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At least 415 records · Page 23Linked to original sources
PubMed2001

Studying the effects of health plan competition: are available data resources up to the task?

OBJECTIVES: To review the availability of data sources to study health plan competition in the United States. DATA SOURCES: The literature on health plan competition was reviewed. Possible data sources to study health plan competition were evaluated. Experts in the field of health plan competition were contacted about their knowledge of existing data sources. Principal Findings. There is much more quantitative data available on HMO plans than on other types of health plans that are growing in popularity, such as PPOs. A key source for health plan data, state health insurance filings, lacks information on beneficiaries in non-HMO plans. Data on health plan quality is growing. In addition, case studies of particular markets is providing useful qualitative information on the dynamics of the health plan industry. CONCLUSIONS: The fragmentation of the health care market and the hesitancy of governments and private organizations to provide detailed information across markets and providers creates serious obstacles to the study of health plan competition.

Databases, Factual↗
PubMed2006

Intravitreal triamcinolone injection for diffuse diabetic macular edema with foveal cystoid changes.

BACKGROUND: Diabetic macular edema causes visual loss in almost one-third of diabetic patients. There is currently no treatment for the accompanying cystoid foveal changes. OBJECTIVES: To assess the clinical outcome, i.e., change in visual acuity, in patients treated with steroids for long-standing diabetic macular edema with foveal cystoid changes. METHODS: In the ophthalmology department of a tertiary care university-affiliated medical center and the ophthalmology service of a health management organization, 46 diabetic subjects (56 eyes) who had diabetic macular edema with cystoid foveal changes received one intravitreal injection of 4 mg triamcinolone acetonide. RESULTS: The mean baseline (pre-injection) visual acuity of 0.21 increased to 0.31 and 0.48 at 1 and 3 months, respectively, after which it decreased to 0.33 at 6 months. The mean intraocular pressure was 15.07 mmHg at baseline, 15.83 at day 1, gradually rising to 17.16, 18.38 and 18.57 mmHg at 1, 3 and 6 months respectively. Three patients suffered immediate visual decline after the injection. CONCLUSIONS: Intravitreal triamcinolone acetonide may be a therapeutic option for long-standing diabetic macular edema with foveal cystoid changes.

Aged↗
PubMed1989

New training for new roles.

Assistant medical practitioners in Sri Lanka are justifiably dissatisfied with their training, which should be modified so that they are enabled to function more effectively in the country's predominantly rural communities. Furthermore, in order to motivate these health professionals to the greatest possible extent, they should be offered an attractive career structure.

Curriculum↗
PubMed1989

Strengthening the backbone of primary health care.

This article discusses how to increase the effectiveness of district health systems, with particular reference to the setting of priorities and targets, the realization of various forms of joint action, and the improvement of management and other skills.

Community Health Services↗
PubMed1988

The marketing audit: a new perspective on library services and products.

A marketing audit enables a library to look at audiences, services, and products with a structured approach. The audit can be used to assess operations and to provide a framework for ongoing decision making, evaluation, and long-range planning. An approach to the audit process is presented and its application is demonstrated in a case study featuring the American Hospital Association Resource Center.

American Hospital Association↗
PubMedDate not supplied

Implenting family planning in a Ministry of Health: organizational barriers at the state and district levels.

1. Family planning occupied a subordinate position in the medical and health bureaucracy almost two decades after its introduction. Senior Ministry officials accorded low priority to formal program objectives, while the State Family Planning Officer, the highest state official concerned solely with the family planning program, suffered from a relatively subordinate position in the Directorate and a lack of authority and support. Within the medical profession, family planning was held in low esteem, and the medical and health bureaucracies did not have a mechanism for selecting personnel on the basis of interest and commitment. 2. Organizational adjustment to family planning in the Ministry of Health was a slow and painful process, absorbing the energy and attention of Ministry officials for almost a decade. The repeated reorganizations of the district setup revolving around the division of labor between medical, health, and family planning acitvities and between the rural and urban program, led to months of almost total inertia and detracted substantially from the supervisory capacity of the officials involved. 3. Decision making and guidance suffered from the quick turnover of the Secretary, the most powerful administrator in the Ministry. In Uttar Pradesh Secretaries stayed barely long enough to begin to understand the complex organizational setup of the program. 4. Multiple and often conflicting lines of authority characterized the relationships between the higher and lower echelons within the Ministry. This was accentuated when the District Family Planning Officer was placed under the administrative control of the District Magistrate. While intended to "energize" family planning through the association of the most prestigious and powerful district official with the program, this organizational arrangement resulted in conflicting instructions to the staffs of the primary health centers. 5. The organizational behavior of the Ministry of Health was shaped by the interplay of the various "professional cultures" of its key actors. The generalist administrators' short time horizon and eagerness to produce quantitative results clashed with the specialists' emphasis upon long-term goals and technical constraints; the politician's defense of the interest of his constituents clashed with the administrator's desire to defend his autonomy. The calculus of political survival made support for family planning goals a costly burden that few politicians have been willing to shoulder. As the party system does not reward the advocacy of family planning, ministers emphasize those programs within their ministry or those decisions within their discretion that correspond to the demands of their constituents.

Family Planning Services↗
PubMed1983

Primary health care according to African requirements.

African conditions and circumstances present specific challenges to health service providers. These conditions have implications for primary health care (PHC), including problems of communication (geographical, educational and cultural), maldistribution of health manpower, political unrest and wars. Local PHC services must compete with the prestige of and faith in the hospitals. Manpower training should be stressed at all levels of education of all medical and paramedical personnel. The status of PHC in the Republic of South Africa is now well recognized, and provision of the required services has a high priority.

Africa↗
PubMed1983

Primary health care provision in terms of community need in South Africa.

In South Africa, early lessons in primary health care were lost to sight and have been rediscovered only recently. Priorities need to be reassessed in order to better allocate resources to community needs. Developing and developed communities require different primary care services. Simple and effective epidemiological methods should be used to gather information required for planning and evaluation of services. In developing communities, where there is a shortage of doctors, trained nurses operate local clinics with the help of community workers. Community participation and the cooperation of the traditional healers are necessary. Appropriate training of personnel for an effective role in public health care is essential.

Community Health Services↗
PubMedDate not supplied

Freestanding abortion clinics: services, structure, fees.

In 1981, The Alan Guttmacher Institute (AGI), in collaboration with the National Abortion Federation (NAF), conducted a survey of 240 abortion clinics to update information about clinic structure and the relationship of structural characteristics to services, policies and fees. The clinics surveyed were a stratified random sample of all non-hospital abortion facilities that provided 400 or more abortions in the United States in 1980. Among the findings are the following: Thirty-one percent of the clinics reported that they are nonprofit or tax-exempt corporations. The nonprofit clinics are not significantly different from for-profit clinics in either the number of patients they serve or the region of the country in which they are located. Twenty percent of facilities, although regarded as clinics by the AGI for research purposes, define themselves as physicians' offices. These offices are more often located in the West and have smaller caseloads than other clinics. They are also disproportionately located in states with high abortion rates, which suggests that private physicians in these states are more willing than doctors in other states to provide relatively large numbers of abortions in their offices. Two-thirds of the clinics are licensed, most of them by states, but some by cities and counties. Licensed clinics have larger caseloads than nonlicensed facilities, but they are no different in terms of the other characteristics measured in the study, including services offered and fee structure. Fifty-four percent of clinics provide abortions after 12 weeks since the last menstrual period (LMP), and 24 percent, past 14 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗