... of the Secretary 32 CFR Part 199 RIN 0720-AB30 TRICARE; Continued Health Care Benefit Program..., some MHS beneficiaries would not be eligible to purchase Continued Health Care Benefit Program (CHCBP... continued health care coverage for eligible beneficiaries who lose their MHS eligibility. It was...
McArdle, Frank B.
Considerations in designing a standard health care benefits package as a part of national health care reform are discussed. Specific features examined include deductibles, employer contributions, regional variations, cost management techniques such as managed care and higher copayments, annual out-of-pocket maximums, and lifetime benefit maximums.…
Canadian employees place such a high value on their employer-sponsored health care benefits, that most would not trade the benefits for extra vacation time or even significant amounts of cash, according to the 2004 Aventis Healthcare Survey.
Routine health care can spell the difference between a strong beginning and a fragile start. After much public and Congressional debate, President Obama signed into law landmark health care reform legislation. Although many provisions will not go into effect this year, several important changes could benefit children within a few months. The…
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…
Planas-Miret, Ivan; Tur-Prats, Ana
This contribution presents entitlements and benefits, decision criteria, and involved actors for services of curative care in Spain. It describes basic benefits included in the category of curative care defined by the central government and any additional benefits that some autonomous communities (ACs) have included to enlarge their own basket. It is concluded that there is no specific and explicit benefit catalogue. As no user charges exist for this category, waiting times serve as the main cost containment tool. There is a need for further legislation, as inequalities may increase across the territory as a matter of fact. Inequalities in access to health care resources between ACs are not due to differences in health baskets but mainly to the availability of technologies. PMID:16267655
Fendrick, A. Mark
Although medical innovation can reduce morbidity and mortality associated with diseases or their treatments, in most instances new interventions tend to increase the amount of resources expended on health care services. In this era of increasing cost consciousness, there is a perceived tension between the desire to improve health outcomes and the necessity to control the growth of health care costs. The dramatic changes in the organization, financing, and delivery of health care services, make it no longer acceptable to provide any and all services to every individual with only a remote probability of clinical benefit. An incentive structure which rewards the practice of cost-effective medical care is rapidly replacing the 'technological imperative' of decades past. As the expansion towards managed care continues, increasing scrutiny will be paid to the clinical and cost implications of our medical interventions.
Technology permeates every dimension of critical care. Bedside technology is integral to the assessment and monitoring of patients and to the provision of treatment. It also helps with access to vital information and can enhance communication. Although it offers extraordinary benefits to patients and clinicians, technology may also create problems. Our research addresses the wise use of technology in the care of critically ill patients. It examines the appropriate and safe use of technology, its equitable distribution, and the human-machine interface. Given that some devices are more effective and safe than others, it is important to assess the appropriateness of a specific technology in a specific situation. Just because a particular device is available, is it necessary to use it in every possible situation? Do we use it just because it is there? Do we employ "heroic" measures sometimes when it would be kinder not to? Studies on the safe use of technology in patient care lead to a consideration of the risk-benefit ratio. Our research on gender and racial differences in the use of cardiac procedures in patients with acute myocardial infarction focused on the equitable distribution of technology. The results of this line of research, along with those of numerous other studies, suggest possible racism in our health care practices. The human-machine interface, or how clinicians and patients interact with health care technology, is a crucial focus of research. Technology is at the heart of critical care. It allows clinicians to perform miracles, but is also a seductive and self-perpetuating force that needs careful monitoring by those who use it.
... of the Secretary TRICARE; Fiscal Year 2014 Continued Health Care Benefit Program Premium Update AGENCY: Office of the Secretary, DoD. ACTION: Notice of Updated Continued Health Care Benefit Program Premiums for Fiscal Year 2014. SUMMARY: This notice provides the updated Continued Health Care...
Ward, Andrew; Johnson, Pamela Jo
According to HealthCare.gov, by improving access to quality health for all Americans, the Affordable Care Act (ACA) will reduce disparities in health insurance coverage. One way this will happen under the provisions of the ACA is by creating a new health insurance marketplace (a health insurance exchange) by 2014 in which "all people will have a choice for quality, affordable health insurance even if a job loss, job switch, move or illness occurs". This does not mean that everyone will have whatever insurance coverage he or she wants. The provisions of the ACA require that each of the four benefit categories of plans (known as bronze, silver, gold and platinum) provides no less than the benefits available in an "essential health benefits package". However, without a clear understanding of what criteria must be satisfied for health care to be essential, the ACA's requirement is much too vague and open to multiple, potentially conflicting interpretations. Indeed, without such understanding, in the rush to provide health insurance coverage to as many people as is economically feasible, we may replace one kind of disparity (lack of health insurance) with another kind of disparity (lack of adequate health insurance). Thus, this paper explores the concept of "essential benefits", arguing that the "essential health benefits package" in the ACA should be one that optimally satisfies the basic needs of the people covered.
Sneiderman, Charles A.; Ackerman, Michael J.
Cellular radio telecommunication has increased exponentially with many applications to health care reported. The authors attempt to summarize published applications with demonstrated effect on health care, review briefly the rapid evolution of hardware and software standards, explain current limitations and future potential of data quality and security, and discuss issues of safety. PMID:15298996
Sneiderman, Charles A; Ackerman, Michael J
Cellular radio telecommunication has increased exponentially with many applications to health care reported. The authors attempt to summarize published applications with demonstrated effect on health care, review briefly the rapid evolution of hardware and software standards, explain current limitations and future potential of data quality and security, and discuss issues of safety.
Purpose This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. Methods A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010–2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Results Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. Conclusions The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system. PMID:28050318
Giffords, Elissa D; Wenze, Linda; Weiss, David M; Kass, Donna; Guercia, Rosemarie
The present study explored hospital community benefits and free care programs at seven hospitals in Nassau and Suffolk counties in Long Island, NewYork. There were two components to this project: (1) assessment of information regarding the availability of free care and (2) an analysis of the community benefits information filed with state regulatory offices. Results show that not one of the seven hospitals consistently informed surveyors that free care was available to low-income, uninsured people. Surveyors had difficulty obtaining written free care policies. The article concludes with suggestions for government agencies, hospital administrators, social workers, and other advocates on how to get involved in efforts to increase access to health care for the uninsured population.
Thompson, J M; Hurley, R E
While health care providers recognize employers as key purchasers of health benefits, there is little understanding of how employers make these important buys. We propose a model of health benefits acquisition using an organizational buying perspective, and discuss findings from a study of employee benefits managers. Critical marketing implications are presented.
Davitt, Joan K; Gellis, Zvi D
Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.
Moore, W B
Each day as Americans prepare to begin their days, many put on their clothing often without a thought as to how or where it was manufactured. The manufacture of clothing in the United States is a labor intensive industry pressed by competition in foreign countries where labor is abundant and less expensive; therefore, the manufacturers must look for every opportunity to reduce their costs. The survey presented here reviews the health benefit plans in the apparel industry and current initiatives for cost reduction. The results are interesting, for they give the hospital administrator vital information on the types of programs that might be in place in local manufacturers and the method of cost containment expected in this industry.
Bunn, William B; Stave, Gregg M; Allen, Harris; Naim, Ahmad B
Health care costs for employers are rising much faster than inflation. The common approach to health benefit design of increasing cost sharing has failed to contain costs. Some employers, however, have been successful at mitigating the cost trend or actually reducing health care costs. These employers have in common a dedication to data analysis, a search for cost drivers, and a willingness to adjust their approach to health benefit design to address these cost drivers. This approach has much in common with the movement in clinical practice toward evidence-based medicine. We propose that employers adopt a similar approach toward health benefits termed evidence-based benefit design, which is based on a health and productivity framework focused on direct and indirect costs. Evidence-based benefit design incorporates the relevant literature and employer-specific data that are integrated and regularly analyzed.
Giffords, Elissa D.; Wenze, Linda; Weiss, David M.; Kass, Donna; Guercia, Rosemarie
The present study explored hospital community benefits and free care programs at seven hospitals in Nassau and Suffolk counties in Long Island, New York. There were two components to this project: (1) assessment of information regarding the availability of free care and (2) an analysis of the community benefits information filed with state…
Rosenbaum, Sara; Teitelbaum, Joel; Hayes, Katherine
In establishing minimum coverage standards for health insurance plans, the Affordable Care Act includes an "essential health benefits" statute that directs the U.S. Secretary of Health and Human Services not to make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life. This issue brief examines how this statute will help Americans with disabilities, who currently are subject to discrimination by insurers based on health status and health care need. The authors also discuss the complex issues involved in implementing the essential benefits provision and offer recommendations to federal policymakers for ensuring that people with disabilities receive the full insurance benefits to which they are entitled.
Kober, Thomas E.
This introduction to the major concepts of cost-benefit analysis (CBA) is intended for individuals involved in health care provider education who are attempting to measure the costs and benefits of their educational activities. After tracing the development of CBA, the paper defines it as an attempt to quantify and compare the expenditures for a…
Akazili, James; Garshong, Bertha; Aikins, Moses; Gyapong, John; McIntyre, Di
The National Health Insurance (NHI) scheme was introduced in Ghana in 2004 as a pro-poor financing strategy aimed at removing financial barriers to health care and protecting all citizens from catastrophic health expenditures, which currently arise due to user fees and other direct payments. A comprehensive assessment of the financing and benefit incidence of health services in Ghana was undertaken. These analyses drew on secondary data from the Ghana Living Standards Survey (2005/2006) and from an additional household survey which collected data in 2008 in six districts covering the three main ecological zones of Ghana. Findings show that Ghana's health care financing system is progressive, driven largely by the progressivity of taxes. The national health insurance levy (which is part of VAT) is mildly progressive while NHI contributions by the informal sector are regressive. The distribution of total benefits from both public and private health services is pro-rich. However, public sector district-level hospital inpatient care is pro-poor and benefits of primary-level health care services are relatively evenly distributed. For Ghana to attain an equitable health system and fully achieve universal coverage, it must ensure that the poor, most of whom are not currently covered by the NHI, are financially protected, and it must address the many access barriers to health care.
Aultman, Julie M; Dean, Erin
In this mixed methods study we identify and assess ethical and pragmatic issues and dilemmas surrounding e-health technologies in the context of primary care, including what is already in the literature. We describe how primary healthcare professionals can access reliable and accurate data, improve the quality of care for patients, and lower costs while following institutional guidelines to protect patients. Using qualitative and quantitative methodologies we identify several underlying ethical and pragmatic burdens and benefits of e-health technologies.The 41 study participants reported more burdens than benefits, and were generally ambivalent about their level of satisfaction with their institutions' e-health technologies, their general knowledge about the technologies, and whether e-health can improve team-based communication and collaboration. Participants provided recommendations to improve e-health technologies in primary care settings.
Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina
The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as "essential health benefits." Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees' experiences with their coverage--information called for under the law's delayed transparency requirements--to determine whether states' differing strategies are producing the coverage improvements promised by reform.
Organizations that depend on a highly-skilled, stable workforce must be attuned to the needs of their employees and provide adequate compensation and benefits that enhance job satisfaction and lessen job mobility. Hospitals, like other organizations that compete for hard-to-find workers, use both traditional and non-traditional benefits to attract and keep skilled employees. This nationwide survey of hospital human resource managers assesses the types of benefits offered to health care workers and gauges the perceived impact of those benefits on job satisfaction and employee retention. Survey findings reveal that certain basic benefits, such as health insurance, are provided to all hospital employees. Other benefits, such as signing bonuses and reimbursement of relocation costs, are used as inducements to attract individuals in hard-to-fill job categories.
Maxwell, James; Temin, Peter; Zaman, Saminaz
This paper is the first to compare health care purchasing in the retail versus other sectors of the Fortune 500. Employing millions of low-wage workers, the retail sector is the largest employer of uninsured workers in the economy. We found that retail companies are using the same competitive bidding process that other companies use to obtain a given level of coverage for the lowest possible cost. However, they are more price oriented than other Fortune 500 companies are. The most striking disparity lies in the nearly fivefold difference in offer rates for health care coverage. This shows that the economy's bifurcation in health benefits extends even to the nation's largest companies.
McHugh, Matthew D; Kutney-Lee, Ann; Cimiotti, Jeannie P; Sloane, Douglas M; Aiken, Linda H
Job dissatisfaction among nurses contributes to costly labor disputes, turnover, and risk to patients. Examining survey data from 95,499 nurses, we found much higher job dissatisfaction and burnout among nurses who were directly caring for patients in hospitals and nursing homes than among nurses working in other jobs or settings, such as the pharmaceutical industry. Strikingly, nurses are particularly dissatisfied with their health benefits, which highlights the need for a benefits review to make nurses' benefits more comparable to those of other white-collar employees. Patient satisfaction levels are lower in hospitals with more nurses who are dissatisfied or burned out-a finding that signals problems with quality of care. Improving nurses' working conditions may improve both nurses' and patients' satisfaction as well as the quality of care.
McGregor, Jules; Mercer, Stewart W; Harris, Fiona M
The prevalence of complex health and social needs in primary care patients is growing. Furthermore, recent research suggests that the impact of psychosocial distress on the significantly poorer health outcomes in this population may have been underestimated. The potential of social work in primary care settings has been extensively discussed in both health and social work literature and there is evidence that social work interventions in other settings are particularly effective in addressing psychosocial needs. However, the evidence base for specific improved health outcomes related to primary care social work is minimal. This review aimed to identify and synthesise the available evidence on the health benefits of social work interventions in primary care settings. Nine electronic databases were searched from 1990 to 2015 and seven primary research studies were retrieved. Due to the heterogeneity of studies, a narrative synthesis was conducted. Although there is no definitive evidence for effectiveness, results suggest a promising role for primary care social work interventions in improving health outcomes. These include subjective health measures and self-management of long-term conditions, reducing psychosocial morbidity and barriers to treatment and health maintenance. Although few rigorous study designs were found, the contextual detail and clinical settings of studies provide evidence of the practice applicability of social work intervention. Emerging policy on the integration of health and social care may provide an opportunity to develop this model of care.
McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark
Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations.
Background New Zealand's Primary Health Care Strategy (NZPHCS) was introduced in 2002. Its features are substantial increases in government funding delivered as capitation payments, and newly-created service-purchasing agencies. The objectives are to reduce health disparities and to improve health outcomes. Analysis The NZPHCS changes New Zealand's publicly-funded primary health care payments from targeted welfare benefits to universal, risk-rated insurance premium subsidies. Patient contributions change from fee-for-service top-ups to insurance premium top-ups, and are collected by service providers who, depending upon their contracts with purchasers, may also be either insurance agents or risk-bearing insurance companies. The change invokes the tensions associated with allocating risk-bearing amongst providers, patients and insurance companies that accompany all insurance-based funding instruments. These include increases in existing incentives for over-consumption and new incentives for insurers to limit their exposure to variations in patient health states by engaging in active patient pool selection. The New Zealand scheme is complex, but closely resembles United States insurance-based, risk-rated managed care schemes. The key difference is that unlike classic managed care models, where provider remuneration is determined by the insurer, the historic right for general practitioners to autonomously set patient charges alters the fiscal incentives normally available to managed care organisations. Consequently, the insurance role is being devolved to individual service providers with very small patient pools, who must recoup the premium top-ups from insured individuals. Premium top-ups are being collected only from those individuals consuming care, in proportion to the number of times care is sought. Co-payments thus constitute perfectly risk-rated premium levies set by inefficiently small insurers, raising questions about the efficiency and equity of a
This final rule sets forth standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.
Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule.
This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.
Hernandez, Alexandra; Nguyen, Tan; Riahi, Sanaz
Background Treatment for mental illness has shifted from focusing purely on treatment of symptoms to focusing on personal recovery. Patient activation is an important component of the recovery journey. Patient portals have shown promise to increase activation in primary and acute care settings, but the benefits to tertiary level mental health care remain unknown. Objective To conduct a benefits evaluation of a Web-based portal for patients undergoing treatment for serious or persistent mental illness in order to examine the effects on (1) patient activation, (2) recovery, (3) productivity, and (4) administrative efficiencies. Methods All registered inpatients and outpatients at a tertiary level mental health care facility were offered the opportunity to enroll and utilize the patient portal. Those who chose to use the portal and those who did not were designated as “users” and “nonusers,” respectively. All patients received usual treatment. Users had Web-based access to view parts of their electronic medical record, view upcoming appointments, and communicate with their health care provider. Users could attend portal training or support sessions led by either the engagement coordinator or peer support specialists. A subset of patients who created and utilized their portal account completed 2 Web-based surveys at baseline (just after enrollment; n=91) and at follow-up (6 and 10 months; n=65). The total score of the Mental Health Recovery Measure (MHRM) was a proxy for patient activation and the individual domains measured recovery. The System and Use Survey Tool (SUS) examined the use of functions and general feedback about the portal. Organizational efficiencies were evaluated by examining the odds of portal users and nonusers missing appointments (productivity) or requesting information from health information management (administrative efficiencies) in the year before (2014) and the year after (2015) portal implementation. Results A total of 461 patients
Macha, Jane; Harris, Bronwyn; Garshong, Bertha; Ataguba, John E; Akazili, James; Kuwawenaruwa, August; Borghi, Josephine
In Ghana, Tanzania and South Africa, health care financing is progressive overall. However, out-of-pocket payments and health insurance for the informal sector are regressive. The distribution of health care benefits is generally pro-rich. This paper explores the factors influencing these distributions in the three countries. Qualitative data were collected through focus group discussions and in-depth interviews with insurance scheme members, the uninsured, health care providers and managers. Household surveys were also conducted in all countries. Flat-rate contributions contributed to the regressivity of informal sector voluntary schemes, either by design (in Tanzania) or due to difficulties in identifying household income levels (in Ghana). In all three countries, the regressivity of out-of-pocket payments is due to the incomplete enforcement of exemption and waiver policies, partial or no insurance cover among poorer segments of the population and limited understanding of entitlements among these groups. Generally, the pro-rich distribution of benefits is due to limited access to higher level facilities among poor and rural populations, who rely on public primary care facilities and private pharmacies. Barriers to accessing health care include medical and transport costs, exacerbated by the lack of comprehensive insurance coverage among poorer groups. Service availability problems, including frequent drug stock-outs, limited or no diagnostic equipment, unpredictable opening hours and insufficient skilled staff also limit service access. Poor staff attitudes and lack of confidence in the skills of health workers were found to be important barriers to access. Financing reforms should therefore not only consider how to generate funds for health care, but also explicitly address the full range of affordability, availability and acceptability barriers to access in order to achieve equitable financing and benefit incidence patterns.
Hazlett, Diane E; Harrison, Laura; Carroll, Jennifer K; Irwin, Anthea; Hoving, Ciska
Background There is currently a lack of information about the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals from primary research. Objective To review the current published literature to identify the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals, and identify current gaps in the literature to provide recommendations for future health communication research. Methods This paper is a review using a systematic approach. A systematic search of the literature was conducted using nine electronic databases and manual searches to locate peer-reviewed studies published between January 2002 and February 2012. Results The search identified 98 original research studies that included the uses, benefits, and/or limitations of social media for health communication among the general public, patients, and health professionals. The methodological quality of the studies assessed using the Downs and Black instrument was low; this was mainly due to the fact that the vast majority of the studies in this review included limited methodologies and was mainly exploratory and descriptive in nature. Seven main uses of social media for health communication were identified, including focusing on increasing interactions with others, and facilitating, sharing, and obtaining health messages. The six key overarching benefits were identified as (1) increased interactions with others, (2) more available, shared, and tailored information, (3) increased accessibility and widening access to health information, (4) peer/social/emotional support, (5) public health surveillance, and (6) potential to influence health policy. Twelve limitations were identified, primarily consisting of quality concerns and lack of reliability, confidentiality, and privacy. Conclusions Social media brings a new dimension to health care as it offers a
Haeder, Simon F
The Essential Health Benefits provisions under the Affordable Care Act require that eligible plans provide coverage for certain broadly defined service categories, limit consumer cost-sharing, and meet certain actuarial value requirements. Although the Department of Health and Human Services (HHS) was tasked with the regulatory development of these EHB under the ACA, the department quickly devolved this task to the states. Not surprisingly, states fully exploited the leeway provided by HHS, and state decision processes and outcomes differed widely. However, none of the states took advantage of the opportunity to restructure fundamentally their health insurance markets, and only a very limited number of states actually included sophisticated policy expertise in their decisionmaking processes. As a result, and despite a major expansion of coverage, the status quo ex ante in state insurance markets was largely perpetuated. Decisionmaking for the 2016 revisions should be transparent, included a wide variety of stakeholders and policy experts, and focus on balancing adequacy and affordability. However, the 2016 revisions provide an opportunity to address these previous shortcomings.
Pronovost, Peter J; Goeschel, Christine A
The need for health services research is likely to rise rapidly as the population ages, health care costs soar, and therapeutic and diagnostic choices proliferate. Building an effective and efficient health care delivery system is a national priority. Yet the national health care quality report concludes that we lack the ability to monitor progress toward even basic quality and patient safety goals effectively. The gap between the need to improve and our ability to do so exists in part because we fail to view the delivery of health care as science, we lack national improvement priorities, and we lack a national infrastructure to achieve our stated goals. We discuss key challenges implicit in correcting these failures and recommend actions to expedite progress. PMID:21054369
Kamimura, Akiko; Nourian, Maziar M; Jess, Allison; Chernenko, Alla; Assasnik, Nushean; Ashby, Jeanie
Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations.
Frank, M S
Health care providers and payers are faced with ever-increasing pressures to lower costs, improve quality, and maximize profits. As medical information technology evolves, more medically related data are being collected, stored electronically within a data warehouse, and made available for decision support in the pursuit of lower costs and higher quality in health care. The article describes how medical expertise can be captured and integrated into decision support systems to improve awareness and predictability of disease and disease-associated financial risk within a population of patients, ultimately providing patient-centric and provider-centric opportunities to improve health and decrease costs. The concept of medical logic engineering is introduced.
Jacobs, Elizabeth A.; Shepard, Donald S.; Suaya, Jose A.; Stone, Esta-Lee
Objectives. We assessed the impact of interpreter services on the cost and the utilization of health care services among patients with limited English proficiency. Methods. We measured the change in delivery and cost of care provided to patients enrolled in a health maintenance organization before and after interpreter services were implemented. Results. Compared with English-speaking patients, patients who used the interpreter services received significantly more recommended preventive services, made more office visits, and had more prescriptions written and filled. The estimated cost of providing interpreter services was $279 per person per year. Conclusions. Providing interpreter services is a financially viable method for enhancing delivery of health care to patients with limited English proficiency. PMID:15117713
Castro-Leal, F.; Dayton, J.; Demery, L.; Mehra, K.
Health care is a basic service essential in any effort to combat poverty, and is often subsidized with public funds to help achieve that aim. This paper examines public spending on curative health care in several African countries and finds that this spending favours mostly the better-off rather than the poor. It concludes that this targeting problem cannot be solved simply by adjusting the subsidy allocations. The constraints that prevent the poor from taking advantage of these services must also be addressed if the public subsidies are to be effective in reaching the poor. PMID:10686734
Gyamfi, Eric; Okyere, Paul; Appiah-Brempong, Emmanuel; Adjei, Rose Odotei; Mensah, Kofi Akohene
The rate of disclosure of HIV status to infected children and adolescents remains low in developing countries. We used a mixed-method approach to determine the perceptions of caregivers and health care providers about the benefits of HIV status disclosure to infected children and adolescents and to assess the support needed by caregivers during disclosure. We recruited a convenience sample of 118 caregivers of HIV-infected children and adolescents for the quantitative component of the study and completed in-depth qualitative interviews with 10 purposefully sampled key informants, including health care providers and volunteer workers. The main benefits of disclosure included improved medication adherence and healthier, more responsible adolescent sexual behavior. The main supports required by caregivers during disclosure included biomedical information, emotional and psychological support, and practical guidelines regarding disclosure. We confirmed the importance of disclosure to HIV-infected children and adolescents and the need to develop culturally specific disclosure guidelines.
Antommaria, Armand H Matheny
Health care institutions have paid increasing attention to preventing nosocomial transmission of influenza through vaccination of health care personnel. While multifaceted voluntary interventions have increased vaccination rates, proponents of mandatory programs contend the rates remain unacceptably low. Conventional bioethical analyses of mandatory programs are inadequate; they fail to account for the obligations of nonprofessional personnel or to justify the weights assigned to different ethical principles. Using an ethics framework for public health permits a fuller analysis. The framework's focus on fairness accentuates the potential differences between the risk of transmitting infection and employment status, and the need to equitably evaluate exemptions. The framework's emphasis on balancing benefits and burdens highlights the need to justify a specific goal and questions the need to exclude all nonmedical exemptions. While mandatory vaccination programs are justifiable, greater attention should be paid to their implementation.
Collins, Sara R; Davis, Karen; Doty, Michelle M; Ho, Alice
Employer-based health insurance provides the majority of U.S. workers with access to health care and protection against devastating financial losses. Millions of workers, however, do not receive health benefits from their employers, and few sources of affordable coverage exist outside the employer-based system. This study, based on data from the Commonwealth Fund Biennial Health Insurance Survey, finds a deep divide in the U.S. labor force and an urgent need for expanding access to comprehensive and affordable coverage to working Americans and their families. According to the authors, higher-wage workers are more likely than their lower-paid counterparts to have health insurance and health-related benefits, such as paid sick leave, and to use preventive care services. Low-wage workers, meanwhile, are much more likely to forgo needed health care because of cost and to report problems paying medical bills.
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 ...
Moses, Richard E; McNeese, Libra G; Feld, Lauren D; Feld, Andrew D
Throughout the past 20 years, the rising use of social media has revolutionized health care as well as other businesses. It allows large groups of people to create and share information, ideas, and experiences through online communications, and develop social and professional contacts easily and inexpensively. Our Gastroenterology organizations, among others, have embraced this technology. Although the health-care benefits may be many, social media must be viewed through a legal lens, recognizing the accompanying burdens of compliance, ethical, and litigation issues. Theories of liability and risk continue to evolve as does the technology. Social media usage within the medical community is fraught with potential legal issues, requiring remedial responses to meet patients' needs and comply with current laws, while not exposing physicians to medical malpractice and other tort risks.
Madler, Billie; Helland, Mary
Maldistribution and shortages of primary care providers, changing reimbursement structures, movement from inpatient to community-based models of care, an aging population, and health care reform lead to increased numbers of patients seeking care. All of these phenomena have a part in creating a health care landscape that requires industry leaders enlist innovative strategies to meet the health care needs of their communities. Delivery of high-quality, efficient care by qualified providers is essential for the success of any health care system. Partnerships between health systems and academic centers of learning to develop a pipeline of providers is one inventive approach that can address primary care workforce needs. The purpose of this article was to share an example of an academic/health care system partnership to address primary care workforce needs in a rural Midwestern region.
Landman, Natalie; Aannestad, Liv K; Smoldt, Robert K; Cortese, Denis A
It is becoming increasingly clear that maintaining and improving the health of the population, and doing so in a financially sustainable manner, requires the coordination of acute medical care with long-term care, and social support services, that is, team-based care. Despite a growing body of evidence on the benefits of team-based care, the health care ecosystem remains "resistant" to a broader implementation of such care models. This resistance is a function of both system-wide and organizational barriers, which result primarily from fragmentation in reimbursement for health care services, regulatory restrictions, and the siloed nature of health professional education. To promote the broader adoption of team-based care models, the health care system must transition to pay for value reimbursement, as well as break down the educational silos and move toward team-based and value-based education of health professionals.
Loushine, S K; Vaden, A G
Data on salaries and fringe benefits of entry-level hospital dietitians were provided by surveys sent to personnel administrators in seven Midwestern states. In September 1982, the annual mean salary offered to dietitians awaiting registration was +16,472, whereas that for entry-level registered dietitians (R.D.s) was +17,250. In the smallest hospitals, annual mean salaries for R.D.s were lowest; non-metropolitan salaries were 2.8% lower than the metropolitan salaries. The salaries of entry-level R.D.s increased 54% from 1977 to 1982, while the Consumer Price Index (CPl), North Central, increased 59.7%. Salaries for selected entry-level health professionals ranked in decreasing order as follows: pharmacist, physical therapist, occupational therapist, social worker, staff nurse, dietitian, medical technologist, and respiratory therapist. Nationally, the entry-level dietitian's mean annual salary was +630 higher than that of the Midwestern dietitian. The increase in the national CPl from 1977 to 1982 was 57%, while the increase in the dietitian's salary was 48%. Leave time generally included 12 sick days, 2 weeks' vacation, 6 holidays, and 3 personal days per year. Employers contribute various amounts to life, health, and dental insurance costs. Discounts often were permitted on various hospital services. More than 80% of the hospitals surveyed provided some reimbursement for continuing education, and 74% permitted educational leaves of absence.
The Attempted Dismantling of the Medicare Home Care Benefit. A Report by the Chairman of the Subcommittee on Health and Long-Term Care of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, Second Session.
This document presents Congressman Claude Pepper's report on the Medicare Home Care Benefit. Section I traces the history of home health care in the United States. Section II offers statistics and general background information about older Americans and Medicare. The beginning of the Medicare home care benefit and its present operation are…
Tumin, Dmitry; Foraker, Randi E; Tobias, Joseph D; Hayes, Don
The use of public insurance is associated with diminished survival in patients with cystic fibrosis (CF) following lung transplantation. No data exist on benefits of gaining private health insurance for post-transplant care among such patients previously using public insurance. The United Network for Organ Sharing database was used to identify first-time lung transplant recipients participating in Medicare or Medicaid, diagnosed with CF, and transplanted between 2005 and 2015. Survival outcomes were compared between recipients gaining private insurance after transplantation and those maintaining public coverage throughout follow-up. Since implementation of the lung allocation score, 575 adults with CF received lung transplantation funded by Medicare or Medicaid and contributed data on insurance status post-transplant. There were 128 (22%) patients who gained private insurance. Multivariable analysis of time-varying insurance status found no survival benefit of gaining private insurance (HR = 0.822; 95% CI = 0.525, 1.286; p = 0.390). Further analysis demonstrated that resuming public insurance coverage was detrimental, relative to gaining and keeping private insurance (HR = 2.315; 95% CI = 1.020, 5.258; p = 0.045). Survival disadvantages of lung transplant recipients with CF who have public health insurance were not ameliorated by a switch to private coverage for post-transplant care.
Significant changes in use or care of human subjects, vertebrate animals , biohazards, and/or select agents Describe significant deviations, unexpected...outcomes, or changes in approved protocols for the use or care of human subjects, vertebrate animals , biohazards, and/or select agents during the...specify the applicable Institutional Review Board/Institutional Animal Care and Use Committee approval dates. Significant changes in use or care of human
... members and dependents. This section shows the benefits for THC members and their eligible dependents. THC... Defense Authorization Act of for Fiscal Year 2005” made the THC program permanent and made the medical... years' commissary and exchange benefits to THC members. Section 734 of Public Law 110-417,...
Price, Jennifer; Hayen, Andrew; Jan, Stephen; Wiseman, Virginia
Introduction Health financing reforms in low- and middle- income countries (LMICs) over the past decades have focused on achieving equity in financing of health care delivery through universal health coverage. Benefit and financing incidence analyses are two analytical methods for comprehensively evaluating how well health systems perform on these objectives. This systematic review assesses progress towards equity in health care financing in LMICs through the use of BIA and FIA. Methods and Findings Key electronic databases including Medline, Embase, Scopus, Global Health, CinAHL, EconLit and Business Source Premier were searched. We also searched the grey literature, specifically websites of leading organizations supporting health care in LMICs. Only studies using benefit incidence analysis (BIA) and/or financing incidence analysis (FIA) as explicit methodology were included. A total of 512 records were obtained from the various sources. The full texts of 87 references were assessed against the selection criteria and 24 were judged appropriate for inclusion. Twelve of the 24 studies originated from sub-Saharan Africa, nine from the Asia-Pacific region, two from Latin America and one from the Middle East. The evidence points to a pro-rich distribution of total health care benefits and progressive financing in both sub-Saharan Africa and Asia-Pacific. In the majority of cases, the distribution of benefits at the primary health care level favoured the poor while hospital level services benefit the better-off. A few Asian countries, namely Thailand, Malaysia and Sri Lanka, maintained a pro-poor distribution of health care benefits and progressive financing. Conclusion Studies evaluated in this systematic review indicate that health care financing in LMICs benefits the rich more than the poor but the burden of financing also falls more on the rich. There is some evidence that primary health care is pro-poor suggesting a greater investment in such services and removal
... Qualified Health Plan SHOP Small Business Health Options Program SSA Social Security Administration The Act Social Security Act The Code Internal Revenue Code of 1986 USP United States Pharmacopeia...
Mazmanian, Paul E
Current approaches to evaluation in continuing medical education (CME) feature results defined as changes in participation, satisfaction, knowledge, behavior, and patient outcomes. Few studies link costs and effectiveness of CME to improved quality of care. As continuing education programs compete for scarce resources, cost-inclusive evaluation offers strategies to measure change and to determine value for resources spent.
... From the Federal Register Online via the Government Publishing Office ] Vol. 77 Monday, No. 227 November 26, 2012 Part V Department of Health and Human Services 45 CFR Parts 147, 155, and 156 Patient... Federal Register online database through Federal Digital System (FDsys), a service of the U.S....
Fradelos, Evangelos C.; Tzavella, Foteini; Koukia, Evmorfia; Papathanasiou, Ioanna V.; Alikari, Victoria; Stathoulis, John; Panoutsopoulos, Georgios; Zyga, Sofia
Introduction: Patients who suffer from chronic renal disease face problems in many aspects of their life; problems such as physical and social as well as mental such as stress, anxiety, depression. In addition, they exhibit an amount of spiritual needs, which relate and influence the psychological adaptation to the illness. Aim: The aim of this article is to examine evidence from the international literature regarding the possible relation of spirituality and health outcomes, mostly in the complex codex of a chronic and life treathing disease such as CKD. Results: Spirituality is a very debatable issue and the term has no single and widely agreed definition. The key components of spirituality were ‘meaning’, ‘hope’, ‘relatedness/connectedness’, and ‘beliefs/beliefs systems’. Spirituality has been characterized as the quest for meaning in life, mainly through experiences and expressions of mind, in a unique and dynamic process different for each individual. For many individuals spirituality and religion are important aspects of their existence, constituting a source support contribute to wellbeing and coping with life’s daily difficulties. Conclusion: Considering, assessing and addressing chronic kidney disease patient’s spirituality and spiritual needs is necessary and it can have a positive outcome in health related quality of life, mental health and life expectancy. PMID:26622206
Luckey, T. D.
Media reports of deaths and devastation produced by atomic bombs convinced people around the world that all ionizing radiation is harmful. This concentrated attention on fear of miniscule doses of radiation. Soon the linear no threshold (LNT) paradigm was converted into laws. Scientifically valid information about the health benefits from low dose irradiation was ignored. Here are studies which show increased health in Japanese survivors of atomic bombs. Parameters include decreased mutation, leukemia and solid tissue cancer mortality rates, and increased average lifespan. Each study exhibits a threshold that repudiates the LNT dogma. The average threshold for acute exposures to atomic bombs is about 100 cSv. Conclusions from these studies of atomic bomb survivors are: One burst of low dose irradiation elicits a lifetime of improved health.Improved health from low dose irradiation negates the LNT paradigm.Effective triage should include radiation hormesis for survivor treatment. PMID:19088902
Luckey, T D
Media reports of deaths and devastation produced by atomic bombs convinced people around the world that all ionizing radiation is harmful. This concentrated attention on fear of miniscule doses of radiation. Soon the linear no threshold (LNT) paradigm was converted into laws. Scientifically valid information about the health benefits from low dose irradiation was ignored. Here are studies which show increased health in Japanese survivors of atomic bombs. Parameters include decreased mutation, leukemia and solid tissue cancer mortality rates, and increased average lifespan. Each study exhibits a threshold that repudiates the LNT dogma. The average threshold for acute exposures to atomic bombs is about 100 cSv. Conclusions from these studies of atomic bomb survivors are: One burst of low dose irradiation elicits a lifetime of improved health.Improved health from low dose irradiation negates the LNT paradigm.Effective triage should include radiation hormesis for survivor treatment.
Medical/Dental benefit expansion ($59) • Medical record privacy ($30) • Custodial care ($15) • Chiropractic health care ($12) FY 2002 (annual cost...Retiree Health Care Fund $11B Numbers may not add due to rounding. Defense Health Program $28B In-Patient Out-Patient $7B Other Private Sector Care $2B...Private Sector Care $11B Appropriation Totals ($B) O&M …………………………… 20 MilPers ………………………….. 6 RDT&E, MilCon, Procurement … 1 Active Duty & TRICARE Prime
Sipe, Theresa Ann; Finnie, Ramona K.C.; Knopf, John A.; Qu, Shuli; Reynolds, Jeffrey A.; Thota, Anilkrishna B.; Hahn, Robert A.; Goetzel, Ron Z.; Hennessy, Kevin D.; McKnight-Eily, Lela R.; Chapman, Daniel P.; Anderson, Clinton W.; Azrin, Susan; Abraido-Lanza, Ana F.; Gelenberg, Alan J.; Vernon-Smiley, Mary E.; Nease, Donald E.
Context Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Evidence acquisition Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Evidence synthesis Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Conclusions Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence is limited for other mental health outcomes. PMID:25998926
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…
... 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, ...
Ishfaq, Mohammad; Lodhi, Bilal Khan
Social sector planning requires rational approaches where community needs are identified by referring to relative deprivation among localities and resources are allocated to address inequalities. Geographical information system (GIS) has been widely argued and used as a base for rational planning for equal resource allocation in social sectors around the globe. Devolution of primary health care is global strategy that needs pains taking efforts to implement it. GIS is one of the most important tools used around the world in decentralization process of primary health care. This paper examines the scope of GIS in social sector planning by concentration on primary health care delivery system in Pakistan. The work is based on example of the UK's decentralization process and further evidence from US. This paper argues that to achieve benefits of well informed decision making to meet the communities' needs GIS is an essential tool to support social sector planning and can be used without any difficulty in any environment. There is increasing trend in the use of Health Management Information System (HMIS) in Pakistan with ample internet connectivity which provides well established infrastructure in Pakistan to implement GIS for health care, however there is need for change in attitude towards empowering localities especially with reference to decentralization of decision making. This paper provides GIS as a tool for primary health care planning in Pakistan as a starting point in defining localities and preparing locality profiles for need identification that could help developing countries in implementing the change.
Breton, Mylaine; Lévesque, Jean-Frédéric; Pineault, Raynald; Hogg, William
Canadian politicians, decision-makers, clinicians and researchers have come to agree that reforming primary care services is a key strategy for improving healthcare system performance. However, it is only more recently that real transformative initiatives have been undertaken in different Canadian provinces. One model that offers promise for improving primary care service delivery is the family medicine group (FMG) model developed in Quebec. A FMG is a group of physicians working closely with nurses in the provision of services to enrolled patients on a non-geographic basis. The objectives of this paper are to analyze the FMG's potential as a lever for improving healthcare system performance and to discuss how it could be improved. First, we briefly review the history of primary care in Quebec. Then we present the FMG model in relation to the four key healthcare system functions identified by the World Health Organization: (a) funding, (b) generating human and technological resources, (c) providing services to individuals and communities and (d) governance. Next, we discuss possible ways of advancing primary care reform, looking particularly at the family health team (FHT) model implemented in the province of Ontario. We conclude with recommendations to inspire other initiatives aimed at transforming primary care. PMID:23115575
Gill, Harsharn; Prasad, Jaya
Probiotics are defined as live microorganisms that, when administered in adequate amount, confer a health benefit on the host. Amongst the many benefits associated with the consumption of probiotics, modulation of the immune system has received the most attention. Several animal and human studies have provided unequivocal evidence that specific strains of probiotics are able to stimulate as well as regulate several aspects of natural and acquired immune responses. There is also evidence that intake of probiotics is effective in the prevention and/or management of acute gastroenteritis and rotavirus diarrhoea, antibiotic-associated diarrhoea and intestinal inflammatory disorders such as Crohn's disease and pouchitis, and paediatric atopic disorders. The efficacy of probiotics against bacterial infections and immunological disorders such as adult asthma, cancers, diabetes, and arthritis in humans remains to be proven. Also, major gaps exist in our knowledge about the mechanisms by which probiotics modulate immune function. Optimum dose, frequency and duration of treatment required for different conditions in different population groups also remains to be determined. Different probiotic strains vary in their ability to modulate the immune system and therefore efficacy of each strain needs to be carefully demonstrated through rigorously designed (randomised, double-blind, placebo-controlled) studies. This chapter provides an over view of the immunomodulatory effects of probiotics in health and disease, and discusses possible mechanisms through which probiotics mediate their disparate effects.
Lewis, John; Dempsey, Joanne R.
An article on American health care which focuses on health care costs and benefits is combined with a lesson plan on health care issues to enable students to consider both issues of cost effectiveness and morality in decisions about the allocation of health care. The article covers the history of interest in health care, the reasons for the…
... Loan Guaranty Medical Care Vocational Rehabilitation and Employment Health Care Benefits: 1-877-222-8387 Additional Numbers and Websites Resource Phone Number Website Bereavement Counseling 1-202-461-6530 Children of Women ... Civilian Health and Medical Program (CHAMPVA) 1-800-733-8387 ...
This page provides background on the relationship between human health and climate change and describes what the CIRA Health analyses cover. It provides links to the subsectors Air Quality, Extreme Temperature, Labor, and Water Quality.
The goal of HRP is to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. Presentation discusses (1) Bone Health: Vitamin D, Fish Consumption and Exercise (2) Medical Support in Remote Areas (3) ISS Ultrasound 4) Dry electrode EKG System (5) Environmental Factors and Psychological Health.
... 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 ...
Udasin, I G
More people are employed in the health care sector than in any other industry in the United States. Health care workers are exposed to a wide variety of hazards, including biological, chemical, physical and psychological stressors. Concerns about exposure to contagious diseases such as HIV, Hepatitis B and C, and tuberculosis have influenced the career choices of many health professionals. Physical hazards, especially ergonomic ones, account for the majority of the disability faced by health care workers. Chemical exposure and psychosocial stresses are also present in health care institutions. The exposure encountered in health care facilities is potentially dangerous to health care workers as well as to their family members and unborn children.
Hudson, Christopher G.; DeVito, Jo Anne
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…
Canadian Association of University Teachers, 2016
Compassionate care leave and benefits were introduced in 2003/04 to help employees cope with this difficult work-life balance challenge. Employment Standards legislation and the Employment Insurance program (EI) were amended to provide leave without pay, with payment of EI benefits for compassionate care leave. Collective agreements have been…
This article presents a structured survey of the German health care and health insurance system, and analyzes major developments of current German health policy. The German statutory health insurance system has been known as a system that provides all citizens with ready access to comprehensive high quality medical care at a cost the country considered socially acceptable. However, an increasing concern for rapidly rising health care expenditure led to a number of cost-containment measures since 1977. The aim was to bring the growth of health care expenditure in line with the growth of wages and salaries of the sickness fund members. The recent health care reforms of 1989 and 1993 yielded only short-term reductions of health care expenditure, with increases in the subsequent years. 'Stability of the contribution rate' is the uppermost political objective of current health care reform initiatives. Options under discussion include reductions in the benefit package and increases of patients' co-payments. The article concludes with the possible consequences of the 1997 health care reform of which the major part became effective 1 July 1997.
Powell, Suzanne K
Health care tourism is often a preplanned event carefully laying out all the details. Sometimes, when one least expects it, medical care is needed outside of the mainland. This Editorial speaks to an unplanned experience.
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.
... 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 ...
Fisk, W J
The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews of papers published before 2000 are summarized. The results of 16 more recent intervention studies are compiled and analyzed. Also, reviewed are four studies that modeled health benefits of using filtration to reduce indoor exposures to particles from outdoors. Prior reviews generally concluded that particle filtration is, at best, a source of small improvements in allergy and asthma health effects; however, many early studies had weak designs. A majority of recent intervention studies employed strong designs and more of these studies report statistically significant improvements in health symptoms or objective health outcomes, particularly for subjects with allergies or asthma. The percentage improvement in health outcomes is typically modest, for example, 7% to 25%. Delivery of filtered air to the breathing zone of sleeping allergic or asthmatic persons may be more consistently effective in improving health than room air filtration. Notable are two studies that report statistically significant improvements, with filtration, in markers that predict future adverse coronary events. From modeling, the largest potential benefits of indoor particle filtration may be reductions in morbidity and mortality from reducing indoor exposures to particles from outdoor air.
Fisk, William J.
The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews of papers published before 2000 are summarized. The results of 16 more recent intervention studies are compiled and analyzed. Also, reviewed are four studies that modeled health benefits of using filtration to reduce indoor exposures to particles from outdoors. Prior reviews generally concluded that particle filtration is, at best, a source of small improvements in allergy and asthma health effects; however, many early studies had weak designs. A majority of recent intervention studies employed strong designs and more of these studies report statistically significant improvements in health symptoms or objective health outcomes, particularly for subjects with allergies or asthma. The percent age improvement in health outcomes is typically modest, for example, 7percent to 25percent. Delivery of filtered air to the breathing zone of sleeping allergic or asthmatic persons may be more consistently effective in improving health than room air filtration. Notable are two studies that report statistically significant improvements, with filtration, in markers that predict future adverse coronary events. From modeling, the largest potential benefits of indoor particle filtration may be reductions in morbidity and mortality from reducing indoor exposures to particles from outdoor air.
Fisk, William J.
The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews of papers published before 2000 are summarized. The results of 16 more recent intervention studies are compiled and analyzed. Also reviewed are four studies that modeled health benefits of using filtration to reduce indoor exposures to particles from outdoors. Prior reviews generally concluded that particle filtration is, at best, a source of small improvements in allergy and asthma health effects; however, many early studies had weak designs. A majority of recent intervention studies employed strong designs and more of these studies report statistically significant improvements in health symptoms or objective health outcomes, particularly for subjects with allergies or asthma. The percentage improvement in health outcomes is typically modest, e.g., 7percent to 25percent. Delivery of filtered air to the breathing zone of sleeping allergic or asthmatic persons may be more consistently effective in improving health than room air filtration. Notable are two studies that report statistically significant improvements, with filtration, in markers that predict future adverse coronary events. From modeling, the largest potential benefits of indoor particle filtration may be reductions in morbidity and mortality from reducing indoor exposures to particles from outdoor air.
Bulger, R J
As prefigured in the Greek tragedy Antigone, one of the primary conflicts in contemporary health care is that between humane concern for the individual and concern for society at large and administrative rules. The computerization of the health care system and development of large data bases will create new forms of this conflict that will challenge the self-definition of health care and health care professionals.
... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Basic health services. 417... benefits plan: Basic health services. (a) An HMO must provide or arrange for the provision of basic health...; (iii) Well-child care from birth; (iv) Periodic health evaluations for adults; (v) Eye and...
Gibson, Alexander R; Scott, Gregory; Harrison, Oliver; Dominiczak, Anna; Hanlon, Phil
Background The global burden of disease is increasingly dominated by non-communicable diseases.These diseases are less amenable to curative and preventative interventions than communicable disease. This presents a challenge to medical practice and medical research, both of which are experiencing diminishing returns from increasing investment. Objective Our aim was to (1) review how medical knowledge is generated, and its limitations, (2) assess the potential for emerging technologies and ideas to improve medical research, and (3) suggest solutions and recommendations to increase medical research efficiency on non-communicable diseases. Methods We undertook an unsystematic review of peer-reviewed literature and technology websites. Results Our review generated the following conclusions and recommendations. (1) Medical knowledge continues to be generated in a reductionist paradigm. This oversimplifies our models of disease, rendering them ineffective to sufficiently understand the complex nature of non-communicable diseases. (2) Some of these failings may be overcome by adopting a “Systems Medicine” paradigm, where the human body is modeled as a complex adaptive system. That is, a system with multiple components and levels interacting in complex ways, wherein disease emerges from slow changes to the system set-up. Pursuing systems medicine research will require larger datasets. (3) Increased data sharing between researchers, patients, and clinicians could provide this unmet need for data. The recent emergence of electronic health care records (EHR) could potentially facilitate this in real-time and at a global level. (4) Efforts should continue to aggregate anonymous EHR data into large interoperable data silos and release this to researchers. However, international collaboration, data linkage, and obtaining additional information from patients will remain challenging. (5) Efforts should also continue towards “Medicine 2.0”. Patients should be given access to
Abdull Razis, Ahmad Faizal; Ibrahim, Muhammad Din; Kntayya, Saie Brindha
Phytomedicines are believed to have benefits over conventional drugs and are regaining interest in current research. Moringa oleifera is a multi-purpose herbal plant used as human food and an alternative for medicinal purposes worldwide. It has been identified by researchers as a plant with numerous health benefits including nutritional and medicinal advantages. Moringa oleifera contains essential amino acids, carotenoids in leaves, and components with nutraceutical properties, supporting the idea of using this plant as a nutritional supplement or constituent in food preparation. Some nutritional evaluation has been carried out in leaves and stem. An important factor that accounts for the medicinal uses of Moringa oleifera is its very wide range of vital antioxidants, antibiotics and nutrients including vitamins and minerals. Almost all parts from Moringa can be used as a source for nutrition with other useful values. This mini-review elaborate on details its health benefits.
This product was developed under an interagency agreement between the U.S. EPA and the U.S. Department of Energy - Lawrence Berkeley National Laboratory (LBNL). The evidence of health benefits of particle filtration in homes and commercial buildings is reviewed. Prior reviews o...
... 45 Public Welfare 1 2014-10-01 2014-10-01 false Coverage of essential health benefits. 147.150 Section 147.150 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE REFORM REQUIREMENTS FOR THE GROUP AND INDIVIDUAL HEALTH INSURANCE...
... 45 Public Welfare 1 2013-10-01 2013-10-01 false Coverage of essential health benefits. 147.150 Section 147.150 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE REFORM REQUIREMENTS FOR THE GROUP AND INDIVIDUAL HEALTH INSURANCE...
... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Health benefits. 630.1211 Section 630... LEAVE Family and Medical Leave § 630.1211 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title...
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Health benefits. 630.1209 Section 630... LEAVE Family and Medical Leave § 630.1209 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title...
... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Health benefits. 630.1211 Section 630... LEAVE Family and Medical Leave § 630.1211 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title...
... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Health benefits. 630.1211 Section 630... LEAVE Family and Medical Leave § 630.1211 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title...
... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Health benefits. 630.1209 Section 630... LEAVE Family and Medical Leave § 630.1209 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title...
... Forgot Password IHS Home Find Health Care Find Health Care IMPORTANT If you are having a health emergency ... services, continuous nursing services and that provides comprehensive health care including diagnosis and treatment. Health Locations An ambulatory ...
Olve, Nils-Göran; Vimarlund, Vivian
The impact of information and communication technology (ICT) is indirect and depends on redesign of practices and structures also outside health care. Improvements will only be realized if all parties involved can coordinate their efforts to take advantage of new technology. A 'package' of changed work practices and structures extending across organizational boundaries needs to be designed and implemented. This is very different from the common conception of introducing new ICT tools. Calls for 'evaluation of benefits' before new ICT systems are introduced need to recognize this complexity. This article investigates how analysis and economic evaluations can be used to improve decision-making when new applications are proposed. This is done by drawing parallels with experiences from other industries. We conclude that the entire 'change package' should be analysed for its consequences on the well-being of care recipients, and the requirements it presents for capital investments and changed labour inputs, in particular changed competence needs. Some concepts and structures are suggested for such evaluations.
Steinberg, T N
This Note examines how both the law and the health care profession neglect women's needs for abortion counseling before, during and after an abortion. Part I analyzes the health care profession's view of counseling, the psychological effects of abortion and how counseling both positively and negatively influences those effects. Part II reviews Supreme Court cases and state law regarding abortion counseling, critizing both the Court's narrow view of counseling and the states' failure to use the legislative process to create laws which benefit maternal health. Part III recommends an expanded role for abortion counseling, in which the counselor can provide emotional support from before the day of an abortion until a woman emotionally recovers from an abortion. This expanded role would be state-mandated, but would remain within constitutional boundaries by providing flexibility for counselors to give individual treatment while respecting a woman's privacy.
Murphy, Fiona; Hugman, Laura; Bowen, Judith; Parsell, Fran; Gabe-Walters, Marie; Newson, Louise; Jordan, Sue
It is thought that integrating health and social care provision can improve services, yet few evaluations of integrated health and social care initiatives have focused on changes in clinical outcomes and used comparator groups. The aim of this pilot study was to identify whether attendance at an integrated health and social care day unit (IHSCDU) affected selected outcomes of functional mobility, number of prescribed medications, and physical and psychological well-being. A secondary aim was to examine the utility of the tools to measure these outcomes in this context; the feasibility of the recruitment and retention strategy and the utility of the comparator group. A before-and-after comparison design was used with non-randomised intervention and comparator arms. The intervention arm comprised 30 service users attending the IHSCDU and the comparator arm comprised 33 service users on a community nursing caseload. Measures of functional mobility (Barthel's Index) and physical and psychological well-being (SF-12(®) ) were taken from all participants in both arms at three data collection points: baseline, 4 and 9 months later, between November 2010 and September 2012. Participants and outcomes were identified prospectively and in both arms, the individual was the unit of assignment. No significant changes were noted in functional mobility and psychological well-being and the number of medications prescribed increased in both arms. There was a trend towards a significant difference between study arms in the change in the SF-12(®) physical health outcome measure and this outcome measure could be usefully explored in future studies. The recruitment and retention strategy was feasible although our comparator group had some limitations in not being closely matched in terms of age, functional mobility and mental well-being.
Parente, Stephen T; Salkever, David S; DaVanzo, Joan
In 1992, the United States Centers for Medicare and Medicaid Services (CMS) introduced new insurance coverage for two preventive services--influenza vaccinations and mammograms. Economists typically assume transactions occur with perfect information and foresight. As a test of the value of information, we estimate the effect of consumer knowledge of these benefits on their demand. Treating knowledge as endogenous in a two-part model of demand, we find that consumer knowledge has a substantial positive effect on the use of preventive services. Our findings suggest that strategies to educate the insured Medicare population about coverage of preventive services may have substantial social value.
Caserta, D; Ralli, E; Matteucci, E; Bordi, G; Mallozzi, M; Moscarini, M
It has been recognized for over 50 years that combined oral contraceptives (COCs) are also capable of offering health benefits beyond contraception through the treatment and prevention of several gynaecological and medical disorders. During the last years a constant attention was given to the adverse effects of COCs, whereas their non-contraceptive benefits were underestimated. To date, most women are still unaware of the therapeutic uses of hormonal contraceptives, while on the contrary there is an extensive and constantly increasing of these non-contraceptive health benefits. This review summarizes the conditions of special interest for physicians, including dysmenorrhoea, menorrhagia, hyperandrogenism (acne, hirsutism, polycystic ovary syndrome), functional ovarian cysts, endometriosis, premenstrual syndrome, myomas, pelvic inflammatory disease, bone mineral density, benign breast disease and endometrial/ovarian and colorectal cancer. The benefits of COCs in rheumatoid arthritis, multiple sclerosis, menstrual migraine and in perimenopause have also been treated for more comprehensive information. Using COCs specifically for non-contraceptive indications is still outside the product licence in the majority of cases. We strongly believe that these aspects are not of minor relevance and they deserve a special consideration by health providers and by the mass media, which have the main responsibility in the diffusion of scientific information. Thus, counseling and education are necessary to help women make well-informed health-care decisions and it is also crucial to increase awareness among general practitioners and gynaecologists.
Simpser, Edwin; Hudak, Mark L
Pediatric home health care is an effective and holistic venue of treatment of children with medical complexity or developmental disabilities who otherwise may experience frequent and/or prolonged hospitalizations or who may enter chronic institutional care. Demand for pediatric home health care is increasing while the provider base is eroding, primarily because of inadequate payment or restrictions on benefits. As a result, home care responsibilities assumed by family caregivers have increased and imposed financial, physical, and psychological burdens on the family. The Patient Protection and Affordable Care Act set forth 10 mandated essential health benefits. Home care should be considered as an integral component of the habilitative and rehabilitative services and devices benefit, even though it is not explicitly recognized as a specific category of service. Pediatric-specific home health care services should be defined clearly as components of pediatric services, the 10th essential benefit, and recognized by all payers. Payments for home health care services should be sufficient to maintain an adequate provider work force with the pediatric-specific expertise and skills to care for children with medical complexity or developmental disability. Furthermore, coordination of care among various providers and the necessary direct patient care from which these care coordination plans are developed should be required and enabled by adequate payment. The American Academy of Pediatrics advocates for high-quality care by calling for development of pediatric-specific home health regulations and the licensure and certification of pediatric home health providers.
This paper reports in detail on a project of Integrated Health Care in cardiology at Nuremberg, Germany. Information on the structure of the contract, the participants, the agreed claiming of benefits and provision of services are provided as well as relevant figures and contact data.
Waldman, J Deane; Yourstone, Steven A; Smith, Howard L
This article explores the uses of learning curve theory in medicine. Though effective application of learning curve theory in health care can result in higher quality and lower cost, it is seldom methodically applied in clinical practice. Fundamental changes are necessary in the corporate culture of medicine in order to capitalize maximally on the benefits of learning.
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
La Rosa-Salas, Virginia; Tricas-Sauras, Sandra
It has long been known that a segment of the population enjoys distinctly better health status and higher quality of health care than others. To solve this problem, prioritization is unavoidable, and the question is how priorities should be set. Rational priority setting would seek equity amongst the whole population, the extent to which people receive equal care for equal needs. Equity in health care is an ethical imperative not only because of the intrinsic worth of good health, or the value that society places on good health, but because, without good health, people would be unable to enjoy life's other sources of happiness. This paper also argues the importance of the health care's efficiency, but at the same time, it highlights how any innovation and rationalization undertaken in the provision of the health system should be achieved from the consideration of human dignity, making the person prevail over economic criteria. Therefore, the underlying principles on which this health care equity paper is based are fundamental human rights. The main aim is to ensure the implementation of these essential rights by those carrying out public duties. Viewed from this angle, equity in health care means equality: equality in access to services and treatment, and equality in the quality of care provided. As a result, this paper attempts to address both human dignity and efficiency through the context of equity to reconcile them in the middle ground.
variety of specialists including chiropractors , optometrists, speech therapists, and mental health specialists (IBISWorld, 2006). Registered nurses... treatment services. These establishments have an organized staff of health care practitioners to provide patient care services and provide other services...Carroll, 2003). Complementary and Alternative Medicine includes a wide variety of treatments and therapies that are generally not supported by scientific
TRICARE PRIME Remote ADFM ($65) • Medical/Dental benefit expansion ($59) • Medical record privacy ($30) • Custodial care ($15) • Chiropractic health care ...39B DoD Medicare Eligible Retiree Health Care Fund $11B Numbers may not add due to rounding. Defense Health Program $28B In-Patient Out-Patient $7B...Other Private Sector Care $2B Private Sector Care $11B Appropriation Totals ($B) O&M …………………………… 20 MilPers ………………………….. 6 RDT&E, MilCon, Procurement
Temporomandibular disorders/myoarthropathy of the masticatory system. Costs of dental treatment and reimbursement by Swiss federal insurance agencies according to the Health Care Benefits Ordinance (KLV).
Katsoulis, Konstantinos; Bassetti, Renzo; Windecker-Gétaz, Isabelle; Mericske-Stern, Regina; Katsoulis, Joannis
The goal of the study was to calculate the direct costs of therapy for patients with MAP. This retrospective study included 242 MAP patients treated at the Department of Prosthodontics of the University of Bern between 2003 and 2006. The following parameters were collected from the clinical charts: chief complaint, diagnosis, treatment modalities, total costs, costs of the dental technician, number of appointments, average cost per appointment, length of treatment, and services reimbursed by health insurance agencies. The average age of the patients was 40.4 ± 17.3 years (76.4% women, 23.6% men). The chief complaint was pain in 91.3% of the cases, TMJ noises (61.2%) or limitation of mandibular mobility (53.3%). Tendomyopathy (22.3%), disc displacement (22.4%), or a combination of the two (37.6%) were more often diagnosed than arthropathy alone (7.4%). Furthermore, 10.3% of the MAP patients had another primary diagnosis (tumor, trauma, etc.). Patients were treated with counseling and exercises (36.0%), physiotherapy (23.6%), or occlusal splints (32.6%). The cost of treatment reached 644 Swiss francs for four appointments spread over an average of 21 weeks. In the great majority of cases, patients can be treated with inexpensive modalities. 99.9% of the MAP cases submitted to the insurance agencies were reimbursed by them, in accordance with Article 17d1-3 of the Swiss Health Care Benefits Ordinance (KLV) and Article 25 of the Federal Health Insurance Act (KVG). The costs of treatment performed by dentists remain modest. The more time-consuming services, such as providing information, counseling and instructions, are poorly remunerated. This aspect should be re-evaluated in a future revision of the tariff schedule.
Cook, Christa L; Hall, Allyson G; Garvan, Cynthia S; Kneipp, Shawn M
Women enrolled in Florida's Temporary Assistance for Needy Families (TANF) program experience high rates of chronic health problems and often lack a usual source of care. Thus, in this study, we aimed to identify variables related to being in a usual source of care at time of study enrollment and determine whether a public health nursing case management intervention affected the obtainment of a usual source of care. To achieve these aims, we conducted a secondary analysis of a randomized controlled trial of a public health nursing case management intervention, which included women with chronic health conditions enrolled in TANF (n = 432). Results indicated 35% of the women did not identify a usual source of care at time of study enrollment, and the public health nursing intervention was effective in helping women obtain a usual source of care (OR = 2.5, 95% CI 1.004-6.491). Thus, a public health nursing case management intervention is an effective way to connect TANF participants to a usual source of care, which may lead to improved health outcomes in this vulnerable population of women.
e-Health has the potential to improve pediatric palliative care. e-Health initiatives use the Internet or health information technology to improve quality of care and have the potential to decrease costs by reducing medical errors, reducing duplication of services, improving access to diagnostic and laboratory results, and improving communication between providers and patients, and so on. The majority of e-health initiatives are for adults and only a limited amount of evidence exists in the literature on e-health interventions in palliative care that are focused on pediatrics. To explore what role e-health could play in pediatric palliative care programs, this article aims to describe the Internet use in general in the United States and in palliative care, describe the use of health information technology in general in the United States and in palliative care, and suggest areas in pediatric palliative care that might benefit from e-health interventions.
Dahl, Wendy J; Agro, Nicole C; Eliasson, Åsa M; Mialki, Kaley L; Olivera, Joseph D; Rusch, Carley T; Young, Carly N
Although fiber is well recognized for its effect on laxation, increasing evidence supports the role of fiber in the prevention and treatment of chronic disease. The aim of this review is to provide an overview of the health benefits of fiber and its fermentation, and describe how the products of fermentation may influence disease risk and treatment. Higher fiber intakes are associated with decreased risk of cardiovascular disease, type 2 diabetes, and some forms of cancer. Fiber may also have a role in lowering blood pressure and in preventing obesity by limiting weight gain. Fiber is effective in managing blood glucose in type 2 diabetes, useful for weight loss, and may provide therapeutic adjunctive roles in kidney and liver disease. In addition, higher fiber diets are not contraindicated in inflammatory bowel disease or irritable bowel syndrome and may provide some benefit. Common to the associations with disease reduction is fermentation of fiber and its potential to modulate microbiota and its activities and inflammation, specifically the production of anti-inflammatory short chain fatty acids, primarily from saccharolytic fermentation, versus the deleterious products of proteolytic activity. Because fiber intake is inversely associated with all-cause mortality, mechanisms by which fiber may reduce chronic disease risk and provide therapeutic benefit to those with chronic disease need further elucidation and large, randomized controlled trials are needed to confirm causality.Teaching Points• Strong evidence supports the association between higher fiber diets and reduced risk of cardiovascular disease, type 2 diabetes, and some forms of cancer.• Higher fiber intakes are associated with lower body weight and body mass index, and some types of fiber may facilitate weight loss.• Fiber is recommended as an adjunctive medical nutritional therapy for type 2 diabetes, chronic kidney disease, and certain liver diseases.• Fermentation and the resulting shifts in
Bowman, Darcia Harris
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…
Brown, M S
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.
Robinson, James C
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.
... 29 Labor 4 2011-07-01 2011-07-01 false Coordination of retiree health benefits with Medicare and State health benefits. 1625.32 Section 1625.32 Labor Regulations Relating to Labor (Continued) EQUAL... Coordination of retiree health benefits with Medicare and State health benefits. (a) Definitions. (1)...
TRICARE program; clarification of benefit coverage of durable equipment and ordering or prescribing durable equipment; clarification of benefit coverage of assistive technology devises under the Extended Care Health Option Program. Final rule.
This final rule modifies the TRICARE regulation to add a definition of assistive technology (AT) devices for purposes of benefit coverage under the TRICARE Extended Care Health Option (ECHO) Program and to amend the definitions of durable equipment (DE) and durable medical equipment (DME) to better conform the language in the regulation to the statute. The final rule amends the language that specifically limits ordering or prescribing of DME to only a physician under the Basic Program, as this amendment will allow certain other TRICARE authorized individual professional providers, acting within the scope of their licensure, to order or prescribe DME. This final rule also incorporates a policy clarification relating to luxury, deluxe, or immaterial features of equipment or devices. That is, TRICARE cannot reimburse for the luxury, deluxe, or immaterial features of equipment or devices, but can reimburse for the base or basic equipment or device that meet the beneficiary's needs. Beneficiaries may choose to pay the provider for the luxury, deluxe, or immaterial features if they desire their equipment or device to have these "extra features."
... This infection causes diarrhea, stomach cramps, and gas. Ear infections, colds, coughs, sore throats, and runny noses ... Head lice and scabies are other common health problems that occur in day care centers. You can ...
... Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ... us get closer to curing diabetes and better treatments for those living with diabetes. Other Ways to ...
... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Health care information. 402.65 Section 402.65 Employees' Benefits SOCIAL SECURITY ADMINISTRATION AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under...
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Health care information. 402.65 Section 402.65 Employees' Benefits SOCIAL SECURITY ADMINISTRATION AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under...
... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Health care information. 402.65 Section 402.65 Employees' Benefits SOCIAL SECURITY ADMINISTRATION AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under...
... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Health care information. 402.65 Section 402.65 Employees' Benefits SOCIAL SECURITY ADMINISTRATION AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under...
... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Health care information. 402.65 Section 402.65 Employees' Benefits SOCIAL SECURITY ADMINISTRATION AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC § 402.65 Health care information. We have some information about health care programs under...
The outcomes for children in kinship care are generally seen as positive in terms of identity formation, stability of placement, behavioural and mental health outcomes, enabling siblings to live together and child protection. However, there is some disquiet about the length of time children stay with relatives; agencies are not sure about how best…
Nuts (tree nuts and peanuts) are nutrient dense foods with complex matrices rich in unsaturated fatty and other bioactive compounds: high-quality vegetable protein, fiber, minerals, tocopherols, phytosterols, and phenolic compounds. By virtue of their unique composition, nuts are likely to beneficially impact health outcomes. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease and gallstones in both genders and diabetes in women. Limited evidence also suggests beneficial effects on hypertension, cancer, and inflammation. Interventional studies consistently show that nut intake has a cholesterol-lowering effect, even in the context of healthy diets, and there is emerging evidence of beneficial effects on oxidative stress, inflammation, and vascular reactivity. Blood pressure, visceral adiposity and the metabolic syndrome also appear to be positively influenced by nut consumption. Thus it is clear that nuts have a beneficial impact on many cardiovascular risk factors. Contrary to expectations, epidemiologic studies and clinical trials suggest that regular nut consumption is unlikely to contribute to obesity and may even help in weight loss. Safety concerns are limited to the infrequent occurrence of nut allergy in children. In conclusion, nuts are nutrient rich foods with wide-ranging cardiovascular and metabolic benefits, which can be readily incorporated into healthy diets.
Nuts (tree nuts and peanuts) are nutrient dense foods with complex matrices rich in unsaturated fatty and other bioactive compounds: high-quality vegetable protein, fiber, minerals, tocopherols, phytosterols, and phenolic compounds. By virtue of their unique composition, nuts are likely to beneficially impact health outcomes. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease and gallstones in both genders and diabetes in women. Limited evidence also suggests beneficial effects on hypertension, cancer, and inflammation. Interventional studies consistently show that nut intake has a cholesterol-lowering effect, even in the context of healthy diets, and there is emerging evidence of beneficial effects on oxidative stress, inflammation, and vascular reactivity. Blood pressure, visceral adiposity and the metabolic syndrome also appear to be positively influenced by nut consumption. Thus it is clear that nuts have a beneficial impact on many cardiovascular risk factors. Contrary to expectations, epidemiologic studies and clinical trials suggest that regular nut consumption is unlikely to contribute to obesity and may even help in weight loss. Safety concerns are limited to the infrequent occurrence of nut allergy in children. In conclusion, nuts are nutrient rich foods with wide-ranging cardiovascular and metabolic benefits, which can be readily incorporated into healthy diets. PMID:22254047
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…
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.
Derzon, Robert A.
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
Lewit, Eugene M.; And Others
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…
... of the Secretary 32 CFR Part 199 RIN 0720-AB33 TRICARE; Extended Care Health Option AGENCY: Office of...'s share of providing certain benefits under the Extended Care Health Option (ECHO) from $2,500 per... home health care, respite care, and other services and supplies as determined appropriate by...
Marušič, Dorjan; Prevolnik Rupel, Valentina
In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.
Prevolnik Rupel, Valentina
Abstract In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country. PMID:27703543
Jackson, C N; Manning, M R
This study explores the relationship between burnout and health care utilization of 238 employed adults. Burnout was measured by the Maslach Burnout Inventory and health care utilization by insurance company records regarding these employees' health care costs and number of times they accessed health care services over a one year period. ANOVAs were conducted using Golembiewski and Munzenrider's approach to define the burnout phase. Significant differences in health care costs were found.
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.
Liyanage, H.; Liaw, S-T.; Kuziemsky, C.; Mold, F.; Krause, P.; Fleming, D.; Jones, S.
Summary Background Generally benefits and risks of vaccines can be determined from studies carried out as part of regulatory compliance, followed by surveillance of routine data; however there are some rarer and more long term events that require new methods. Big data generated by increasingly affordable personalised computing, and from pervasive computing devices is rapidly growing and low cost, high volume, cloud computing makes the processing of these data inexpensive. Objective To describe how big data and related analytical methods might be applied to assess the benefits and risks of vaccines. Method: We reviewed the literature on the use of big data to improve health, applied to generic vaccine use cases, that illustrate benefits and risks of vaccination. We defined a use case as the interaction between a user and an information system to achieve a goal. We used flu vaccination and pre-school childhood immunisation as exemplars. Results We reviewed three big data use cases relevant to assessing vaccine benefits and risks: (i) Big data processing using crowd-sourcing, distributed big data processing, and predictive analytics, (ii) Data integration from heterogeneous big data sources, e.g. the increasing range of devices in the “internet of things”, and (iii) Real-time monitoring for the direct monitoring of epidemics as well as vaccine effects via social media and other data sources. Conclusions Big data raises new ethical dilemmas, though its analysis methods can bring complementary real-time capabilities for monitoring epidemics and assessing vaccine benefit-risk balance. PMID:25123718
van Uden-Kraan, Cornelia F; Peek, Niels; Cuijpers, Pim; Leemans, C René; Verdonck-de Leeuw, Irma M
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
... 7 Agriculture 1 2011-01-01 2011-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...
... 7 Agriculture 1 2012-01-01 2012-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...
... 7 Agriculture 1 2014-01-01 2014-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...
... 7 Agriculture 1 2013-01-01 2013-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...
This chapter describes the various compounds that can act as prebiotic fibers: their structure, occurrence, production, and physiological effects (health effects) will be presented. The basis for the description is the latest definitions for dietary fibers and for prebiotics. Using as much as possible data from human studies, both the fiber and the prebiotic properties will be described of a variety of compounds. Based on the presented data the latest developments in the area of prebiotics, fibers and gut and immune health will be discussed in more detail as they show best what the potential impact of prebiotics on health of the human host might be.
Chin, Jean Lau; Yee, Barbara W K; Banks, Martha E
As health care reform promises to change the landscape of health care delivery, its potential impact on women's health looms large. Whereas health and mental health systems have historically been fragmented, the Affordable Care Act (ACA) mandates integrated health care as the strategy for reform. Current systems fragment women's health not only in their primary care, mental health, obstetrical, and gynecological needs, but also in their roles as the primary caregivers for parents, spouses, and children. Changes in reimbursement, and in restructuring financing and care coordination systems through accountable care organizations and medical homes, will potentially improve women's health care.
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).
Barry, Catherine N; Abraham, Kristen M; Weaver, Kendra R; Bowersox, Nicholas W
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
address the best method of funding for veterans’ health care, while continuing to focus on ensuring a “seamless transition” process for servicemembers...Health Enrollment Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Table 2. VA Spending and Number of OIF and OEF...Home for Disabled Volunteer Soldiers, administered various benefits for the nation’s veterans. 9 For details on the appeals process , see CRS Report
Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L
The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.
Wesolowski, C E
Organizations that clearly demonstrate they care about their people reap the benefits of a positive self-image, higher productivity and financial gains. Consider the effects that a demoralized, unappreciated staff have on productivity, recruitment and retention, public relations, marketing, customer satisfaction and the resulting financial repercussions. Can we afford not to care?
Kunin, Sharon Brown; Kanze, David Mitchell
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.
... medlineplus.gov/ency/patientinstructions/000878.htm Understanding your health care costs To use the sharing features on this ... This is the payment you make for certain health care provider visits and prescriptions. It is a set ...
Rosenstein, Alan H.
The article focuses on the merits of a comprehensive, medically-oriented health maintenance/risk assessment program, and suggests that such conditions as heart disease, cancer, and arteriosclerosis can be prevented or postponed through proper nutrition, weight control, exercise, smoking cessation, and stress management. (Author/CB)
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Provision of health care... Health Care Benefits for Certain Children of Vietnam Veterans-Spina Bifida and Covered Birth Defects § 17.901 Provision of health care. (a) Spina bifida. VA will provide a Vietnam veteran's child who has...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Provision of health care... Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida and Covered Birth Defects § 17.901 Provision of health care. (a) Spina bifida. VA...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Provision of health care... Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida and Covered Birth Defects § 17.901 Provision of health care. (a) Spina bifida. VA...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Provision of health care... Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida and Covered Birth Defects § 17.901 Provision of health care. (a) Spina bifida. VA...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Provision of health care... Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida and Covered Birth Defects § 17.901 Provision of health care. (a) Spina bifida. VA...
... 32 National Defense 3 2010-07-01 2010-07-01 true Medical care benefits. 564.39 Section 564.39... REGULATIONS Medical Attendance and Burial § 564.39 Medical care benefits. (a) A member of the ARNG who incurs a disease or injury under the conditions enumerated herein is entitled to medical care, in...
Fadope, Cece Modupe; And Others
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…
Evered, Sharrilyn R.; Center, Bruce A.
Abstract This study explores whether personal care services for functionally dependent or cognitively impaired individuals paid for by a long-term care (LTC) insurance policy can reduce health care utilization and costs at the end of life. This retrospective study uses propensity score matching methodology, hierarchical multiple regression, and Poisson regression to compare 830 decedents who utilized benefits from a voluntary LTC insurance plan (“claimants”) to 6860 decedents who never purchased coverage but were similar to claimants on 17 variables, including age, sex, frailty, burden of illness markers, and propensity to have needed LTC services. Claimants using LTC benefits experienced significantly lower health care costs at end of life, including 14% lower total medical costs, 13% lower pharmacy costs, 35% lower inpatient admission costs, and 16% lower outpatient visit costs. They also experienced 8% fewer inpatient admissions and 10% fewer inpatient days. The presence of dementia at the end of life moderated these effects. This study suggests that use of insurance-based LTC services measurably reduces health care expenditures at the end of life. (Population Health Management 2014;17:332–339) PMID:24784144
... 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...
Guralnick, Eva, Ed.; Zamani, Rahman, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Oku, Cheryl, Ed.; Kunitz, Judith, Ed.
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…
Changes in the scale of values associated with society entering plural democracy caused as regards conceptual problems of health care some ethical doubts and objections. In the author's opinion the most important ones are: problems on the essence of health and mission of health policy, responsibility for health care, nature of health services under conditions of market economy, problems of the interpretation of right to health, health requirements and the importance of equity in advanced cultural societies.
Smithies, R; Steeves, L
Flexible benefits plans have grown more slowly in Canada than in the United States, largely because of certain legal and regulatory considerations. Health care spending accounts (HCSAs) provide a cost-effective way for Canadian employers to address the health care benefit needs of a diverse workforce. A flexible health care spending account is a versatile and cost-effective instrument that can be used by Canadian employers that wish to provide a full range of health care benefits to employees. The health care alternatives available through an HCSA can provide employees with an opportunity to customize and optimize their benefits program. Regulatory requirements that an HCSA must meet in order to qualify for available tax advantages are discussed, as are the range of health care services that may be covered.
Schieber, G J; Puollier, J P
Trends in health are reviewed for the member countries of the Organization for Economic Cooperation and Development (OECD) covering the following: the basic difficulties inherent in international comparative studies; the absolute levels of health expenditures in 1984; the levels and rates of growth of the health share in the gross domestic product (GDP) and the public share of total health expenditures; the elasticities of real health expenditures to real GDP for the 1960-75, 1975-84, and 1960-84 time periods; growth in health expenditures for the largest 7 OECD countries in terms of growth in population, health prices, health care prices in excess of overall prices, and utilization/intensity of services per person. International comparisons are a problem due to differences in defining the boundaries of the health sector, the heterogeneity of data, and methodological problems arising from comparing different economic, demographic, cultural, and institutional structures. The most difficult problem in international comparisons of health expenditures is lack of appropriate measures of health outcome. Exhibit 1 contains per capita health expenditures denominated in US dollars based on GDP purchasing power parities for 21 OECD countries for 1984. Per capita health expenditures ranged from less than $500 in Greece, Portugal, and Spain to over $1400 in Sweden and the US, with an OECD average of $871. After adjusting for price level differences, there still appears to be a greater than 3-fold difference in the "volume" of services consumed across the OECD countries. To determine if per capita health expenditures are related to a country's wealth as measured by its per capita GDP, the relationship between per capita health expenditures and per capita GDP for the 21 countries were examined for 1984. The data points and the "best fitting" trend line indicate a statistically significant relationship in which each $100 difference in per capita GDP is associated with a $10
Cox, Don; Lanyi, Bettina; Strabic, Allison
This article reports the results of an analysis of the relationship between supplemental benefits offered by Medicare+Choice (M+C) plans and their plan performance ratings. We examined two measures of plan performance: (1) plan ratings as reported in the Medicare Managed Care (MMC) Consumer Assessment of Health Care Study (CAHPS), and (2) disenrollment rates. The results of our analysis indicated that variations in plan supplemental offerings have little impact on enrollees' plan performance ratings--both overall ratings and access to care measures. Furthermore, disenrollment rates were found to be more sensitive to the availability of alternative M+C plans, either in general, or for specific benefits than to variations in benefit offerings.
Historically, the medicinal use of green tea dates back to China 4700 years ago and drinking tea continues to be regarded traditionally in Asia as a general healthful practice. Numerous scientific publications now attest to the health benefits of both black and green teas, including clinical and epidemiological studies. Although all tea contains beneficial antioxidants, high-quality green and white teas have them in greater concentrations than black tea. Today, scientists believe that the main active ingredients of green tea include the polyphenols, in particular the catechins and the amino acid, theanine. Studies on the health benefits of drinking tea, particularly green tea, are finding exciting results, particularly in cancer research. Modern studies in both Asia and the West have provided encouraging results indicating that drinking green tea contributes to fighting many different kinds of cancers including stomach, oesophageal, ovarian and colon. Recent studies describing the health benefits of these compounds will be reviewed.
Mendoza, Roger Lee
The essential health benefits mandate constitutes one of the most controversial health care reforms introduced under the U.S. Affordable Care Act of 2010. It bears important theoretical and practical implications for health care risk and insurance management. These essential health benefits are examined in this study from a rent-seeking perspective, particularly in terms of three interrelated questions: Is there an economic rationale for standardized, minimum health care coverage? How is the scope of essential health services and treatments determined? What are the attendant and incidental costs and benefits of such determination/s? Rents offer ample incentives to business interests to expend considerable resources for health care marketing, particularly when policy processes are open to contestation. Welfare losses inevitably arise from these incentives. We rely on five case studies to illustrate why and how rents are created, assigned, extracted, and dissipated in equilibrium. We also demonstrate why rents depend on persuasive marketing and the bargained decisions of regulators and rentiers, as conditioned by the Tullock paradox. Insights on the intertwining issues of consumer choice, health care marketing, and insurance reform are offered by way of conclusion.
Miller, Franklin G; Kim, Scott Y H
The idea of a "learning health care system"--one that systematically integrates clinical research with medical care--has received considerable attention recently. Some commentators argue that under certain conditions pragmatic comparative effectiveness randomized trials can be conducted ethically within the context of a learning health care system without the informed consent of patients for research participation. In this article, we challenge this perspective and contend that conducting randomized trials of individual treatment options without consent is neither necessary nor desirable to promote and sustain learning health care systems. Our argument draws on the normative conception of personal care developed by Charles Fried in a landmark 1974 book on the ethics of randomized controlled trials.
Glymour, M. Maria; Avendano, Mauricio
Objectives. We assessed the impact of unemployment benefit programs on the health of the unemployed. Methods. We linked US state law data on maximum allowable unemployment benefit levels between 1985 and 2008 to individual self-rated health for heads of households in the Panel Study of Income Dynamics and implemented state and year fixed-effect models. Results. Unemployment was associated with increased risk of reporting poor health among men in both linear probability (b = 0.0794; 95% confidence interval [CI] = 0.0623, 0.0965) and logistic models (odds ratio = 2.777; 95% CI = 2.294, 3.362), but this effect is lower when the generosity of state unemployment benefits is high (b for interaction between unemployment and benefits = −0.124; 95% CI = −0.197, −0.0523). A 63% increase in benefits completely offsets the impact of unemployment on self-reported health. Conclusions. Results suggest that unemployment benefits may significantly alleviate the adverse health effects of unemployment among men. PMID:25521897
... Care » Program Overview » Outreach Materials » FAQs Women Veterans Health Care Menu Menu Womens Health Women Veterans Health Care ... Who can I call for more help? What health care services are available to women Veterans? A full ...
Petrochuk, M A; Javalgi, R G
Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.
Durán-Arenas, Luis; Salinas-Escudero, Guillermo; Granados-García, Víctor; Martínez-Valverde, Silvia
Access to health services is a social basic determinant of health in Mexico unlike what happens in developed countries. The demand for health services is focused on primary care, but the design meets only the supply of hospital care services. So it generates a dissonance between the needs and the effective design of health services. In addition, the term affiliation refers to population contributing or in the recruitment process, that has been counted as members of these social security institutions (SS) and Popular Insurance (SP). In the case of Instituto Mexicano del Seguro Social (IMSS) three of four contributors are in contact with health services; while in the SP, this indicator does not exist. Moreover, the access gap between health services is found in the health care packages so that members of the SS and SP do not have same type of coverage. The question is: which model of health care system want the Mexicans? Primary care represents the first choice for increasing the health systems performance, as well as to fulfill their function of social protection: universal access and coverage based on needs, regardless whether it is a public or private health insurance. A central aspect for development of this component is the definition of the first contact with the health system through the creation of a primary health care team, led by a general practitioner as the responsible of a multidisciplinary health team. The process addresses the concepts of primary care nursing, consumption of inputs (mainly medical drugs), maintenance and general services. Adopting a comprehensive strategy that will benefit all Mexicans equally and without discrimination, this primary care system could be financed with a total operating cost of approximately $ 22,809 million by year.
Mickan, Sharon M
While it is recognised that effective health care teams are associated with quality patient care, the literature is comparatively sparse in defining the outcomes of effective teamwork. This literature review of the range of organisational, team and individual benefits of teamwork complements an earlier article which summarised the antecedent conditions for (input) and team processes (throughput) of effective teams. This article summarises the evidence for a range of outcome measures of effective teams. Organisational benefits of teamwork include reduced hospitalisation time and costs, reduced unanticipated admissions, better accessibility for patients, and improved coordination of care. Team benefits include efficient use of health care services, enhanced communication and professional diversity. Patients report benefits of enhanced satisfaction, acceptance of treatment and improved health outcomes. Finally, team members report enhanced job satisfaction, greater role clarity and enhanced well-being. Due to the inherent complexity of teamwork, a constituency model of team evaluation is supported where key stakeholders identify and measure the intended benefits of a team.
... 32 National Defense 3 2012-07-01 2009-07-01 true Medical care benefits. 564.39 Section 564.39 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY ORGANIZED RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.39 Medical care benefits. (a) A member of the ARNG who...
... 32 National Defense 3 2011-07-01 2009-07-01 true Medical care benefits. 564.39 Section 564.39 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY ORGANIZED RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.39 Medical care benefits. (a) A member of the ARNG who...
... 32 National Defense 3 2013-07-01 2013-07-01 false Medical care benefits. 564.39 Section 564.39 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY ORGANIZED RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.39 Medical care benefits. (a) A member of the ARNG who...
... 32 National Defense 3 2014-07-01 2014-07-01 false Medical care benefits. 564.39 Section 564.39 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY ORGANIZED RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.39 Medical care benefits. (a) A member of the ARNG who...
Trimmer, Kenneth J; Pumphrey, Lela D; Wiggins, Carla
Enterprise resource planning (ERP) systems provide organizations with the opportunity to integrate individual, functionally-oriented information systems. Although much of the focus in the popular press has been placed on ERP systems in large for-profit organizations, small hospitals and clinics are candidates for ERP systems. Focusing information systems on critical success factors (CSFs) allows the organization to address a limited number of areas associated with performance. This limited number of factors can provide management with an insight into dimensions of information that must be addressed by a system. Focuses on CSFs for small health-care organizations. In addition, also considers factors critical to the implementation of health-care information systems. Presents two cases. The results indicate support for the continuing use of CSFs to help focus on the benefits of ERPs. Focusing on groups of tangible and intangible benefits can also assist the rural health-care organization in the use of ERPs.
Silvers, Anita; Francis, Leslie
This article explores rights-based approaches to protecting disabled people against inequities in access to health care services. Understanding health care as a human right, as is found in the UN Convention on the Rights of People with Disabilities (CRPD), fails to provide theoretical machinery for responding to certain pressing challenges. An alternative account, understanding health care as a civil right, proves more promising. This latter approach then is applied to the right to health care under the U.S. Affordable Care Act (ACA), which contains provisions that could be antithetical to, and thus fail to comply with, the nondiscrimination standard of meaningful access to health care benefits.
Since the late 1980s, virtually every developed, and many developing, countries have re-examined the structure of their health care systems. Health care reform has become a truly global phenomenon with considerable potential for cross-nation lesson-learning. In countries where the state has been the central actor in the health sector, its role is being reassessed and, in some cases, reconfigured. The introduction of market principles to health care is a feature of many countries: market romantics believe markets in health care will improve efficiency, empower consumers, control costs, and overthrow monolithic bureaucracies. But will they? The evidence, such as it is, suggests otherwise. The greatest pressure for change and for introducing markets into health care has been in the relative role of the private sector in the operation, and in some countries also the financing of health care services. But it is not a simple case of the state versus the market. The issues are much more complex and various hybrid models are emerging involving some sort of public-private mix. The move is towards greater diversity and pluralism, an inevitable consequence of which is growing fragmentation in the funding and provision of care with all the associated on-costs in terms of increased coordination and management that this entails. The policy aim is to harness the benefits of market behaviour without also adopting the inherent weaknesses of markets with regard to questions of distributive justice and equity.
Li, Ya; Zhang, Jiao-Jiao; Xu, Dong-Ping; Zhou, Tong; Zhou, Yue; Li, Sha; Li, Hua-Bin
Wild fruits are exotic or underutilized. Wild fruits contain many bioactive compounds, such as anthocyanins and flavonoids. Many studies have shown that wild fruits possess various bioactivities and health benefits, such as free radical scavenging, antioxidant, anti-inflammatory, antimicrobial, and anticancer activity. Therefore, wild fruits have the potential to be developed into functional foods or pharmaceuticals to prevent and treat several chronic diseases. In the present article, we review current knowledge about the bioactivities and health benefits of wild fruits, which is valuable for the exploitation and utilization of wild fruits. PMID:27527154
Li, Ya; Zhang, Jiao-Jiao; Xu, Dong-Ping; Zhou, Tong; Zhou, Yue; Li, Sha; Li, Hua-Bin
Wild fruits are exotic or underutilized. Wild fruits contain many bioactive compounds, such as anthocyanins and flavonoids. Many studies have shown that wild fruits possess various bioactivities and health benefits, such as free radical scavenging, antioxidant, anti-inflammatory, antimicrobial, and anticancer activity. Therefore, wild fruits have the potential to be developed into functional foods or pharmaceuticals to prevent and treat several chronic diseases. In the present article, we review current knowledge about the bioactivities and health benefits of wild fruits, which is valuable for the exploitation and utilization of wild fruits.
Tuttle, Mark S.
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
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
Sherertz, R. J.; Bassetti, S.; Bassetti-Wyss, B.
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
staggering cost of hospitalization and health care in general. Vast insurance pools that pay the bills encourage both the provider and consumer to utilize...incentives built into the system for either the consumer or the provider to encourage medical services cost control. 6 Massive, expensive and seemingly...1991.11 Ethical Considerations in Health Care Bioethical questions will prevail during any discussion of how to resolve America’s health care crisis. The
Brown, Judith Belle; French, Reta; McCulloch, Amy; Clendinning, Eric
Abstract Objective To explore the knowledge and perceptions of fourth-year medical students regarding the new models of primary health care (PHC) and to ascertain whether that knowledge influenced their decisions to pursue careers in family medicine. Design Qualitative study using semistructured interviews. Setting The Schulich School of Medicine and Dentistry at The University of Western Ontario in London. Participants Fourth-year medical students graduating in 2009 who indicated family medicine as a possible career choice on their Canadian Residency Matching Service applications. Methods Eleven semistructured interviews were conducted between January and April of 2009. Data were analyzed using an iterative and interpretive approach. The analysis strategy of immersion and crystallization assisted in synthesizing the data to provide a comprehensive view of key themes and overarching concepts. Main findings Four key themes were identified: the level of students’ knowledge regarding PHC models varied; the knowledge was generally obtained from practical experiences rather than classroom learning; students could identify both advantages and disadvantages of working within the new PHC models; and although students regarded the new PHC models positively, these models did not influence their decisions to pursue careers in family medicine. Conclusion Knowledge of the new PHC models varies among fourth-year students, indicating a need for improved education strategies in the years before clinical training. Being able to identify advantages and disadvantages of the PHC models was not enough to influence participants’ choice of specialty. Educators and health care policy makers need to determine the best methods to promote and facilitate knowledge transfer about these PHC models. PMID:22518904
Rushmer, R; Davies, H
Learning in health care is essential if healthcare organisations are to tackle a challenging quality of care agenda. Yet while we know a reasonable amount about the nature of learning, how learning occurs, the forms it can take, and the routines that encourage it to happen within organisations, we know very little about the nature and processes of unlearning. We review the literature addressing issues pivotal to unlearning (what it is, why it is important, and why it is often neglected), and go further to explore the conditions under which unlearning is likely to be encouraged. There is a difference between routine unlearning (and subsequent re-learning) and deep unlearning—unlearning that requires a substantive break with previous modes of understanding, doing, and being. We argue that routine unlearning merely requires the establishment of new habits, whereas deep unlearning is a sudden, potentially painful, confrontation of the inadequacy in our substantive view of the world and our capacity to cope with that world competently. PMID:15576685
Edgar, Andrew; Pattison, Stephen
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.
Dopkeen, J C
One-fourth of all those over 65 have some form of employer-provided retirement medical benefits. For these retirees and dependents, having this medical coverage may mean the difference between retirement security and ruin; but for employers, providing it could mean serious financial strain or even a threat to survival. The unfunded liability for retirement medical coverage has been variously projected from +100 billion to nearly +2 trillion. Continuing corporate concerns over the costs of health care, and recent changes in federal policies regarding Medicare and the taxation of employee benefit funds, threaten to alter the system of postretirement health benefits substantially and perhaps irrevocably for many. Employers are being forced to reassess their retiree commitments. Some corporations have undertaken to modify and even eliminate postretirement medical coverage for those over 65. These changes will affect not only the corporations involved and their retirees, but also the national and state governments to whom retirees may turn for additional assistance in meeting their health care needs. The purpose of this synthesis is to explain the issue of postretirement health benefits (PRHBs) for both public and private sector policymakers who will be most involved with this issue over the next five years. The analysis identifies the issues involved, considers the dimensions of the problem, and attempts to assess the implications for the future. PMID:3106266
Tracy, Jane; McDonald, Rachael
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.…
... 49 Transportation 1 2011-10-01 2011-10-01 false Health and insurance benefits and services. 25.440... Basis of Sex in Education Programs or Activities Prohibited § 25.440 Health and insurance benefits and... coverage health service shall provide gynecological care....
... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Health care and services. 638.510 Section 638... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and...
... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Health care and services. 638.510 Section 638... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Health care and services. 638.510 Section 638... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and...
... 163535.html Cancer Survivors Gain From Web-Based Health Care But some patients reported missing face-to-face ... 10, 2017 (HealthDay News) -- Online- and phone-based health care offers a number of benefits for cancer survivors, ...
Faced with eroding profitability from rising health care costs, corporations are beginning to aggressively implement cost containment strategies. Although few companies have coordinated long range plans in place, corporations' attempts to exert control over the health care system will affect insurers, providers, and consumers. Occupational health nurses need to be aware of how cost-containment pressures will affect the various aspects of the U.S. health care system if they want to influence the changes. Occupational health nurses have an opportunity to work with benefits personnel and others in their company to maximize employee health while helping to implement programs to contain health care costs.
Farrar, S.; Kates, N.; Crustolo, A. M.; Nikolaou, L.
OBJECTIVE: To determine whether health care providers are satisfied with an integrated program of mental health care. DESIGN: Surveys using a mailed questionnaire. Surveys were developed for each of the three disciplines; each survey had 30 questions. SETTING: Thirty-six primary care practices in Hamilton, Ont, participating in the Hamilton-Wentworth Health Service Organization's Mental Health Program. PARTICIPANTS: Family physicians, psychiatrists, and mental health counselors providing mental health care in primary care settings. MAIN OUTCOME MEASURE: Satisfaction as shown on 5-point Likert scales. RESULTS: High levels of satisfaction with the model were recorded. Family physicians increased their skills, felt more comfortable with handling mental health problems, and were satisfied with the benefit to their patients. Psychiatrists and counselors were gratified that they were accepted by other members of the primary care team. Areas for improvement included finding space in primary care settings and better scheduling to allow for optimal communication. CONCLUSION: Family physicians, counselors, and psychiatrists expressed great satisfaction with a shared mental health care program based in primary care. PMID:11785279
Jones, W. L.
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.
Steaban, Robin Lea
This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid. This maximizes the roles of nurses across the continuum as transformational leaders in the patient/family and nursing relationship. The author explores the role of the nurse in a transactional versus transformational relationship with patients, leading to actualization of the nurse in care coordination. Focusing on the role of the nurse leader, the challenges and necessary actions for optimization of the professional nurse role are explored, using principles of transformational leadership.
... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy,...
... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy,...
... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy,...
... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy,...
... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy,...
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)
Maronde, Robert F.
Pharmacists' contribution to the health care of the future in the future in the U.S. may have to be in the context of increasing the efficiency and effectiveness of health-care delivery. It is from the area of drug therapy, now poorly administered, that the pharmacist will have to justify his role in a cost-effective manner. (Author/LBH)
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…
Wick, Jeannette Y; Zanni, Guido R
When groups of people relocate from their homelands to other nations, especially if the movement is involuntary, minority populations are created in the countries that receive them. The issues related to these diaspora and diasporic communities--any groups that have been dispersed outside their traditional homelands--are financial, social, historical, political, or religious. In health care, issues include heritable diseases, cultural barriers, patients' health care beliefs, and unique disease presentations. In long-term care, many residents and health care providers have relocated to the United States from other countries.
McDavid, Lolita M
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.
... 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 ...
Kenagy, J W; Berwick, D M; Shore, M F
Although US health care is described as "the world's largest service industry," the quality of service--that is, the characteristics that shape the experience of care beyond technical competence--is rarely discussed in the medical literature. This article illustrates service quality principles by analyzing a routine encounter in health care from a service quality point of view. This illustration and a review of related literature from both inside and outside health care has led to the following 2 premises: First, if high-quality service had a greater presence in our practices and institutions, it would improve clinical outcomes and patient and physician satisfaction while reducing cost, and it would create competitive advantage for those who are expert in its application. Second, many other industries in the service sector have taken service quality to a high level, their techniques are readily transferable to health care, and physicians caring for patients can learn from them.
Kruis, A L; Chavannes, N H
Chronic obstructive pulmonary disease (COPD) represents a major and progressive cause of morbidity and mortality worldwide, resulting in an important financial and health burden in coming decades. Pulmonary rehabilitation (PR) has been proven to be the most effective treatment in all patients in whom respiratory symptoms are associated with diminished functional capacity or reduced quality of life. Nevertheless, despite wide recommendation and proven efficacy, the use of PR is limited in daily practice. Reasons for these include low accessibility and availability, high costs, and lack of motivation to continue a healthy life style after treatment. By contrast, it has been demonstrated that primary care patients can be reactivated by formulating personal targets and designing individualized treatment plans in collaboration with their general practitioner or practice nurse. Based on these personal plans and targets, specific education must be provided and development of self management skills should be actively encouraged. Ideally, elements of pulmonary rehabilitation are tailored into a comprehensive primary care integrated disease management program. In that way, the benefits of PR can be extended to a substantially larger part of the COPD population, to reach even those with milder stages of disease. Favorable long-term effects on exercise tolerance and quality of life in a number of studies have been demonstrated in recent years, but broad introduction in the primary care setting still needs further justification in the form of a proper cost effectiveness analysis.
Dixon, Robert Brent; Hertelendy, Attila J
With the implementation of the Affordable Care Act (ACA), access to insurance and coverage of preventive care services has been expanded. By removing the barrier of shared costs for preventive care, it is expected that an increase in utilization of preventive care services will reduce the cost of chronic diseases. Early detection and treatment is anticipated to be less costly than treatment at full onset of chronic conditions. One concern of early detection of disease is the cost to treat. In reality, the confluence of early detection may result in greater overall expenditures. Even with improved access to preventive care benefits, cost-sharing of other health services remains a major component of insurance plans. In order to treat identified conditions or diseases, cost-sharing comes into play. With the greater adoption of cost-sharing insurance plans, expenditures on the part of enrollee are anticipated to rise. Once the healthcare recipients realize the implication of early identification and resultant treatment costs, enrollment in preventive care may decline. Healthcare legislation and regulation should consider the full spectrum of care and the microeconomic costs associated with preventive treatment. Although the system at large may not realize the immediate impact, behavioral shifts on the part of healthcare consumers may alter healthcare. Rather than the current status quo of treating presenting conditions, preventive treatment is largely anticipated to require more resources and may impact the consumer's financial capacity. This report will explore how these two concepts are co-dependent, and highlight the need for continued reform.
Halamandaris, V J
In summary, the nation's health care system is in serious need of reform. It is expensive and woefully inefficient. Millions of people are excluded from coverage, while others receive limited or second-class care. For those millions who suffer serious chronic problems that require long-term care, there is virtually no help. There is no help for the family whose loved one suffers from Alzheimer's disease. There is no help for the family whose child is born with cerebral palsy or epilepsy. There is no help for the middle-aged father, disabled in an automobile accident. Providing good care to all Americans is not a matter of money. America currently spends some 13% of its gross national product on health care, and yet the health statistics of Americans are the worst in the industrialized world. What America needs is a comprehensive system of health care that includes both acute and long-term care. Congress must take action to restore health care as a basic constitutional right of all Americans. Coverage for long-term care must be included within the context of any new national health care program. Funding for such a program should come from the most progressive tax that the Congress can fashion, which to this point is the federal income tax. Although there is an appropriate role for private insurance, it should function as a supplement to rather than as a substitute for a new national program. There are several other elements that are key to a national health care program: Home care must be the first line of any national long-term care program.(ABSTRACT TRUNCATED AT 250 WORDS)
Chang, Jason; McLemore, Elisabeth; Tejirian, Talar
Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate. Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area. Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases. In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists. PMID:27723447
Chang, Jason; Mclemore, Elisabeth; Tejirian, Talar
Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy.The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate.Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area.Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases.In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists.
Merlino, James I; Raman, Ananth
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.
Miles, Stephen H.; And Others
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…
Beatty, Rebecca M.
Survey responses from 71 health professionals, benchmarking data from 8 hospitals, continuing education program evaluations, and focus groups with nursing, allied health, and primary care providers indicated a need for professional continuing education on women's health issues. Primary topic needs were identified. The data formed the basis for…
Leanza, Francesco; Hauser, Diane
Teens are avid users of new technologies and social media. Nearly 95% of US adolescents are online at least occasionally. Health care professionals and organizations that work with teens should identify online health information that is both accurate and teen friendly. Early studies indicate that some of the new health technology tools are acceptable to teens, particularly texting, computer-based psychosocial screening, and online interventions. Technology is being used to provide sexual health education, medication reminders for contraception, and information on locally available health care services. This article reviews early and emerging studies of technology use to promote teen health.
Podein, Rian J; Hernke, Michael T
Unsustainable development around the world has contributed to ecological degradation and human suffering while compromising the ability of ecosystems and social institutions to support human life. The United States health care system and its institutions are significant contributors to unsustainable development, but leaders of change are emerging from the health care arena. Health professionals, including primary care providers, are poised to serve as models for sustainability and to facilitate the necessary transformation toward more sustainable practices. Health professionals must, within a practical framework, embrace an objective definition of sustainability and then act to achieve it.
Cuellar, Alison Evans; Cheema, Jehanzeb
The 2010 Patient Protection and Affordable Care Act (ACA) has a number of important features for individuals who are involved with the criminal justice system. Among the most important changes is the expansion of Medicaid to more adults. The current study estimates that 10% of the total Medicaid expansion could include individuals who have experienced recent incarceration. The ACA also emphasizes the importance of mental health and substance abuse benefits, potentially changing the landscape of behavioral health treatment providers willing to serve criminal justice populations. Finally, it seeks to promote coordinated care delivery. New care delivery and appropriate funding models are needed to address the behavioral health and other chronic conditions experienced by those in criminal justice and to coordinate care within the complex structure of the justice system itself.
Abraham, Jean; Feldman, Roger; Carlin, Caroline; Christianson, Jon; Davis, Linda
More than half of all Americans receive health insurance coverage through an employer. The rising costs and escalating complexity of health insurance has led many employers to embark on extensive employee education campaigns. In 2002, 1,365 randomly selected employees from 16 Buyers Health Care Action Group firms in the Minneapolis region were surveyed to evaluate their awareness of employer-provided health plan quality information and the extent to which this information influences their enrollment decisions. The study found mixed evidence with respect to the value of employer communication. On one hand, employer communication does not significantly increase the probability that an employee responded correctly to the pharmacy benefit question posed in the survey. However, employer communication has a large effect on the awareness of quality information. How well those campaigns work, and by extension how well employees are informed about the health benefits decisions they make, is a key issue in health care today.
Kuo, Dennis Z; Bird, T Mac; Tilford, J Mick
The objective of this study is to examine the association of family-centered care (FCC) with specific health care service outcomes for children with special health care needs (CSHCN). The study is a secondary analysis of the 2005-2006 National Survey of Children with Special Health Care Needs. Receipt of FCC was determined by five questions regarding how well health care providers addressed family concerns in the prior 12 months. We measured family burden by reports of delayed health care, unmet need, financial costs, and time devoted to care; health status, by stability of health care needs; and emergency department and outpatient service use. All statistical analyses used propensity score-based matching models to address selection bias. FCC was reported by 65.6% of respondents (N = 38,915). FCC was associated with less delayed health care (AOR: 0.56; 95% CI: 0.48, 0.66), fewer unmet service needs (AOR: 0.53; 95% CI: 0.47, 0.60), reduced odds of ≥1 h/week coordinating care (AOR: 0.83; 95% CI: 0.74, 0.93) and reductions in out of pocket costs (AOR: 0.88; 95% CI: 0.80, 0.96). FCC was associated with more stable health care needs (AOR: 1.11; 95% CI: 1.01, 1.21), reduced odds of emergency room visits (AOR: 0.90; 95% CI: 0.82, 0.99) and increased odds of doctor visits (AOR: 1.25; 95% CI: 1.14, 1.37). Our study demonstrates associations of positive health and family outcomes with FCC. Realizing the health care delivery benefits of FCC may require additional encounters to build key elements of trust and partnership.
Schultz, D S; Rafferty, M P
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
... 42 Public Health 4 2013-10-01 2013-10-01 false Essential health benefits. 440.347 Section 440.347 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...-Equivalent Coverage § 440.347 Essential health benefits. (a) Alternative Benefit Plans must contain...
... 42 Public Health 4 2014-10-01 2014-10-01 false Essential health benefits. 440.347 Section 440.347 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...-Equivalent Coverage § 440.347 Essential health benefits. (a) Alternative Benefit Plans must contain...
This article summarizes a presentation given at 'Health and Well-being: the 21st Century Agenda', which focused on the potential to make progress by making appropriate connections between activity to promote health and respond to the threat of climate change. It argues that a transition to a low carbon economy would bring together two of our greatest public health challenges, supporting action to improve public health within resource constraints and action to avert climate change as far as possible. Deep cuts in emissions are needed to prevent dangerous consequences arising from climate change. In addition, many of the policies to reduce greenhouse gas emissions will, in themselves, have beneficial effects on public health. This article provides an overview of several modelling studies which demonstrate that well-designed initiatives that curb greenhouse gas emissions in energy, residential construction, urban transport and agricultural systems can enhance global public health, including improving health among poor populations. Some of these health co-benefits can be achieved in a relatively short time frame, and they can help offset the costs of climate change mitigation policies.
Kwakye, Gifty; Brat, Gabriel A; Makary, Martin A
The objective of this study was to identify leading practices to promote environmentally friendly and efficient efforts in the provision of surgical health care. Health care is the second leading contributor to waste in the United States. Despite widespread enthusiasm for "going green" in the US economy, little substantive information is available to the medical community, to our knowledge. We explore safe and efficient strategies for hospitals and providers to protect the environment while delivering high-quality care. We performed a systematic review of the literature using relevant PubMed search terms and surveyed a panel of hospital managers and chief executive officers of health care organizations pursuing green initiatives. Recommendations were itemized and reviewed by a 7-member panel to generate a consensus agreement. We identified 43 published articles and used interview data from the panel. The following 5 green recommendations for surgical practices were identified: operating room waste reduction and segregation, reprocessing of single-use medical devices, environmentally preferable purchasing, energy consumption management, and pharmaceutical waste management. The medical community has a large opportunity to implement green practices in surgical units. These practices can provide significant benefits to the health care community and to the environment. Additional research and advocacy are needed to further explore green practices in health care.
Stempsey, William E
Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers.
Hine, Jeffrey F; Grennan, Allison Q; Menousek, Kathryn M; Robertson, Gail; Valleley, Rachel J; Evans, Joseph H
As the benefits of integrated behavioral health care services are becoming more widely recognized, this study investigated physician satisfaction with ongoing integrated psychology services in pediatric primary care clinics. Data were collected across 5 urban and 6 rural clinics and demonstrated the specific factors that physicians view as assets to having efficient access to a pediatric behavioral health practitioner. Results indicated significant satisfaction related to quality and continuity of care and improved access to services. Such models of care may increase access to care and reduce other service barriers encountered by individuals and their families with behavioral health concerns (ie, those who otherwise would seek services through referrals to traditional tertiary care facilities).
... m-health (mobile health), includes a variety of health care services, including but not limited to: Online support ... self-management tools Email and online communication with health care providers Electronic health records Remote monitoring of vital ...
The treatment of wounds forms a major part of nurses' practice in patients' homes. The choice of dressing requires real expertise drawing notably on collaborative approaches and the sharing of the patient's records. Based on this observation, Laurent Klein, a private practice nurse, designed and developed an e-health tool aimed specifically at the treatment of wounds. A real nursing success story which has helped to improve the quality of care.
The direct-to-consumer (DTC) movement is gaining momentum as the health care industry becomes more consumer driven and the ability to target narrow population segments is better refined. To fully benefit from DTC marketing, health care marketers must modify their methodologies and recognize the promise represented by 280 million potential customers. This radical approach requires throwing out some preconceived ideas about marketing and learning to treat health care consumers as individuals with unique lifestyle traits.
If you have been diagnosed with cancer, finding a doctor and treatment facility for your cancer care is an important step to getting the best treatment possible. Learn tips for choosing a doctor and treatment facility to manage your cancer care.
Blanchard, Anita K; Goodall, Perpetua
Specialists in general obstetrics and gynecology are key providers of primary care in women. They diagnose and provide the initial management of many medical conditions unrelated to reproductive health. Most importantly they can impact the overall health of patients through incorporating preventive approaches in the annual well-woman visit. This article defines preventive care and identifies leading causes of mortality in women. A framework for identifying key elements of the well-woman examination is summarized. Examples of prevention are provided, which focus on major health care issues that affect adult women.
Morrisey, M A
This note focuses on the role of the personal income tax in reducing the effective price of health care benefits. Tax-bracket creep is shown to provide a cushion that absorbs relatively large increases in health benefit costs, thus reducing the impetus for employer initiatives to control health care costs. It is hypothesized that the Economic Recovery Tax Act of 1981, with its provision for the indexing of tax brackets, will increase employer concern, and may therefore spur the development of effective employer initiatives to reduce the costs of health benefits.
The employment-based health benefits system established its roots many years ago. It was during World War II that many more employers began to offer health benefits. Recently, however, both the percentage of workers with employment-based health benefits and the comprehensiveness of such coverage have been declining. This paper examines recent trends in employment-based health benefits. It also considers the likely future of this important workplace benefit in light of shifts from defined benefit to defined contribution models of employee benefits and with regard to the implementation of health reform.
Racine, Andrew D
The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty.
Maskerine, Courtney; Loeb, Mark
Increased adherence to hand hygiene is widely acknowledged to be the most important way of reducing infections in health care facilities. Despite evidence of benefit, adherence to hand hygiene among health care professionals remains low. Several behavioral and organizational theories have been proposed to explain this. As a whole, the success of…
... This information in Spanish ( en español ) Paying for health care More information on paying for health care Better ... Coping without insurance More information on paying for health care Explore other publications and websites Age Page: Choosing ...
Ruchman, Samuel G; Singh, Prabhjot; Stapleton, Anna
Why should health care systems in the United States engage with the world's poorest populations abroad while tremendous inequalities in health status and access are pervasive domestically? Traditionally, three arguments have bolstered global engagement: (1) a moral obligation to ensure opportunities to live, (2) a duty to protect against health threats, and (3) a desire to protect against economic downturns precipitated by health crises. We expand this conversation, arguing that US-based clinicians, organizational stewards, and researchers should engage with and learn from low-resource settings' systems and products that deliver high-quality, cost-effective, inclusive care in order to better respond to domestic inequities. Ultimately, connecting "local" and "global" efforts will benefit both populations and is not a sacrifice of one for the other.
... plan. The group health plan may be a fee-for-service plan or a managed care plan, ... Medicare & Veterans’ benefits (continued) I have a VA fee-basis identification (ID) card. Who pays first? The ...
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.
Tandel, Kirtida R.
Sugar is an inseparable part of the food we consume. But too much sugar is not ideal for our teeth and waistline. There have been some controversial suggestions that excessive sugar may play an important role in certain degenerative diseases. So artificial sweeteners or artificially sweetened products continue to attract consumers. A sugar substitute (artificial sweetener) is a food additive that duplicates the effect of sugar in taste, but usually has less food energy. Besides its benefits, animal studies have convincingly proven that artificial sweeteners cause weight gain, brain tumors, bladder cancer and many other health hazards. Some kind of health related side effects including carcinogenicity are also noted in humans. A large number of studies have been carried out on these substances with conclusions ranging from “safe under all conditions” to “unsafe at any dose”. Scientists are divided in their views on the issue of artificial sweetener safety. In scientific as well as in lay publications, supporting studies are often widely referenced while the opposing results are de-emphasized or dismissed. So this review aims to explore the health controversy over perceived benefits of sugar substitutes. PMID:22025850
The health benefits of dietary fiber have long been appreciated. Higher intakes of dietary fiber are linked to less cardiovascular disease and fiber plays a role in gut health, with many effective laxatives actually isolated fiber sources. Higher intakes of fiber are linked to lower body weights. Only polysaccharides were included in dietary fiber originally, but more recent definitions have included oligosaccharides as dietary fiber, not based on their chemical measurement as dietary fiber by the accepted total dietary fiber (TDF) method, but on their physiological effects. Inulin, fructo-oligosaccharides, and other oligosaccharides are included as fiber in food labels in the US. Additionally, oligosaccharides are the best known "prebiotics", "a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-bring and health." To date, all known and suspected prebiotics are carbohydrate compounds, primarily oligosaccharides, known to resist digestion in the human small intestine and reach the colon where they are fermented by the gut microflora. Studies have provided evidence that inulin and oligofructose (OF), lactulose, and resistant starch (RS) meet all aspects of the definition, including the stimulation of Bifidobacterium, a beneficial bacterial genus. Other isolated carbohydrates and carbohydrate-containing foods, including galactooligosaccharides (GOS), transgalactooligosaccharides (TOS), polydextrose, wheat dextrin, acacia gum, psyllium, banana, whole grain wheat, and whole grain corn also have prebiotic effects.
Chung, Min-Yu; Oh, Deok-Kun; Lee, Ki Won
Diabetes is an emerging health problem worldwide. The incidence of type 2 diabetes has dramatically increased and is expected to increase more rapidly in the future. Most patients with type 2 diabetes suffer from obesity and diabetes-related complications, including cardiovascular disease and hepatic steatosis. It has been proposed that simple sugar consumption is one of the major risk factors in the development of diabetes. Hence, the replacement of sugars with a low glycemic response would be an effective strategy to prevent type 2 diabetes. Accumulating evidence demonstrates that D-psicose, which has 70% the sweetness of sucrose and no calories, is a functional sugar exerting several health benefits preventing the development of diabetes. Although D-psicose presents in small amounts in natural products, a recent new technique using biocatalyst sources enables large-scale D-psicose production. More importantly, several clinical and animal studies demonstrated that D-psicose has hypoglycemic, hypolipidemic, and antioxidant activities, which make it an ideal candidate for preventing diabetes and related health concerns. This review will summarize the protective effects of D-psicose against type 2 diabetes and its complications, suggesting its potential benefits as a sucrose substitute.
Marasović Šušnjara, Ivana
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.
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…
Under the Compacts of Free Association (COFA), people from the Freely Associated States — the Republic of Palau (ROP), the Republic of the Marshall Islands (RMI), and the Federated States of Micronesia (FSM) — have been migrating to the United States in increasing numbers. In 1996, Congress passed broad welfare reform (Personal Responsibility and Work Opportunity Reconciliation Act) which limited certain federal benefits previously available to COFA migrants, including Medicaid benefits. Prior to July 2010, the State of Hawai‘i had continued to include COFA migrants under its state-funded Medicaid program. In the face of budget constraints, the State removed these people from its Medicaid rolls. A challenge on the legal basis of the denial of equal protection of the laws, ie, the Fourteenth Amendment to the US Constitution, was successful in reinstating health care to the COFA migrants in December 2010. From the health worker's perspective, regardless of various social justice arguments that may have been marshaled in favor of delivering health care to the people, it was an appeal to the judicial system that succeeded. From the attorney's perspective, the legal victories are potentially limited to the four walls of the courtroom without community involvement and related social justice movements. Together, the authors propose that in order to better address the issue of health care access for Micronesian peoples, we must work together, as health and legal advocates, to define a more robust vision of both systems that includes reconciliation and community engagement. PMID:22235150
Shek, Dina; Yamada, Seiji
Under the Compacts of Free Association (COFA), people from the Freely Associated States--the Republic of Palau (ROP), the Republic of the Marshall Islands (RMI), and the Federated States of Micronesia (FSM)--have been migrating to the United States in increasing numbers. In 1996, Congress passed broad welfare reform (Personal Responsibility and Work Opportunity Reconciliation Act) which limited certain federal benefits previously available to COFA migrants, including Medicaid benefits. Prior to July 2010, the State of Hawai'i had continued to include COFA migrants under its state-funded Medicaid program. In the face of budget constraints, the State removed these people from its Medicaid rolls. A challenge on the legal basis of the denial of equal protection of the laws, ie, the Fourteenth Amendment to the US Constitution, was successful in reinstating health care to the COFA migrants in December 2010. From the health worker's perspective, regardless of various social justice arguments that may have been marshaled in favor of delivering health care to the people, it was an appeal to the judicial system that succeeded. From the attorney's perspective, the legal victories are potentially limited to the four walls of the courtroom without community involvement and related social justice movements. Together, the authors propose that in order to better address the issue of health care access for Micronesian peoples, we must work together, as health and legal advocates, to define a more robust vision of both systems that includes reconciliation and community engagement.
Simms, Mark D.; Freundlich, Madelyn; Battistelli, Ellen S.; Kaufman, Neal D.
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)
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 ...
Domaszewicz, Sander; Havlin, Linda; Connolly, Susan
Employers affected by the recession's 2009 peak must press for cost containment in 2010, especially in health care benefits. Encouraging employee consumerism--through consumer-directed health plans and other strategies--can be enhanced by incentives, but federal efforts at health care reform add some element of uncertainty to the consumer-directed solution. This article provides some lessons to guide the course of action for employers considering implementing a consumerist approach to improve employee health and control the cost trend.
... preferred... Read More Executive Director | Dogwood Village of Orange County US - VA - Orange, Executive Director Dogwood Village of Orange County Health and Rehabilitation and Senior Living, a ...
Dimitriadi, Dimitra; Gyftopoulou, Konstantina; Skarmoutsou, Nikoletta
Probiotic bacteria have become increasingly popular during the last two decades as a result of the continuously expanding scientific evidence pointing to their beneficial effects on human health. As a result they have been applied as various products with the food industry having been very active in studying and promoting them. Within this market the probiotics have been incorporated in various products, mainly fermented dairy foods. In light of this ongoing trend and despite the strong scientific evidence associating these microorganisms to various health benefits, further research is needed in order to establish them and evaluate their safety as well as their nutritional aspects. The purpose of this paper is to review the current documentation on the concept and the possible beneficial properties of probiotic bacteria in the literature, focusing on those available in food. PMID:24959545
Kechagia, Maria; Basoulis, Dimitrios; Konstantopoulou, Stavroula; Dimitriadi, Dimitra; Gyftopoulou, Konstantina; Skarmoutsou, Nikoletta; Fakiri, Eleni Maria
Probiotic bacteria have become increasingly popular during the last two decades as a result of the continuously expanding scientific evidence pointing to their beneficial effects on human health. As a result they have been applied as various products with the food industry having been very active in studying and promoting them. Within this market the probiotics have been incorporated in various products, mainly fermented dairy foods. In light of this ongoing trend and despite the strong scientific evidence associating these microorganisms to various health benefits, further research is needed in order to establish them and evaluate their safety as well as their nutritional aspects. The purpose of this paper is to review the current documentation on the concept and the possible beneficial properties of probiotic bacteria in the literature, focusing on those available in food.
Grazier, Kyle L; Metzler, Bridget
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.
Buchanan, Larry M.
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…
... Your 1- to 2-Year-Old Managing Home Health Care KidsHealth > For Parents > Managing Home Health Care A ... español La atención médica en el hogar Intensive Health Care at Home Kids can need intensive health care ...
Sulku, S Nur; Bernard, D Minbay
In this study, we examine whether and to what extent the health insurance system in Turkey provided adequate protection against high out of pocket expenditures in the period prior to “The Health Transformation Programme”. Furthermore, we examine the distribution of out of pocket expenditures by demographic characteristics, poverty status, health service type, access to health care and self-reported health status. We employ the 2002/03 National Household Health Expenditure Survey data to analyze financial burden of health care expenditure. Following the literature, we define high burdens as expenses above 10 and 20% of income. We find that 19% of the nonelderly population were living in families spending more than 10% of family income and that 14% of the nonelderly population were living in families spending more than 20% of family income on health care. Furthermore, the poor and those living in economically less developed regions had the greatest risk of high out of pocket burdens. The risk of high financial burdens varied by the type of insurance among the insured due to differences in benefits among the five separate public schemes that provided health insurance in the pre-reform period. Our results are robust to three alternative specifications of the burden measure and including elderly adults in the sample population. We see that prior to the reforms there were not adequate protection against high health expenditures. Our study provides a baseline against which policymakers can measure the success of the health care reform in terms of providing financial protection. PMID:23113149
Griffiths, Gareth; Trueman, Laurence; Crowther, Timothy; Thomas, Brian; Smith, Brian
Onion (Allium cepa L.) is botanically included in the Liliaceae and species are found across a wide range of latitudes and altitudes in Europe, Asia, N. America and Africa. World onion production has increased by at least 25% over the past 10 years with current production being around 44 million tonnes making it the second most important horticultural crop after tomatoes. Because of their storage characteristics and durability for shipping, onions have always been traded more widely than most vegetables. Onions are versatile and are often used as an ingredient in many dishes and are accepted by almost all traditions and cultures. Onion consumption is increasing significantly, particularly in the USA and this is partly because of heavy promotion that links flavour and health. Onions are rich in two chemical groups that have perceived benefits to human health. These are the flavonoids and the alk(en)yl cysteine sulphoxides (ACSOs). Two flavonoid subgroups are found in onion, the anthocyanins, which impart a red/purple colour to some varieties and flavanols such as quercetin and its derivatives responsible for the yellow and brown skins of many other varieties. The ACSOs are the flavour precursors, which, when cleaved by the enzyme alliinase, generate the characteristic odour and taste of onion. The downstream products are a complex mixture of compounds which include thiosulphinates, thiosulphonates, mono-, di- and tri-sulphides. Compounds from onion have been reported to have a range of health benefits which include anticarcinogenic properties, antiplatelet activity, antithrombotic activity, antiasthmatic and antibiotic effects. Here we review the agronomy of the onion crop, the biochemistry of the health compounds and report on recent clinical data obtained using extracts from this species. Where appropriate we have compared the data with that obtained from garlic (Allium sativum L.) for which more information is widely available.
Petrou, Stavros; Henderson, Jane
Studies that measure benefits of health care interventions in natural or physical units cannot incorporate the several health changes that might occur within a single measure, and they overlook individuals' preferences for those health changes. This paper discusses and critically appraises the application of preference-based approaches to the measurement of the benefits of perinatal care that have developed out of economic theory. These include quality adjusted life year (QALY)-based approaches, monetary-based approaches, and discrete choice experiments. QALY-based approaches use scaling techniques, such as the rating scale, standard gamble approach, and time trade-off approach, or multi-attribute utility measures, to measure the health-related quality of life weights of health states. Monetary-based approaches include the revealed preference approach, which involves observing decisions that individuals actually make concerning health risks, and the willingness-to-pay approach, which provides a framework for investigating individuals' willingness to pay for benefits of health care interventions. Discrete choice experiments describe health care interventions in terms of their attributes, and elicit preferences for scenarios that combine different levels of those attributes. Empirical examples are used to illustrate each preference-based approach to benefit measurement, and several methodological issues raised by the application of these approaches to the perinatal context are discussed. Particular attention is given to identifying the relevant attributes to incorporate into the measurement instrument, appropriate respondents for the measurement exercise, potential sources of bias in description and valuation processes, and the practicality, reliability, and validity of alternative measurement approaches. The paper's conclusion is that researchers should be explicit and rigorous in their application of preference-based approaches to benefit measurement in the context
Wise, Paul H.; Halfon, Neal
The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, understanding potential effects will require state-by-state monitoring of policies and their impact on children. The “voltage drop” framework is a useful interpretive guide for assessing the impact of insurance market change on the quality of care received. Using this framework we suggest a state-level checklist to examine ACA statewide implementation, assess its impact on health care delivery, and frame policy correctives to improve child health system performance. Although children’s health care is a small part of US health care spending, child health provides the foundation for adult health and must be protected in ACA implementation. PMID:25225140
Boyer, Jeanelle; Liu, Rui Hai
Evidence suggests that a diet high in fruits and vegetables may decrease the risk of chronic diseases, such as cardiovascular disease and cancer, and phytochemicals including phenolics, flavonoids and carotenoids from fruits and vegetables may play a key role in reducing chronic disease risk. Apples are a widely consumed, rich source of phytochemicals, and epidemiological studies have linked the consumption of apples with reduced risk of some cancers, cardiovascular disease, asthma, and diabetes. In the laboratory, apples have been found to have very strong antioxidant activity, inhibit cancer cell proliferation, decrease lipid oxidation, and lower cholesterol. Apples contain a variety of phytochemicals, including quercetin, catechin, phloridzin and chlorogenic acid, all of which are strong antioxidants. The phytochemical composition of apples varies greatly between different varieties of apples, and there are also small changes in phytochemicals during the maturation and ripening of the fruit. Storage has little to no effect on apple phytochemicals, but processing can greatly affect apple phytochemicals. While extensive research exists, a literature review of the health benefits of apples and their phytochemicals has not been compiled to summarize this work. The purpose of this paper is to review the most recent literature regarding the health benefits of apples and their phytochemicals, phytochemical bioavailability and antioxidant behavior, and the effects of variety, ripening, storage and processing on apple phytochemicals.
Boyer, Jeanelle; Liu, Rui Hai
Evidence suggests that a diet high in fruits and vegetables may decrease the risk of chronic diseases, such as cardiovascular disease and cancer, and phytochemicals including phenolics, flavonoids and carotenoids from fruits and vegetables may play a key role in reducing chronic disease risk. Apples are a widely consumed, rich source of phytochemicals, and epidemiological studies have linked the consumption of apples with reduced risk of some cancers, cardiovascular disease, asthma, and diabetes. In the laboratory, apples have been found to have very strong antioxidant activity, inhibit cancer cell proliferation, decrease lipid oxidation, and lower cholesterol. Apples contain a variety of phytochemicals, including quercetin, catechin, phloridzin and chlorogenic acid, all of which are strong antioxidants. The phytochemical composition of apples varies greatly between different varieties of apples, and there are also small changes in phytochemicals during the maturation and ripening of the fruit. Storage has little to no effect on apple phytochemicals, but processing can greatly affect apple phytochemicals. While extensive research exists, a literature review of the health benefits of apples and their phytochemicals has not been compiled to summarize this work. The purpose of this paper is to review the most recent literature regarding the health benefits of apples and their phytochemicals, phytochemical bioavailability and antioxidant behavior, and the effects of variety, ripening, storage and processing on apple phytochemicals. PMID:15140261
Rastegar, Darius A.
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
Solovy, A; Serb, C
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."
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…
In food science the term 'phytochemicals' includes a variety of plant ingredients with different structures that are capable of health-promoting effects. Phytonutrients are natural substances but are not called nutrients in the traditional sense, since they are synthesized by plants neither in energy metabolism nor in anabolic or catabolic metabolism, but only in specific cell types. They differ from primary plant compounds in that they are not essential to the plant. Phytonutrients perform important tasks in the secondary metabolism of plants as repellents to pests and sunlight as well as growth regulators. They occur only in low concentrations and usually have a pharmacological effect. Since antiquity, these effects have been used in naturopathy in the form of medicinal herbs, spices, teas, and foods. With the development of highly sensitive analytical methods, a variety of these substances could be identified. These phytochemicals may have health benefits or adverse health effects, depending on the dosage. In the past, these effects were studied in cell and tissue cultures as well as in animal models. Meanwhile there are numerous epidemiological data that point to the extensive health potential of phytochemicals in humans. A high dietary intake of phytochemicals with vegetables, fruits, nuts, legumes, and whole grain is associated with a reduced risk for cardiovascular and other diseases.
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... 42 Public Health 4 2010-10-01 2010-10-01 false Benchmark health benefits coverage. 440.330 Section 440.330 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.330 Benchmark health benefits coverage. Benchmark coverage is...
... 42 Public Health 4 2013-10-01 2013-10-01 false Benchmark health benefits coverage. 440.330 Section 440.330 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.330 Benchmark health benefits coverage. Benchmark coverage is...
... 42 Public Health 4 2014-10-01 2014-10-01 false Benchmark health benefits coverage. 440.330 Section 440.330 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.330 Benchmark health benefits coverage. Benchmark coverage is...
... 42 Public Health 4 2012-10-01 2012-10-01 false Benchmark health benefits coverage. 440.330 Section 440.330 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.330 Benchmark health benefits coverage. Benchmark coverage is...
... 42 Public Health 4 2011-10-01 2011-10-01 false Benchmark health benefits coverage. 440.330 Section 440.330 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.330 Benchmark health benefits coverage. Benchmark coverage is...
Kalb, P E
In recent years, health care fraud and abuse have become major issues, in part because of the rising cost of health care, industry consolidation, the emergence of private "whistle-blowers," and a change in the concept of fraud to include an emerging concern about quality of care. The 3 types of conduct that are generally prohibited by health care fraud laws are false claims, kickbacks, and self-referrals. False claims are subject to several criminal, civil, and administrative prohibitions, notably the federal civil False Claims Act. Kickbacks, or inducements with the intent to influence the purchase or sale of health care-related goods or services, are prohibited under the federal Anti-Kickback statute as well as by state laws. Finally, self-referrals-the referral of patients to an entity with which the referring physician has a financial relationship-are outlawed by the Ethics in Patient Referral Act as well as numerous state statutes. Consequences of violations of these laws can include, in addition to imprisonment and fines, civil monetary penalties, loss of licensure, loss of staff privileges, and exclusion from participation in federal health care programs. Federal criminal and civil statutes are enforced by the US Department of Justice; administrative actions are pursued by the Department of Health and Human Services' Office of Inspector General; and all state actions are pursued by the individual states. In addition, private whistle-blowers may, acting in the name of the United States, file suit against an entity under the False Claims Act. Enforcement of health care fraud and abuse laws has become increasingly commonplace and now affects many mainstream providers. This trend is likely to continue.
Birenbaum, A; Guyot, D; Cohen, H J
60% of these children had routine dental examinations within the last 12 months, a worse record than the average child. For the individuals whose primary physicians judged that they would benefit from physical or speech therapy, less than one quarter were receiving them. Care for seriously, chronically disabled children places great burdens on immediate family members. Only 20% of the severely retarded youngsters from age 10 to 24 could be left alone at home, even for a few minutes, and only 30% of the autistic ones. These developmental disabilities create needs for personal care and family support that traditionally have not been considered health services.(ABSTRACT TRUNCATED AT 400 WORDS)
National Environmental Education & Training Foundation, 2012
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…
Frank, S R
The author believes that interactive media (the Internet and the World Wide Web) and associated applications used to access those media (portals, browsers, specialized Web-based applications) will result in a substantial, positive, and measurable impact on medical care faster than any previous information technology or communications tool. Acknowledging the dynamic environment, the author classifies "pure" digital health care companies into three business service areas: content, connectivity, and commerce. Companies offering these services are attempting to tap into a host of different markets within the health care industry including providers, payers, pharmaceutical and medical products companies, employers, distributors, and consumers. As the fastest growing medium in history, and given the unique nature of health care information and the tremendous demand for content among industry professionals and consumers, the Internet offers a more robust and targeted direct marketing opportunity than traditional media. From the medical consumer's standpoint (i.e., the patient) the author sees the Internet as performing five critical functions: (1) Disseminate information, (2) Aid informed decision making, (3) Promote health, (4) Provide a means for information exchange and support--the community concept, and (5) Increase self-care and manage demand for health services, lowering direct medical costs. The author firmly submits the Web will provide overall benefits to the health care economy as health information consumers manage their own health problems that might not directly benefit from an encounter with a health professional. Marrying the Internet to other interactive technologies, including voice recognition systems and telephone-based triage lines among others, holds the promise of reducing unnecessary medical services.
Halfon, Neal; And Others
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.…
... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Health and insurance benefits and services... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 41.440 Health and insurance... provides full coverage health service shall provide gynecological care....
The health promotion discourse is comprised of assumptions about health and health care that are compatible with primary health care. An examination of the health promotion discourse illustrates how assumptions of health can help to inform primary health care. Despite health promotion being a good fit for primary health care, this analysis demonstrates that the scope in which it is being implemented in primary health care settings is limited. The health promotion discourse appears largely compatible with primary health care-in theory and in the health care practices that follow. The aim of this article is to contribute to the advancement of theoretical understanding of the health promotion discourse, and the relevance of health promotion to primary health care.
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.
Koba, Kazunori; Yanagita, Teruyoshi
Conjugated linoleic acid (CLA) is a group of positional and geometric (cis or trans) isomers of linoleic acid with a conjugated double bond. The most representative CLA isomers are 9c,11t-18:2 and 10t,12c-18:2. CLA has been shown to exert various potent physiological functions such as anticarcinogenic, antiobese, antidiabetic and antihypertensive properties. This means CLA can be effective to prevent lifestyle diseases or metabolic syndromes. Also, reports suggest that physiological effects of CLA are different between the isomers, for example the 10t,12c isomer is anticarcinogenic, antiobese and antidiabetic, whereas the 9c,11t isomer is mainly anticarcinogenic. We describe here the physiological properties of CLA including the possible mechanism and the possibility to benefit human health.
Jiang, Nan; Doseff, Andrea I.; Grotewold, Erich
Flavones correspond to a flavonoid subgroup that is widely distributed in the plants, and which can be synthesized by different pathways, depending on whether they contain C- or O-glycosylation and hydroxylated B-ring. Flavones are emerging as very important specialized metabolites involved in plant signaling and defense, as well as key ingredients of the human diet, with significant health benefits. Here, we appraise flavone formation in plants, emphasizing the emerging theme that biosynthesis pathway determines flavone chemistry. Additionally, we briefly review the biological activities of flavones, both from the perspective of the functions that they play in biotic and abiotic plant interactions, as well as their roles as nutraceutical components of the human and animal diet. PMID:27338492
Forgionne, G A; Gangopadhyay, A; Klein, J A; Eckhardt, R
Mounting costs have escalated the pressure on health care providers and payers to improve decision making and control expenses. Transactions to form the needed decision data will routinely flow, often electronically, between the affected parties. Conventional health care information systems facilitate flow, process transactions, and generate useful decision information. Typically, such support is offered through a series of stand-alone systems that lose much useful decision knowledge and wisdom during health care electronic commerce (e-commerce). Integrating the stand-alone functions can enhance the quality and efficiency of the segmented support, create synergistic effects, and augment decision-making performance and value for both providers and payers. This article presents an information system that can provide complete and integrated support for e-commerce-based health care decision making. The article describes health care e-commerce, presents the system, examines the system's potential use and benefits, and draws implications for health care management and practice.
Connors, H R
Telehealth has many applications, including the education and training of health professionals. This article describes the use of advanced telecommunications technology to educate family nurse practitioners in rural areas of Kansas. Four Kansas universities use compressed video technology (an interactive audio and video system) to offer five common core courses in primary care to students enrolled in FNP programs at the respective institutions. Using technology to educate FNPs in rural communities has resulted in a greater percentage of graduates (approximately 67% of 258 graduates) going to work in rural underserved communities. In addition to learning the course content, students learn to use technology as a tool to access telehealth information and services Knowing how to use these technologies provides greater opportunities to rural health care providers, as well as the recipients of health care.
Beronio, Kirsten; Glied, Sherry; Frank, Richard
The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.
Baily, Mary Ann
Rising expenditures on health care have become a major cause for public concern. Attention focuses on the level of expenditures and the increasing share they take of GNP, but for most Americans, the real issue is not how much society spends, but what it gets for the money. There are several ways in which it could be said that the United States fails to get full value for the dollars spent on health care. Some care does not benefit, or even harms, those who receive it. Some care is beneficial but could be produced with fewer resources. Some care is efficiently produced and yields benefits, but the benefits are not worth their cost. And finally, despite the system's cost, many people are excluded from it and thus fail to receive care of great benefit. The need to address the problem of wasteful care is relatively uncontroversial. Everyone agrees that it would be desirable to eliminate care of no benefit and to produce beneficial care as efficiently as possible. There is also a growing consensus that steps must be taken soon to improve access. There is far less agreement on what, if anything, needs to be done about care whose benefits are not worth their cost. The public's limited understanding of this issue is an obstacle to good health policy. Meaningful debate about health care reform must include open and informed discussion of the extent to which different reform proposals will restrict beneficial care, how they will do it, and how well the results will reflect the preferences and values of the
Greenfield, Robert H.; Kardaun, Jan W. P. F.
The " crisis" in rural health care i. e. the decreasing number of practitioners is partially caused by the increasing use of technology in health care. Health care practitioners in rural Canada are progressively finding their practice more difficult because of their isolation from the population centers housing many of the services and supplies needed in the modern practice of medicine. The centralization of these supplies and services results from the increasing use of technology in medicine. It is uneconomical to place expensive equipment highly trained technicians and consultants and well-stocked and current information sources in rural locations where they are underutilized. Thus over the years the increasing use of technology makes rural practice more difficult and less attractive in comparison to an urban practice that can easily and cheaply employ the benefits of technology and expert consultation. The Saskatchewan situation is examined using data collected by the authors and compared to other rural areas reported in the literature. The ways that computer communications can help alleviate this situation are explained and illustrated through a review of North American telematics activities. Telematic services for physicians are developing in North America. This is in synergy with the increasing ownership of computers by physicians. We contrast the Canadian scene with the American. Telematics is a technological approach that can be employed to reduce the isolation of rural health care practitioners. It can provide
Goodman, Melody S.; Gonzalez, Maria; Gil, Sandra; Si, Xuemei; Pashoukos, Judith L.; Stafford, Jewel D.; Ford, Elsa; Pashoukos, Dennis A.
Background The Community Alliance for Research Empowering Social Change (CARES) is an academic–community research partnership designed to train community members on research methods and develop the infrastructure for community-based participatory research (CBPR) to examine and address racial/ethnic health disparities. The Brentwood Community Health Assessment (BCHA) was developed through a CBPR pilot project grant from CARES. Objectives The purpose of the BCHA is to assess health care utilization and identify existing barriers to health care access among a multi-ethnic community in the Hamlet of Brentwood, New York. Methods Using CBPR approaches, the community–academic research partnership develop the study design and survey instrument. Trained Bilingual (English/Spanish) data collectors verbally administered surveys door-to-door to residents of Brentwood from October 2010 to May 2011. Inclusion criteria required participants to be at least 18 years of age and speak either English or Spanish. Results Overall, 232 residents completed the BCHA; 49% were male, 66% Hispanic, 13% non-Hispanic White, 13% non-Hispanic Black, 29% had less than a high school education, and 33% were born in United States. The assessment results revealed that most residents are able to access health care when needed and the most significant barriers to health care access are insurance and cost. Conclusions We describe the community–academic partnered process used to develop and implement the BCHA and report assessment findings; the community-partnered approach improved data collection and allowed access into one of Suffolk County’s most vulnerable communities. PMID:24859100
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.
Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio
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
Heller, Kathryn Wolff; Avant, Mary Jane Thompson
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…
Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R
As reimbursement transitions from a volume-based to a value-based system, innovation in health care delivery will be needed. The process of innovation begins with framing the problem that needs to be solved along with the strategic vision that has to be achieved. Similar to scientific testing, a hypothesis is generated for a new solution to a problem. Innovation requires conducting a disciplined form of experimentation and then learning from the process. This manuscript will discuss the different types of innovation, and the key steps necessary for successful innovation in the health care field.
India's health care system, despite several significant achievements, suffers from some weaknesses and deficiencies. There has been a preoccupation with the promotion of curative and clinical services through city based hospitals which have essentially catered to certain sections of the urban population. The concept of health in its totality, with preventive and promotive health care services in addition to the curative, has yet to be made operational. There has been an overdependence on the states for health care measures and voluntary and local effort has not been able to accept responsibility in any significant way. The involvement of the people in solving their health problems has been almost nonexistent. Health needs to be viewed as part of the strategy of human resources development. Horizontal and vertical linkages must be obtained among all the interrelated programs--protected water supply environmental sanitation and hygiene, nutrition, education, family planning, and maternal and child welfare. Only with such linkages can the benefits of the various programs be optimized. An attack on the problems of diseases cannot be completely successful unless it is accompanied by an attack on poverty. For this reason the 6th plan assigns a high priority to programs of promotion, or gainful employment, eradication of poverty, population control, and meeting the basic human needs of the population. The Alma Alta Declaration of 1977 has become the accepted health policy of India, simplified into the slogan "health for all by 2000." To realize this goaL, the Planning Commission recommends in the 6th 5-Year Plan a restructing and reorientation of the country's health services. The proposed alternative scheme is more decentralized and provides for many more people to be trained at the grassroots level. People would be involved in tackling their health problems and community participation would be encouraged. Finally, the alternative strongly urges the screening of patients
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…
A plethora of epidemiologic evidence from large studies supports unequivocally an inverse, independent, and graded association between volume of physical activity, health, and cardiovascular and overall mortality. This association is evident in apparently healthy individuals, patients with hypertension, type 2 diabetes mellitus, and cardiovascular disease, regardless of body weight. Moreover, the degree of risk associated with physical inactivity is similar to, and in some cases even stronger than, the more traditional cardiovascular risk factors. The exercise-induced health benefits are in part related to favorable modulations of cardiovascular risk factors observed by increased physical activity or structured exercise programs. Although the independent contribution of the exercise components, intensity, duration, and frequency to the reduction of mortality risk is not clear, it is well accepted that an exercise volume threshold defined at caloric expenditure of approximately 1,000 Kcal per week appears to be necessary for significant reduction in mortality risk. Further reductions in risk are observed with higher volumes of energy expenditure. Physical exertion is also associated with a relatively low and transient increase in risk for cardiac events. This risk is significantly higher for older and sedentary individuals. Therefore, such individuals should consult their physician prior to engaging in exercise. “Walking is man’s best medicine”Hippocrates PMID:23198160
Kizer, K W
As the US health care system begins to reengineer itself to address the need for quality improvement, it also is being actively reshaped by the expectations of consumers. The confluence of these forces requires a new approach to setting health care performance standards. The National Quality Forum (NQF) has been established as a private, not-for-profit, open membership, public benefit corporation for the purposes of developing consensus about standardized health care performance measures, reporting mechanisms, and a national strategy for health care quality improvement. The NQF has broad representation from all segments of the health care industry and provides an equitable way of addressing the disparate priorities of health care's many stakeholders. Agreement and implementation of standardized health care performance measures and achievement of quality improvement in the emerging era of consumerism will be facilitated by (1) establishing national goals for health care quality; (2) embracing public policy that recognizes the complementary roles of quality improvement, cost control, and improved access; (3) giving greater priority to measuring and reporting the performance of those aspects of the health care system that directly affect consumers; (4) focusing on creating a health care culture of excellence; and (5) promoting the active collaboration of all stakeholders.
Mawn, Barbara; Siqueira, Eduardo; Koren, Ainat; Slatin, Craig; Devereaux Melillo, Karen; Pearce, Carole; Hoff, Lee Ann
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.
The question of whether illegal immigrants should be entitled to some form of health coverage in the United States sits at the intersection of two contentious debates: health reform and immigration reform. Proponents of extending coverage argue that the United States has a moral obligation to provide health care to all those within its borders. Conversely, those against doing so argue that immigrants illegally present in the country should not be entitled to public benefits. This Article seeks to chart a middle course between these extremes while answering two questions. First, does constitutional law mandate extending health coverage to illegal immigrants? Second, even if not legally mandated, are there compelling policy reasons for extending such coverage? This Article concludes that while health coverage for illegal immigrants is not required under prevailing constitutional norms, extending coverage as a matter of policy would serve the broader interests of the United States. Extending coverage would be beneficial as a matter of economics and public health, generating spillover benefits for all US citizens and those in the US healthcare and health insurance systems.
Barber, Collin; Fraser, James F; Mendez, Guillermo G; Bradley, Barrie; Loftus, Terry J; Jacofsky, David J
The objective of this study was to determine if implementation of a simplified care pathway for total knee arthroplasty (TKA) would affect outcomes of total hip arthroplasty (THA) patients in the same health care system. Data were collected from a total of 5,095 consecutive THA patients in the year before and 2 years after implementation of the care pathway for TKA patients. Postimplementation increases were observed in both early activity (p < 0.0001) and continuous urinary catheter avoidance (p < 0.0001) among THA patients. These improvements in protocol adherence were associated with decreased complications (p < 0.0001), fewer 30-day readmissions (p < 0.0019), and decreased hospital length of stay (p < 0.0001). Based on these results, the implementation of a simplified care pathway for TKA patients can also improve outcomes for THA patients in the same health care system.
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Aguirre-Boza, Francisca; Achondo, Bernardita
To move towards universal access to health, the Pan American Health Organization recommends strengthening primary health care (PHC). One of the strategies is to increase the number qualified professionals, both medical and non-medical, working in PHC. In Chile there is a lack of professionals in this level of care, hampering the provision of health. Physicians still prefer secondary and tertiary levels of health. International experience has shown that advanced practice nurses (APN), specialists in PHC are cost-effective professionals able to deliver a complete and quality care to patients. Strong evidence demonstrates the benefits that APN could provide to the population, delivering nursing care that incorporates medical tasks, for example in patients with chronic diseases, allowing greater availability of medical hours for patients requiring more complex management. The success in the implementation of this new role requires the support of the health team, especially PHC physicians, endorsing and promoting the benefits of the APN for the population.
'Selective primary health care' and other recent vertical health strategies have been justified on the grounds that the broad primary health care (PHC) approach cannot be afforded by developing countries in the present constrained economic circumstances. This judgement is too sweeping. A simulated case example is presented, starting with baseline health expenditure data that are representative of the situation in many developing countries. It is assumed that real economic growth occurs and that government funding of health care is allowed to grow in parallel. Two annual growth rates are considered: 2 and 5 per cent. Two restrictive conditions are applied: none of the main health services is subjected to absolute cuts; and, additional funds from existing or new sources of finance are not considered. It is shown that, even with slow growth rates, substantial increases in the funding of priority (rural and PHC) services can be achieved if the growth in expenditures of lower-priority services is curtailed. Also, savings from improved health service efficiency can be channelled to priority services. The message is that the PHC approach is viable even with slow economic growth. What is required is the technical capacity to identify and plan resource flows in the health sector, and the political will to effect resource allocations according to PHC priorities. A strategic policy like PHC should not be 'adjusted' out of effective existence because of reversible economic problems. Rather, actions should be taken to reverse the adverse economic environment. International health-related agencies should continue to support countries to develop national health systems based on PHC, and should campaign for reforms in the world economy to create at least the minimum economic conditions necessary for PHC implementation.
Rose, Sherri; Bergquist, Savannah L; Layton, Timothy J
Health insurers may attempt to design their health plans to attract profitable enrollees while deterring unprofitable ones. Such insurers would not be delivering socially efficient levels of care by providing health plans that maximize societal benefit, but rather intentionally distorting plan benefits to avoid high-cost enrollees, potentially to the detriment of health and efficiency. In this work, we focus on a specific component of health plan design at risk for health insurer distortion in the Health Insurance Marketplaces: the prescription drug formulary. We introduce an ensembled machine learning function to determine whether drug utilization variables are predictive of a new measure of enrollee unprofitability we derive, and thus vulnerable to distortions by insurers. Our implementation also contains a unique application-specific variable selection tool. This study demonstrates that super learning is effective in extracting the relevant signal for this prediction problem, and that a small number of drug variables can be used to identify unprofitable enrollees. The results are both encouraging and concerning. While risk adjustment appears to have been reasonably successful at weakening the relationship between therapeutic-class-specific drug utilization and unprofitability, some classes remain predictive of insurer losses. The vulnerable enrollees whose prescription drug regimens include drugs in these classes may need special protection from regulators in health insurance market design.
Roberfroid, Marcel; Gibson, Glenn R; Hoyles, Lesley; McCartney, Anne L; Rastall, Robert; Rowland, Ian; Wolvers, Danielle; Watzl, Bernhard; Szajewska, Hania; Stahl, Bernd; Guarner, Francisco; Respondek, Frederique; Whelan, Kevin; Coxam, Veronique; Davicco, Marie-Jeanne; Léotoing, Laurent; Wittrant, Yohann; Delzenne, Nathalie M; Cani, Patrice D; Neyrinck, Audrey M; Meheust, Agnes
The different compartments of the gastrointestinal tract are inhabited by populations of micro-organisms. By far the most important predominant populations are in the colon where a true symbiosis with the host exists that is a key for well-being and health. For such a microbiota, 'normobiosis' characterises a composition of the gut 'ecosystem' in which micro-organisms with potential health benefits predominate in number over potentially harmful ones, in contrast to 'dysbiosis', in which one or a few potentially harmful micro-organisms are dominant, thus creating a disease-prone situation. The present document has been written by a group of both academic and industry experts (in the ILSI Europe Prebiotic Expert Group and Prebiotic Task Force, respectively). It does not aim to propose a new definition of a prebiotic nor to identify which food products are classified as prebiotic but rather to validate and expand the original idea of the prebiotic concept (that can be translated in 'prebiotic effects'), defined as: 'The selective stimulation of growth and/or activity(ies) of one or a limited number of microbial genus(era)/species in the gut microbiota that confer(s) health benefits to the host.' Thanks to the methodological and fundamental research of microbiologists, immense progress has very recently been made in our understanding of the gut microbiota. A large number of human intervention studies have been performed that have demonstrated that dietary consumption of certain food products can result in statistically significant changes in the composition of the gut microbiota in line with the prebiotic concept. Thus the prebiotic effect is now a well-established scientific fact. The more data are accumulating, the more it will be recognised that such changes in the microbiota's composition, especially increase in bifidobacteria, can be regarded as a marker of intestinal health. The review is divided in chapters that cover the major areas of nutrition research where
Ung, Brian L; Mullins, C Daniel
The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability.
Webster, Ruth; Lacey, Judith; Quine, Susan
Palliative care is an emerging specialist discipline worldwide with the majority of services located in developed countries. Developing countries, however, have higher incidences of cancer and AIDS and most of these patients would benefit from palliative care. While there is prominent coverage of this issue in the palliative care literature, there is limited coverage in the specialist public health literature, which suggests that the challenges of palliative care may not yet have been generally recognized as a public health priority, particularly in developing countries. The aim of this article is to introduce the topic of "Palliative care in developing countries" into the specialist public health literature to raise awareness and stimulate debate on this issue among public health professionals and health policy makers, thereby potentially facilitating establishment of palliative care services in developing countries.
Reich, Joel J.
Telemedicine, the use of bidirectional telecommunications systems for the delivery of health care at a distance, could create a more equitable distribution of medical care. Many medical tasks can be performed at a distance although some require the presence of a physician's assistant. Cost-benefit analysis of this service is difficult and requires…
Hayes, J A
Medical care futures contracts offer new hedging opportunities to increase protection against unexpected price changes. Commodity futures contracts can be designed explicitly to hedge volatile group health insurance premiums and capitated hospital and physician prices. This article describes one way to design and use these hedging instruments.
Arnould, R J; Finifter, D H; Schifrin, L G
This serves as an introduction to this special issue devoted to a selection of papers chosen and revised from a conference on public policy entitled "Health Care Policy: Where Is the Revolution Headed?" sponsored by the Thomas Jefferson Program in Public Policy at the College of William and Mary, Williamsburg, VA, November 12-14, 1987.
Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W
Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.
Somasundaram, D. J.; van de Put, W. A.
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
Boustani, Maya Mroué; Frazier, Stacy L; Hartley, Chelsey; Meinzer, Michael; Hedemann, Erin
The purpose of this article is to examine youth care workers' perceptions of the specific and unique sexual health needs of youth at risk for foster care. Semistructured interviews were conducted with youth care workers (N = 10) at a shelter for youth in or at risk for foster care. Youth care workers perceive that youth have unique experiences and needs related to sexual health programming and pregnancy prevention. Reflecting a great deal of family dysfunction, 3 themes emerged that revealed perceived benefits of teen pregnancy: youths' effort to prove themselves as adults, opportunity to secure their relationship with a partner, and desire to create an emotional connection with a baby. Lack of knowledge and accumulation of risk factors were viewed as most problematic. Current pregnancy prevention programs assume teen pregnancies are unwanted and emphasize the costs of sexual risk taking. Current findings suggest that sexual health programming for youth in or at risk for foster care should account for 3 perceived benefits of teen pregnancy. New opportunities for improving the reach and effectiveness of intervention for youth in or at risk for foster care are discussed.
Thailand has a universal multi-payer system with two main types of health insurance: National Health Security Office or public health insurance and private insurance. National health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private health insurance is also available, all Thai citizens are required to be enrolled in either national health insurance or employees’ health insurance. There are many differences between the public health insurance and private insurance. Public health insurance, therefore, initiates programs that offer many sets of benefit packages for high-cost care. For cancer care, cover screening, curative treatment such as surgery, chemotherapy, radiation together with supportive and palliative care. PMID:27981139
The United States is culturally oriented more toward individual rights and values than to communitarian values. That proclivity has made it hard to develop a common good, or solidarity-based, perspective on health care. Too many people believe they have no obligation to support the health care of others and resist a strong role for government, higher taxation, or reduced health benefits. I argue that we need to build a communitarian perspective on the concept of solidarity, which has been the concept underlying European health care systems, by focusing not on individual needs, but rather, on those of different age groups--that is, what people need at different stages of life.
Dried beans (often referred to as grain legumes) may contribute to some of the health benefits associated with plant-based diets. Beans are rich in a number of important micronutrients, including potassium, magnesium, folate, iron, and zinc, and are important sources of protein in vegetarian diets. In particular, they are among the only plant foods that provide significant amounts of the indispensable amino acid lysine. Commonly consumed dried beans are also rich in total and soluble fiber as well as in resistant starch, all of which contribute to the low glycemic index of these foods. They also provide ample amounts of polyphenols, many of which are potent antioxidants. Intervention and prospective research suggests that diets that include beans reduce low-density lipoprotein cholesterol, favorably affect risk factors for metabolic syndrome, and reduce risk of ischemic heart disease and diabetes. The relatively low bean intakes of North Americans and northern Europeans can be attributed to a negative culinary image as well as to intestinal discomfort attributable to the oligosaccharide content of beans. Cooking practices such as sprouting beans, soaking and discarding soaking water before cooking, and cooking in water with a more alkaline pH can reduce oligosaccharide content. Promotional efforts are needed to increase bean intake.
Oñatibia-Astibia, Ainhoa; Franco, Rafael; Martínez-Pinilla, Eva
Methylxanthines (MTXs) are consumed by almost everybody in almost every area of the world. Caffeine, theophylline and theobromine are the most well-known members of this family of compounds; they are present, inter alia, in coffee, tea, cacao, yerba mate and cola drinks. MTXs are readily absorbed in the gastrointestinal tract and are able to penetrate into the central nervous system, where they exert significant psychostimulant actions, which are more evident in acute intake. Coffee has been paradigmatic, as its use was forbidden in many diseases, however, this negative view has radically changed; evidence shows that MTXs display health benefits in diseases involving cell death in the nervous system. This paper reviews data that appraise the preventive and even therapeutic potential of MTXs in a variety of neurodegenerative diseases. Future perspectives include the use of MTXs to advance the understanding the pathophysiology of, inter alia, Alzheimer's disease (AD) and Parkinson's disease (PD), and the use of the methylxanthine chemical moiety as a basis for the development of new and more efficacious drugs.
Slavin, Joanne L; Lloyd, Beate
Fruits and vegetables are universally promoted as healthy. The Dietary Guidelines for Americans 2010 recommend you make one-half of your plate fruits and vegetables. Myplate.gov also supports that one-half the plate should be fruits and vegetables. Fruits and vegetables include a diverse group of plant foods that vary greatly in content of energy and nutrients. Additionally, fruits and vegetables supply dietary fiber, and fiber intake is linked to lower incidence of cardiovascular disease and obesity. Fruits and vegetables also supply vitamins and minerals to the diet and are sources of phytochemicals that function as antioxidants, phytoestrogens, and antiinflammatory agents and through other protective mechanisms. In this review, we describe the existing dietary guidance on intake of fruits and vegetables. We also review attempts to characterize fruits and vegetables into groups based on similar chemical structures and functions. Differences among fruits and vegetables in nutrient composition are detailed. We summarize the epidemiological and clinical studies on the health benefits of fruits and vegetables. Finally, we discuss the role of fiber in fruits and vegetables in disease prevention.
Wan, Thomas T H; Demachkie Masri, Maysoun; Ortiz, Judith; Lin, Blossom Y J
This study examines how health care managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors, and knowledge about ACOs as predictors. Propensity score matching and analysis are used to adjust the state and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, health care managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Health care managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACO participation. The perspective of health care managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of health care managers.
Zhang, Yingting; Lin, Yu-Hung
This article describes how librarians created a Wikipedia article on cultural competence in health care to support the medical school's curriculum. Wikipedia, often considered not as reliable as scholarly articles, continues to be popular. Rutgers librarians conducted a Wikipedia project to improve its content to benefit students. The importance of cultural competency in health care is widely recognized due to increasingly diverse patient populations. Medical schools integrate cultural competency in curricula to train students to be culturally competent. Therefore, this topic was chosen for the Wikipedia Project. It is hoped that health sciences librarians and educators will benefit from their experience.
Bodenmann, P; Bossart, R; Di Bernardo, N; Dominice Dao, M; Durieux, S; Faucherre, F; Hudelson, P; Keller, M; Schuster, S; Zellweger, E; Houmard, S
The development of Migrant Friendly Hospitals is an important first step towards eliminating health care disparities in Switzerland and an important reminder to health policy makers and practitioners across the health care system of their responsibility to provide non-discriminatory quality health care to all patients.
Stamatova, Iva; Meurman, Jukka H
Probiotics or health-beneficial bacteria have only recently been introduced in dentistry and oral medicine after years of successful use in mainly gastro-intestinal disorders. The concept of bacteriotherapy and use of health-beneficial micro-organisms to heal diseases or support immune function was first introduced in the beginning of the 20th century. Later the concept lead to the development of modem dairy industry and even today most probiotic strains are lactobacilli or bifidobacteria used in milk fermentation. The mechanisms of probiotic action are mainly unknown but the inter-microbial species interactions are supposed to play a key role in this together with their immuno-stimulatory effects. The introduction of probiotic bacteria in the mouth calls for ascertainment of their particular safety. Since acid production from sugar is detrimental to teeth, care must be taken not to select strains with high fermentation capacity. The first randomized controlled trials have nevertheless shown that probiotics may control dental caries in children due to their inhibitory action against cariogenic streptococci. Less evidence exists on their role in periodontal disease or oral yeast infections. Furthermore the best vehicles for oral probiotic applications need to be assessed. So far mainly dairy products have been investigated but other means such as probiotics in chewing gums or lozenges have also been studied. From the clinical practitioner's point of view direct recommendations for the use of probiotics cannot yet be given. However, scientific evidence so far indicates that probiotic therapy may be a reality also in dentistry and oral medicine in the future.
Monroe, C Douglas; Chin, Karen Y
The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.
In certain situations, home health care has been shown to be a cost-effective alternative to inpatient hospital care. National health expenditures reveal that pediatric home health costs totaled $5.3 billion in 2000. Medicaid is the major payer for pediatric home health care (77%), followed by other public sources (22%). Private health insurance and families each paid less than 1% of pediatric home health expenses. The most important factors affecting access to home health care are the inadequate supply of clinicians and ancillary personnel, shortages of home health nurses with pediatric expertise, inadequate payment, and restrictive insurance and managed care policies. Many children must stay in the NICU, PICU, and other pediatric wards and intermediate care areas at a much higher cost because of inadequate pediatric home health care services. The main financing problem pertaining to Medicaid is low payment to home health agencies at rates that are insufficient to provide beneficiaries access to home health services. Although home care services may be a covered benefit under private health plans, most do not cover private-duty nursing (83%), home health aides (45%), or home physical, occupational, or speech therapy (33%) and/or impose visit or monetary limits or caps. To advocate for improvements in financing of pediatric home health care, the American Academy of Pediatrics has developed several recommendations for public policy makers, federal and state Medicaid offices, private insurers, managed care plans, Title V officials, and home health care professionals. These recommendations will improve licensing, payment, coverage, and research related to pediatric home health services.
Realization of health care as primary objective is necessary to strengthen primary health care (PHC). There is a need to build financial viable and sustainable PHC based on rational principles to fulfill the goals of providing quality health services on an affordable and equitable basis and also ensuring fiscal prudence. Health-care leadership, innovations in primary care, family medicine specialists, and effective and accountable health governance are the key steps toward our goal. PMID:28217580
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…
Crone, Robert K
Trailing nearly every other industry, health care is finally globalizing. Highly trained and experienced expatriate health care professionals are returning to their home countries from training in the West or are staying home to work in newly developed corporate health care delivery systems that can compete quite favorably with less-than-perfect providers in Europe and North America. In turn, these health care systems are attracting patients from around the world who are interested in exploring high-quality, lower-cost health care alternatives. Much of this activity is occurring in the emerging economies of the Middle East, South and Southeast Asia, and beyond. Three Harvard Medical International collaborations--in Dubai, Turkey, and India--highlight these trends and demonstrate the potential for new models of global health care, as well as potential ramifications for patients and providers in the established economies of the West, including the United States. Although globalization is not a cure-all solution to achieving universal access to health care, it is not only a significant first step for patients in these emerging economies, but may also present alternative solutions for those patients in wealthier nations who nonetheless lack adequate health care coverage. The increase in health care quality and competitiveness around the globe is important, but these improvements will need to be matched by the development of comprehensive payer solutions, to benefit as many people as possible.
Sherrill, Windsor W; Keels-Williams, Frankie
Health care organizations increasingly face the pressures of meeting the needs of patients while responding to the financial pressures of cost containment and quality optimization. One strategy that health care providers use to adapt to the changing environment is multiskilling. Multi-skilled health care technicians are trained to perform multiple tasks so that they can be deployed more efficiently within health care organizations. Multiskilling can provide numerous benefits to providers, organizations, and patients, but appropriate training for such individuals is critical. The Multiskilled Competencies Development Project was initiated to identify professional standards for entry-level multi-skilled health care technicians. The project was designed to meet the training needs of multiskilled workers through improved allied health curricula. The results of the DACUM (Developing a Curriculum) competency profile for multiskilled health care technicians are presented.
Deshpande, Satish P; Deshpande, Samir S
The purpose of this study was to examine factors that impact consumer satisfaction with health care. This is a secondary analysis of the Center for Studying Health System Change's 2010 Health Tracking Household Survey. Regression analysis was used to examine the impact of treatment issues, financial issues, family-related issues, sources of health care information, location, and demographics-related factors on satisfaction with health care. The study involved 12280 subjects, 56% of whom were very satisfied with their health care, whereas 66% were very satisfied with their primary care physician. Fourteen percent of the subjects had no health insurance; 34% of the subjects got their health care information from the Web. Satisfaction with primary care physician, general health status, promptness of visit to doctor, insurance type, medical cost per family, annual income, persons in family, health care information from friends, and age significantly impacted satisfaction with health care. The regression models accounted for 23% of the variance in health care satisfaction. Satisfaction with primary care physicians, health insurance, and general health status are the 3 most significant indicators of an individual's satisfaction with health care.
Moo, Stephen; Fletcher, John
This presentation summarises the learnings from the HealthConnect Northern Territory (HCNT) Shared Electronic Health Record Service (SEHR) from Trial to Implementation and the emerging benefits realized as the project is implemented across the Northern Territory of Australia. The presentation: * explores the challenges and experiences of implementing a SEHR service in urban and in some of the remotest regions on the Australian continent. * demonstrates the emerging health benefits e-Health can provide in enabling the sharing of medical information between public and private health service providers in particular the service delivery and benefits provided to a highly mobile Indigenous population who currently experience the greatest health problems and experience difficulties accessing continuum of care created by factors which include remoteness, mobility and communication. * explores the evolvement of the "opt in" consumer consent model adopted by the Territory for the implementation of the HCNT SEHR.* advises of plans for future development, which inform other implementations, and NeHTA standards development for the implementation of the National SEHR Service. * Informs project plans to incorporate NeHTA standards as they are developed and transition the HCNT SEHR to the National SEHR Service when implemented recognising the importance of developing strong partnerships with key stakeholders, in particular consumers, health care providers and system vendors who inform project development and implementation.
The increasing popularity of health promotion and lifestyle management techniques call for a careful look at the misuse and costs of suasion, imposition of values as science, social inequities and individual consequences, and biases in communication of health risk information. The application of more systematic cost-benefit analysis is…
... 42 Public Health 4 2010-10-01 2010-10-01 false Benchmark health benefits coverage. 457.420 Section 457.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2013-10-01 2013-10-01 false Benchmark health benefits coverage. 457.420 Section 457.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2014-10-01 2014-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2010-10-01 2010-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2012-10-01 2012-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2013-10-01 2013-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2014-10-01 2014-10-01 false Benchmark health benefits coverage. 457.420 Section 457.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2012-10-01 2012-10-01 false Benchmark health benefits coverage. 457.420 Section 457.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2011-10-01 2011-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
... 42 Public Health 4 2011-10-01 2011-10-01 false Benchmark health benefits coverage. 457.420 Section 457.420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...
The reemerging field of Medical Geology is concerned with the impacts of geologic materials and geologic processes on animal and human health. Most medical geology research has been focused on health problems caused by excess or deficiency of trace elements, exposure to ambient dust, and on other geologically related health problems or health problems for which geoscience tools, techniques, or databases could be applied. Little, if any, attention has been focused on the beneficial health effects of rocks, minerals, and geologic processes. These beneficial effects may have been recognized as long as two million years ago and include emotional, mental, and physical health benefits. Some of the earliest known medicines were derived from rocks and minerals. For thousands of years various clays have been used as an antidote for poisons. "Terra sigillata," still in use today, may have been the first patented medicine. Many trace elements, rocks, and minerals are used today in a wide variety of pharmaceuticals and health care products. There is also a segment of society that believes in the curative and preventative properties of crystals (talismans and amulets). Metals and trace elements are being used in some of today's most sophisticated medical applications. Other recent examples of beneficial effects of geologic materials and processes include epidemiological studies in Japan that have identified a wide range of health problems (such as muscle and joint pain, hemorrhoids, burns, gout, etc.) that may be treated by one or more of nine chemically distinct types of hot springs, and a study in China indicating that residential coal combustion may be mobilizing sufficient iodine to prevent iodine deficiency disease. ?? 2006 MDPI. All rights reserved.
Friedman, M; Brandon, D L
Soy protein is a major component of the diet of food-producing animals and is increasingly important in the human diet. However, soy protein is not an ideal protein because it is deficient in the essential amino acid methionine. Methionine supplementation benefits soy infant formulas, but apparently not food intended for adults with an adequate nitrogen intake. Soy protein content of another essential amino acid, lysine, although higher than that of wheat proteins, is still lower than that of the milk protein casein. Adverse nutritional and other effects following consumption of raw soybean meal have been attributed to the presence of endogenous inhibitors of digestive enzymes and lectins and to poor digestibility. To improve the nutritional quality of soy foods, inhibitors and lectins are generally inactivated by heat treatment or eliminated by fractionation during food processing. Although lectins are heat-labile, the inhibitors are more heat-stable than the lectins. Most commercially heated meals retain up to 20% of the Bowman-Birk (BBI) inhibitor of chymotrypsin and trypsin and the Kunitz inhibitor of trypsin (KTI). To enhance the value of soybeans in human nutrition and health, a better understanding is needed of the factors that impact the nutrition and health-promoting aspects of soy proteins. This paper discusses the composition in relation to properties of soy proteins. Also described are possible beneficial and adverse effects of soy-containing diets. The former include soy-induced lowering of cholesterol, anticarcinogenic effects of BBI, and protective effects against obesity, diabetes, irritants of the digestive tract, bone, and kidney diseases, whereas the latter include poor digestibility and allergy to soy proteins. Approaches to reduce the concentration of soybean inhibitors by rearrangement of protein disulfide bonds, immunoassays of inhibitors in processed soy foods and soybean germplasm, the roles of phytoestrogenic isoflavones and lectins, and
Talaei-Khoei, Amir; Seale, Holly; Ray, Pradeep; MacIntyre, C Raina
Background eHealth is an application of information and communication technologies across the whole range of functions that affect health. The benefits of eHealth (eg, improvement of health care operational efficiency and quality of patient care) have previously been documented in the literature. Health care providers (eg, medical doctors) are the key driving force in pushing eHealth initiatives. Without their acceptance and actual use, those eHealth benefits would be unlikely to be reaped. Objective To identify and synthesize influential factors to health care providers’ acceptance of various eHealth systems. Methods This systematic literature review was conducted in four steps. The first two steps facilitated the location and identification of relevant articles. The third step extracted key information from those articles including the studies’ characteristics and results. In the last step, identified factors were analyzed and grouped in accordance with the Unified Theory of Acceptance and Use of Technology (UTAUT). Results This study included 93 papers that have studied health care providers’ acceptance of eHealth. From these papers, 40 factors were identified and grouped into 7 clusters: (1) health care provider characteristics, (2) medical practice characteristics, (3) voluntariness of use, (4) performance expectancy, (5) effort expectancy, (6) social influence, and (7) facilitating or inhibiting conditions. Conclusions The grouping results demonstrated that the UTAUT model is useful for organizing the literature but has its limitations. Due to the complex contextual dynamics of health care settings, our work suggested that there would be potential to extend theories on information technology adoption, which is of great benefit to readers interested in learning more on the topic. Practically, these findings may help health care decision makers proactively introduce interventions to encourage acceptance of eHealth and may also assist health policy makers
Midwives are working in federally funded health centers in increasing numbers. Health centers provide primary and preventive health care to almost 20 million people and are located in every US state and territory. While health centers serve the entire community, they also serve as a safety net for low-income and uninsured individuals. In 2010, 93% of health center patients had incomes below 200% of the Federal Poverty Guidelines, and 38% were uninsured. Health centers, including community health centers, migrant health centers, health care for the homeless programs, and public housing primary care programs, receive grant funding and enjoy other benefits due to status as federal grantees and designation as federally qualified health centers. Clinicians working in health centers are also eligible for financial and professional benefits because of their willingness to serve vulnerable populations and work in underserved areas. Midwives, midwifery students, and faculty working in, or interacting with, health centers need to be aware of the regulations that health centers must comply with in order to qualify for and maintain federal funding. This article provides an overview of health center regulations and policies affecting midwives, including health center program requirements, scope of project policy, provider credentialing and privileging, Federal Tort Claims Act malpractice coverage, the 340B Drug Pricing Program, and National Health Service Corps scholarship and loan repayment programs.
Eibner, Christine; Nowak, Sarah A; Liu, Jodi L; White, Chapin
In 2015, Vermont legislators may consider financing plans to implement Act 48, a law that aims to provide universal health care coverage to all Vermont residents starting in 2017. In this analysis, we estimate the economic incidence of payments for health care by Vermont residents and the value of health care benefits received by Vermont residents in 2012 and 2017, without the implementation of Act 48 reforms. The goal of the analysis was to understand how health care is currently paid for in Vermont, and to provide a baseline for understanding the possible effects of Act 48. We use data from the 2012 Vermont Household Health Interview Survey, the Vermont Health Care Uniform Evaluation and Reporting System, and administrative data on taxes to estimate payments in 2012. We then project these estimates forward to 2017, using the RAND COMPARE microsimulation to account for how health care coverage in Vermont will change as a result of the Affordable Care Act (ACA). We find that most Vermont residents receive more in health benefits than they pay for directly or through taxes. While lower-income individuals, on average, pay less than higher-income individuals, there is considerable variation across individuals in the level of payment for health care. Much of the current variation stems from the fractured nature of the health system, with some individuals receiving coverage through employers, some through the Exchange (i.e., the health insurance marketplace created by the ACA), and some through other sources. As Vermont considers health care reform, legislators may wish to consider options to reduce the degree of variation in payments made by individuals with similar income levels.
This article addresses the issue of women as primary caregivers to children and the concept of "maternal practice." The idea of maternal practice guides mothers as they learn (1) how to meet their child's physical, psychological, and spiritual needs, and (2) how to make their child socially acceptable. Hindrances to maternal practice include severe poverty and disabilities of the mother. The relationship between maternal practice and the quest for health care in the U.S. is discussed. Maintaining adequate health care is more difficult when parents are poorly educated and/or impoverished. Without proper health care, poor children are less likely to be able to compete with rich children in society. Dental care is also a concern, because proper dental care is fundamental in the maintenance of overall health. Dental care is not a "luxury" but medically necessary care. Solutions include increasing the awareness of such programs as CHIP and WIC, extending Medicaid benefits to more children, and compensating health care practitioners for working with Medicaid recipients. In addition, society must think more maternally and increase health and dental care accessibility, particularly to the poor in rural areas. The article concludes with the thought that if society expects mothers to care for their children, then society must care for mothers.
Today's health care market must balance the demands of many stakeholders. Consumers want choice over providers, benefit flexibility, and freedom from having to obtain permission for health services. At the same time, employer groups demand that plans hold the line on premiums, or pass cost-increases along to employees. Provider organizations, caught in the middle of these conflicting interests--containing costs yet providing unfettered access to care--are struggling to balance their own capital, financial risk, and service levels.
Stewart, Della Wyatt
Fiduciary duty is the responsibility to act in the best interest of a person or organization. Health care professionals, as well as managers in other industries, struggle continuously with the dilemma of whether or not to admit potentially harmful mistakes to unsuspecting customers and patients. Limited public disclosure of medical errors will benefit health care staff, organizational executives, and patients if specific policies are enacted to improve error prevention.
Brooks, J P; Dempsey, J
Health care managers are being required to respond to the growing concerns of the public about alcohol and drug use in the health care workplace. To this end, the following recommendations are offered. A drug testing policy should be developed with input from and support of employees and unions. "For cause" testing should be used because it results in more definitive results and better employee acceptance. Unless there are compelling reasons for random testing, "for cause" testing is the preferable method. All levels of employees and the medical staff should be subject to the drug-testing policy. Rehabilitation rather than punishment should be emphasized in dealing with employees with alcohol and drug problems.
Barawid, Edward; Covarrubias, Natalia; Tribuzio, Bianca; Liao, Solomon
Palliative care requires an interdisciplinary team approach to provide the best care for patients with life-threatening illnesses. Like palliative medicine, rehabilitation also uses an interdisciplinary approach to treating patients with chronic illnesses. This review article focuses on rehabilitation interventions that can be beneficial in patients with late stage illnesses. Rehabilitation may be useful in improving the quality of life by palliating function, mobility, activities of daily living, pain relief, endurance, and the psyche of a patient while helping to maintain as much independence as possible, leading to a decrease in burden on caregivers and family. Rehabilitative services are underutilized in the palliative care setting, and more research is needed to address how patients may benefit as they approach the end of their lives.
Dinaj-Koci, Veronica; Deveaux, Lynette; Wang, Bo; Lunn, Sonya; Marshall, Sharon; Li, Xiaoming; Stanton, Bonita
The inclusion of parents in adolescent-targeted interventions is intended to benefit the adolescent. Limited research has explored whether parents participating in these programs also benefit directly. We examined the impact of Caribbean Informed Parents and Children Together, the parenting portion of an adolescent-targeted HIV prevention…
Gould, Stephen J.
Questionnaires returned by 343 out of 350 subjects measured health attitudes and health status. Results suggest that some consumers take a more scientific approach to health care and prevention. Demographic factors, health status, and health consciousness are partial predictors of consumer attitudes and approach to health care. (SK)
place to the base unit (consultation site). The transmission is performed through GSM, Satellite links or POTS . Using this device a specialist...standardized medical protocol. Keywords – Emergency Health Care Telemedicine, GSM, Satellite, POTS I. INTRODUCTION The availability of prompt and expert...of communication means (Satellite, GSM and Plain Old Telephony System - POTS ). The base unit is comprised of a set of user-friendly software
Loewy, E H
An argument based on Kant for access to health-care for all is a most helpful addition to prior discussions. My paper argues that while such a point of view is helpful it fails to be persuasive. What is needed, in addition to a notion of the legislative will, is a viewpoint of community which sees justice as originating not merely from considerations of reason alone but from a notion of community and from a framework of common human experiences and capabilities.
Weaver, Andrew J.; Flannelly, Kevin J.; Flannelly, Laura T.; Oppenheimer, Julia E.
Examines how collaboration with clergy was viewed by mental health and other health care professionals outside the religious community. Seven themes were identified through a content analysis of health care journals, including the benefits of collaboration to each profession, the need to increase the clergy's knowledge about mental health, and the…
... Archives learn more » For Patients Your health care choices matter. Whether you're anticipating a surgical procedure, ... 853.9028 E: firstname.lastname@example.org About Us Careers News & Resources Surveyors Find a Health Care Organization ...
... safety efforts happening across the state. Health care facility CEOs/administrators can: Implement systems to alert receiving ... Germs spread between patients and across health care facilities. Antibiotic resistance is a threat. Nightmare germs called ...
... gov/ency/patientinstructions/000864.htm Savings account for health care costs To use the sharing features on this ... can set aside tax-exempt money for your health care expenses. This means you will pay no or ...
... 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 ...
... Urodynamic Testing Virtual Colonoscopy Celiac Disease Testing (for Health Care Professionals) Serologic tests for celiac disease provide an ... 6332) or visit www.fda.gov . Consult your health care provider for more information. September 2013 Share Alternate ...
... 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 ...
... 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 ...
... 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 ...
... Information Clinical Trials Resources and Publications How do health care providers diagnose vaginitis? Skip sharing on social media ... out the cause of a woman's symptoms, her health care provider will Examine the vagina, the vulva, and ...
Mansur, Greg; Thompson, Michael
While the Affordable Care Act (ACA) focused largely on improving access to health care coverage for the uninsured, its broader and longer-term influence may have been its impact on accelerating key trends and strategies that major employers and other stakeholders have been targeting for years. This article looks at some of these trends, where we were pre-ACA and how ACA (through benefit mandates, shared responsibility penalties, Cadillac plan tax, health information technology, accountable care organizations, etc.) has helped to accelerate and refocus efforts. In addition, the public exchange paradigm has given rise to a private exchange movement that is helping further accelerate the transformation of the New Health Economy.
Edler, A A
Over the last decade, development aid has increasingly used a more collaborative model, with donors and recipients both contributing ideas, methods and goals. Though many examples of collateral aid projects exist in agriculture, business administration and banking, few have found their way into health care and health education, a typically donor-dominated model. The following case report describes a collateral project in health care education. This case report analyzes data-inducing project proposals, personal interviews and project reports obtained through standard archival research methods. The setting for this joint project was the collaboration between international nongovernmental (NGO) aid foundations and the faculty of a major sub-Saharan African Medical School's Department of Anesthesia. The initial goal of this project was to improve record keeping for all anesthetic records, both in the operating theatres and outside. Analysis of the data was performed using ethnographic methods of constant comparative analysis. The purpose of the analysis was to critically evaluate both the goals and their results in the Department of Anesthesiology. The findings of this analysis suggested that results included not only quality assurance and improvement programs in the department but also advances in the use of critical incidents as teaching tools, hospital-wide drug and equipment utilization information and the initiation of an outreach program to district hospitals throughout the country for similar projects.
Vujicic, Marko; Buchmueller, Thomas; Klein, Rachel
The Affordable Care Act is improving access to and the affordability of a wide range of health care services. While dental care for children is part of the law's essential health benefits and state Medicaid programs must cover it, coverage of dental care for adults is not guaranteed. As a result, even with the recent health insurance expansion, many Americans face financial barriers to receiving dental care that lead to unmet oral health needs. Using data from the 2014 National Health Interview Survey, we analyzed financial barriers to a wide range of health care services. We found that irrespective of age, income level, and type of insurance, more people reported financial barriers to receiving dental care, compared to any other type of health care. We discuss policy options to address financial barriers to dental care, particularly for adults.
... Benefits Security Administration Publication of Model Notices for Health Care Continuation Coverage... Administration, Department of Labor. ACTION: Notice of the Availability of the Model Health Care Continuation... announces the availability of the model health care continuation coverage notices required by ARRA,...
Bryant Jr., Alfred; Goins, R. Turner; Bell, Ronny; Herrell, Richard; Manson, Spero M.; Buchwald, Dedra
Context: Of 2.4 million American Indians, approximately 60% are eligible to receive Indian Health Service (IHS) benefits, leaving many to seek care elsewhere. It is unknown if their quality of care, health behaviors, and health status vary by source of care, as demonstrated for other populations. Purpose: The purpose of this study was to determine…
Powell, Suzanne K
Music therapy has been around since the 1940s when physicians notice a positive effect that music had on the soldiers with "shell shock" (now more commonly known as posttraumatic stress disorder). For decades, veterans were the primary patients worked with by music therapists. In the 1970s, the hospice movement started to enter the health care continuum, largely due to Dr Elisabeth Kübler-Ross, who advocated for home care and patient choice for the terminally ill. Two decades later, it became apparent that hospice patients could benefit from music. And currently, there are not enough people certified to work with music in hospice patients, veterans, or patients with dementia/Alzheimer's disease. No, music does not prolong life, but it does add life to the time left.
McManus, Marilyn C., Ed.
This theme issue of a bulletin on family support and children's mental health focuses on managed care and the impact on children who are in need of mental health services. Articles include: "Private Sector Managed Care and Children's Mental Health" (Ira S. Lourie and others); "Just What Is Managed Care?" (Chris Koyanagi); "Managed Behavioral…
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…
Douglas, Bruce L.
In a context of forecasts of major changes for America's entire health care system, colleges and universities are exploring the implications of new trends in campus health care delivery. On January 30-31, 1975, the Society for College and University Planning sponsored a workshop on "Campus Health Care Services" in Chicago to discuss such issues as…
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…
... benefits. The authority to permit the Plan to offer more than two levels of benefits is a matter for... to subsidize health insurance premium payments for certain low-income children who have access to... child health assistance are eligible to receive State premium subsidy assistance payments to help...
Tarasuk, Valerie; Cheng, Joyce; de Oliveira, Claire; Dachner, Naomi; Gundersen, Craig; Kurdyak, Paul
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
Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E.
Objectives The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child’s development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Methods Using data from a national urban birth cohort study in the U.S., we estimate the effects of prenatal care on four markers of child health at age 5—maternal-reported health status, asthma diagnosis, overweight, and height. We implement a number of different strategies to address the issue of potential omitted variables bias as well as a large number of specification checks to validate the findings. Results and Conclusions Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children’s health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime helathcare on child health. PMID:22374319
Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E
The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child's development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Using data from a national urban birth cohort study in the US, we estimate the effects of prenatal care on four markers of child health at age 5-maternal-reported health status, asthma diagnosis, overweight, and height. Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children's health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime healthcare on child health.
Watson, Nathaniel F.
Two new white papers commissioned by the American Academy of Sleep Medicine (AASM) provide an in-depth, detailed analysis of the vast economic burden associated with undiagnosed and untreated obstructive sleep apnea among adults in the United States. While the individual health benefits of treating OSA are well established, these papers emphasize the value of comprehensive OSA testing and treatment, which can provide dramatic health care savings for payors and large employers. Citation: Watson NF. Health care savings: the economic value of diagnostic and therapeutic care for obstructive sleep apnea. J Clin Sleep Med 2016;12(8):1075–1077. PMID:27448424
Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L
Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery.
Ziebarth, Deborah Jean
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
Maass, Marianne C; Asikainen, Paula; Mäenpää, Tiina; Wanne, Olli; Suominen, Tarja
The goal of this paper is to describe some benefits and possible cost consequences of computer based access to specialised health care information. A before-after activity analysis regarding 20 diabetic patients' clinical appointments was performed in a Health Centre in Satakunta region in Finland. Cost data, an interview, time-and-motion studies, and flow charts based on modelling were applied. Access to up-to-date diagnostic information reduced redundant clinical re-appointments, repeated tests, and mail orders for missing data. Timely access to diagnostic information brought about several benefits regarding workflow, patient care, and disease management. These benefits resulted in theoretical net cost savings. The study results indicated that Regional Information Systems may be useful tools to support performance and improve efficiency. However, further studies are required in order to verify how the monetary savings would impact the performance of Health Care Units.
Wheeler, Sarahn M; Bryant, Allison S
A health disparity is defined as an increased burden of an adverse health outcome or health determinant within a specific subset of the population. There are well-documented racial and ethnic disparities throughout health care at the patient, provider, and health care system levels. As the minority populations within the United States grow to record numbers, it is increasingly important to invest in efforts to characterize, understand, and end racial and ethnic disparities in health care. Inequities in health outcomes and care pose real threats to the entire nation's well-being. Eliminating health disparities is fundamental to the well-being, productivity, and viability of the entire nation.
Kimmey, James R.
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…
Syre, Thomas R.; Wilson, Richard W.
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…
There is mounting public awareness of an increasing number of adverse clinical incidents within the National Health Service (NHS), but at the same time, large health care projects like the National Programme for IT (NPFIT) are claiming that safer care is one of the benefits of the project and that health software systems in particular have the potential to reduce the likelihood of accidental or unintentional harm to patients. This paper outlines the approach to clinical safety management taken by CSC, a major supplier to NPFIT; discusses acceptable levels of risk and clinical safety as an end-to-end concept; and touches on the future for clinical safety in health systems software.
Munns, Ailsa; Forde, Karen A; Krouzecky, Miriam; Shields, Linda
Within the current Australian health system is the understanding of a need to change from the predominate biomedical model to incorporate a comprehensive primary health care centred approach, embracing the social contexts of health and wellbeing. Recent research investigated the benefits of the primary health care philosophy and strategies in relation to the Rainbows programme which addresses grief and loss in primary school aged students in Western Australia. A multidisciplinary collaboration between the Western Australian Departments of Health and Education enabled community school health nurse coordinators to train teacher facilitators in the implementation of Rainbows, enabling support for students and their parents. The results of this qualitative study indicate that all participants regard Rainbows as effective, with many perceived benefits to students and their families.
Murray, Sally B; Skull, Sue A
Refugees and asylum seekers face a number of barriers to accessing health care and improved health status. These include language difficulties, financial need and unemployment, cultural differences, legal barriers and a health workforce with generally low awareness of issues specific to refugees. Importantly, current Australian government migration and settlement policy also impacts on access to health and health status. An adequate understanding of these 'hurdles to health' is a prerequisite for health providers and health service managers if they are to tailor health care and services appropriately. We include tables of available resources and entitlements to health care according to visa category to assist providers and managers.
Kamil, Alison; Chen, C-Y Oliver
Almonds are rich in monounsaturated fat, fiber, α-tocopherol, minerals such as magnesium and copper, and phytonutrients, albeit being energy-dense. The favorable fat composition and fiber contribute to the hypocholesterolemic benefit of almond consumption. By virtue of their unique nutrient composition, almonds are likely to benefit other modifiable cardiovascular and diabetes risks, such as body weight, glucose homeostasis, inflammation, and oxidative stress. This paper briefly reviews the nutrient composition and hypocholesterolemic benefits; the effects of almond consumption on body weight, glucose regulation, oxidative stress, and inflammation, based on the data of clinical trials, will then be discussed. Although more studies are definitely warranted, the emerging evidence supports that almond consumption beneficially influences chronic degenerative disease risk beyond cholesterol reduction, particularly in populations with metabolic syndrome and type 2 diabetes mellitus.
Deutsch, Stephanie Anne; Fortin, Kristine
Children and adolescents in foster care placement represent a unique population with special health care needs, often resulting from pre-placement early adversity and neglected, unaddressed health care needs. High rates of all health problems, including acute and/or chronic physical, mental, and developmental issues prevail. Disparities in health status and access to health care are observed. This article summarizes the physical health problems of children in foster care, who are predisposed to poor health outcomes when complex care needs are unaddressed. Despite recognition of the significant burden of health care need among this unique population, barriers to effective and optimal health care delivery remain. Legislative solutions to overcome obstacles to health care delivery for children in foster care are discussed.
Kansas State Dept. of Health and Environment, Topeka.
Profiles are provided for innovative public health activities that focus on the health of children in day care. All are considered to be models worthy of replication. Profiles depict (1) child care in Arizona; (2) child day care licensing in Connecticut; (3) safeguarding children in day care in Kansas; (4) paired state and local inspection in…
Birt, C A
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.
Walzer, S.; Nuijten, M.; Wiesner, C.; Kaier, K.; Johansson, P-O.; Oertel, S.
Introduction: In economic theory economic surplus refers to two related quantities: Consumer and producer surplus. Applying this theory to health care “convenience” could be one way how consumer benefits might manifest itself. Methods: Various areas of economic surplus were identified and subsequently screened and analyzed in Germany, Spain, The Netherlands, and the UK: Cesarean births, emergency room visits (nights or weekends), drug availability after test results, and response surplus. A targeted literature search was being conducted to identify the associated costs. Finally the economic surplus (convenience value) was calculated. Results: The economic surplus for different health care areas was being calculated. The highest economic surplus was obtained for the example of response surplus IVF-treatments in The Netherlands. Conclusion: The analyzed examples in this article support the underlying hypothesis for this research: “Value of convenience defined as the consumer surplus in health care can be shown in different health care settings.” Again, this hypothesis should be accepted as a starting point in this research area and hence further primary research is strongly recommended in order to fully proof this concept. PMID:23423475
Njue, Maureen; Molyneux, Sassy; Kombe, Francis; Mwalukore, Salim; Kamuya, Dorcas; Marsh, Vicki
Background Providing benefits and payments to participants in health research, either in cash or in kind, is a common but ethically controversial practice. While much literature has concentrated on appropriate levels of benefits or payments, this paper focuses on less well explored ethical issues around the nature of study benefits, drawing on views of community members living close to an international health research centre in Kenya. Methods The consultation, including 90 residents purposively chosen to reflect diversity, used a two-stage deliberative process. Five half-day workshops were each followed by between two and four small group discussions, within a two week period (total 16 groups). During workshops and small groups, facilitators used participatory methods to share information, and promote reflection and debate on ethical issues around types of benefits, including cash, goods, medical and community benefits. Data from workshop and field notes, and voice recordings of small group discussions, were managed using Nvivo 10 and analysed using a Framework Analysis approach. Findings and Conclusions The methods generated in-depth discussion with high levels of engagement. Particularly for the most-poor, under-compensation of time in research carries risks of serious harm. Cash payments may best support compensation of costs experienced; while highly valued, goods and medical benefits may be more appropriate as an ‘appreciation’ or incentive for participation. Community benefits were seen as important in supporting but not replacing individual-level benefits, and in building trust in researcher-community relations. Cash payments were seen to have higher risks of undue inducement, commercialising relationships and generating family conflicts than other benefits, particularly where payments are high. Researchers should consider and account for burdens families may experience when children are involved in research. Careful context-specific research planning
Olsen, J A; Smith, R D
This paper is based upon an extensive review of 71 willingness-to-pay (WTP) surveys of health and health care published in English during the period 1985--1998. The aim of the paper is to outline the arguments advanced for the superiority of WTP over quality-adjusted-life-years (QALYs) as a measure of benefit of health care programmes, and to review how empirical WTP studies adhere to their implications. An important argument is that WTP enables a more comprehensive valuation of benefits than QALYs. Our main focus is therefore to provide a careful review of the scenario descriptions used in the surveys, according to which types of benefits are being valued, and how comprehensively the descriptions are presented. Furthermore, the 'cost-benefit argument', that WTP can assist in improving social efficiency, is discussed before we inquire into the extent to which the studies actually compare WTP with social costs.
Person, Donald Ames
Introduction/Background: US Associated/Affiliated Pacific Islands (USAPI) include three freely associated states: Marshall Islands, Federated States of Micronesia, Palau, and three Territories: American Samoa, Guam, and Commonwealth of the Northern Mariana Islands. Objective: The Pacific Island Health Care Project (PIHCP) provides humanitarian medical referral/consultation/care to >500,000 indigenous people of these remote islands. Methods: In the mid-1990s, we developed a simple store-and-forward program to link the USAPI with Tripler Army Medical Center. This application allowed image attachment to email consultations. Results: More than 8000 Pacific Islanders have benefited from the program. Three thousand Pacific Islanders prior to telemedicine (1990–1997) and since store-and-forward telemedicine (1997-present), the PIHCP has helped an additional 5000. Records post dynamically and are stored in an archival database. Conclusion: The PIHCP is the longest running telemedicine program in the world delivering humanitarian medical care. It has bridged the Developing World of the remote Pacific Islands with advanced medical and surgical care available at a major US military teaching hospital. (The opinions expressed here are those of the author and not that of the Army, Department of Defense, or the US Government.) PMID:25353012
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…
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.
Sorrell, Jeanne M
Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.
Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon
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.
This article examines the benefits and risks associated with caffeinated foods and drinks, taking an evidence-based approach to identify appropriate daily caffeine limits. Suggestions are provided on how to structure dietary advice for different patient groups including children, individuals with hypertension, renal patients, athletes and older adults.
Almonds are rich in monounsaturated fat, fiber, alpha-tocopherol, minerals such as magnesium copper, and phytonutrients, albeit being energy-dense. The favorable fat composition and fiber contribute to the hypocholesterolemic benefit of almond consumption. By virtue of their unique nutrient composit...
Health care reform efforts have increasingly emphasized payment models that reward value (quality/cost). It seems appropriate, therefore, to examine what we value in health care, and that will require that we examine our definition of health. In spite of admonitions from the World Health Organization and others, our current health care system operates under the assumption that health represents the absence of health problems. While that perspective has led to incredible advances in medical science, it now may be adversely affecting value. Problem-oriented care is clearly one of the drivers of rising costs and it could be adversely affecting the quality of care, depending upon how quality is defined. If we redefined health in terms of patient-centered goals, health care could be focused more directly on meaningful outcomes, reducing the number of irrelevant tests and treatments. Greater emphasis would be placed on prevention, meaningful activities, advance directives and personal growth and development. The role of patients within clinician-patient relationships would be elevated, strengthening therapeutic relationships. Reframing health in terms of health-related goals and directing the health care system to help people achieve them, could both improve quality and reduce costs. In the process, it could also make health care less mechanical and more humane. PMID:28367382
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
Núñez, Alicia; Chi, Chunhuei
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.
Jeansson, John S
At the very heart of Swedish healthcare digitalisation are large investments in electronic health records (EHRs). These integrated information systems (ISs) carry promises of great benefits and value for organisations. However, realising IS benefits and value has, in general, proven to be a challenging task, and as organisations strive to formalise their realisation efforts a misconception of rationality threatens to emerge. This misconception manifests itself when the formality of analysis threatens to underrate the impact of social processes in deciding which potential benefits to pursue. This paper suggests that these decisions are the result of a social process of negotiation. The purpose of this paper is to observe three benefits analysis projects of three Swedish hospitals to better understand the character and management of proposed benefits negotiations. Findings depict several different categories of benefits negotiations, as well as key factors to consider during the benefits negotiation process.
The current human resource (HR) management practices in health care are consistent with the industrial model of management. However, health care organizations are not factories. They are highly knowledge-intensive and service-oriented entities and thus require a different set of HR practices and systems to support them. Drawing from the resource-based theory, I argue that HRs are a potent weapon of competitive advantage for health care organizations and propose a five-dimensional conception of HR capability for harnessing HRs in health care organizations. The significant complementarities that exist between HRs and information technologies for delivering safer and better quality of patient care are also discussed.
Lima, Bruno R.
This paper outlines selected differences between the United States and Latin America health care systems as they relate to primary mental health care. It notes that historically both the United States and Latin America have relied on custodial psychiatric hospitals. The alternative of community care for psychiatric patients is described as it is…
Schraiber, Lilia Blima; Figueiredo, Wagner dos Santos; Gomes, Romeu; Couto, Márcia Thereza; Pinheiro, Thiago Félix; Machin, Rosana; Silva, Geórgia Sibele Nogueira da; Valença, Otávio
This study deals with the relations between masculinities and health care, approaching the recognition of health needs among male users of primary health care and the responses by the services. The study is part of a larger research project in four Brazilian States, with a convenience sample of eight health services. Ethnographic observation was compared with semi-structured interviews with 182 health care users from 15 to 65 years of age and 72 health professionals. Thematic analysis of the ethnographic records and interviews was based on gender references and studies on health work. The findings show how medicalization of health needs affects users, professionals, and services, disguising issues related to masculinity. Primary care focuses mainly on women, thereby reproducing gender inequalities in health services operations and professional performance, with women receiving disciplined care and men receiving insufficient attention and care.
Martin, Keith R
Silicon is the second most abundant element in nature behind oxygen. As a metalloid, silicon has been used in many industrial applications including use as an additive in the food and beverage industry. As a result, humans come into contact with silicon through both environmental exposures but also as a dietary component. Moreover, many forms of silicon, that is, Si bound to oxygen, are water-soluble, absorbable, and potentially bioavailable to humans presumably with biological activity. However, the specific biochemical or physiological functions of silicon, if any, are largely unknown although generally thought to exist. As a result, there is growing interest in the potential therapeutic effects of water-soluble silica on human health. For example, silicon has been suggested to exhibit roles in the structural integrity of nails, hair, and skin, overall collagen synthesis, bone mineralization, and bone health and reduced metal accumulation in Alzheimer's disease, immune system health, and reduction of the risk for atherosclerosis. Although emerging research is promising, much additional, corroborative research is needed particularly regarding speciation of health-promoting forms of silicon and its relative bioavailability. Orthosilicic acid is the major form of bioavailable silicon whereas thin fibrous crystalline asbestos is a health hazard promoting asbestosis and significant impairment of lung function and increased cancer risk. It has been proposed that relatively insoluble forms of silica can also release small but meaningful quantities of silicon into biological compartments. For example, colloidal silicic acid, silica gel, and zeolites, although relatively insoluble in water, can increase concentrations of water-soluble silica and are thought to rely on specific structural physicochemical characteristics. Collectively, the food supply contributes enough silicon in the forms aforementioned that could be absorbed and significantly improve overall human health
Scahill, Shane; Harrison, Jeff; Carswell, Peter; Shaw, John
The aim of our paper is to expose the challenges primary health care reform is exerting on community pharmacy and other groups. Our paper is underpinned by the notion that a broad understanding of the issues facing pharmacy will help facilitate engagement by pharmacy and stakeholders in primary care. New models of remuneration are required to deliver policy expectations. Equally important is redefining the place of community pharmacy, outlining the roles that are mooted and contributions that can be made by community pharmacy. Consistent with international policy shifts, New Zealand primary health care policy outlines broad directives which community pharmacy must respond to. Policymakers are calling for greater integration and collaboration, a shift from product to patient-centred care; a greater population health focus and the provision of enhanced cognitive services. To successfully implement policy, community pharmacists must change the way they think and act. Community pharmacy must improve relationships with other primary care providers, District Health Boards (DHBs) and Primary Health Organisations (PHOs). There is a requirement for DHBs to realign funding models which increase integration and remove the requirement to sell products in pharmacy in order to deliver services. There needs to be a willingness for pharmacy to adopt a user pays policy. General practitioners (GPs) and practice nurses (PNs) need to be aware of the training and skills that pharmacists have, and to understand what pharmacists can offer that benefits their patients and ultimately general practice. There is also a need for GPs and PNs to realise the fiscal and professional challenges community pharmacy is facing in its attempt to improve pharmacy services and in working more collaboratively within primary care. Meanwhile, community pharmacists need to embrace new approaches to practice and drive a clearly defined agenda of renewal in order to meet the needs of health funders, patients
... writing directly to the Office of Insurance Programs, Retirement and Insurance Service, Office of... PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS... access to and choice of quality primary and specialty medical care throughout the service...
Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris
, etc., which gives a special emphasis on public health aspects of information, especially in the field of medicine and health care. The authors of this paper discuss the role and practical importance of social networks in improving the health and solving of health problems without the physical entrance into the health care system. Social networks have their advantages and disadvantages, benefits and costs, especially when it comes to information which within the network set unprofessional people from unreliable sources, without an adequate selection. The ethical aspect of the norms in this segment is still not adequately regulated, so any sanctions for the unauthorized and malicious use of social networks in private and other purposes in order to obtain personal gain at the expense of individuals or groups (sick or healthy, owners of certain businesses and companies, health organizations and pharmaceutical manufacturers, etc.), for which there is still no global or European codes and standards of conduct. Cyber crime is now one of the mostly present types of crime in modern times, as evidenced by numerous scandals that are happening both globally and locally.
Fisher, Elisa; Hasselberg, Michael; Conwell, Yeates; Weiss, Linda; Padrón, Norma A; Tiernan, Erin; Karuza, Jurgis; Donath, Jeremy; Pagán, José A
Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO(®) (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.
Murphy, John W
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
Fava, Nicole M; Munro-Kramer, Michelle L; Felicetti, Irene L; Darling-Fisher, Cynthia S; Pardee, Michelle; Helman, Abigail; Trucco, Elisa M; Martyn, Kristy K
Research informed by individuals' lived experiences is a critical component of participatory research and nursing interventions for health promotion. Yet, few examples of participatory research in primary care settings with adolescents and young adults exist, especially with respect to their sexual health and health-risk behaviors. Therefore, we implemented a validated patient-centered clinical assessment tool to improve the quality of communication between youth patients and providers, sexual risk assessment, and youths' health-risk perception to promote sexual health and reduce health-risk behaviors among adolescents and young adults in three community health clinic settings, consistent with national recommendations as best practices in adolescent health care. We describe guiding principles, benefits, challenges, and lessons learned from our experience. Improving clinical translation of participatory research requires consideration of the needs and desires of key stakeholders (e.g., providers, patients, and researchers) while retaining flexibility to successfully navigate imperfect, real-world conditions.
Stöver, Heino; Wolff, Hans
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
Pont, Jörg; Stöver, Heino; Wolff, Hans
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.
Hom, Jeffrey K; Wong, Charlene; Stillson, Christian; Zha, Jessica; Cannuscio, Carolyn C; Cahill, Rachel; Grande, David
Understanding how new Medicaid enrollees are approaching their own health and health care in the shifting health care landscape of the Affordable Care Act has implications for future outreach and enrollment efforts, as well as service planning for this population. The objective of this study was to explore the health care experiences and expectations of new Medicaid expansion beneficiaries in the immediate post-enrollment period. We conducted semistructured, qualitative interviews with a random sample of 40 adults in Philadelphia who had completed an application for Medicaid through a comprehensive benefits organization after January 1, 2015, when the Medicaid expansion in Pennsylvania took effect. We conducted an inductive, applied thematic analysis of interview transcripts. The new Medicaid beneficiaries described especially high levels of pent-up demand for care. Dental care was a far more pressing and motivating concern than medical care. Preventive services were also frequently mentioned. Participants anticipated that insurance would reduce both stress and financial strain and improve their experience in the health care system by raising their social standing. Participants highly valued the support of telephone application counselors in the Medicaid enrollment process to overcome bureaucratic obstacles they had encountered in the past. Dental care and preventive services appear to be high priorities for new Medicaid enrollees. Telephone outreach and enrollment support services can be an effective way to overcome past experiences with administrative barriers.
Collins, Sandra K; Collins, Kevin S
With the workforce growing older and the supply of younger workers diminishing, it is critical for health care managers to understand the factors necessary to capitalize on their vintage employees. Retaining this segment of the workforce has a multitude of benefits including the preservation of valuable intellectual capital, which is necessary to ensure that health care organizations maintain their competitive advantage in the consumer-driven market. Retaining the aging employee is possible if health care managers learn the motivators and training differences associated with this category of the workforce. These employees should be considered a valuable resource of human capital because without their extensive expertise, intense loyalty and work ethic, and superior customer service skills, health care organizations could suffer severe economic repercussions in the near future.
Brower, Mary R.; Sull, Theresa M.
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…
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…
Szalai, Bianca; Detsis, Emmanouil; Peeters, Walter
Humanity will be faced with an important number of future challenges, including an expansion of the lifespan, a considerable increase of the population (estimated 9 billion by 2050) and a depletion of resources. These factors could trigger an increase of chronic diseases and various other health concerns that would bear a heavy weight on finances worldwide. Scientific advances can play an important role in solving a number of these problems, space technology; in general, can propose a panoply of possible solutions and applications that can make life on Earth easier and better for everyone. Satellites, Earth Observation, the International Space Station (ISS) and the European Space Agency (ESA) may not be the first tools that come to mind when thinking of improving health, yet there are many ways in which ESA and its programmes contribute to the health care arena. The research focuses on quantifying two ESA spin-offs to provide an initial view on how space can contribute to worldwide health. This quantification is part of the present strategy not only to show macroeconomic return factors for space in general, but also to identify and describe samples of 'best practice' type of examples close to the general public's interest. For each of the 'best practices' the methodology takes into account the cost of the space hardware/software, a number of tangible and intangible benefits, as well as some logical assumptions in order to determine the potential overall returns. Some of the hindering factors for a precise quantification are also highlighted. In conclusion, the study recommends a way in which ESA's spin-offs can be taken into account early on in the development process of space programmes in order to generate higher awareness with the general public and also to provide measurable returns.
In his new book, futurist Russell C. Coile Jr. presents predictions about seven aspects of health care for the next five years. Aided by a panel of health care experts, he analyzes likely developments in health care consumerism, technology, managed care, and other areas that raise a number of issues for health care marketers. Even if only a few of these predictions come true, marketers will be forced to rethink some of their techniques to adapt to this rapidly changing environment.
Muntaner, Carles; Salazar, René M Guerra; Benach, Joan; Armada, Francisco
Throughout the 1990s, all Latin American countries but Cuba implemented health care sector reforms based on a neoliberal paradigm that redefined health care less as a social right and more as a market commodity. These reforms were couched in the broader structural adjustment of Latin American welfare states as prescribed by international financial institutions since the mid-1980s. However, since 2003, Venezuela has been developing an alternative to this neoliberal trend through its health care reform program, Misión Barrio Adentro (Inside the Neighborhood). In this article, the authors review the main features of the Venezuelan health care reform, analyzing, within their broader sociopolitical and economic contexts, previous neoliberal health care reforms that mainly benefited transnational capital and domestic Latin American elites. They explain the emergence of the new health care program, Misión Barrio Adentro, examining its historical, social, and political underpinnings and the central role played by popular resistance to neoliberalism. This program not only provides a compelling model of health care reform for other low- to middle-income countries but also offers policy lessons to wealthy countries.
Kampelmacher, E. H.
The problem of foodborne diseases, in which especially food of animals origin and the infected animal is involved, is reviewed. Salmonella and Campylobacter contamination of meat and poultry may today, together with parasites in meat and fish be considered as an increasing public health problem. Control and prevention measures, especially including radiation processing is summarized and with regard to specific micro-organisms and parasites and to various food commodities suitable for irradiation purposes. The possibilities of this new processing technique for reduction and probably elimination of pathogens and parasites are discussed and recommendations are given for practical application of radiation in order to eliminate health risks eliminating from contaminated food.
Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A
Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt. In 1933, Franklin D. Roosevelt, a Democrat, included a publicly funded health care program while drafting provisions to Social Security legislation, which was eliminated from the final legislation. Subsequently, multiple proposals were introduced, starting in 1949 with President Harry S Truman who proposed universal health care; the proposal by Lyndon B. Johnson with Social Security Act in 1965 which created Medicare and Medicaid; proposals by Ted Kennedy and President Richard Nixon that promoted variations of universal health care. presidential candidate Jimmy Carter also proposed universal health care. This was followed by an effort by President Bill Clinton and headed by first lady Hillary Clinton in 1993, but was not enacted into law. Finally, the election of President Barack Obama and control of both houses of Congress by the Democrats led to the passage of the Affordable Care Act (ACA), often referred to as "ObamaCare" was signed into law in March 2010. Since then, the ACA, or Obamacare, has become a centerpiece of political campaigning. The Republicans now control the presidency and both houses of Congress and are attempting to repeal and replace the ACA. Key words: Health care reform, Affordable Care Act (ACA), Obamacare, Medicare, Medicaid, American Health Care Act.
Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.
Schaeffer, Leonard D
Rising health care costs have been an issue for decades, yet federal-level health care reform hasn't happened. Support for reform, however, has changed. Purchasers fear that health care cost growth is becoming unaffordable. Research on costs and quality is questioning value. International comparisons rank the United States low on important health system performance measures. Yet it is not these factors but the unsustainable costs of Medicare and Medicaid that will narrow the window for health care stakeholders to shape policy. Unless the health care system is effectively reformed, sometime after the 2008 election, budget hawks and national security experts will eventually combine forces to cut health spending, ultimately determining health policy for the nation.
I N S T I T U T E F O R D E F E N S E A N A L Y S E S Health Care Analysis for the MCRMC Insurance Cost Model (Presentation) Sarah K. Burns...incentive to reduce utilization Subsidy to leave TRICARE and use other private health insurance Increases in TRICARE premiums and co-pays This...analysis develops the estimated cost of providing health care through a premium-based insurance model consistent with an employer-sponsored benefit
Heinzelmann, F.; Durbeck, D. C.
A study was made of the benefits reported by participants in a health evaluation and enhancement program dealing with physical activity. Program benefits were identified and defined in regard to three major areas: program effects on work; program effects on health; and program effects on habits and behavior. A strong positive and consistent relationship was found between reported benefits in each of these areas and measures of improvement in cardiovascular functioning based on treadmill performance. Significant differences in these measures of improvement were also found between participants who reported program benefits and those persons who did not. These findings provide a meaningful profile of the pattern of benefits generated by this kind of health program.
In 1960-1980 Costa Rica experienced a health boom, achieving significant improvements which moved that country into the number two position in Latin America for indicators such as population coverage, infant mortality, life expectancy and health services. In addition, there was a gradual process of integration of health services. But in the same period, the cost of health care as a percentage of GNP increased almost 5-fold and in 1980 was the fourth highest in the region. The economic crisis of the 1980s aggravated the financial difficulties; to cope with them, the government introduced an austere program to reduce costs and plans to transform the current model of health care into a more efficient one capable of maintaining Costa Rica's high health standards in the future. The paper is divided into five sections: summary of the historical development of health care, and description of its current organization and of its gradual process of integration; estimation of population coverage and its trends, evaluation of inequalities in coverage, and identification of the non-covered group; analysis of health-care financing and its sources, as well of the recent financial desequilibrium, its causes and measures to restore the equilibrium; description of health care benefits and their differences among groups and regions, analysis of the country's advances in health-care facilities and standards, and measurement of the impact of the health care system in income distribution; and description of the rising cost of health care and the current crisis, analysis of the causes of both phenomena, and review of the measures that have been and should be implemented to solve these problems.
Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes
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…
Doherty, William J., Ed.; McCubbin, Hamilton I., Ed.
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)
Häsler, B; Cornelsen, L; Bennani, H; Rushton, J
One Health as a concept has been with us for many years, yet it is only recently that it is actively being discussed as a way of mitigating risks in society. Initiatives in the use of this concept require methods to monitor the benefits gained from an holistic approach to health, yet there is an absence of adequate frameworks to measure One Health benefits. This paper explores the problem with a review of the available literature and an examination of methods used. It concludes that most published work on One Health describes how this concept is valuable without trying to estimate the size of benefit or type of value. A framework for measuring the advantages of a One Health approach is needed and, through the process of an international workshop and the development of a One Health business case, the authors are working towards its development.
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)
Hall, Mark A
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.
Hook-Shelton, Sara Anne
Discusses the strained financial situation of the health care industry and the debate whether medical libraries should attempt to recover costs by charging for information and library services. The discussion covers both possible benefits of cost recovery and problems, including difficulties in quantifying library services and ethical concerns…
This article reviews why nursing operations automation is important, reviews the impact of computer technology on nursing from a historical perspective, and considers the future of nursing operations automation and health care technology innovations in 2025 and beyond. The increasing automation in health care organizations will benefit patient care, staffing and scheduling systems and central staffing offices, census control, and measurement of patient acuity.
Bindman, A B
The use of primary and managed care is likely to increase under proposed federal health care reform. I review the definition of primary care and primary care physicians and show that this delivery model can affect access to medical care, the cost of treatment, and the quality of services. Because the use of primary care is often greater in managed care than in fee-for-service, I compare the two insurance systems to further understand the delivery of primary care. Research suggests that primary care can help meet the goal of providing accessible, cost-effective, and high-quality care, but that changes in medical education and marketplace incentives will be needed to encourage students and trained physicians to enter this field. PMID:7941522
de Almeida, Patty Fidelis; dos Santos, Adriano Maia
RESUMO OBJECTIVE To analyze the breadth of care coordination by Primary Health Care in three health regions. METHODS This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia. RESULTS Primary Health Care as first contact of preference faced strong competition from hospital outpatient and emergency services outside the network. Issues related to access to and provision of specialized care were aggravated by dependence on the private sector in the regions, despite progress observed in institutionalizing flows starting out from Primary Health Care. The counter-referral system was deficient and interprofessional communication was scarce, especially concerning services provided by the contracted network. CONCLUSIONS Coordination capacity is affected both by the fragmentation of the regional network and intrinsic problems in Primary Health Care, which poorly supported in its essential attributes. Although the health regions have common problems, Primary Health Care remains a subject confined to municipal boundaries. PMID:28099663
Physician and Sportsmedicine, 1987
A panel of eight experts discuss the cardiovascular, lipoprotein, weight control, and psychological benefits of exercise on health. The challenge of motivating people to exercise regularly is explored. (Author/MT)
Maynard, A; Bloor, K
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.
Bala, M V; Mauskopf, J A; Wood, L L
In this paper, we discuss the use of cost-benefit analysis (CBA) for evaluating new healthcare interventions, present the theoretical basis for the use of willingness to pay as a method for valuing benefits in a CBA and describe how to obtain willingness-to-pay (WTP) measures of health benefits and how to use these values in a CBA. We review selected economic studies on consumer demand and consumer surplus and studies presenting WTP estimates for healthcare interventions. The theoretical foundations of willingness to pay as a measure of commodity value are rooted in consumer demand theory. The area under the fixed income consumer demand curve represents the consumer's maximum willingness to pay for the commodity. We identify 3 types of potential benefits from a new healthcare intervention, namely patient benefits, option value and altruistic value, and suggest WTP questions for valuing different combinations of these benefits. We demonstrate how responses to these questions can be adjusted for income effects and incorporated into economic evaluations. We suggest that the lack of popularity of CBAs in the health area is related to the perceived difficulty in valuing health benefits as well as concern over how CBA incorporates the distribution of income. We show that health benefits can be valued using simple survey techniques and that these values can be adjusted to any desired income distribution.
Tanner, D J
Methods for conducting a comprehensive analysis of the potential for strategic entry or expansion in the home health-care (HHC) market are discussed. By conducting a comprehensive analysis of the HHC market, hospital pharmacists can evaluate the feasibility of developing and implementing a hospital-based HHC service. A comprehensive market analysis should include an initial assessment of potential product-line offerings, development of strengths-and-weaknesses and opportunities-and-threats profiles, evaluations of competing providers of HHC and regulatory issues, and formulation of a business plan. The potential impact of program structure, operations management, product pricing, advertising and promotion, and marketing controls should also be considered. The hospital pharmacist has a unique opportunity to further the organizational objectives of the hospital by participating in the provision of HHC; a comprehensive market analysis represents a useful method of assessing the benefits and costs associated with providing integrated HHC services.
Kulshreshtha, Archana; Zacharia, Anish J; Jarouliya, Urmila; Bhadauriya, Pratiksha; Prasad, G B K S; Bisen, P S
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.
Shoaib, Muhammad; Shehzad, Aamir; Omar, Mukama; Rakha, Allah; Raza, Husnain; Sharif, Hafiz Rizwan; Shakeel, Azam; Ansari, Anum; Niazi, Sobia
Inulin is a water soluble storage polysaccharide and belongs to a group of non-digestible carbohydrates called fructans. Inulin has attained the GRAS status in USA and is extensively available in about 36,000 species of plants, amongst, chicory roots are considered as the richest source of inulin. Commonly, inulin is used as a prebiotic, fat replacer, sugar replacer, texture modifier and for the development of functional foods in order to improve health due to its beneficial role in gastric health. This review provides a deep insight about its production, physicochemical properties, role in combating various kinds of metabolic and diet related diseases and utilization as a functional ingredient in novel product development.
Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes
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 global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health.
Lin, Lin; Allemekinders, Hanja; Dansby, Angela; Campbell, Lisa; Durance-Tod, Shaunda; Berger, Alvin; Jones, Peter JH
Canola oil-based diets have been shown to reduce plasma cholesterol levels in comparison with diets containing higher levels of saturated fatty acids. Consumption of canola oil also influences biological functions that affect various other biomarkers of disease risk. Previous reviews have focused on the health effects of individual components of canola oil. Here, the objective is to address the health effects of intact canola oil, as this has immediate practical implications for consumers, nutritionists, and others deciding which oil to consume or recommend. A literature search was conducted to examine the effects of canola oil consumption on coronary heart disease, insulin sensitivity, lipid peroxidation, inflammation, energy metabolism, and cancer cell growth. Data reveal substantial reductions in total cholesterol and low-density lipoprotein cholesterol, as well as other positive actions, including increased tocopherol levels and improved insulin sensitivity, compared with consumption of other dietary fat sources. In summary, growing scientific evidence supports the use of canola oil, beyond its beneficial actions on circulating lipid levels, as a health-promoting component of the diet. PMID:23731447
Lin, Lin; Allemekinders, Hanja; Dansby, Angela; Campbell, Lisa; Durance-Tod, Shaunda; Berger, Alvin; Jones, Peter J H
Canola oil-based diets have been shown to reduce plasma cholesterol levels in comparison with diets containing higher levels of saturated fatty acids. Consumption of canola oil also influences biological functions that affect various other biomarkers of disease risk. Previous reviews have focused on the health effects of individual components of canola oil. Here, the objective is to address the health effects of intact canola oil, as this has immediate practical implications for consumers, nutritionists, and others deciding which oil to consume or recommend. A literature search was conducted to examine the effects of canola oil consumption on coronary heart disease, insulin sensitivity, lipid peroxidation, inflammation, energy metabolism, and cancer cell growth. Data reveal substantial reductions in total cholesterol and low-density lipoprotein cholesterol, as well as other positive actions, including increased tocopherol levels and improved insulin sensitivity, compared with consumption of other dietary fat sources. In summary, growing scientific evidence supports the use of canola oil, beyond its beneficial actions on circulating lipid levels, as a health-promoting component of the diet.
Young, D W; Pinakiewicz, D C; McCarthy, S M; Barrett, D; Kenagy, J
Many companies are beginning to focus on value in their health care purchasing decisions, and some are going beyond value-based purchasing to value-based partnering. Value-based partnering recognizes the interdependencies among stakeholder groups in the health care system and creates a strategic reason for them to exchange information and create long-term strategic alliances. This article discusses the principles of value-based partnering, impediments to practicing it and its future role in the health care system.
In 13 more years, the first of the baby boom generation will turn 65, becoming the heaviest users of the health care system. Do you know what the boomer patients will want? And are you ready to satisfy them? In this first part of a series on boomers and health care, we'll find out why boomers aren't happy about the current health care system.
Agarwal, Shanu; Abell, Virginia; File, Thomas M
Nosocomial Legionnaire's disease is most frequently associated with presence of the organism in hospital water systems. Patients are often susceptible as a result of age, underlying comorbidities, or immunosuppression. Prevention focuses on reducing the reservoir within water systems and includes super heating, ultraviolent light, chlorination, silver-copper ionization, and distal filtration. This article reviews the epidemiology of health care-associated Legionnaire's disease, reviews characteristics of several health care-associated outbreaks, and discusses strategies to prevent health care-associated infection.
RD-RI54 682 EXCELLENCE WiTHIN THE NAVY HEALTH CARE SYSTEM (U) NAVAL I. POSTGRADUATE SCHOOL MONTEREY CA J A NORTON DEC 84 UNCLRSSIFIED F/G 6/12...STANDAROS-1963-A -J% * .NAVAL POSTGRADUATE SCHOOL Monterey, California DTIC THESIS EXCELLENCE WITHIN THE NAVY HEALTH CARE SYSTEM by JAMES ALFRED NORTON...Within the Navy Health Care December 1984 System S. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(s) I. CONTRACT OR GRANT NUMBER(@) James Alfred Norton S
Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O
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.
Schiozer, Rafael Felipe; Saito, Cristiana Checchia; Saito, Richard
This paper analyzes the relationship between the financial health and organizational form of private health care providers in Brazil. It also examines the major determinants of customer satisfaction associated with the provider's organizational form. An adjusted Altman's z-score is used as an indicator of financial health. A proxy variable based on customer complaints filed at the Brazilian National Agency for Supplementary Health is used as an indicator for customer satisfaction. The study uses a sample of 270 private health care providers and their operations over the period 2003-2005. Panel data analysis includes control variables related to market, operations, and management. Principal results indicate that: (1) private health care providers benefit from economies of scale; (2) self-funded health plans have better financial health; (3) spending on marketing does not have a significant impact on customer satisfaction in Brazil; (4) weak empirical evidence exists showing that good financial performance enhances customer's satisfaction.
Goodman, C S; Gelijns, A C
having considerable effects on investment patterns and the development, adoption, and use of new technologies. Until recently, new technologies that offered the prospect for health benefit, however, marginal or unproven, were paid for with little or no regard to cost. Technical wizardry alone no longer carries the day in health care. Today's health care market increasingly demands what other markets do--measurable improvements in benefits at acceptable costs--and innovators have begun to respond accordingly. Even so, certain key venues for health care innovation are at risk.
Consumer health-care information technology is intended to improve patients' opportunities to gather information about their own health. Ideally, this will be achieved through an improved involvement of existing data bases and an improved communication of information to patients and to care providers, if desired by patients. Additionally, further interconnection of existing and new systems and pervasive system design may be used. All consumer health-care information technology services are optional and leave patients in control of their medical data at all times. This article reflects the current status of consumer health-care information technology research and suggests further research areas that should be addressed.
Malvey, Donna; Alderman, Barbara; Todd, Andrew D
The use of blogs in the workplace has emerged as a communication tool that can rapidly and simultaneously connect managers with their employees, customers, their peers, and other key stakeholders. Nowhere is this connection more critical than in health care, especially because of the uncertainty surrounding health care reform and the need for managers to have access to timely and authentic information. However, most health care managers have been slow to join the blogging bandwagon. This article examines the phenomenon of blogging and offers a list of blogs that every health care manager should read and why. This article also presents a simplified step-by-step process to set up a blog.
Wentzer, Helle; Bygholm, Ann
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
Danovitch, Itai; Kan, David
Health care insurance plans covering treatment for substance use disorders (SUD) offer a wide range of benefits. Distinctions between health plan benefits are confusing, and consumers making selections may not adequately understand the characteristics or significance of the choices they have. The California Society of Addiction Medicine sought to help consumers make informed decisions about plan selections by providing education on the standard of care for SUD and presenting findings from an expert analysis of selected health plans. We developed an assessment framework, based on criteria endorsed by the American Society of Addiction Medicine, to rate the quality of SUD treatment benefits offered by a sample of insurance plans. We convened an expert panel of physicians to rate 16 policies of 10 insurance providers across seven categories. Data from published resources for 2014 insurance plans were extracted, categorized, and rated. The framework and ratings were summarized in a consumer-facing white paper. We found significant heterogeneity in benefits across comparable plans, as well as variation in the characterization and clarity of published services. This article presents findings and implications of the project. There is a pressing need to define requirements for SUD benefits and to hold health plans accountable for offering quality services in accordance with those benefits.
Latulipe, Celine; Melius, Kathryn A; Quandt, Sara A; Arcury, Thomas A
Background The United States government is encouraging physicians to adopt patient portals—secure websites that allow patients to access their health information. For patient portals to recognize their full potential and improve patient care, health care providers’ acceptance and encouragement of their use will be essential. However, little is known about provider concerns or views of patient portals. Objective We conducted this qualitative study to determine how administrators, clinic staff, and health care providers at practices serving a lower income adult population viewed patient portals in terms of their potential benefit, areas of concern, and hopes for the future. Methods We performed in-depth interviews between October 2013 and June 2014 with 20 clinic personnel recruited from health centers in four North Carolina counties. Trained study personnel conducted individual interviews following an interviewer guide to elicit perceptions of the benefits and disadvantages of patient portals. Interviews were recorded and transcribed. Research team members reviewed transcribed interviews for major themes to construct a coding dictionary. Two researchers then coded each transcript with any coding discrepancies resolved through discussion. Results The interviews revealed that clinic personnel viewed patient portals as a mandated product that had potential to improve communication and enhance information sharing. However, they expressed many concerns including portals’ potential to generate more work, confuse patients, alienate non-users, and increase health disparities. Clinic personnel expected few older and disadvantaged patients to use a portal. Conclusions Given that clinic personnel have significant concerns about portals’ unintended consequences, their uptake and impact on care may be limited. Future studies should examine ways portals can be implemented in practices to address providers’ concerns and meet the needs of vulnerable populations. PMID
Mahé, Antoine; Faye, Ousmane; N'Diaye, Hawa Thiam; Konaré, Habibatou Diawara; Coulibaly, Ibrahima; Kéita, Somita; Traoré, Abdel Kader; Hay, Roderick J.
OBJECTIVE: To evaluate, in a developing country, the effect of a short training programme for general health care workers on the management of common skin diseases--a neglected component of primary health care in such regions. METHODS: We provided a one-day training programme on the management of the skin diseases to 400 health care workers who worked in primary health care centres in the Bamako area. We evaluated their knowledge and practice before and after training. FINDINGS: Before training, knowledge about skin diseases often was poor and practice inadequate. We found a marked improvement in both parameters after training. We analysed the registers of primary health care centres and found that the proportion of patients who presented with skin diseases who benefited from a clear diagnosis and appropriate treatment increased from 42% before the training to 81% after; this was associated with a 25% reduction in prescription costs. Improved levels of knowledge and practice persisted for up to 18 months after training. CONCLUSIONS: The training programme markedly improved the basic dermatological abilities of the health care workers targeted. Specific training may be a reasonable solution to a neglected component of primary health care in many developing countries. PMID:16462986
Carpio-Obeso, M P; Shorr, M; Valdez-Salas, B
Salty bodies of water in desert zones are known worldwide. The Salton Sea in California, USA, and the Dead Sea between Israel and Jordan are located in arid areas at approximately the same latitude, which might explain some similarities. Both the Salton and Dead Seas have ecosystems consisting of a singular saline sea/hot desert interface. The Salton Sea, the largest inland body of water in California, is a saline lake in the Coachella and Imperial Valleys. The Imperial Valley is one of the 10 top agricultural areas in the United States. Several thermoelectric plants exploiting geothermal wells operate around the Salton Sea, and some areas comprise a National Wildlife Refuge. The Dead Sea (Sea of Salt in Hebrew), the lowest saline lake on earth, contains high concentrations of salts and is a reservoir of minerals with a unique evaporation regime. The Dead Sea salts are the raw materials for the production of several chemical and health products. Magnesium salts and sulfur-containing mud are used for treating human skin disorders, allergies, arthritis, and respiratory diseases. After visiting both zones, we recorded, analyzed, and compared the similarities and differences between the areas. Some differences were found in the geographic, orographic, hydraulic, and climatic properties, but the main difference is in the economic-industrial aspect. The characteristics and health aspects are described in this report.
Drati, Nathan; Kleiner, Brian
Managed care has become one of the leading developments in health care financial management, but ignorance and confusion surround its meaning and origins. Managed care seeks to reduced costs and increase profits while maintaining quality, yet the evidence that it is able to achieve these aims is mixed. The following analysis is a review of the events leading to the establishment of managed care and what it has become. Various terms and health care organizations involved in managed care are identified, with emphasis placed on the strengths and weaknesses of managed care programs. This analysis is performed to gain insight and better understanding of the direction health care financial management is headed in the 21st century.
Jennings, Bonnie M; Loan, Lori A; Heiner, Stacy L; Hemman, Eileen A; Swanson, Kristen M
Patient satisfaction can be enhanced by narrowing gaps between what health care consumers experience and what they expect. A study was therefore conducted to better understand health care experiences and expectations among Army beneficiaries. Data collected using focus groups were analyzed by using qualitative research methods. A concept was identified and labeled "Soldier Care." It involves first-line care delivered at the unit level as well as the interface between first-line care and military treatment facilities. There are four features of Soldier Care, i.e., provider competence, the sick call cycle, getting appointments, and unit leadership. Together, these features affect soldiers' time from injury to recovery. Insights about Soldier Care can provide decision-makers with direction for initiating changes that may contribute to improved soldier satisfaction with health care.
Cattaneo, Anna Giulia; Gornati, Rosalba; Sabbioni, Enrico; Chiriva-Internati, Maurizio; Cobos, Everardo; Jenkins, Marjorie R; Bernardini, Giovanni
Nanotechnology is expected to be promising in many fields of medical applications, mainly in cancer treatment. While a large number of very attractive exploitations open up for the clinics, regulatory agencies are very careful in admitting new nanomaterials for human use because of their potential toxicity. The very active research on new nanomaterials that are potentially useful in medicine has not been counterbalanced by an adequate knowledge of their pharmacokinetics and toxicity. The different nanocarriers used to transport and release the active molecules to the target tissues should be treated as additives, with potential side effects of themselves or by virtue of their dissolution or aggregation inside the body. Only recently has a systematic classification of nanomaterials been proposed, posing the basis for dedicated modeling at the nanoscale level. The use of in silico methods, such as nano-QSAR and PSAR, while highly desirable to expedite and rationalize the following stages of toxicological research, are not an alternative, but an introduction to mandatory experimental work.
One of the major challenges facing the nursing profession is the globalization of nursing education, research, and practice. The word diversity is derived from the Latin word divertere meaning being different or having differences. Diversity in nursing practice means providing competent care to clients from different cultures, conducting research in multi-cultural settings, and implementing educational programs to diverse populations. Key principles and practices that provide a framework for diverse relationships in nursing practice, research, and education must be driven by a professional commitment in building a global community that is inclusive, respectful, and dedicated to global health care for all. Through international collaborations and individual and collective partnerships, nurses can build bridges between and among national health care systems, strengthen the international health care infrastructure, broaden health care delivery systems, and improve the quality of health care for all.
Cornett, Becky Sutherland
Our health-care system is burdened with high costs, health-care disparities, overtreatment, undertreatment, high error rates, and fraud and abuse. At the same time, the United States has achieved spectacular medical advances using the latest technology. As a result, health-care quality measurement, publicly reported patient safety and quality indicators, and evaluation of patients' experience of care are watchwords of a new era of accountability for health-care professionals and organizations. The health-care industry is subject to increasing regulation, private sector challenges, and public demand to make significant improvements in all three components of the quality triad: structure, process, and outcome. This article examines regulatory initiatives and industry trends pertaining to patient safety and quality measurement and concludes with specific suggestions for the professions of speech-language pathology and audiology.
Kuklinski, Margaret R.; Briney, John S.; Hawkins, J. David; Catalano, Richard F.
This paper presents a cost-benefit analysis of the Communities That Care (CTC) prevention system, a public health approach to reducing risk, enhancing protection, and reducing the prevalence of adolescent health and behavior problems community wide. The analysis is based on outcomes from a panel of students followed from Grade 5 through Grade 8 in a randomized controlled trial involving 24 communities in 7 states. Previous analyses have shown that CTC prevented the initiation of cigarette smoking, alcohol use, and delinquency by the end of 8th grade in CTC communities compared to controls. This paper estimates long-term monetary benefits associated with significant intervention effects on cigarette smoking and delinquency as compared to the cost of conducting the intervention. Under conservative cost assumptions, the net present benefit is $5,250 per youth, including $812 from the prevention of cigarette smoking and $4,438 from the prevention of delinquency. The benefit-cost ratio indicates a return of $5.30 per $1.00 invested. Under less conservative but still viable cost assumptions, the benefit-cost ratio due to prevention of cigarette smoking and delinquency increases to $10.23 per $1.00 invested. Benefits from CTC’s reduction in alcohol initiation as well as broader inclusion of quality-of-life gains would further increase CTC’s benefit-cost ratio. Results provide evidence that CTC is a cost-beneficial preventive intervention and a good investment of public dollars, even under very conservative cost and benefit assumptions. PMID:22108900
... 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...
Heron, W. David; Donatelli, Ben
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)
Dykeman, Sarah; Williams, Allison M
The Compassionate Care Benefit was implemented in Canada in 2004 to support employed informal caregivers, the majority of which we know are women given the gendered nature of caregiving. In order to examine how this policy might evolve over time, we examine the evolution of a similar employment insurance program, Canada's Maternity Leave Benefit. National media articles were reviewed (n = 2,698) and, based on explicit criteria, were analyzed using content analysis. Through the application of Kingdon's policy agenda-setting framework, the results define key recommendations for the Compassionate Care Benefit, as informed by the developmental trajectory of the Maternity Leave Benefit. Recommendations for revising the Compassionate Care Benefit are made.
The Compassionate Care Benefit was implemented in Canada in 2004 to support employed informal caregivers, the majority of which we know are women given the gendered nature of caregiving. In order to examine how this policy might evolve over time, we examine the evolution of a similar employment insurance program, Canada’s Maternity Leave Benefit. National media articles were reviewed (n = 2,698) and, based on explicit criteria, were analyzed using content analysis. Through the application of Kingdon’s policy agenda-setting framework, the results define key recommendations for the Compassionate Care Benefit, as informed by the developmental trajectory of the Maternity Leave Benefit. Recommendations for revising the Compassionate Care Benefit are made. PMID:24758563
Coile, R C
The arrival of the Internet offers the opportunity to fundamentally reinvent medicine and health care delivery. The "e-health" era is nothing less than the digital transformation of the practice of medicine, as well as the business side of the health industry. Health care is only now arriving in the "Information Economy." The Internet is the next frontier of health care. Health care consumers are flooding into cyberspace, and an Internet-based industry of health information providers is springing up to serve them. Internet technology may rank with antibiotics, genetics, and computers as among the most important changes for medical care delivery. Utilizing e-health strategies will expand exponentially in the next five years, as America's health care executives shift to applying IS/IT (information systems/information technology) to the fundamental business and clinical processes of the health care enterprise. Internet-savvy physician executives will provide a bridge between medicine and management in the adoption of e-health technology.
Key, T J; Davey, G K; Appleby, P N
Compared with non-vegetarians, Western vegetarians have a lower mean BMI (by about 1 kg/m2), a lower mean plasma total cholesterol concentration (by about 0.5 mmol/l), and a lower mortality from IHD (by about 25%). They may also have a lower risk for some other diseases such as constipation, diverticular disease, gallstones and appendicitis. No differences in mortality from common cancers have been established. There is no evidence of adverse effects on mortality. Much more information is needed, particularly on other causes of death, other morbidity including osteoporosis, and long-term health in vegans. The evidence available suggests that widespread adoption of a vegetarian diet could prevent approximately 40,000 deaths from IHD in Britain each year.
Booth, Mark; Hill, Graham; Moore, Michael J; Dalla, Danielle; Moore, Michael G; Messenger, Anne
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.
delivery, benign gynecological disorders, postpartum care, and surgical, medical, and radiation treatment of breast, ovarian, cervical, and uterine...installations reported offering female- specific programs or activities, such as a post-deployment group for female servicemembers or a postpartum ...specialized services, such as obstetric care (which includes prenatal, labor and delivery, and postpartum care) and the treatment of reproductive
Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica
The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670
Yi, Mu-Qing; Liu, Jian-Kang; Zhang, Yong
Adequate physical activity/exercise and nutrition are the footstone for health, and primary components of healthy life style and prevention and treatment of life style-related diseases. Here we briefly review the recent advances in mechanisms of health benefits of regular physical activity/exercise and adequate nutrition, mitochondrial nutrients, and so on.
Takaku, Reo; Bessho, Shun-Ichiro
Although the payment systems of public health insurance vary greatly across countries, we still have limited knowledge of their effects. To quantify the changes from a benefits in kind system to a refund system, we exploit the largest physician strike in Japan since the Second World War. During the strike in 1971 led by the Japan Medical Association (JMA), JMA physicians resigned as health insurance doctors, but continued to provide medical care and even health insurance treatment in some areas. This study uses the regional differences in resignation rates as a natural experiment to examine the effect of the payment method of health insurance on medical service utilization and health outcomes. In the main analysis, aggregated monthly prefectural data are used (N=46). Our estimation results indicate that if the participation rate of the strike had increased by 1% point and proxy claims were refused completely, the number of cases of insurance benefits and the total amount of insurance benefits would have decreased by 0.78% and 0.58%, respectively compared with the same month in the previous year. Moreover, the average amount of insurance benefits per claim increased since patients with relatively less serious diseases might have sought health care less often. Finally, our results suggest that the mass of resignations did not affect death rates.
Both private and public payers have experienced a persistent rise in health care spending that has exceeded income growth. The issue now transcends the health care system because health care spending growth threatens the fiscal health of the nation. This paper examines the causes and consequences of health care spending growth. It notes that the determinants of spending growth may differ from the determinants of high spending at a point in time. Specifically, the evidence overwhelmingly suggests that the primary driver ofinflation-adjusted, per capita spending growth over the past decades (and thus premium growth) has been the diffusion of new medical technology. The paper argues that while new technology has provided significant clinical benefit, we can no longer afford the persistent gap between health spending and income growth. In simple terms, if the economy is growing 2%, we cannot afford persistent health care spending growth of 4%. Growth in public spending is particularly important. If not abated, high public spending will require either substantially higher taxes or debt, both of which could lead to fiscal Armageddon. Growth in private spending also threatens economic well-being by forcing more resources toward health care and away from other sectors. For example, since the cost of employer-based coverage is always borne by employees (directly or indirectly), salary increases and health care cost increases cannot continue on together. To avoid economic disaster, payers will be forced to have a greater resolve in the future. Specifically, because neither public nor private payers will be able to finance growing health care spending, the coming decade will likely experience significant changes in health care financing. Consumers may be asked to pay more out of pocket when they seek care and both public and private payers will put increasing pressure on payment rates. Furthermore, payment rates to providers are likely to rise more slowly than in the past
Lee, Joshua; Vlahov, David; Freudenberg, Nicholas
Factors associated with primary care utilization and health insurance coverage were examined among 511 women leaving jail in New York City from 1997-2001. One year after release, roughly half of the sample reported primary care utilization (47%) and health insurance coverage (56%). Neither outcome was more likely among those reporting diabetes, asthma, or depression. Primary care utilization was more likely among those reporting receipt of public benefits, health insurance coverage, moderate social support, avoidance of illegal activity, and HIV seropositivity. Health insurance coverage was associated with receipt of public benefits, hospitalization, primary care, and avoiding re-arrest. This study demonstrated that a majority of women leaving jail, including those with chronic diseases, lack primary care. These data highlight the need to plan for continuity of care from corrections to the community and suggest further that this can be facilitated with provision of health benefits and social support.
Mudryj, Adriana N; Yu, Nancy; Aukema, Harold M
Pulses (beans, peas, and lentils) have been consumed for at least 10 000 years and are among the most extensively used foods in the world. A wide variety of pulses can be grown globally, making them important both economically as well as nutritionally. Pulses provide protein and fibre, as well as a significant source of vitamins and minerals, such as iron, zinc, folate, and magnesium, and consuming half a cup of beans or peas per day can enhance diet quality by increasing intakes of these nutrients. In addition, the phytochemicals, saponins, and tannins found in pulses possess antioxidant and anti-carcinogenic effects, indicating that pulses may have significant anti-cancer effects. Pulse consumption also improves serum lipid profiles and positively affects several other cardiovascular disease risk factors, such as blood pressure, platelet activity, and inflammation. Pulses are high in fibre and have a low glycemic index, making them particularly beneficial to people with diabetes by assisting in maintaining healthy blood glucose and insulin levels. Emerging research examining the effect of pulse components on HIV and consumption patterns with aging populations indicates that pulses may have further effects on health. In conclusion, including pulses in the diet is a healthy way to meet dietary recommendations and is associated with reduced risk of several chronic diseases. Long-term randomized controlled trials are needed to demonstrate the direct effects of pulses on these diseases.
Grumbach, Kevin; Bodenheimer, Thomas
In health care settings, individuals from different disciplines come together to care for patients. Although these groups of health care personnel are generally called teams, they need to earn true team status by demonstrating teamwork. Developing health care teams requires attention to 2 central questions: who is on the team and how do team members work together? This article chiefly focuses on the second question. Cohesive health care teams have 5 key characteristics: clear goals with measurable outcomes, clinical and administrative systems, division of labor, training of all team members, and effective communication. Two organizations are described that demonstrate these components: a private primary care practice in Bangor, Me, and Kaiser Permanente's Georgia region primary care sites. Research on patient care teams suggests that teams with greater cohesiveness are associated with better clinical outcome measures and higher patient satisfaction. In addition, medical settings in which physicians and nonphysician professionals work together as teams can demonstrate improved patient outcomes. A number of barriers to team formation exist, chiefly related to the challenges of human relationships and personalities. Taking small steps toward team development may improve the work environment in primary care practices.
... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ... manage stress. National Institute for Occupational Safety and Health
Myers, Wayne; Russell, Jack; Baldwin, Fred D.
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…
Lindley, Lisa C
Within the Patient Protection and Affordable Care Act of 2010 or health care reform, is a relatively small provision about concurrent curative care that significantly affects terminally ill children. Effective on March 23, 2010, terminally ill children, who are enrolled in a Medicaid or state Children's Health Insurance Plans (CHIP) hospice benefit, may concurrently receive curative care related to their terminal health condition. The purpose of this article was to conduct a policy analysis of the concurrent curative care legislation by examining the intended goals of the policy to improve access to care and enhance quality of end of life care for terminally ill children. In addition, the policy analysis explored the political feasibility of implementing concurrent curative care at the state-level. Based on this policy analysis, the federal policy of concurrent curative care for children would generally achieve its intended goals. However, important policy omissions focus attention on the need for further federal end of life care legislation for children. These findings have implications nurses.
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
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.
Valdivieso D, Vicente; Montero L, Joaquín
Five years ago Chile implemented a Health Care Reform to reduce the great inequalities in health care provision that affects the low- income, high-risk segment of its population. A universal care plan ("AUGE") was designed to make medical coverage available to all Chilean citizens suffering from one of a specified, growing list of diseases (66 at present time). The diseases are prioritized by the Ministry of Health and its inclusion in the plan is revised periodically by an Advisory Committee according to four cardinal criteria: burden of disease, effectiveness of treatment, specific capacity of the health system and financial costs. The plan is funded by the state and enforced by law through a set of four specific guarantees: access, opportunity, quality and financial protection. This paper reviews the origin and development of the reform, the benefits and drawbacks of the application of the specific guarantees and the perception of the public regarding its strengths and weaknesses.
Burnes Bolton, Linda; Giger, Joyce Newman; Georges, C Alicia
Limited access to health care and a system fraught with discriminatory practices inhibit some racial and ethnic minorities from gaining access to health care and assurance of equal treatment once they enter the health care system. The purpose of this chapter is to critically and systematically analyze the research literature to determine what impact individual and institutional racism has had on the prevailing health disparities across racial and ethnic minority groups. The chapter includes the following: (1) a review of the term racism and a brief overview of the history of racism in health care; (2) a review of the research literature analyzing the impact of racism on health disparities; and (3) recommendations to end the systematic institutional racism in scientific research, which is necessary to end health disparities.
... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...
... 42 Public Health 3 2013-10-01 2013-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE...
... 42 Public Health 3 2014-10-01 2014-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE...