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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.

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At least 235 records · Page 13Linked to original sources
PubMed1986

Governmental spending for mental retardation and developmental disabilities, 1977-1984.

A study of public spending for mental retardation and developmental disabilities in fiscal years 1977 through 1984 reveals that combined state and federal government spending grew by 23 percent despite diminished growth in federal spending after passage of the Omnibus Budget Reconciliation Act of 1981. Combined state and federal expenditures for community services grew by 40 percent, primarily because of an unprecedented rise in state spending. Total state and federal spending for institutional services plateaued, as a 26 percent drop in state appropriations was offset by an infusion of federal dollars, mostly through the Intermediate Care Facilities for the Mentally Retarded program. Federal, state, and local expenditures in fiscal 1984, estimated to total $16.49 billion, are assessed, and future trends in the financing of institutional and community services in the U.S. are discussed.

Child↗
PubMed2005

Why have academic medical centers survived?

Over the past decade, many observers predicted the demise of the academic medical center (AMC) due to competition from community hospitals and physicians, fragile finances, inefficiency, and organizational complexity. In 2004, we interviewed 23 AMC and community hospital administrators to determine why those predictions have proven unfounded, learn the leaders' current concerns and priorities, and to identify desirable changes. Chief concerns were reimbursement uncertainty, federal research policy, ineffective internal decision-making, and clinical quality (mentioned in more than 75% of interviews). Priorities included ensuring sufficient investment capital, revising undergraduate and graduate curricula, strengthening ties with physicians and community hospitals, attracting faculty, and meeting regulatory requirements. We advocate that the AMC: (1) modify the research model to allow greater collaboration with institutions and researchers; (2) enhance free and open export of new and proven clinical techniques and knowledge; (3) devote greater attention to meeting patients' increasing needs for counsel and guidance, not just intervention, given the plethora of complex new technologies and their promotion in the popular media; and (4) simplify their organizations. To accomplish this, it is desirable for future leaders to gain experience outside the AMC, and for faculty and institutions to be less inwardly focused and more attentive to preserving the public's trust.

Academic Medical Centers↗
PubMed1988

Faith and finance.

Explore the source record for details and available documents.

Community Health Nursing↗
PubMed1986

Expenditures for the medical care of elderly people living in the community in 1980.

Policy debates about financing medical care for the elderly are often clouded by evidence drawn from averages based on aggregate data. The National Medical Care Utilization and Expenditure Survey enables examination of the circumstances of the 95 percent of the elderly who are not institutionalized. A significant portion of out-of-pocket charges falls on the poor; public expenditures are highly concentrated for the relatively few elderly in their last year of life. Medicare and Medicaid have successfully lessened the burden on families.

Aged↗
PubMed1990

Tax levy gives hospital chance for survival.

In 1987, executives of Preston Memorial Hospital, Kingwood, W. Va., said the hospital risked closure in five years. But now the facility, bolstered by a special tax levy and community support, is being touted as an example of how a rural hospital can redefine itself to remain competitive in the marketplace.

Capital Financing↗
PubMed1990

Public-private solution to protection against the cost of long-term care.

The demographics of our population and our current reliance on Medicaid with a means test that no one likes suggest the need for revising our financing of long-term care. Given that persons with Alzheimer's disease and related dementias are a substantial proportion of those needing long-term care, support for research to cure or control these problems should be part of a strategy for addressing the problem of long-term care. However, even if substantial progress is made there is still a need for revising our method of financing long-term care. However, other pressing societal needs, such as reducing the 2 trillion dollar federal debt, addressing the needs of the growing number of children in poverty, and caring for the more than 30 million uninsured Americans, limit the role of the federal government in financing long-term care. A proposal to provide coverage for those with functional disabilities or cognitive impairment who need chronic home care and for the initial portion of nursing home stays within a social insurance program is outlined. More extensive coverage for nursing home stays would be provided for those with community-dwelling spouses. Major financing would be provided through either a payroll tax or by a federal income tax for all age groups with supplementation from estate taxes or capital gains taxes at death. Improvement of benefits in the Medicaid program and an important role for private insurance in protecting the estates of those who become permanent nursing home residents are also suggested.

Aged↗
PubMedDate not supplied

Federal block grants and public health: a call for physician partnership and leadership. AMA Council on Scientific Affairs.

Current transitions in health care financing and delivery systems have significant implications for public hospitals, community clinics, and health agencies, which provide important outreach and preventive services and rely heavily on federal and state funds. Strong concerns are being raised about the consequences of abrupt and drastic changes in funding of community health institutions and the continuing deterioration of rural and urban public health infrastructures. The viability of public hospitals, clinics, and local health agencies is threatened as government officials consider proposals for defunding, restructuring, or eliminating these entities. In 1996, Congress, the Clinton administration, and state and local government officials considered federal grant proposals and reforms that had potentially far-reaching implications for medical and public health professionals, expressing strong interest in consolidating various specific and narrowly defined categorical grant programs into broader block grant programs. Although no legislation was enacted, deliberations about federal block grant proposals provided important opportunities for physicians and medical societies to support public health activities and guard against further funding reductions that could weaken community health programs and diminish existing levels of quality and access. Ultimately, such deliberations provided a stimulus for medical associations and physicians to strengthen or renew partnerships with public health agencies and officials and provide necessary leadership to ensure that public health and preventive medicine become more integral components of the nation's health system.

American Medical Association↗
PubMed2003

Health policy and the coloring of an American male crisis: a perspective on community-based health services.

Health services at the community level are organized and financed in such a way that men need access but encounter barriers to care such as poor service design, lack of insurance, and the absence of health literacy. Community health delivery systems may not be appropriate, effective, fit, or able to meet the needs they are charged to fill. Community-based health services, including health departments, are underfunded, understaffed, and unable to carry out their mission in a way that protects the health of the community. The current design for funding and delivering health care services excludes poor men, particularly men of color. Improving the health of men requires modifications in the way health care is financed, delivered, and managed.

Adult↗
PubMed2003

A call for help. Collaboration with community officials is key.

The U.S. government's war on terrorism is a battle with an unseen enemy that uses tactics that are just as elusive. Although such conventional terrorists' assault methods as bombs and other explosives are a major concern, the threat of a biological, chemical or nuclear attack is particularly troubling to the government and those who would have to deal with the aftermath of such an attack.

Bioterrorism↗
PubMedDate not supplied

[Decentralization: part of the health system problem or the solution?].

The greatest change experienced by the Spanish health system in the last two decades has probably been the devolution of power to the autonomous communities composing the Spanish state. This may generate tensions in the status quo and poses questions of whether decentralization of the health system is compatible with a cohesive national health system and whether this devolution of power is part of the problem of the health system or part of its solution. Generalized devolution occurring as rapidly as that produced in Spain (negotiated in slightly less than 6 months, with minimal financial agreements, without explicit legal frameworks in the areas of coordination and development of basic norms, and with a new agreement of general financing of the autonomous communities which possibly contains lacunae, etc.) presents an uncertain panorama. The possible misuse of the wide powers recently transferred to the autonomous communities could easily be used by those who would like to see a restoration of pre-democratic centralism to sow fear of the collapse of the health service as the cornerstone of the welfare state among the general public. The present article briefly addresses these questions.

Delivery of Health Care↗