Health cost moderation seen as a joint responsibility at Ohio Blue Cross forum.
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Myopia is now recognized as a progressive, potentially sight‑threatening disease rather than just a refractive error, with its prevalence rising rapidly worldwide due to its high occurrence, major vision losses and huge public health cost. The World Health Organization estimates that 2.6 billion individuals in the world were myopic in 2020 this figure is projected to increase to 3.364 billion by 2030. Although myopia may be better controlled in its early stages, it may not be completely reversed at this time. Of all of the methods for controlling myopia, atropine, a muscarinic receptor antagonist, remains an effective pharmacological option for slowing myopia progression in children. However, the mechanisms of action of atropine remain to be fully elucidated. This review provided a systematic review for myopia epidemiology, pathogenesis, the effects and side effects, as well as up‑to‑date possible mechanisms, in the hope of facilitating that researchers in this field elucidate its underlying mechanisms so that clinical ophthalmologists may be able to better control this disease.
A physician in Manitoba reports that a national health care system has worked well in Canada, particularly for poor people and for governments concerned about the equitable and universal delivery of health care, as well as about rising health costs. Physicians, however, find the greatest problems are their own low salary and their lack of impact on government policy.
Many organizations are attempting to increase the physical fitness levels of their employees to help stem the rapidly-increasing employer health costs. Using basic economic concepts and models of human health behaviors, this study finds that the time and effort costs of exercise may exceed the present value of the economic benefits of improved physical fitness. These high costs help explain the small incidence of consistent adult exercise and the lack of in-house, on-work-time employer exercise programs. The study concludes that while health education campaigns may be useful, employers must find ways to reduce the time and effort costs of exercise by making it a low-cost byproduct of more immediately desired outputs or goals.
Considerations of ecology, public health hazards, and rising health costs have been critically reevaluated in the matter of appropriate medical waste disposal at nursing homes and hospitals. The Maryland Department of Health has intermittently received reports from the public of human tissues, bandages, and other inappropriate, unaesthetic materials visible in landfill areas. The Department has experienced increasing concern for communicable disease transmission, e.g. hepatitis, to landfill waste handlers and to the general public. Incineration had been considered as an alternative to landfilling of medical wastes, but fear of increasing hospital costs dampened initial enthusiasm for this possibility, particularly when coupled with fears of air pollution by smoke and noxious fumes generated by incineration. Other problems requiring resolution were conflicting definitions of medical waste and disposal requirements by federal, state, and local regulatory bodies. On-site incineration of all waste generated at hospitals is proposed as an economical and ecologically feasible solution to this public health problem in Maryland.
Numerous tests have been proposed in recent years to screen the antenatal population for various diseases which might contribute to perinatal and even maternal morbidity and mortality. Screening tests of any kind are currently the centre of controversy as measures are being strenuously taken to contain health costs. This paper critically examines twelve such screening tests.
The inadequacy of the current national formula in dealing with flows of patients across administrative boundaries is illustrated. In particular, the problems of dealing with varying admission rates for inpatients and in allocating revenues for outpatient services are discussed. We draw attention to an oversight in the recommendations concerning psychiatric services and criticise the general approach to the allocation of revenue under this heading. It is concluded that the national formula should not be applied for revenue allocation at district level in an unmodified form.
Development of health policy goals necessitates a choice among normative premises--an accommodation of conflicting values. Any debate that does not identify underlying assumptions or link policy prescriptions to a theoretical perspective is destined to degenerate into uncommunicative and unproductive rhetorical posturing. A sensible approach toward formulating national health policy requires that competing values be identified and discussed explicitly. This article will examine the effect that selection of different theoretical perspectives can have on the identification of problems and on the formulation of prescriptive policies in the health field. It will also focus on the different values that are promoted by different policy perspectives and consider alternative models for implementing value choices.
Thirty of the 39 patients treated at the Blacktown Dialysis Centre, the first "satellite" dialysis centre in the greater metropolitan Sydney, had been referred from four Sydney renal units for long-term dialysis therapy. The move save approximately 150 kilometres in travelling and eight hours time each week for each of these patients. The cost of running the unit was approximately $10,000 per patient per year in the first year--no greater than that of home dialysis, and less than that of dialysis in a teaching hospital. The advantages of establishing satellite dialysis centre, the method of operation, and the results of the first year of operation of the Blacktown Dialysis Centre are described.
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Surveys conducted in five areas of Southern Ontario obtained clinical and service utilization data from 5,478 adults over 25 years of age. The two week period prevalence rates of arthritic and rheumatic (AR) complaints were 1.72 per cent and 2.14 per cent among two groups of users of primary care. In free-living general populations, the rates ranged from 6.23 per cent to 8.84 per cent. It was shown that only 25 per cent of complainants with AR symptoms sought health services. Of all adults seen by family physicians in one year, 28 per cent presented at least once with an AR complaint. While 20 per cent of all respondents reported some physical impairment, 43 per cent of those with AR complaints had impairment. The excess impairment was two per cent. Complaints with AR symptoms used health services at costs 78 per cent higher than the average expenditures in the same communities. The essential role of the primary care practitioner in the identification and control of AR disorders is strongly supported.
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