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At least 217 records · Page 12Linked to original sources
PubMed1989

Umbilical cord blood serosurvey for human immunodeficiency virus in parturient women in a voluntary hospital in New York City.

The potential spread of the human immunodeficiency virus (HIV) to childbearing women in areas of high acquired immunodeficiency syndrome (AIDS) endemicity is a major public health concern. As a private institution providing obstetric care to such a population of women, we undertook an anonymous HIV cord blood serosurvey to estimate the number of childbearing women at our institution at risk for perinatal transmission of the virus and to assess the success of our voluntary screening program to identify seropositive women. Between November 1987 and January 1988, cord blood samples from all clinic deliveries were analyzed for the presence of HIV antibody. For each sample obtained, the mother's age and site of prenatal care were known. Overall, 2.7% (six of 224) of the samples tested were seropositive; two of the 34 samples (5.9%) from teenage mothers were seropositive. All positive samples were from women who received prenatal care; none were identified through a voluntary screening program based on patient self-acknowledged risk-behavior assessment. This confirms that risk factor history elicited by personal interview is not a reliable screening tool for initiating HIV antibody counseling and testing. The high seropositive rate in teenagers is disturbing and needs further assessment.

AIDS Serodiagnosis↗
PubMed1992

Surveillance of human immunodeficiency virus (HIV) antibodies in medicolegal autopsies in Finland--monitoring early changes in HIV-seropositivity among risk groups and average population.

In order to cooperate with voluntary screening programs aimed at the surveillance of the HIV epidemic in Finland, we have studied medicolegal autopsies for HIV antibodies since 1986 using an enzyme immunoassay on postmortem sera. The investigation covered 47.4% and 39.2%, respectively, of all deaths under the age of 65 years in the metropolitan areas of Helsinki and Turku--two cities on the densely populated southern coast of Finland from which most HIV infections have thus far been detected. Nine HIV-positive cases (0.12%) were detected among the 7305 medicolegal autopsies tested in 1986 to 1990. This figure is higher than the prevalence of 0.01 to 0.03% in voluntary screening programs for the general population would suggest. Seven of our cases had previously tested positive, and two were previously unknown cases, indicating that people at high risk are clustered in the medicolegal autopsy series. Of the six cases in an early stage of infection, three committed suicide suggesting the importance of HIV-screening in suicide cases in tracing symptomless HIV carriers. Five of the cases were detected in 1990, a year when the number of new HIV infections had more than doubled compared to the previous two years. This suggests that testing of medicolegal autopsies as surrogate tests for the population gives useful information even in low-prevalence areas like Finland. Such testing has none of the ethical problems of many other back-up surveys, and may be particularly sensitive to early changes in epidemiology.

Adult↗
PubMed1995

Home health agencies: targets of anti-fraud and abuse investigations.

Increased health care fraud and abuse investigations could result in home health agencies, and other targets, becoming politically acceptable casualties of war in the battle to balance the federal budget. To protect themselves, home health agencies would be well advised to conduct internal fraud and abuse audits on an annual basis and to develop corporate compliance plans (see Newsletter, Vol. 9, No. 7, July 1994, at 16, and next month's issue, which will discuss corporate compliance programs as well as the OIG's new voluntary disclosure program). In addition, purchasers of home health agencies should be especially vigilant of fraud and abuse problems during the due diligence phase of the acquisition and, if problems are discovered, should consider whether voluntary disclosure to the OIG and settlement of any resulting claims is an appropriate condition of closing.

Aged↗
PubMed1988

Proficiency testing. Its role in a voluntary clinical Laboratory Accreditation Program.

The author's long experience as Chairman of the Laboratory Accreditation Program of the College of American Pathologists provides the background for this article. Laboratory accreditation and proficiency testing have now become an established part of the clinical laboratories in the United States. This article attempts to demonstrate the relationship between proficiency testing and accreditation, and highlights some of the current problems and future challenges facing proficiency testing as pertains to accreditation.

Academies and Institutes↗
PubMed1979

Voluntary dental laboratory certification program. Council on Prosthetic Services and Dental Laboratory Relations.

Laboratory certification does not offer concrete guarantees of consistent high quality of products or services. It does, however, identify, for the dental profession, a competency and acceptability factor on which to base a predication of performance by the laboratory. Also, laboratory certification establishes a framework within which the dental laboratory industry can work to continue upgrading its facilities and personnel, demonstrates the concern of certified laboratories for continuing competence, and indicates to government and third-party payers a willingness to develop standards endorsed by the industry.

Certification↗
PubMed1999

Legal audits and investigations: a key component of healthcare corporate compliance programs.

In today's complex legal environment, healthcare organizations are increasingly implementing voluntary compliance programs as a means of avoiding severe penalties for violations of the law. The Office of the Inspector General has identified legal audits and investigations as key components of effective compliance programs. The author demonstrates the applicability of legal audits and investigations to healthcare organizations by examining the audit and investigation process from beginning to end. The author also examines the role of attorneys in legal audits and investigations, and explains how information communicated from the healthcare organization to its attorneys can be protected from disclosure. As this Article indicates, the monetary and human resource costs of such compliance audits and investigations are insignificant when compared to the potential costs of defending a legal action or paying monetary penalties.

Confidentiality↗
PubMed1992

The planning, development, and implementation of a work-site health promotion program: a case study.

A voluntary health promotion program was introduced at an academic institution with 665 employees. The 239 employees who volunteered to participate in a health risk appraisal were significantly younger and more likely to be female than were nonparticipants. The prevalence rates of the major coronary heart disease risk factors in the participants were as follows: hypercholesterolemia, 25.5%; elevated blood pressure, 15.5%; and current cigarette smoker, 15.1%. In addition, many participants daily consumed food high in cholesterol or fat (54.2%), were obese (44.8%), and led sedentary lifestyles (28.5%). Although a majority of female participants had received physician/nurse breast examinations and had Papanicolaou smears taken during the previous year, only about half this number performed monthly breast self-examinations. A telephone survey of employees revealed the most desired health promotion program components to be stress reduction, nutrition counseling, exercise fitness, and weight reduction. The program is now being monitored for health benefits and program costs.

Adult↗
PubMed1970

CMA's proposal for a voluntary, universally available Health Benefits Program. A socio-economic report of the Bureau of Research and Planning, California Medical Association.

The May 4, 1970 issue of the American Medical News contains an article on a report released in April by the British Medical Association following a two-year study of the British National Health Service. Although the BMA study is oriented to the specific program as it has evolved in Great Britain since 1946, its main thrust is in the development of a system of voluntary health insurance which would provide for greater consumer choice, based upon nationally determined guidelines and regulations. BMA's recommendations would have the NHS utilize a combination of tax-supported and voluntary-supported mechanisms in providing medical services to various segments of the population, based upon categories of illness and income levels. Since the BMA proposal as reported in the AMA News parallels in some respects the one approved by the CMA House of Delegates and submitted to the AMA House of Delegates for its consideration, the reader will be interested in seeing the concept for a Voluntary Universally Available Health Benefits Program, independently developed by the California Medical Association. It is interesting to note that the CMA proposal attempts to avoid many of the problems with which the NHS has been identified, and at the same time would establish a single, coherent, integrated approach for development over the next decade, incorporating public programs into a unified system of medical care which utilizes the multiplicity of voluntary health insurance approaches and mechanisms.

California↗