Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Income Generation Programs”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Medicare reform: who pays and who benefits?

As Medicare's share of federal spending and gross domestic product (GDP) rises, the program may have increasingly important consequences not only for the health of Americans but also for their net income and financial well-being. We use incidence analysis to study payments and benefits in Medicare to various generations and income groups. We find that Medicare actually provides larger net dollar transfers to wealthier beneficiaries, although the "insurance value" of these dollars is greater for low-income households. We then evaluate a range of proposed Medicare reforms with regard to their impact on the distribution of both health care and disposable income.

Aged↗
PubMed1999

Income inequality, social cohesion, and class relations: a critique of Wilkinson's neo-Durkheimian research program.

Wilkinson's "income inequality and social cohesion" model has emerged as a leading research program in social epidemiology. Public health scholars and activists working toward the elimination of social inequalities in health can find several appealing features in Wilkinson's research. In particular, it provides a sociological alternative to former models that emphasize poverty, health behaviors, or the cultural aspects of social relations as determinants of population health. Wilkinson's model calls for social explanations, avoids the subjectivist legacy of U.S. functionalist sociology that is evident in "status" approaches to understanding social inequalities in health, and calls for broad policies of income redistribution. Nevertheless, Wilkinson's research program has characteristics that limit its explanatory power and its ability to inform social policies directed toward reducing social inequalities in health. The model ignores class relations, an approach that might help explain how income inequalities are generated and account for both relative and absolute deprivation. Furthermore, Wilkinson's model implies that social cohesion rather than political change is the major determinant of population health. Historical evidence suggests that class formation could determine both reductions in social inequalities and increases in social cohesion. Drawing on recent examples, the authors argue that an emphasis on social cohesion can be used to render communities responsible for their mortality and morbidity rates: a community-level version of "blaming the victim." Such use of social cohesion is related to current policy initiatives in the United States and Britain under the New Democrat and New Labor governments.

Community Health Planning↗
PubMed1997

Markets and public programs: insights from Oregon and Tennessee.

Medicaid is the major national program promoting access to care for low-income populations, but the program also is a federal-state partnership. With costs rising and universal access still a remote objective, many states have turned to market-based strategies involving managed care, with the goals of generating savings for the state, improving access for Medicaid beneficiaries, and sometimes expanding coverage to those who were previously uninsured. Yet Medicaid is a complex social insurance system that over time has been used to finance a variety of needs, often using cross-subsidies. In addition, states vary in both the scope of their Medicaid programs and the sophistication of the skills and resources they can bring to bear in shaping them. Understanding how these influence the ability to implement market-based strategies in Medicaid and what the effects of these strategies appear to be is of crucial importance because most states now include some features of this approach in their programs.

Health Care Reform↗
PubMed1995

Can not-for-profits learn from for-profits?

Marketing management will help you maintain service quality, keep donors satisfied and generate a dependable source of income. For-profits survive on these activities.

Fund Raising↗
PubMed2002

Change in the U.S. health care system: effects on physician retirement and implications for health care managers.

Several authors have postulated that managed care and other related changes in the U.S. health care system, perceived negatively by mature physicians, may contribute to their early retirement. This, in turn, may produce adverse effects on the availability of medical care. The authors investigate this and other related issues through analysis of a unique data set obtained from a survey of nearly four thousand physicians that elicited responses to numerous factors potentially relevant to their retirement decisions. The empirical analysis reveals that, while managed care is an important factor in the retirement decision of physicians, it does not necessarily lead to earlier retirement. Physicians rank other factors, related to financial and personal issues, as more important in their retirement decisions and the authors find that several of these factors significantly impact their expected retirement age. The results have several implications for health care managers relating to the retention or retirement of practicing physicians, successful planning, and seamless generation of income.

Decision Making↗
PubMed2005

Maternal employment and income affect dietary calorie adequacy in households in Sri Lanka.

Nutritional deficiencies among children and mothers in lower-income households in Sri Lanka continue to be a major obstacle to the country's social and economic development. This study investigates the factors affecting dietary caloric adequacy in Sri Lanka, paying special attention to maternal income. An econometric analysis was performed using a household data set collected from a sample of 183 low-income households in the urban, rural, and estate sectors. The results showed that on average, mothers and children in the sample did not consume adequate levels of calories according to the recommendations of the Medical Research Institute of Sri Lanka. The mother's income and educational status, the number of children and adults in the family, and the ages, sexes, and birth orders of the children significantly influenced household and individual caloric adequacy. Specifically, the mother's income had a significant positive effect on the total caloric intake (CI) and caloric adequacy ratio (CAR) of the household, mother, and children and a significant negative effect on the relative caloric allocation (RCA) of the children. The results imply that when maternal employment generates extra income, the CIs of all individuals increase, yet the allocation of calories to the children of the household is reduced. Thus, provision of employment opportunities for mothers, along with adequate child-care facilities and nutritional educational programs, is a possible strategy to improve caloric adequacy among low-income households in Sri Lanka.

Adult↗
PubMed1989

[Maximization of economic yield, minimum cost optimal diets and cultivation diversification for small scale farmers of the highland region of Guatemala].

The present study was conducted as part of an evaluation of the economic and nutritional effects of a crop diversification program for small-scale farmers in the Western highlands of Guatemala. Linear programming models are employed in order to obtain optimal combinations of traditional and non-traditional food crops under different ecological conditions that: a) provide minimum cost diets for auto-consumption, and b) maximize net income and market availability of dietary energy. Data used were generated by means of an agroeconomic survey conducted in 1983 among 726 farming households. Food prices were obtained from the Institute of Agrarian Marketing; data on production costs, from the National Bank of Agricultural Development in Guatemala. The gestation periods for each crop were obtained from three different sources, and then averaged. The results indicated that the optimal cropping pattern for the minimum-cost diets for auto consumption include traditional foods (corn, beans, broad bean, wheat, potato), non-traditional foods (carrots, broccoli, beets) and foods of animal origin (milk, eggs). A significant number of farmers included in the sample did not have sufficient land availability to produce all foods included in the minimum-cost diet. Cropping patterns which maximize net incomes include only non-traditional foods: onions, carrots, broccoli and beets for farmers in the low highland areas, and raddish, broccoli, cauliflower and carrots for farmers in the higher parts. Optimal cropping patterns which maximize market availability of dietary energy include traditional and non-traditional foods; for farmers in the lower areas: wheat, corn, beets, carrots and onions; for farmers in the higher areas: potato, wheat, raddish, carrots and cabbage.

Agriculture↗
PubMed2006

Decision analysis model for paratuberculosis control in commercial dairy herds.

A previous economic test-and-cull decision analysis model has been strengthened and updated with current epidemiologic information. Created using Excel and PrecisionTree software, the model incorporates costs and benefits of herd management changes, diagnostic testing, and different management actions based on test results to control paratuberculosis in commercial dairy herds. This novel "JD-Tree" model includes a herd management decision node (four options), a test/no test decision node (two options), a diagnostic test choice decision node (five options), test result chance nodes (four levels of possible results), and test action decision nodes (three options; cull, manage, no action). The model culminates in a chance node for true infection status. Outcomes are measured as a net cost-benefit value to the producer. The model demonstrates that improving herd management practices to control infection spread (hygiene) is often more cost-effective than testing; not all herds should test as part of a paratuberculosis control program. For many herds, low-cost tests are more useful than more sensitive, higher cost tests. The model also indicates that test-positive cows in early stages of infection may be retained in the herd to generate farm income, provided they are managed properly to limit infection transmission. JD-Tree is a useful instructional tool, helping veterinarians understand the complex interactions affecting the economics of paratuberculosis control and to define the accuracy and cost specifications of better diagnostic tests.

Animals↗
PubMed1992

Compensating and providing incentives for academic physicians: balancing earning, clinical, research, teaching, and administrative responsibilities.

Providing a comprehensive compensation and incentive plan for a group of faculty members in a department with multiple goals provides a challenge that few administrators may take. Many academic departments have given up on implementing a comprehensive compensation and incentive plan since department goals generate competing uses of a faculty member's time. Whatever the plan design your department adopts, you can be sure that it will generate controversy. The JPN department has attempted to reward and encourage faculty members to pursue scholarly activities balanced with clinical activities. As a result, this strategy has only considered physicians who can generate both clinical income and research funding. Thus far, the JPN department faculty have embraced the plan. Long-term effects are not known as this is the first year of the plan. The measure of a successful total compensation program is one that develops a sense of entrepreneurship among its members to develop new clinical programs, to pursue new research collaborations, and to devise innovative methods of training. The program described in this article is not intended to serve as the ideal model for all departments, even in academic institutions, but rather to provide a strategy that may have applicability to many other departments where the goals induce inherent conflict for faculty members attempting to decide where to place their time commitments. In addition, this strategy does not work well on an individual basis for young, beginning faculty members but does work well in the collective--to promote the goals of the department. Be prepared, however, to modify your plan after a trial period of perhaps two years. You must allow time to monitor the effects of your compensation plan and its impact on the goals and direction of the department.

Academic Medical Centers↗
PubMed2002

Exemplars of successful Alzheimer's demonstration projects.

The Alzheimer's Demonstration program was established in 1991 to develop models of home and community-based care for persons with Alzheimer's disease and their families. After more than ten years of program experience and evaluation, the Alzheimer's Demonstration program has generated significant information about how to work successfully with families coping with Alzheimer's disease. In particular, the Demonstration program has been very successful in developing innovative program models and approaches to serving traditionally underserved populations such as ethnic minorities, low income, and rural families. Of particular interest is the significant number of successful project components that are replicable in a variety of community settings. This article provides detailed programmatic and replication information for successful Alzheimer's Demonstration program models: Mobile Day Care Rural Geriatric Dementia Evaluation, El Portal services for Latino, Client Advocates, and AL-CARE services for clients who live alone.

Adaptation, Psychological↗
PubMed1989

Homeless women with minor children in the Detroit metropolitan area.

Eighty-seven homeless families served by the emergency shelter of the Coalition on Temporary Shelter in Detroit during the first quarter of 1987 were studies through a review of admission data. Most of the families were black and contained an adult female with one or two minor children. Most of the mothers were young, did not have a high school diploma, and had no income. Some had histories of psychiatric disorders or substance abuse. Many had been in a dependent living situation before becoming homeless. Children accounted for more than one-fourth of admissions during the study period. Policies should address prevention of homelessness through income support programs, provision of low-income housing, basic living skill training programs, and mental health service delivery. When available resources fail in prevention, programming should address the effects of homelessness on children, because these effects perpetuate a cycle that will increase the homeless population in future generations.

Adolescent↗
PubMed2005

Sustainable pattern analysis of a publicly owned Material Recovery Facility in a fast-growing urban setting under uncertainty.

Sustainable development goals are achievable through the installation of Material Recovery Facilities (MRFs) in certain solid waste management systems, especially those in rapidly expanding multi-district urban areas. MRFs are a cost-effective alternative when curbside recycling does not demonstrate long-term success. Previous capacity planning uses mixed integer programming optimization for the urban center of the city of San Antonio, Texas to establish that a publicly owned material recovery facility is preferable to a privatized facility. As a companion study, this analysis demonstrates that a MRF alleviates economic, political, and social pressures facing solid waste management under uncertainty. It explores the impact of uncertainty in decision alternatives in an urban environmental system. From this unique angle, waste generation, incidence of recyclables in the waste stream, routing distances, recycling participation, and other planning components are taken as intervals to expand upon previous deterministic integer-programming models. The information incorporated into the optimization objectives includes economic impacts for recycling income and cost components in waste management. The constraint set consists of mass balance, capacity limitation, recycling limitation, scale economy, conditionality, and relevant screening restrictions. Due to the fragmented data set, a grey integer programming modeling approach quantifies the consequences of inexact information as it propagates through the final solutions in the optimization process. The grey algorithm screens optimal shipping patterns and an ideal MRF location and capacity. Two case settings compare MRF selection policies where optimal solutions exemplify the value of grey programming in the context of integrated solid waste management.

Algorithms↗
PubMed2000

"Second-generation" Medicaid managed care: can it deliver?

This article offers insight into what we term "second-generation" Medicaid managed care. In case studies of seven States, we examined three critical questions: (1) Does managed care experience facilitate program operations? (2) Can Medicaid managed care deliver on important goals? and (3) Can States extend the program beyond low-income families and children to others? The answers are encouraging but also suggest caution. Medicaid managed care is not a solution to fundamental problems facing the Medicaid program. It may be a tool to encourage better delivery of care. This requires a long-term commitment and adequate financing to develop stable partnerships with all stakeholders.

Aged↗
PubMed1993

Coordinated strategies for controlling micronutrient malnutrition: a technical workshop.

Participants in a November 1991 workshop concluded that coordinated strategies for controlling malnutrition due to iodine, iron, vitamin A and other micronutrients deficiencies are technically feasible and should be given consideration in planning control efforts. Coordinated surveys involving clinical, biochemical and dietary assessment of multiple micronutrients are feasible. Multiple fortification is also possible using such vehicles as salt, processed rice or sugar. Supplementation efforts can be integrated with existing health care programs. Food-based strategies are also effective. The best examples have been community-based and have included a strong nutrition and health education component designed to change food consumption patterns, improve food preservation and preparation practices, and link income-generating activities with food production activities. Successful coordinated efforts will require a strong political commitment and a supportive infrastructure. Specific recommendations include the formation of national coordinating bodies for micronutrient deficiency control, establishment of a micronutrient information network and expansion of technical exchange and training.

Developing Countries↗
PubMedDate not supplied

Benefits of the Comprehensive Child Development Program as a function of AFDC receipt and SES.

The benefits for children at the Pittsburgh site of the federal Comprehensive Child Development Program (CCDP) were examined as a function of family welfare status (Aid to Families with Dependent Children; AFDC) and SES. The CCDP was the largest attempt by the federal government to provide two-generation, case-managed, comprehensive services to low-income families. Participating families could set their own goals and choose services to achieve them, but relatively few services were directed specifically at children. Results showed that more Pittsburgh families in the CCDP treatment group (N = 120) left AFDC than in the control group (N = 120), consistent with results from a national evaluation of the CCDP. Children whose families were on AFDC regardless of treatment group had lower mental test scores, even after controlling for family SES, a result suggesting that AFDC receipt over and above income level was associated with poorer child mental performance. The CCDP was associated with higher children's mental scores plus improvements over time in achievement scores only for children in families who were not on AFDC, even after controlling for SES. Such parents were more likely to choose parenting and child goals and services, which in turn were associated with higher child mental scores. In contrast, parents who were on AFDC tended to choose adult-centered goals and services, which did not benefit children. Therefore, in contrast to the national evaluation, which found no benefits of the CCDP for children, these analyses showed that the CCDP did produce benefits for children whose parents were not on AFDC, who tended to choose parenting and child services.

Aid to Families with Dependent Children↗
PubMed1978

The Aroman food crisis: a fable with a lesson for national health insurance.

An analogy is always imperfect. Nevertheless, at times it is an effective way to communicate an insight. This paper uses an analogy to examine the consequences of attempting to achieve health sector efficiency through regulation, instead of consumer cost-sharing. It is suggested that as long as hospital care continues to be virtually "free" to patients at the time of use, such regulation may well do more harm than good. Moreover, a national health insurance plan that would make all medical care "free" to patients, and would pay for all health care through taxes (the proposed Health Security Act), would not only generate significant inefficiency; but, in contrast to the intentions of its supporters, would prove harmful to the poor and the elderly, by shifting scarce Federal tax dollars away from the programs that assist them in order to pay the medical bills of middle and upper income households. It is therefore urged that we enact income-related catastrophic national health insurance, that would place a ceiling, which varies with household income, on the financial burden a household must bear; but at the same time, would require most families to pay part of their own medical cost out-of-pocket, so that consumer cost-consciousness can help promote health sector efficiency.

Community Participation↗
PubMed2001

Duckweed based wastewater treatment (DWWT): design guidelines for hot climates.

Conventional wastewater treatment systems are expensive in either investment or running costs. On the other hand, waste stabilisation ponds may be unable to meet effluent standards for nutrients. Wastewater treatment using duckweed therefore becomes more significant as an option capable of achieving effluent standards and generating revenue from selling the duckweed. However existing duckweed based wastewater treatment (DWWT) systems have high land requirements despite being able to reduce concentrations of organic compounds and pathogens to acceptable levels. Improved guidelines for the design of DWWT are necessary to obtain a reliable and cost-effective wastewater treatment plant using duckweed. This guideline provides a DWWT design program using spreadsheets for different configurations of wastewater treatment units using duckweed. The design program developed suggests that a combination of anaerobic ponds, DWWT systems and maturation ponds can minimise land requirements and capital costs while achieving specified effluent standards. In order to achieve effluent standards, the land required is typically from 1.5 to 1.8 m2/capita (excluding associated facilities), capital costs are in the range from 7.9 to 9.7 USD/capita, with a retention time from 15 to 18 days. Income generation is dependent mainly on the social and cultural acceptability of duckweed use within the community.

Adsorption↗
PubMed1986

Mammographic screening: how to operate successfully at low cost.

To offer mammographic screening to asymptomatic women at low cost requires a different approach than is appropriate for solving the more complex problems presented by symptomatic patients. Since the goal of screening is to detect unsuspected abnormalities, not to characterize them fully, operational procedures can be streamlined to maximize patient throughput and achieve substantial cost savings. Such procedures will be successful only if applied to large numbers of patients, thereby permitting cost reduction by economies of large-scale operation. Computerization of record-keeping and of image interpretation is ideally suited for screening examinations and permits further cost savings. Experience with a prototype low-cost screening program has shown that with only 15 patients per day, operation is feasible at a charge of $50 per patient. The income lost from asymptomatic patients, who will pay lower fees compared with the traditional mammography fees they now pay, is more than offset by the income generated by additional problem-solving mammograms needed to fully characterize screening-detected abnormalities and by the increased use of needle localization procedures to guide biopsy.

Breast Neoplasms↗