medication administration in five intensive care units. These data were used within the context of a larger study to design information system decision support to decrease medication administration errors in these settings. Nurses were observed during the course of their work and their intravenous medication administration process, medication order source, references used, calculation method, number of medications prepared simultaneously, and any interruptions occurring during the preparation and delivery phases of the administration event were recorded. In addition, chart reviews of medication administration records were completed and nurses were asked to complete an anonymous drop-box questionnaire regarding their experiences with medication administration error. The results of this study are discussed in terms of potential informatics solutions for reducing medication administration error. PMID:18998790

  16. Wholistic Health Care: Evolutionary Conceptual Analysis.

    PubMed

    Ziebarth, Deborah Jean

    2016-10-01

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

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

    PubMed

    Giangrande, A

    1998-11-01

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

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

    ERIC Educational Resources Information Center

    Syre, Thomas R.; Wilson, Richard W.

    1990-01-01

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

  19. Health Care Reform and the Academic Health Center.

    ERIC Educational Resources Information Center

    Kimmey, James R.

    1994-01-01

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

  20. 77 FR 22949 - Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ...This proposed rule would implement section 1104 of the Patient Protection and Affordable Care Act (hereinafter referred to as the Affordable Care Act) by establishing new requirements for administrative transactions that would improve the utility of the existing Health Insurance Portability and Accountability Act of 1996 (HIPAA) transactions and reduce administrative burden and costs. It......

  1. Primary Health Care Needs of Immigrants.

    ERIC Educational Resources Information Center

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

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

  2. Establishment of primary health care in Vietnam.

    PubMed Central

    Birt, C A

    1990-01-01

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

  3. Rural Youth and the Health Care System

    ERIC Educational Resources Information Center

    McGruk, Lois F.

    1978-01-01

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

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

    PubMed

    Terry, D

    1994-01-01

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

  5. Health care: a brave new world.

    PubMed

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

    2015-03-01

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

  6. Preventive Health Care for the Elderly

    PubMed Central

    Stults, Barry M.

    1984-01-01

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

  7. The changing face of health care consumers.

    PubMed

    2001-01-01

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

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed

    Orlando, Rocco; Haytaian, Marcia

    2012-08-01

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

  10. Controversies in faith and health care.

    PubMed

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

    2015-10-31

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

  11. Challenges for health care development in Croatia.

    PubMed

    Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja

    2012-09-01

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

  12. Health Care: Infection Control, Medication Administration, and Seizure Management. A Series for Caregivers of Infants and Toddlers. Model for Interdisciplinary Training for Children with Handicaps: MITCH Module 8.

    ERIC Educational Resources Information Center

    Monroe County School District, Key West, FL.

    Intended for use in Florida training programs for caregivers of infants and toddlers with disabilities, this guide presents an overview of the Model of Interdisciplinary Training for Children with Handicaps (MITCH); offers a user's guide to the series; and provides specific information for presenting Module 8, which focuses on health care…

  13. Health Care Financing Administration--conditions for coverage of suppliers of ESRD services; revocation of requirements for emergency generator and ground fault interrupters. Final rule.

    PubMed

    1980-04-10

    These amendments remove the requirements for emergency generators and ground fault interrupters in end-stage renal dialysis (ESRD) facilities. The purpose is to reduce unnecessary and burdensome requirements which are not necessary to the health and safety of patients. PMID:10246083

  14. [Motivational interviewing in health care].

    PubMed

    Lev-Ran, Shaul; Nitzan, Uri

    2011-09-01

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

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

    PubMed

    Binder, A; Braun, G E

    2015-03-01

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

  16. 75 FR 34459 - Converged Communications and Health Care Devices Impact on Regulation; Public Meeting; Request...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... HUMAN SERVICES Food and Drug Administration Converged Communications and Health Care Devices Impact on... significant developments in recent years in medical and health care devices using radio technology to monitor..., caregivers, and patients. These and other products cover a broad range of health care solutions. At one...

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

    PubMed

    Mekonnen, Robin; Noonan, Kathleen; Rubin, David

    2009-04-01

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

  18. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-01-01

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

  19. Equity in health care utilization in Chile

    PubMed Central

    2013-01-01

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

  20. Prioritizing health-care funding.

    PubMed

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

    2005-07-01

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

  1. Coordinating Mental Health Care Across Primary Care and Schools: ADHD as a Case Example

    PubMed Central

    Power, Thomas J.; Blum, Nathan J.; Guevara, James P.; Jones, Heather A.; Leslie, Laurel K.

    2012-01-01

    Although primary care practices and schools are major venues for the delivery of mental health services to children, these systems are disconnected, contributing to fragmentation in service delivery. This paper describes barriers to collaboration across the primary care and school systems, including administrative and fiscal pressures, conceptual and linguistic differences between healthcare and educational professionals, role restrictions among professionals, and privacy laws. Strategies for overcoming these barriers that can be applied in both primary care and school settings are described. The paper has a primary focus on children with ADHD, but the principles and strategies described are applicable to children with a range of mental health and health conditions. PMID:23459527

  2. Beware the Managed Health-Care Companies.

    ERIC Educational Resources Information Center

    Ashbaugh, John; Smith, Gary

    1996-01-01

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

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

    PubMed

    Guo, Kristina L

    2010-01-01

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

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

    PubMed

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

    2013-01-01

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

  5. Primary Health Care and Narrative Medicine.

    PubMed

    Murphy, John W

    2015-01-01

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

  6. Primary Health Care and Narrative Medicine

    PubMed Central

    Murphy, John W

    2015-01-01

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

  7. Ethics and geographical equity in health care.

    PubMed

    Rice, N; Smith, P C

    2001-08-01

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

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

    PubMed

    Lichtenberg, Frank R

    2012-01-01

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

  9. Commentary: Institutes versus traditional administrative academic health center structures.

    PubMed

    Karpf, Michael; Lofgren, Richard

    2012-05-01

    In the Point-Counterpoint section of this issue, Kastor discusses the pros and cons of a new, institute-based administrative structure that was developed at the Cleveland Clinic in 2008, ostensibly to improve the quality and efficiency of patient care. The real issue underlying this organizational transformation is not whether the institute model is better than the traditional model; instead, the issue is whether the traditional academic health center (AHC) structure is viable or whether it must evolve. The traditional academic model, in which the department and chair retain a great deal of autonomy and authority, and in which decision-making processes are legislative in nature, is too tedious and laborious to effectively compete in today's health care market. The current health care market is demanding greater efficiencies, lower costs, and thus greater integration, as well as more transparency and accountability. Improvements in both quality and efficiency will demand coordination and integration. Focusing on quality and efficiency requires organizational structures that facilitate cohesion and teamwork, and traditional organizational models will not suffice. These new structures must and will replace the loose amalgamation of the traditional AHC to develop the focus and cohesion to address the pressures of an evolving health care system. Because these new structures should lead to more successful clinical enterprises, they will, in fact, support the traditional academic missions of research and education more successfully than traditional organizational models can. PMID:22531588

  10. Journal of Child-Care Administration, 1997-1998.

    ERIC Educational Resources Information Center

    Kalbaugh, Christine, Ed.

    1998-01-01

    This document is comprised of the four 1997-1998 issues of the Journal of Child-Care Administration, which addresses the concerns of child care centers, learning centers, preschools, nursery schools, kindergartens, and intergenerational centers. Issue 214 includes the following articles: (1) "Turning Your Staff into a Team: The Basics"; (2)…

  11. Dual loyalty in prison health care.

    PubMed

    Pont, Jörg; Stöver, Heino; Wolff, Hans

    2012-03-01

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

  12. Cost-effective health care: new data.

    PubMed

    Kalies, R F

    1997-06-01

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

  13. Connecting the dots: interprofessional health education and delivery system redesign at the Veterans Health Administration.

    PubMed

    Gilman, Stuart C; Chokshi, Dave A; Bowen, Judith L; Rugen, Kathryn Wirtz; Cox, Malcolm

    2014-08-01

    Health systems around the United States are embracing new models of primary care using interprofessional team-based approaches in pursuit of better patient outcomes, higher levels of satisfaction among patients and providers, and improved overall value. Less often discussed are the implications of new models of care for health professions education, including education for physicians, nurse practitioners, physician assistants, and other professions engaged in primary care. Described here is the interaction between care transformation and redesign of health professions education at the largest integrated delivery system in the United States: the Veterans Health Administration (VA). Challenges and lessons learned are discussed in the context of a demonstration initiative, the VA Centers of Excellence in Primary Care Education. Five sites, involving VA medical centers and their academic affiliates in Boise, Cleveland, San Francisco, Seattle, and West Haven, introduced interprofessional primary care curricula for resident physicians and nurse practitioner students beginning in 2011. Implementation struggles largely revolved around the operational logistics and cultural disruption of integrating educational redesign for medicine and nursing and facilitating the interface between educational and clinical activities. To realize new models for interprofessional teaching, faculty, staff, and trainees must understand the histories, traditions, and program requirements across professions and experiment with new approaches to achieving a common goal. Key recommendations for redesign of health professions education revolve around strengthening the union between interprofessional learning, team-based practice, and high-value care. PMID:24853198

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

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

    Brower, Mary R.; Sull, Theresa M.

    2003-01-01

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

  16. Can managed care plans control health care costs?

    PubMed

    Zwanziger, J; Melnick, G A

    1996-01-01

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

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

    PubMed

    Lasair, Simon

    2016-03-01

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

  18. 78 FR 61367 - Health Resources and Services Administration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities; Proposed Collection; Public Comment Request AGENCY: Health Resources and Services Administration,...

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

    PubMed

    Porter, Michael E; Teisberg, Elizabeth Olmsted

    2007-03-14

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

  20. Prospects for Flourishing in Contemporary Health Care.

    PubMed

    Pattison, Stephen; Edgar, Andrew

    2016-06-01

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

  1. Rx for Rising Health Care Premiums.

    ERIC Educational Resources Information Center

    Younger, Sandra Millers

    1990-01-01

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

  2. Health Care Access among Deaf People

    ERIC Educational Resources Information Center

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

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

  3. Predictors of Adolescent Health Care Utilization

    ERIC Educational Resources Information Center

    Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

    2007-01-01

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

  4. The Participatory Imperative in Primary Health Care.

    ERIC Educational Resources Information Center

    Hollnsteiner, Mary Racelis

    1982-01-01

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

  5. The recovery of Bay State Health Care.

    PubMed

    Maltz, D L

    1994-03-01

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

  6. Special Issue: The Family and Health Care.

    ERIC Educational Resources Information Center

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

    1985-01-01

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

  7. Mental Health in Long Term Care Settings.

    ERIC Educational Resources Information Center

    Shore, Herbert

    1978-01-01

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

  8. Health care law versus constitutional law.

    PubMed

    Hall, Mark A

    2013-04-01

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

  9. Health care agreements as a tool for coordinating health and social services

    PubMed Central

    Rudkjøbing, Andreas; Strandberg-Larsen, Martin; Vrangbaek, Karsten; Andersen, John Sahl; Krasnik, Allan

    2014-01-01

    Introduction In 2007, a substantial reform changed the administrative boundaries of the Danish health care system and introduced health care agreements to be signed between municipal and regional authorities. To assess the health care agreements as a tool for coordinating health and social services, a survey was conducted before (2005–2006) and after the reform (2011). Theory and methods The study was designed on the basis of a modified version of Alter and Hage's framework for conceptualising coordination. Both surveys addressed all municipal level units (n = 271/98) and a random sample of general practitioners (n = 700/853). Results The health care agreements were considered more useful for coordinating care than the previous health plans. The power relationship between the regional and municipal authorities in drawing up the agreements was described as more equal. Familiarity with the agreements among general practitioners was higher, as was the perceived influence of the health care agreements on their work. Discussion Health care agreements with specific content and with regular follow-up and systematic mechanisms for organising feedback between collaborative partners exemplify a useful tool for the coordination of health and social services. Conclusion There are substantial improvements with the new health agreements in terms of formalising a better coordination of the health care system. PMID:25550691

  10. Health care reform: informing difficult choices.

    PubMed

    Maynard, A; Bloor, K

    1995-01-01

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

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

    PubMed

    Rich, Preston B; Adams, Sasha D

    2015-02-01

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

  12. Spirulina in health care management.

    PubMed

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

    2008-10-01

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

  13. Health care leader competencies and the relevance of emotional intelligence.

    PubMed

    Weiszbrod, Twila

    2015-01-01

    As health care leader competencies continue to be refined and emphasized in health care administration educational programs, the "soft skills" of emotional intelligence have often been implied, but not included explicitly. The purpose of this study was to better understand what relationship, if any, could be identified between health care leader competencies and emotional intelligence. A quantitative correlational method of study was used, utilizing self-assessments and 360-degree assessments of both constructs. There were 43 valid participants in the study, representing the various types of health care delivery systems. Correlational analysis suggested there was a positive relationship; for each unit of increase in emotional intelligence, there was a 0.6 increase in overall health care leadership competence. This study did not suggest causation, but instead suggested that including the study and development of emotional intelligence in health care administration programs could have a positive impact on the degree of leader competence in graduates. Some curricula suggestions were provided, and further study was recommended. PMID:25909402

  14. Public health care provisions: access and equity.

    PubMed

    Bin Juni, M H

    1996-09-01

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

  15. The readiness of addiction treatment agencies for health care reform.

    PubMed

    Molfenter, Todd; Capoccia, Victor A; Boyle, Michael G; Sherbeck, Carol K

    2012-01-01

    The Patient Protection and Affordable Care Act (PPACA) aims to provide affordable health insurance and expanded health care coverage for some 32 million Americans. The PPACA makes provisions for using technology, evidence-based treatments, and integrated, patient-centered care to modernize the delivery of health care services. These changes are designed to ensure effectiveness, efficiency, and cost-savings within the health care system.To gauge the addiction treatment field's readiness for health reform, the authors developed a Health Reform Readiness Index (HRRI) survey for addiction treatment agencies. Addiction treatment administrators and providers from around the United States completed the survey located on the http://www.niatx.net website. Respondents self-assessed their agencies based on 13 conditions pertinent to health reform readiness, and received a confidential score and instant feedback.On a scale of "Needs to Begin," "Early Stages," "On the Way," and "Advanced," the mean scores for respondents (n = 276) ranked in the Early Stages of health reform preparation for 11 of 13 conditions. Of greater concern was that organizations with budgets of < $5 million (n = 193) were less likely than those with budgets > $5 million to have information technology (patient records, patient health technology, and administrative information technology), evidence-based treatments, quality management systems, a continuum of care, or a board of directors informed about PPACA.The findings of the HRRI indicate that the addiction field, and in particular smaller organizations, have much to do to prepare for a future environment that has greater expectations for information technology use, a credentialed workforce, accountability for patient care, and an integrated continuum of care. PMID:22551101

  16. The liberty principle and universal health care.

    PubMed

    Sachs, Benjamin

    2008-06-01

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

  17. 42 CFR 433.56 - Classes of health care services and providers defined.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Classes of health care services and providers defined. 433.56 Section 433.56 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE FISCAL ADMINISTRATION General Administrative Requirements State...

  18. Assessing administrative costs of mental health and substance abuse services.

    PubMed

    Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

    2004-05-01

    Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care. PMID:15379386

  19. Attending unintended transformations of health care infrastructure

    PubMed Central

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

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

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

    SciTech Connect

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

    2010-02-15

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

  1. 28 CFR 115.235 - Specialized training: Medical and mental health care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Specialized training: Medical and mental health care. 115.235 Section 115.235 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON... Education § 115.235 Specialized training: Medical and mental health care. (a) The agency shall ensure...

  2. 28 CFR 115.235 - Specialized training: Medical and mental health care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Specialized training: Medical and mental health care. 115.235 Section 115.235 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON... Education § 115.235 Specialized training: Medical and mental health care. (a) The agency shall ensure...

  3. 28 CFR 115.235 - Specialized training: Medical and mental health care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Specialized training: Medical and mental health care. 115.235 Section 115.235 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON... Education § 115.235 Specialized training: Medical and mental health care. (a) The agency shall ensure...

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

    PubMed

    Sigmond, R; Seay, J D

    1994-01-01

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

  5. Health Services Management in the Health Administration Curriculum. Report by the Curriculum Task Force on Administration.

    ERIC Educational Resources Information Center

    Association of Univ. Programs in Health Administration, Washington, DC.

    Critical decisions that need to be made by faculties of health administration education programs when developing and assessing the health services management portion of the curriculum are identified. Decisions should draw from the information available concerning professional target roles of graduates, graduate behavior expected, resources for…

  6. Association between household food insecurity and annual health care costs

    PubMed Central

    Tarasuk, Valerie; Cheng, Joyce; de Oliveira, Claire; Dachner, Naomi; Gundersen, Craig; Kurdyak, Paul

    2015-01-01

    Background: Household food insecurity, a measure of income-related problems of food access, is growing in Canada and is tightly linked to poorer health status. We examined the association between household food insecurity status and annual health care costs. Methods: We obtained data for 67 033 people aged 18–64 years in Ontario who participated in the Canadian Community Health Survey in 2005, 2007/08 or 2009/10 to assess their household food insecurity status in the 12 months before the survey interview. We linked these data with administrative health care data to determine individuals’ direct health care costs during the same 12-month period. Results: Total health care costs and mean costs for inpatient hospital care, emergency department visits, physician services, same-day surgeries, home care services and prescription drugs covered by the Ontario Drug Benefit Program rose systematically with increasing severity of household food insecurity. Compared with total annual health care costs in food-secure households, adjusted annual costs were 16% ($235) higher in households with marginal food insecurity (95% confidence interval [CI] 10%–23% [$141–$334]), 32% ($455) higher in households with moderate food insecurity (95% CI 25%–39% [$361–$553]) and 76% ($1092) higher in households with severe food insecurity (95% CI 65%–88% [$934–$1260]). When costs of prescription drugs covered by the Ontario Drug Benefit Program were included, the adjusted annual costs were 23% higher in households with marginal food insecurity (95% CI 16%–31%), 49% higher in those with moderate food insecurity (95% CI 41%–57%) and 121% higher in those with severe food insecurity (95% CI 107%–136%). Interpretation: Household food insecurity was a robust predictor of health care utilization and costs incurred by working-age adults, independent of other social determinants of health. Policy interventions at the provincial or federal level designed to reduce household food

  7. Cutting the Nation's Health Care Costs

    PubMed Central

    Davis, Emsley A.

    1987-01-01

    In 1984 health care expenditures totaled $387.4 billion, and may reach $757.9 billion by 1990. The following factors and their annual cost overrun price tags are the prime forces behind this rapidly growing expense: professional liability insurance, litigations, and defensive medicine, $30 billion; hospital administrative management and employee excess, $6.3 billion; community hospital profits, $8.3 billion; oversupply and duplication of drugs and drug sundries, $22.5 billion; the oversupply of physician specialists, at least $10 to $15 billion; unsolicited physician interpretation of routine, unsophisticated tests, $13.2 billion; and, finally, an American lifestyle adversely affected by illicit drugs ($60 billion), alcohol ($117 billion), and automobile accidents ($43.3 billion), for a total cost of $220 billion yearly. The intent of this article is to educate the public in an open and responsible fashion, and to demonstrate that the health care industry in the United States can save approximately $334.0 billion yearly. PMID:3118051

  8. Comparative effectiveness research with administrative health data in rheumatoid arthritis.

    PubMed

    Hudson, Marie; Tascilar, Koray; Suissa, Samy

    2016-06-01

    Comparative effectiveness research (CER) enables the comparison of different treatments in the real-world setting to inform clinical decision-making. Rheumatoid arthritis (RA) has been identified as a high priority area for CER. Administrative health databases, which generally consist of physician billing claims, hospital discharge summaries and prescription drug records, have been widely used to conduct observational research in RA. These data are accurate and complete records of health-care use unaffected by recall bias, and provide large, general population samples and information on long-term follow-up. However, administrative health data pose unique methodological challenges for CER in the field of RA. Here, we discuss the challenges of studying treatment effectiveness with CER (as distinct from harms and costs), in particular, issues relating to the identification and definition of RA cases, timing of disease onset and determination of disease severity. We also discuss an algorithm developed to measure effectiveness outcomes of RA treatments in administrative data, and potential sources of bias that might affect the validity of results. Finally, we explore opportunities for use of administrative data in CER, such as comparisons between reference drugs and biosimilars. PMID:27080692

  9. Coming Together To Cut Health Care Costs.

    ERIC Educational Resources Information Center

    Heron, W. David; Donatelli, Ben

    2003-01-01

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

  10. Hazardous waste compliance in health care settings.

    PubMed

    Marcoux, Rita M; Vogenberg, F Randy

    2015-02-01

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

  11. Health Care Revival Renews, Rekindles, and Revives

    PubMed Central

    Lawson, Erma; Young, Azzie

    2002-01-01

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

  12. The informatics of health care reform.

    PubMed

    Masys, D R

    1996-01-01

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

  13. Health care in the Yemen Arab Republic.

    PubMed

    Lambeth, S

    1988-01-01

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

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

    PubMed

    Zimbelman, J

    2000-01-01

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

  15. Challenges for the German Health Care System.

    PubMed

    Dietrich, C F; Riemer-Hommel, P

    2012-06-01

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

  16. Health Care: Lessons from China and Cuba

    PubMed Central

    Younge, Richard G.

    1982-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  18. Measuring the quality of health care.

    PubMed

    Custer, W

    1995-03-01

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

  19. Western impressions of the Hong Kong health care system.

    PubMed Central

    Bennett, C L; Pei, G K; Ultmann, J E

    1996-01-01

    Hong Kong, Taiwan, Singapore, and Malaysia are initiating health care reform to meet the changing demands of populations with improved socioeconomic status and access to modern technologies and who are living longer than in previous generations. Hong Kong, in particular, is facing a unique set of circumstances as its people prepare for the transition in 1997 from a British colony to a Special Administrative Region of China. While spending only 4% of its gross domestic product on health care, it has a large and regulated public hospital system for most inpatient medical care and a separate, loosely regulated private health care system for most outpatient medical care. In 1993 the Secretary for Health and Welfare of Hong Kong initiated a year-long process to debate the pros and cons of 5 fundamental programs for health care reform. After a year of open consultation, options were chosen. We describe the Hong Kong health care system, the fundamental changes that have been adopted, and lessons for reformers in the United States. PMID:8855683

  20. A curriculum for training quality scholars to improve the health and health care of veterans and the community at large.

    PubMed

    Splaine, Mark E; Aron, David C; Dittus, Robert S; Kiefe, Catarina I; Landefeld, C Seth; Rosenthal, Gary E; Weeks, William B; Batalden, Paul B

    2002-01-01

    In 1998, the Veterans Health Administration invested in the creation of the Veterans Administration National Quality Scholars Fellowship Program (VAQS) to train physicians in new ways to improve the quality of health care. We describe the curriculum for this program and the lessons learned from our experience to date. The VAQS Fellowship program has developed a core improvement curriculum to train postresidency physicians in the scholarship, research, and teaching of the improvement of health care. The curriculum covers seven domains of knowledge related to improvement: health care as a process; variation and measurement; customer/beneficiary knowledge; leading, following, and making changes in health care; collaboration; social context and accountability; and developing new, locally useful knowledge. We combine specific knowledge about the improvement of health care with the use of adult learning strategies, interactive video, and development of learner competencies. Our program provides insights for medical education to better prepare physicians to participate in and lead the improvement of health care. PMID:12512460

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

    PubMed

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

    2013-07-01

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

  2. Health Care and the Search for Wholeness.

    ERIC Educational Resources Information Center

    Connell, David B.; And Others

    1979-01-01

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

  3. A Conversation on Rural Health Care.

    ERIC Educational Resources Information Center

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

    1999-01-01

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

  4. Insights From Health Care in Germany

    PubMed Central

    Altenstetter, Christa

    2003-01-01

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

  5. Health Care and the High Court: An Overview

    ERIC Educational Resources Information Center

    Joondeph, Bradley W.; Camp, Bryan; Barry, Jordan; Pollack, Elliott B.; Chemerinsky, Erwin; Schwinn, Steven

    2012-01-01

    On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (ACA). Whatever its merits as a matter of policy, it was a historic legislative achievement. No prior administration had successfully pushed national health reform through Congress, despite several attempts. Understandably, the mood at the act's…

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

    PubMed

    Edgar, A

    1998-09-01

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

  7. Applying economic principles to health care.

    PubMed Central

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

    2001-01-01

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

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

    ERIC Educational Resources Information Center

    BCEL Brief, 1991

    1991-01-01

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

  9. Health Care Provider Physical Activity Prescription Intervention

    ERIC Educational Resources Information Center

    Josyula, Lakshmi; Lyle, Roseann

    2013-01-01

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

  10. Primary care NPs: Leaders in population health.

    PubMed

    Swartwout, Kathryn D

    2016-08-18

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

  11. Viewing health care as a war theater.

    PubMed

    Kessler, D M

    1988-03-01

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

  12. FastStats: Home Health Care

    MedlinePlus

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

  13. Research Challenges in Future Health Care Systems

    NASA Astrophysics Data System (ADS)

    Kulatunga, Harini

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

  14. A Guide to Adolescent Health Care EPSDT.

    ERIC Educational Resources Information Center

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

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

  15. Child Health and Access to Medical Care

    ERIC Educational Resources Information Center

    Leininger, Lindsey; Levy, Helen

    2015-01-01

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

  16. Teaching Primary Health Care: An Interdisciplinary Approach.

    ERIC Educational Resources Information Center

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

    1998-01-01

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

  17. Financial management in leading health care systems.

    PubMed

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

    2000-01-01

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

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

    ERIC Educational Resources Information Center

    Kastner, Theodore A.; Walsh, Kevin K.

    2006-01-01

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

  19. Issues of accountability in mental health administration.

    PubMed

    Sneed, R J; Lee, J R

    1984-01-01

    The issue of accountability in state hospitals and state schools-hospitals can be expected to remain paramount in the future. Almost all areas of mental health services are being scrutinized by consumers who are demanding more for their money. From the Perspective of the mental administrator consumers will have to become a more meaningful part of the decision making process to produce productive changes in these human service fields. Thus, to this end, human service institutions must have the ability to function as open systems and must develop a sense of responsiveness to their consumers' needs. PMID:10269100

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

    PubMed

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

    2006-09-01

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

  1. Wholistic Health Care: Challenge to Health Providers.

    ERIC Educational Resources Information Center

    McKay, Susan

    1980-01-01

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

  2. Integrating Behavioral Health into Primary Care.

    PubMed

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

    2016-04-01

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

  3. Integrating Behavioral Health into Primary Care

    PubMed Central

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

    2016-01-01

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

  4. Impact of financial agreements in European chronic care on health care expenditure growth.

    PubMed

    Tsiachristas, Apostolos; Dikkers, Carolien; Boland, Melinde R S; Rutten-van Mölken, Maureen P M H

    2016-04-01

    Various types of financial agreements have been implemented in Europe to reduce health care expenditure by stimulating integrated chronic care. This study used difference-in-differences (DID) models to estimate differences in health care expenditure trends before and after the introduction of a financial agreement between 9 intervention countries and 16 control countries. Intervention countries included countries with pay-for-coordination (PFC), pay-for-performance (PFP), and/or all inclusive agreements (bundled and global payment) for integrated chronic care. OECD and WHO data from 1996 to 2013 was used. The results from the main DID models showed that the annual growth of outpatient expenditure was decreased in countries with PFC (by 21.28 US$ per capita) and in countries with all-inclusive agreements (by 216.60 US$ per capita). The growth of hospital and administrative expenditure was decreased in countries with PFP by 64.50 US$ per capita and 5.74 US$ per capita, respectively. When modelling impact as a non-linear function of time during the total 4-year period after implementation, PFP decreased the growth of hospital and administrative expenditure and all-inclusive agreements reduced the growth of outpatient expenditure. Financial agreements are potentially powerful tools to stimulate integrated care and influence health care expenditure growth. A blended payment scheme that combines elements of PFC, PFP, and all-inclusive payments is likely to provide the strongest financial incentives to control health care expenditure growth. PMID:26971018

  5. The new Australian Primary Health Networks: how will they integrate public health and primary care?

    PubMed

    Booth, Mark; Hill, Graham; Moore, Michael J; Dalla, Danielle; Moore, Michael G; Messenger, Anne

    2016-01-01

    On 1 July 2015, the Australian Government established 31 new Primary Health Networks (PHNs), following a review by its former Chief Medical Officer, John Horvath, of 61 Medicare Locals created under the previous Labor administration. The Horvath review recommended, among other things, that new, larger primary health organisations be established to reduce fragmentation of care by integrating and coordinating health services, supporting the role of general practice, and leveraging and administering health program funding. The two main objectives of the new PHNs, as stated on the Department of Health's website, are "increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time". Below are three viewpoints, commissioned for this primary health care themed issue of Public Health Research & Practice, from the Australian Government Department of Health, the Public Health Association of Australia and a Sydney-based PHN. We asked the authors to focus particularly on how the newly established networks might help to integrate public health within the primary health care landscape. Our authors have pointed out the huge overlap between public health and primary care and looked at evidence showing the great benefits for health systems of collaboration between the two. Challenges ahead include a possible government focus on delivery of 'frontline' medical services, which may come at the expense of population health, and the complexity of dealing with all primary health care stakeholders, including health professionals, Local Health Districts, nongovernment organisations, research institutions and local communities. PMID:26863166

  6. Health care enters the real world.

    PubMed

    Schroeder, N J

    1987-01-01

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

  7. The promise of Lean in health care.

    PubMed

    Toussaint, John S; Berry, Leonard L

    2013-01-01

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

  8. Future trends in the health care economy.

    PubMed

    Kajander, J; Samuels, M

    1996-01-01

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

  9. Improving mental health through primary care.

    PubMed Central

    Dowrick, C

    1992-01-01

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

  10. Redistributive effects in public health care financing.

    PubMed

    Honekamp, Ivonne; Possenriede, Daniel

    2008-11-01

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

  11. Palau assessment for a continuing health care professional development program.

    PubMed

    Chen, Tai-Ho; Dever, Gregory; Kuartei, Stevenson; Maskarinec, Gregory G

    2007-03-01

    In 2003, the University of Hawai'i Department of Family Medicine and Community Health entered a 4-year cooperative agreement with the U.S. Health Resources and Services Administration to establish the "Pacific Association for Clinical Training" (PACT). PACT's goal is to develop effective distance education methods to improve the education and skills of health care professionals in the U.S.-Affiliated Pacific Island nations. To determine the situation existing in 2004, one of PACT's first projects was to perform site visits to each jurisdiction, conducting needs assessments through interviews with key health care professionals, hospital administrators and government officials. This article highlights findings of PACT's Palau assessment. Meant to establish a baseline for future reference, all data were collected in 2004-2005 and have not been updated. PMID:19772140

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

    MedlinePlus

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

  13. Estimated hospital costs associated with preventable health care-associated infections if health care antiseptic products were unavailable

    PubMed Central

    Schmier, Jordana K; Hulme-Lowe, Carolyn K; Semenova, Svetlana; Klenk, Juergen A; DeLeo, Paul C; Sedlak, Richard; Carlson, Pete A

    2016-01-01

    Objectives Health care-associated infections (HAIs) pose a significant health care and cost burden. This study estimates annual HAI hospital costs in the US avoided through use of health care antiseptics (health care personnel hand washes and rubs; surgical hand scrubs and rubs; patient preoperative and preinjection skin preparations). Methods A spreadsheet model was developed with base case inputs derived from the published literature, supplemented with assumptions when data were insufficient. Five HAIs of interest were identified: catheter-associated urinary tract infections, central line-associated bloodstream infections, gastrointestinal infections caused by Clostridium difficile, hospital- or ventilator-associated pneumonia, and surgical site infections. A national estimate of the annual potential lost benefits from elimination of these products is calculated based on the number of HAIs, the proportion of HAIs that are preventable, the proportion of preventable HAIs associated with health care antiseptics, and HAI hospital costs. The model is designed to be user friendly and to allow assumptions about prevention across all infections to vary or stay the same. Sensitivity analyses provide low- and high-end estimates of costs avoided. Results Low- and high-end estimates of national, annual HAIs in hospitals avoided through use of health care antiseptics are 12,100 and 223,000, respectively, with associated hospital costs avoided of US$142 million and US$4.25 billion, respectively. Conclusion The model presents a novel approach to estimating the economic impact of health care antiseptic use for HAI avoidance, with the ability to vary model parameters to reflect specific scenarios. While not all HAIs are avoidable, removing or limiting access to an effective preventive tool would have a substantial impact on patient well-being and infection costs. HAI avoidance through use of health care antiseptics has a demonstrable and substantial impact on health care

  14. The organisation of health care in Nepal.

    PubMed

    Bentley, H

    1995-06-01

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

  15. Transforming Care Delivery through Health Information Technology

    PubMed Central

    Wheatley, Benjamin

    2013-01-01

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

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

    PubMed Central

    Adams, Diane L.; Leath, Brenda A.

    2002-01-01

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

  17. Transition Care for Children With Special Health Care Needs

    PubMed Central

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

    2014-01-01

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

  18. Strategic service quality management for health care.

    PubMed

    Anderson, E A; Zwelling, L A

    1996-01-01

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

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

    PubMed Central

    Buciuniene, Ilona; Blazeviciene, Aurelija; Bliudziute, Egle

    2005-01-01

    Background The aim of this research paper is to study job satisfaction of physicians and general practitioners at primary health care institutions during the health care reform in Lithuania. Methods Self-administrated anonymous questionnaires were distributed to all physicians and general practitioners (N = 243, response rate – 78.6%), working at Kaunas primary health care level establishments, in October – December 2003. Results 15 men (7.9%) and 176 women (92.1%) participated in the research, among which 133 (69.6%) were GPs and 58 (30.4%) physicians. Respondents claimed to have chosen to become doctors, as other professions were of no interest to them. Total job satisfaction of the respondents was 4.74 point (on a 7 point scale). Besides 75.5% of the respondents said they would not recommend their children to choose a PHC level doctor's profession. The survey also showed that the respondents were most satisfied with the level of autonomy they get at work – 5.28, relationship with colleagues – 5.06, and management quality – 5.04, while compensation (2.09), social status (3.36), and workload (3.93) turned to be causing the highest dissatisfaction among the respondents. The strongest correlation (Spearmen's ratio) was observed between total job satisfaction and such factors as the level of autonomy – 0.566, workload – 0.452, and GP's social status – 0.458. Conclusion Total job satisfaction of doctors working at primary health care establishments in Lithuania is relatively low, and compensation, social status, and workload are among the key factors that condition PHC doctors' dissatisfaction with their job. PMID:15748299

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

    MedlinePlus

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

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

    PubMed

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

    2015-02-01

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

  2. 45 CFR 50.5 - Waivers for the delivery of health care service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Waivers for the delivery of health care service. 50.5 Section 50.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION U.S... for the delivery of health care service. In determining whether to request a waiver for an...

  3. 45 CFR 50.5 - Waivers for the delivery of health care service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Waivers for the delivery of health care service. 50.5 Section 50.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION U.S... for the delivery of health care service. In determining whether to request a waiver for an...

  4. 45 CFR 50.5 - Waivers for the delivery of health care service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Waivers for the delivery of health care service. 50.5 Section 50.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION U.S... for the delivery of health care service. In determining whether to request a waiver for an...

  5. Health profiles of adolescents in foster care.

    PubMed

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

    2013-01-01

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

  6. 77 FR 52061 - Notice of Proposed Exemption Involving Sharp HealthCare Located in San Diego, CA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... Benefits Security Administration Notice of Proposed Exemption Involving Sharp HealthCare Located in San... involve the Sharp HealthCare Health and Dental Plan (the Plan). The proposed exemption, if granted, would... does not reflect the views of the Department. 1. Background Sharp is an integrated health care...

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

    ERIC Educational Resources Information Center

    Hudson, Christopher G.; DeVito, Jo Anne

    1994-01-01

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

  8. 29 CFR 825.125 - Definition of health care provider.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  9. 29 CFR 825.125 - Definition of health care provider.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  10. Health care and equity in India

    PubMed Central

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

    2011-01-01

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

  11. Primary health care of the newborn baby.

    PubMed

    Bhakoo, O N; Kumar, R

    1990-01-01

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

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

    ERIC Educational Resources Information Center

    Trotter, Robert T., II

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

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

    PubMed

    Fortuit, P

    2005-09-01

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

  14. Evaluation of the Arizona health care cost-containment system

    PubMed Central

    McCall, Nelda; Henton, Douglas; Crane, Michael; Haber, Susan; Freund, Deborah; Wrightson, William

    1985-01-01

    This article evaluates Arizona's alternative to the acute portion of Medicaid, the Arizona Health Care Cost-Containment System (AHCCCS), during its first 18 months of operation from October 1982 through March 1984. It focuses on the program's implementation and describes and evaluates the program's innovative features. The features of the program outlined in the original AHCCCS legislation included: Competitive bidding, prepaid capitation of providers, capitation of the State by the Health Care Financing Administration, assignment of gatekeepers, beneficiary copayment, private administration, inclusion of private and public employees and county financed long-term care. An assessment of implementation during the second 18 months of the program reporting on more recent developments and is now being prepared by SRI International. PMID:10311438

  15. Child Health and Access to Medical Care

    PubMed Central

    Leininger, Lindsey; Levy, Helen

    2016-01-01

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

  16. MEDICAL CARE AND PUBLIC HEALTH SERVICES

    PubMed Central

    Emerson, Haven

    1952-01-01

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

  17. The foundation for future health care.

    PubMed

    Marcarelli, J L

    1987-01-01

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

  18. Privatization and bidding in the health-care sector.

    PubMed

    Bovbjerg, R R; Held, P J; Pauly, M V

    1987-01-01

    Public provision of health care, as under Medicare and Medicaid, traditionally "privatized" major production decisions. Providers of care, largely private physicians and hospitals (but also public hospitals), made significant decisions about public beneficiaries' access to care, the quality and quantity of individual services, and the prices to be paid. The result was high access and quality/quantity, but also high program spending, which has prompted a reassertion of public budgetary control. Newly activist program administration is using various mechanisms to promote economizing. Unable and unwilling to specify standards of public access or quality/quantity too overtly, administration instead seeks to squeeze prices--mainly through administrative price setting but also through competitive bidding and voucherlike arrangements. Under such new incentives, major choices that in many non-American systems would be public are here "reprivatized" to be resolved out of the limelight by beneficiaries, traditional providers, or new intermediaries like Competitive Medical Plans. PMID:10301821

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

    PubMed

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

    2016-02-01

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

  20. Corporate moral responsibility in health care.

    PubMed

    Wilmot, S

    2000-01-01

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

  1. Mastering health care executive education: creating transformational competence.

    PubMed

    Clement, D G; Wan, T T

    1997-01-01

    The effective health services executive needs to continue to develop analytical, technical and behavioral skills to anticipate and meet the changing requirements of the health care industry. Those leading the field of health administration will need to be competent in achieving transformations. Lifelong learning is a necessity. As the structure and knowledge of the field change, so must the ways of exchanging information about health and medical care. Distance learning is a strategy for lifelong learning that can be used to continue one's education. In order to be successful in positioning a health care organization in the competitive world, investment in continued education to update strategic thinking and the analytical competency of executives and managers is imperative. Academic programs able to respond to the educational needs of the health care industry have a dedicated faculty who understand corporate culture and competitiveness in the health care marketplace and are able to offer effective adult education using cutting-edge computer technology for distance learning. PMID:10178099

  2. Indiana Health Occupations Education: Student Modules for Administration of Medications for Unlicensed Nursing Personnel. Revised Edition.

    ERIC Educational Resources Information Center

    Bilger, Phyllis; And Others

    These learning modules are designed to provide health care workers involved with medications with basic information about the nature and administration of medications. The 30 modules are organized into six units. An overview of preparation and administration of medicines, principles of medication therapy, and medication fundamentals are presented…

  3. Reflections on curative health care in Nicaragua.

    PubMed Central

    Slater, R G

    1989-01-01

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

  4. Space technology in remote health care

    NASA Technical Reports Server (NTRS)

    Belasco, N.

    1974-01-01

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

  5. The changing environment for technological innovation in health care.

    PubMed

    Goodman, C S; Gelijns, A C

    1996-01-01

    A distinguishing feature of American health care is its emphasis on advanced technology. Yet today's changing health care environment is overhauling the engine of technological innovation. The rate and direction of technological innovation are affected by a complex of supply- and demandside factors, including biomedical research, education, patent law, regulation, health care payment, tort law, and more. Some distinguishing features of technological innovation in health care are now at increased risk. Regulatory requirements and rising payment hurdles are especially challenging to small technology companies. Closer management of health care delivery and payment, particularly the standardization that may derive from practice guidelines and clamping down on payment for investigational technologies, curtails opportunities for innovation. Levels and distribution of biomedical research funding in government and industry are changing. Financial constraints are limiting the traditional roles of academic health centers in fostering innovation. Despite notable steps in recent years to lower regulatory barriers and speed approvals, especially for products for life-threatening conditions, the Food and Drug Administration is under great pressure from Congress, industry, and patients to do more. Technology gatekeeping is shifting from hundreds of thousands of physicians acting on behalf of their patients to fewer, yet more powerful, managed care organizations and health care networks. Beyond its direct effects on adoption, payment, and use of technologies, the extraordinary buying leverage of these large providers is cutting technology profit margins and heightening competition among technology companies. It is contributing to unprecedented restructuring of the pharmaceutical and medical device industries, leading to unprecedented alliances with generic product companies, health care providers, utilization review companies, and other agents. These industry changes are already

  6. Nutrition support teams: role in the new health care environment.

    PubMed

    Clemmer, T P

    1994-12-01

    Many hospitals have strong political leaders who question the need for a nutrition support service. In addition, the pressures of economic and health care reform are forcing administrators to cut unnecessary and unproven, albeit beneficial, services. The challenge for nutrition support services is clear-cut: in order to survive, nutrition support teams must understand the changes in health care and must learn how to adapt to them. This article clarifies the issues and assists nutrition support teams in establishing a new direction. PMID:7476796

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

    PubMed

    Henke, Klaus-Dirk

    2007-05-15

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

  8. Health Care Robotics: A Progress Report

    NASA Technical Reports Server (NTRS)

    Fiorini, Paolo; Ali, Khaled; Seraji, Homayoun

    1997-01-01

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

  9. Future developments in health care performance management.

    PubMed

    Crema, Maria; Verbano, Chiara

    2013-01-01

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

  10. Future developments in health care performance management

    PubMed Central

    Crema, Maria; Verbano, Chiara

    2013-01-01

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

  11. Health care evaluation, utilitarianism and distortionary taxes.

    PubMed

    Calcott, P

    2000-09-01

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

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

    PubMed

    Kuhlmey, A

    2011-08-01

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

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

    PubMed

    Richard, V

    2005-01-01

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

  14. Understanding and Measuring Health Care Insecurity

    PubMed Central

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

    2015-01-01

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

  15. Massachusetts health care reform: is it working?

    PubMed

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

    2013-01-01

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

  16. Working toward financial sustainability of integrated behavioral health services in a public health care system.

    PubMed

    Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

    2012-06-01

    The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains. PMID:22563727

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

    PubMed Central

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-01-01

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

  18. mHealth in Cardiovascular Health Care.

    PubMed

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

    2016-08-01

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

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

    PubMed

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

    2015-02-01

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

  20. Challenges to Native American health care.

    PubMed Central

    Noren, J; Kindig, D; Sprenger, A

    1998-01-01

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

  1. Health Care Expenditures Attributable to Smoking in Military Veterans

    PubMed Central

    Hamlett-Berry, Kim; Sung, Hai-Yen; Max, Wendy

    2015-01-01

    Introduction: The health effects of cigarette smoking have been estimated to account for between 6%–8% of U.S. health care expenditures. We estimated Veterans Health Administration (VHA) health care costs attributable to cigarette smoking. Methods: VHA survey and administrative data provided the number of Veteran enrollees, current and former smoking prevalence, and the cost of 4 types of care for groups defined by age, gender, and region. Cost and smoking status could not be linked at the enrollee level, so we used smoking attributable fractions estimated in sample of U.S. residents where the linkage could be made. Results: The 7.7 million Veterans enrolled in VHA received $40.2 billion in VHA provided health services in 2010. We estimated that $2.7 billion in VHA costs were attributable to the health effects of smoking. This was 7.6% of the $35.3 billion spent on the types of care for which smoking-attributable fractions could be determined. The fraction of inpatient costs that was attributable to smoking (11.4%) was greater than the fraction of ambulatory care cost attributable to smoking (5.3%). More cost was attributable to current smokers ($1.7 billion) than to former smokers ($983 million). Conclusions: The fraction of VHA costs attributable to smoking is similar to that of other health care systems. Smoking among Veterans is slowly decreasing, but prevalence remains high in Veterans with psychiatric and substance use disorders, and in younger and female Veterans. VHA has adopted a number of smoking cessation programs that have the potential for reducing future smoking-attributable costs. PMID:25239960

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

    PubMed

    Bauer, M; Bach, A

    1998-06-01

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

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

    PubMed

    Rydlewska-Liszkowska, Izabela

    2006-01-01

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

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

    PubMed Central

    Cueto, Marcos

    2004-01-01

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

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

    PubMed

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

    2016-03-01

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

  6. THE NEOLIBERAL TURN IN AMERICAN HEALTH CARE.

    PubMed

    Gaffney, Adam

    2015-01-01

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

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

    PubMed

    2013-06-01

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

  8. Reforming the Israeli health care market.

    PubMed

    Chinitz, D P

    1994-11-01

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

  9. Disparities in Health Care Quality among Minority Women

    MedlinePlus

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

  10. [Redesigning Swiss ambulatory health care system].

    PubMed

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

    2012-11-28

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

  11. Health insurance in India: need for managed care expertise.

    PubMed

    Thomas, Thomas K

    2011-02-01

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

  12. Big data in health care.

    PubMed

    Schouten, Pieter

    2013-02-01

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

  13. Types of health care providers

    MedlinePlus

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

  14. Types of health care providers

    MedlinePlus

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

  15. National Health Care Anti-Fraud Association

    MedlinePlus

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

  16. Primary health care nurse practitioners in Canada.

    PubMed

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

    2007-08-01

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

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

    PubMed

    Mina, András

    2016-04-24

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

  18. Ensuring optimal health care for LGBT patients.

    PubMed

    Glasper, Alan

    2016-07-14

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

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

    PubMed

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

    2016-01-01

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

  20. Health care philanthropies: how communities can participate.

    PubMed

    1996-09-01

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

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

    ERIC Educational Resources Information Center

    Washington State Workforce Training and Education Coordinating Board, Olympia.

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

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

    ERIC Educational Resources Information Center

    Abel, Cynthia H., Ed.

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

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

    ERIC Educational Resources Information Center

    Juarbe, Teresa C.

    1995-01-01

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

  4. Comfort Theory: Unraveling the Complexities of Veterans' Health Care Needs.

    PubMed

    Boudiab, Lina Daou; Kolcaba, Katharine

    2015-01-01

    The health care needs of veterans, especially those who have served in combat zones and their families are complicated, challenging, and interrelated. Physical limitations impact mental health, and mental health problems affect every aspect of adjustment to civilian life. Comfort theory offers a simple and holistic pattern for identifying needs, creating interventions to meet those needs, and evaluating the effects of those interventions. The aim of this article is to demonstrate how comfort theory has been applied throughout 1 Veterans Administration System to fulfill the goal of providing quality veteran-centric care. The application of comfort theory to daily patient and family care, discharge planning, and follow-up in various settings, as well as ways to enhance institutional integrity and branding are discussed. PMID:26517339

  5. The Health Care Dilemma. Second Edition.

    ERIC Educational Resources Information Center

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

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

  6. Improving Health Care for Assisted Living Residents

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  7. Obamacare Paying Off with Improved Health Care

    MedlinePlus

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

  8. Model Child Care Health Policies. Fourth Edition.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

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

  9. Multidisciplinary teamwork in US primary health care.

    PubMed

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

    2007-08-01

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

  10. Risk management issues in postmenopausal health care.

    PubMed

    Edozien, Leroy C

    2007-12-01

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

  11. Emerging trends in health care finance.

    PubMed

    Sterns, J B

    1994-01-01

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

  12. Health care choices: sharing the quality message.

    PubMed

    2001-01-01

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

  13. Organization theory. Analyzing health care organizations.

    PubMed

    Cors, W K

    1997-02-01

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

  14. The English and Swedish health care reforms.

    PubMed

    Glennerster, H; Matsaganis, M

    1994-01-01

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

  15. Validation of the Health Care Surrogate Preferences Scale

    ERIC Educational Resources Information Center

    Buckey, Julia W.; Abell, Neil

    2004-01-01

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

  16. The physician's perception of health care.

    PubMed Central

    Lawrence, R S

    1994-01-01

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

  17. Who administers? Who cares? Medical administrative and clinical employment in the United States and Canada.

    PubMed Central

    Himmelstein, D U; Lewontin, J P; Woolhandler, S

    1996-01-01

    OBJECTIVES. We compared US and Canadian health administration costs using national medical care employment data for both countries. METHODS. Data from census surveys on hospital, nursing home, and outpatient employment in the United States (1968 to 1993) and Canada (1971 and 1986) were analyzed. RESULTS. Between 1968 and 1993, US medical care employment grew from 3.976 to 10.308 million full-time equivalents. Administration grew from 0.719 to 2.792 million full-time equivalents, or from 18.1% to 27.1% of the total employment. In 1986, the United States deployed 33,666 health care full-time equivalent personnel per million population, and Canada deployed 31,529. The US excess was all administrative; Canada employed more clinical personnel, especially registered nurses. Between 1971 and 1986, hospital employment per capita grew 29% in the United States (mostly because of administrative growth) and fell 14% in Canada. In 1986, Canadian hospitals still employed more clinical staff per million. Outpatient employment was larger and grew faster in the United States. Per capita nursing home employment was substantially higher in Canada. CONCLUSIONS. If US hospitals and outpatient facilities adopted Canada's staffing patterns, 1,407,000 fewer managers and clerks would be necessary. Despite lower medical spending, Canadians receive slightly more nursing and other clinical care than Americans, as measured by labor inputs. PMID:8633732

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

    ERIC Educational Resources Information Center

    Adler, Michele

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

  19. Applying business management models in health care.

    PubMed

    Trisolini, Michael G

    2002-01-01

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

  20. Health care data in the United States.

    PubMed

    Rice, D P

    1983-06-01

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