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At least 235 records · Page 13Linked to original sources
PubMed2004

Joint impact of health risks on health care charges: 7-year follow-up of National Health Insurance beneficiaries in Japan (the Ohsaki Study).

BACKGROUND: The objective of this study was to examine the joint impact of modifiable health-risk factors such as smoking, obesity, and physical inactivity on direct health care charges. METHOD: We conducted a population-based prospective cohort study, with follow-up from 1995 to 2001. The participants were Japanese National Health Insurance (NHI) beneficiaries (26,110 men and women aged 40-79 years). RESULTS: 'No risk' group defined as never-smoking, body mass index (BMI) 20.0-24.9 kg/m(2), and walking for >/=1 h/day had mean health care charges of 171.6 dollars after adjustment for potential confounders. Compared with this group, the presence of smoking (SM; ever-smoking) alone, obesity alone (OB; BMI >/=25.0 kg/m(2)), or physical inactivity (PI; walking for <1 h/day) alone were associated with a 8.3%, 7.1%, or 8.0% increase in health care charges, respectively. The combinations of the risks of SM and OB, SM and PI, OB and PI, and SM and OB and PI were associated with a 11.7%, 31.4%, 16.4%, and 42.6% increase in charges, respectively. CONCLUSION: Interventions to improve modifiable health-risk factors may be a cost-effective approach for reducing health care charges as well as improving people's health.

Adult↗
PubMed2002

Efficient use of health care resources: the interaction between improved health and reduced health related income loss.

Cost effectiveness is a criterion that is often recommended for prioritizing between different types of health care. A modified use of this criterion can be justified as the outcome of a choice that is made "behind a veil of ignorance." Reduced health will in many cases also gives an income loss that is shared between the patient and society ar large. In the special case where the marginal utilities of health status (measured by QALYs) and income are independent of the health state, an efficient allocation of health resources is characterized by net marginal costs per QALY being equalized across different types of health care. Net marginal costs are equal to gross marginal costs minus the reduction in health related income losses due to treatment. In the general case where marginal utilities depend on the health state this rule must be modified.

Budgets↗
PubMed2000

Implementing a new model of integrated women's health in academic health centers: lessons learned from the National Centers of Excellence in Women's Health.

The National Centers of Excellence in Women's Health Program (CoE) represents a new model for women's health in academic health centers that unites women's health research, teaching, clinical care, public education and outreach, and career advancement for women in the health sciences. Lessons learned from the first 3 years of implementation indicate that this type of model requires a transformation from the traditionally fragmented set of activities in academic health centers to an integrated system united around the goal of advancing women's health. The transformation requires institutional commitment, dedicated players, and an ability to build on existing resources and bring added value to the institution. Challenges and strategies to link women's health activities and increase collaboration are also discussed.

Academic Medical Centers↗
PubMed1999

Health risks of health care workers: health risks appraisal results from the newly independent country of Georgia.

Health promotion and disease prevention activities should be carried out by all health care professionals. These activities are especially important in the Newly Independent States (NIS) of the former Soviet Union where resources are not available to meet all health care needs. Little is known about actual health risks among health care professionals in the NIS. Such self knowledge is important to link professional's prevention activities to risk factors for disease. To determine the prevalence of selected health risks of health professionals in Tbilisi, the capital of the NIS Georgia, a survey was conducted in 1996 with a convenience sample of 107 physicians and nurses. Participants completed the Healthier People Health Risk Appraisal (HPHRA), then researchers measured each subject's height, weight, blood pressure, and total cholesterol. Compared to the U.S. norms used in the HPHRA program analysis, measured group results for the Georgians were in the very high risk category for lack of seatbelt usage and stressful lifestyle, in the high risk category for lack of exercise, and in the moderately high risk category for blood pressure and smoking. The measured weight and reported alcohol consumption for Georgians was comparable to the U.S. national averages and total cholesterol values were below U.S. average levels.

Adult↗
PubMed1994

Public health and health care reform: the American Public Health Association's perspective.

This paper discusses the American Public Health Association's goals with regards to the current health care reform debate. By outlining the organization's historical context with regards to health care reform as well as the parameters of the current medical care and public health crises, the paper explains why APHA's advocacy efforts focused on two major issues: the adoption of a national health program that features universal coverage with a comprehensive set of benefits for all our nation's residents, and the enhancement of the federal, state, and local public health infrastructure. The paper argues that both medical care services and public health programs must be expanded if we are to improve the nation's overall health status.

Forecasting↗
PubMed2003

The World Oral Health Report 2003: continuous improvement of oral health in the 21st century--the approach of the WHO Global Oral Health Programme.

Chronic diseases and injuries are the leading health problems in all but a few parts of the world. The rapidly changing disease patterns throughout the world are closely linked to changing lifestyles, which include diets rich in sugars, widespread use of tobacco, and increased consumption of alcohol. In addition to socio-environmental determinants, oral disease is highly related to these lifestyle factors, which are risks to most chronic diseases as well as protective factors such as appropriate exposure to fluoride and good oral hygiene. Oral diseases qualify as major public health problems owing to their high prevalence and incidence in all regions of the world, and as for all diseases, the greatest burden of oral diseases is on disadvantaged and socially marginalized populations. The severe impact in terms of pain and suffering, impairment of function and effect on quality of life must also be considered. Traditional treatment of oral diseases is extremely costly in several industrialized countries, and not feasible in most low-income and middle-income countries. The WHO Global Strategy for Prevention and Control of Noncommunicable Diseases, added to the common risk factor approach is a new strategy for managing prevention and control of oral diseases. The WHO Oral Health Programme has also strengthened its work for improved oral health globally through links with other technical programmes within the Department for Noncommunicable Disease Prevention and Health Promotion. The current oral health situation and development trends at global level are described and WHO strategies and approaches for better oral health in the 21st century are outlined.

Adolescent↗
PubMed2004

[Health economy and health promotion -- self-responsibility for health?].

The social insurance systems in Germany are about to face radical changes, predominantly due to demographic developments. The solution might be an increasing self-responsibility of the population. The suitability of this health economical concept is to be verified for health insurance. The starting point of the health economic debate, discussing the issue of responsibility, is its description, and therefore the health of populations and the fundamental determinants for the maintenance of health and for illness. This is followed by a theoretical health economic discussion on the question whether insurants and patients are suitable market partners shoulder the responsibility transferred to them. The description of empiric evidence of the effects of co-payment questions the concept of self-responsibility and finally leads to discussing the individual versus social responsibility for health and illness.

Aged↗
PubMed2001

Collaboration among the education, mental health, and public health systems to promote youth mental health.

The authors discuss the growing movement in the United States to develop expanded school mental health programs. These programs represent partnerships between schools and community mental health agencies to expand the range of mental health services provided by schools. Such programs emphasize effective prevention, assessment, and intervention. The authors describe efforts that have been undertaken to improve the fragmented and incomplete nature of children's services and to proactively identify and address children's emotional and behavioral problems. They also discuss a strategy to improve youth mental health programs, which includes needs assessments and an analysis of existing programs in a community. They describe the augmenting roles played by the mental health and public health systems in expanding and improving school-based mental health services. The authors outline steps to minimize or avoid the turfism and negative attitudes that may arise among professionals from different disciplines when they collaborate to expand and improve school-based programs.

Adolescent↗
PubMed1998

Alaska Native community assessment: health care services, knowledge of health issues, and health education.

This project gathered information from 32 Alaska Native communities in Bristol Bay, located in southwestern Alaska, regarding use of health care services and knowledge of health care issues. It also educated residents about health care and their role in improving health status, enabling participants to feel that their involvement in planning health care services is important. In conjunction with the University of Washington Community Development Program and the Alaska Center for Rural Health, a household survey was developed. A coordinator in each community was trained, and packets of surveys and health education materials were delivered to each household or post-office box. Completed surveys were returned, confidentially, to the village clinic. An English/Yup'ik cassette tape explaining the project was also available. Results were analyzed by the University of Washington. The findings were determined to be accurate with a 95% confidence level. Of surveys delivered to households, there was a 66% return rate and an overall return rate of 45%.

Adult↗
PubMed1994

Beyond report cards: a health profile for HealthPartners Health Plan and the Business Health Care Action Group.

HealthPartners Health Plan and the "Business Health Care Action Group" (a buyer's coalition) operate in a market place increasingly concerned about accountability and quality improvement. Improving the population's health is a strategy that satisfies the mission and business purposes of employers and health care providers alike. Proposed quality measures and "report cards" have focused on clinical performance standards such as procedure rates or adherence to clinical practice guidelines. This paper describes a unique collaboration between an HMO and a purchasing coalition to assess member health status and health risks as a catalyst for increasing consumer involvement in health care.

Community Participation↗