The Wisconsin Health Care Plan: a practical, effective, and comprehensive response to our health care crisis.
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Advisory Committees↗
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Results for “Comprehensive Health Care”
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[Medical care in comprehensive health insurance systems and the role of nursing].
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Delivery of Health Care↗
Taiwan's 1995 health care reform.
Under considerable domestic political pressure, the Taiwan government inaugurated a compulsory universal health insurance scheme on 1 March 1995. This new scheme is financed mainly by payroll tax and provides comprehensive health care benefits with a moderate cost sharing. In order to gain efficiency in delivering health services, the scheme enters contracts with health care providers and has been developing a prospective payment system. Meanwhile, the scheme uses a uniform fee schedule and makes all payments through a public single-payer system to control health care costs. By the end of the inaugural year, the scheme covered 92% of the population and the utilization pattern of the newly insured became close to that of the previously insured. However, there is the beginning of a financial crisis because the payments of the scheme are rapidly increasing and expect to exceed the premiums in the coming year. Besides, the scheme did not bring in the efficient use of health care resources and probably caused it to worsen. Taiwan's health care reform has an unfinished agenda.
Comprehensive Health Care↗
Pressure on the emergency department: the expanding right to medical care.
Lack of a comprehensive health care system in the United States has resulted in a series of legal cases that have expanded the common-law right to care in the hospital emergency department, thereby bringing increased pressure on hospitals to provide care under an ever-widening variety of nonemergency conditions. Health care legislation at the state and federal level during the 1980s expanded the concept of physician duty to include women in labor as well as any condition that could reasonably be expected to lead to serious impairment to bodily functions or serious dysfunction of any bodily organ or part. Presently, any patient presenting to a hospital ED must be examined to determine whether an emergency exists. The expanding definition of an emergency and mandated patient examination requirements have hit urban hospitals particularly hard, as the uninsured and disenfranchised increasingly find the ED their only source of medical care. The United States needs a national health care solution that does not rely on the ED as the locus of care for general medical practice. Failure to act will jeopardize the ability of hospital EDs to provide the highly specialized care that only they can provide and will put more hospitals at financial risk as they struggle to comply with state and federal law while serving a growing population of uninsured and underinsured patients.
Emergency Service, Hospital↗
Medical care for special children.
Comprehensive health care planning can augment the educational programming for children with exceptional health and/or learning needs. The coordination of medical service and education is critically needed to reduce the traditional gulf between these two essential disciplines. Bridging this gulf will enable patients and their families, referral sources, and providers to collectively profit from the effort.
Child↗
Comprehensive state health reform initiatives.
Policy makers, consumers, providers and purchasers of health care will do well to pay close attention to the many comprehensive health care reform initiatives under consideration by state legislatures.
Child↗
The smaller hospital in the health care system. Comprehensive pharmacy services for small hospitals.
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Costs and Cost Analysis↗
Effect of parasite screening on refugee health.
Intestinal parasitic infections among refugees have been perceived as a public health problem for decades. A control program strategy to reduce morbidity and eventually transmission of intestinal parasites was initiated in 1993 by Mercy International (MI) for a group of Somalia refugee and has been implemented successfully. The management of the program operating within a comprehensive health care project and the control activities has been performed through the existing health facilities. This project was based on the "Comprehensive Health Care Approach" concept and applied to a collection of 10,000 Somali refugees. A project, which could be further, developed and modified for other similar situations. The strategy adopted was based on periodic chemotherapy of schoolchildren, intense health education in close collaboration with the local community leaders. An overall reduction in prevalence of intestinal parasitic infections of 53% was one of the targets achieved through this effort after three years of activities. 92% and 62% reduced the intensity of Ascaris lumbricoides and Trichuris trichiura infection, respectively. This approach in concert with the political commitment and limited operational costs is a warranty for the future sustainability of the control activities. Future control strategies are tailored to the results of evaluation surveys and are targeted to the identified high-risk areas. This project can be seen as a model in other refugee situation with the use of limited local resources.
Adult↗
Comprehensive care of the chronically ill cancer patient: an inter-agency model.
The article identifies continuity of care between hospital and community as the key element of comprehensive health care for the chronically ill cancer patient. It describes the collaborative effort of the Michigan Cancer Foundation and the Metropolitan Detroit Cancer Control Program to provide this continuity. The structure, process, and outcome of the inter-agency model is presented and illustrated through case example. The authors believe that this model is applicable to treatment of persons with other chronic diseases which require frequent hospitalization.
Adaptation, Psychological↗
Comprehensive integrated primary mental health care for South Africa. Pipedream or possibility?
While the vision for restructuring health care in South Africa is based on a comprehensive primary health care system, care at the primary level remains largely biomedical in orientation. Given this, I argue that whilst adding mental health care to primary level care may increase accessibility of psychiatric care. it will not, however, provide for comprehensive integrated primary mental health care as planned. This would require a paradigm shift towards a comprehensive discourse of care which includes mental health care. While efforts towards reorienting health care personnel in South Africa towards the primary health care approach have been initiated, an examination of the primary health care system in one sub-district in South Africa, reveals that the delivery of biomedical care is sustained by a number of factors within the primary health care system as well as within the macro-context. A shift in the paradigm of care provided would therefore require the transformation of the system on many fronts. Of central importance would be the restructuring of the primary health care system to be supportive of emotional labour, health promotion, empowerment of service users and of care which takes the subjectivity of the illness experience for the patient into account.
Culture↗
Actuarial status of the Social Security and Medicare programs.
The Boards of Trustees for the two Social Security and the two Medicare Trust Funds recently released their annual reports to Congress detailing the operations of the trust funds during 1992 and their projected financial status for future years. Based on the Trustees' best estimates, the reports show: The Federal Old-Age and Survivors Insurance (OASI) Trust Fund is projected to be able to pay benefits for about 50 years. Congress will eventually need to take action to assure the long-range financial soundness of the program. The Federal Disability Insurance (DI) Trust Fund is projected to be exhausted in about 2 years. As a result, the Board urges that prompt legislative action be taken to improve the financial integrity of this trust fund by reallocating to the DI fund a larger share of the overall OASDI tax rate. The Federal Hospital Insurance (HI) Trust Fund is projected to be able to pay benefits for only about 6 years and is severely out of financial balance in the long-range. The Trustees urge the Congress to take additional actions designed to control HI program costs through specific program legislation and as a part of enacting comprehensive health care reform. The Federal Supplementary Medical Insurance (SMI) Trust Fund is financed on a year-by-year basis and is adequately financed. The Trustees urge the Congress to take additional actions designed to control SMI costs through specific program legislation and as a part of enacting comprehensive health care reform.
Actuarial Analysis↗
Actuarial status of the Social Security and Medicare programs.
The Boards of Trustees for the two Social Security and the two Medicare Trust Funds recently released their annual reports to Congress detailing the operations of the trust funds during 1991 and their projected financial status for future years. Based on the Trustees' best estimates, the reports show: The Federal Old-Age and Survivors Insurance (OASI) Trust Fund will be able to pay benefits for about 50 years. Congress will eventually need to take action to assure the long-range financing of the program. The Federal Disability Insurance (DI) Trust Fund will be able to pay benefits for only about 5 years and is not adequately financed. As a result, the Board is required to make a separate report to the Congress on the unfavorable financial condition of this trust fund. The Board urges that prompt legislative action be taken to improve the financial integrity of the trust fund, after a review of the disability program. The Federal Hospital Insurance (HI) Trust Fund will be able to pay benefits for only about 10 years and is severely out of financial balance in the long-range. The Trustees urge the Congress to take additional actions designed to control HI program costs either through specific program legislation or as a part of enacting comprehensive health care reform. The Federal Supplementary Medical Insurance (SMI) Trust Fund is financed on a year-by-year basis and, on this limited basis, is adequately financed. The Trustees urge the Congress to take additional actions designed to control SMI costs either through specific program legislation or as part of enacting more comprehensive health care reform.
Budgets↗
The making of an adolescent clinic.
This paper addresses the nationwide need for comprehensive health care services directed toward adolescents, outlining a multidisciplinary team program designed to provide such services. The national problem of teenage pregnancy is discussed, and the multidisciplinary team's success with family planning counseling is described. The authors strongly encourage the development of more school- or community-based clinics based on a comprehensive health care team model.
Adolescent↗
Drug abuse in a farm community; a brief appraisal of a research work.
This project was initiated in the rural areas of the Punjab to assess the prevailing trends in the abuse of intoxicating drugs by rural folk, with a view to contributing to future primary mental health care planning as an integral part of comprehensive health care planning. Twenty-four villages were selected from six community development blocks in the three bordering districts of the Punjab. In the rural population, the abuse of intoxicating drugs is mainly confined to alcohol, tobacco, opium and cannabis. Among psychosocial correlates, religion was of obvious predominance. Since Sikh are non-smokers, tobacco abuse was much less among them; but they had maximum alcohol ;and opium abuse. The structure of the family and number of family members tend to move together in their association with drug abuse. In relation to income in general, drug abuse was more common at the two ends of economic scale-the richest and the poorest. Social perception of drug abuse has highlighted the fact that in villages it has still not become an illicit or underground activity. The findings suggest a number of measures for promoting future primary mental health care among rural fold of the country.
Adolescent↗
Health care reform and the Medicare program.
None of the health care reform bills introduced during the last session of Congress would have ended the deepening Medicare fiscal crisis. Delays in resolving Medicare's fiscal problems will increase generational inequities and cause disruptions in health care delivery. Because of the pressures of increasing health care costs on government, business, and individuals, comprehensive health care reform will be deliberated in future sessions of Congress. It remains to be seen, though, whether policymakers will be able to develop reforms that address the basic problem of rising health care costs.
Costs and Cost Analysis↗
Views from Capitol Hill--11 congressional leaders paint varying reform scenarios. Interview by Marybeth Burke.
The following exclusive interviews with top congressional health care leaders were conducted by Washington-based reporter Marybeth Burke. In the interviews, Burke found that congressional health care leaders are optimistic yet cautious that comprehensive health care reform legislation will pass in 1993 under President Clinton. Some members of Congress believe that the election of a president committed to action on the issue drastically improves the outlook for reform. Others say that long-term controversy over reform will not resolve itself overnight. Lawmakers expect the issue to heat up quickly as soon as Clinton hands Congress a legislative reform package, but they are reluctant to predict quick enactment.
Competitive Medical Plans↗
Structuring policy options in geriatric oral health care.
Efforts to contain health care costs typically affect the elderly most. Comprehensive health care for the elderly includes dental services in addition to medical care. This article discusses the factors underlying the elderly's scant utilization of dental resources and suggests several strategies which may appreciably assist the elderly in procuring such necessary services.
Aged↗
General practitioner beds in Finland--lessons for the UK?
The Finnish Primary Health Care Act of 1972 aimed to provide comprehensive health care to the population. One consequence was an increase in the number of beds for the use of general practitioners, so that there are now 2.2 general practitioner beds per thousand population. Use of these beds varies with the location of the health station in which they are situated, but in rural areas approximates to that of general practitioner hospitals in the United Kingdom. Despite integration of general practitioner beds into overall planning, some potential benefits of these facilities have not been realized. For the UK, with traditions of personal general practice and continuity of care, the Finnish system offers one model of community care which may have medical and economic advantages.
Beds↗