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PubMedDate not supplied

Accreditation of mammography facilities by the American College of Radiology: results of a national survey.

Mammographic screening for the early detection of breast cancer is rapidly becoming an increasingly common practice in the United States. With more than 20 million mammograms estimated to be performed annually by more than 11,000 units, ongoing quality assurance and evaluative programs have gained importance. Recent federal legislative and regulatory efforts augment a patchwork of state mandates establishing or encouraging specific quality control requirements for mammography facilities, personnel, equipment, and radiation exposure. Many of these requirements are based on the American College of Radiology's (ACR) voluntary accreditation program that has been offering facility certification since 1987. The ACR collects and maintains detailed data on the characteristics of accredited facilities; however, little is known about facilities not participating in the ACR program. This article describes national results from the 1992 National Mammography Facilities Survey, a representative sample of 1,057 mammography facilities. We found statistically significant (P < .05) differences between accredited and nonaccredited facilities in type of mammography practices, cost, personnel standards, variables linked to accessibility, and corollary screening practices (availability of breast self-examination instruction and breast physical examination). Other variables showed minor or little variation between accredited and nonaccredited facilities. The results of this study suggest that, although all facilities engage in various components of "good" quality assurance practices, ACR-accredited facilities reported conducting these programs more frequently. Further, despite the substantially increased costs associated with these programs, ACR-accredited facilities reported lower average charges for screening mammograms and were more likely to participate in reduced fee programs.

Accreditation↗
PubMed1990

HIV infection, pregnant women, and newborns: A policy proposal for information and testing.

As the public health impact of human immunodeficiency virus (HIV) infection in women and children has increased, so has interest in screening pregnant women and newborns for evidence of HIV infection. However, screening of pregnant women and newborns raises profound moral, legal, and policy issues. In this article, we present and defend a detailed 10-point program of policy recommendations for both pregnant women and newborns. We advocate informing all pregnant women and new mothers about the HIV epidemic and the availability of testing.

AIDS Serodiagnosis↗
PubMed1990

Private Acts, Social Consequences by Ronald Bayer (New York: Free Press; 1989).

Bayer's approach is most effective when he uses it to describe the politicized nature of AIDS policy in the United States. He succeeds in showing the reader that public health authorities dealing with the spread of HIV/AIDS had a wide variety of competing interests to take into account in formulating AIDS social policy and that political interest groups, most notably gay community organizations, played a large role in fashioning AIDS policy. Those who might have doubted the significance of contextual factors such as these for health policy, and especially for AIDS policy, will be convinced of it after reading Bayer's book. But Bayer is not content to make only descriptive claims about AIDS health policy. He is also interested in advancing normative and prescriptive claims, the nature of which, I have argued, requires an approach other than the one that he has adopted.

AIDS Serodiagnosis↗
PubMed1998

Publication of the OIG compliance program guidance for hospitals--OIG. Notice.

This Federal Register notice sets forth the recently issued compliance program guidance for hospitals developed by the Office of Inspector General (OIG) in cooperation with, and with input from, several provider groups and industry representatives. Many providers and provider organizations have expressed an interest in better protecting their operations from fraud and abuse through the adoption of voluntary compliance programs. The first compliance guidance, addressing clinical laboratories, was prepared by the OIG and published in the Federal Register on March 3, 1997. We believe the development of this second program guidance, for hospitals, will continue as a positive step towards promoting a higher level of ethical and lawful conduct throughout the health care industry.

Financial Audit↗
PubMed2005

Psychological distress among GPs--who is at risk and how best to reach them?

OBJECTIVE: To identify key characteristics of psychologically distressed general practitioners and whether these GPs volunteered for a "GP health" educational program. SETTING: Eight Australian divisions of general practice responding to an invitation to participate in the research in 1999, representing 1356 GPs. MAIN OUTCOME MEASURE: The General Health Questionnaire (GHQ-12), together with demographic and practice questions. DESIGN: Observational study of GPs invited to participate in a voluntary education program on GP health offered through each division of general practice. PARTICIPANTS: 819/1356 GPs responded to the baseline questionnaire (60%). Of these, 233/819 (28%) scored above the GHQ-12 threshold indicating psychological distress. Ninety GPs enrolled in the program, data were available for 69 GPs. RESULTS: General practitioners who were identified as being psychologically distressed were over-represented in the 35-49 years age group (p=0.02) and were more likely to be the practice principal (p=0.04). Over 62% of enrolled GPs had scores that indicated none to mild distress. Of those GPs who were distressed, 42% were from the identified at risk age group, and 44% were practice principals. DISCUSSION: Alternative targeted interventions may be needed to reach GPs with high levels of psychological distress.

Adult↗
PubMed1986

AIDS, power, and reason.

The AIDS epidemic at once challenges the biological, social, and political fabric of American life. Individual liberty and communal welfare are always in a state of tension in public health policy. AIDS-specific fears, merged with common distrust for scientific authority, have led to appeals to coercive state power. Others counter with equally illusory promises of voluntarism and education. In fashioning new policies we must preserve a social capacity for reasoned analysis and public discourse.

AIDS Serodiagnosis↗