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At least 775 records · Page 43Linked to original sources
PubMed2004

Smoking may affect root coverage outcome: a prospective clinical study in humans.

BACKGROUND: Cigarette smoking has been shown to negatively influence healing following periodontal therapeutic procedures. Therefore, the aim of this study was to evaluate the impact of smoking on clinical outcome of root coverage following subepithelial connective tissue graft (CTG) surgery. METHODS: Eighteen defects were treated in 15 patients (seven smokers and eight non-smokers) who presented canine and pre-molar Miller Class I and II recessions. CTG was performed and clinical measurements were obtained at baseline, and 30, 60, 90, and 120 days after surgery. Clinical measurements included plaque and gingival indexes, gingival recession, probing depth, clinical attachment level, gingival thickness, and keratinized tissue width. RESULTS: Intragroup analysis showed that CTG was able to promote root coverage, increase gingival thickness, and improve clinical attachment level in both groups (P < 0.05). On the other hand, intergroup analysis demonstrated that smokers presented with a lower percentage of root coverage (58.84% +/- 13.68% versus 74.73% +/- 14.72%), less clinical attachment level gain (2.54 +/- 0.79 mm versus 2.00 +/- 1.04 mm), and deeper probing depths (1.56 +/- 0.53 mm versus 2.35 +/- 0.67 mm) than non-smokers (P < 0.05). Moreover, 4 months after CTG, smokers presented more keratinized tissue compared to non-smokers (3.30 +/- 0.86 mm versus 4.50 +/- 1.16 mm) (P < 0.05). CONCLUSION: Within the limits of the present study, it can be concluded that cigarette consumption may present a negative impact on root coverage outcome by CTG and, therefore, may represent one more challenge for periodontal plastic therapy.

Adult↗
PubMed1984

Changing patterns in mental health service coverage within health maintenance organizations.

This 1982 national survey of all operational health maintenance organizations (HMOs) provides information on the current status of mental health services, benefits, costs, and utilization within HMOs, updating and augmenting a 1978 study. Approximately 94 per cent of the responding HMOs offered mental health service coverage; over one-half (54 per cent) offered alcohol and drug abuse service coverage. The present coverage benefits and utilization of mental health services within HMOs continue to reflect greater variability vis-a-vis other health services within HMOs. Over one-half (57 per cent) of the HMOs provided for 30 days of inpatient mental health coverage (per member per year). Three out of four (77 per cent) of the health plans provided for 20 ambulatory visits (per member per year). The mean mental health hospital utilization rate was 32 days (per 1,000 members per year). The mean mental health ambulatory utilization rate was 0.33 encounters (per member per year). Further studies should investigate the combined influence of organization characteristics, mental health service organization characteristics, and service benefits on the costs and utilization of HMO mental health services.

Adolescent↗
PubMed1985

The elderly's private insurance coverage of nursing home care.

About 40 per cent of Medicare beneficiaries had private insurance coverage of skilled nursing facilities (SNF) in 1977. Data from the 1977 National Medical Care Expenditure Survey show that among such persons, about 85 per cent had full coverage of Medicare's Part A copayments for days 21-100 but only 15.7 per cent had maximum coverage of at least 365 days of care or a benefit of $100,000 or more. The most comprehensive benefits are found among persons with middle or high incomes; more generous first-dollar coverage is found in the North Central and South regions, and more generous maximums in the West.

Aged↗
PubMed1992

Medicaid coverage of screening tests for breast and cervical cancer.

Although most women receive periodic Papanicolaou smear (Pap) those who do not are more likely to be of lower socioeconomic status. Similarly, for the many women who do not receive periodic mammography for early diagnosis of breast cancer, cost has often been cited as a reason. Medicaid provides health benefits to roughly 9.4 million women of the appropriate ages for Pap tests and roughly 3.3 million women of the appropriate ages for mammography. The decision to provide such coverage is made on the state level. Of the 50 states and the District of Columbia, 49 provide some level of coverage for Pap smears, 39 for screening mammography. Knowing the extent of coverage allows public health professionals to take advantage of this funding source to provide services for lower-income women and may help initiate coverage in those states where it is not currently available.

Adolescent↗
PubMed1997

Medical necessity and defined coverage benefits in the Oregon Health Plan.

The policy debate in Oregon has primarily focused on the Prioritized List of Services. However, little information is available on how defined coverage benefits and managed care affect the role of medical necessity in determining care for Medicaid patients. This issue is important because medical necessity determinations are currently used by many states to limit extraneous health care costs but require resource-intensive oversight, are open to wide variance, and frequently prompt litigation challenging interpretations of what is necessary and what is not. The qualitative study described here addressed whether medical necessity remains a salient and useful concept in the Oregon Health Plan. Our results indicate that defined coverage benefits, as described by the funded portion of the Prioritized List of Services, supplant medical necessity determinations for coverage, while managed care incentives limit the need for medical necessity determinations at the provider level. Clinical choices are, for the most part, guided by providers' judgment within the financial constraints of capitation and by targeted use management techniques. The combination of capitated care and Oregon's defined coverage benefits package has marginalized the use of medical necessity, albeit with consequences for state oversight of Medicaid services.

Government Regulation↗
PubMed1998

News media coverage and the epidemiology of homicide.

OBJECTIVES: This study assessed how newspaper coverage of homicides corresponds to the epidemiology of homicide. METHODS: Stories in the Los Angeles Times about homicide (n = 2782) were compared with the homicides that occurred in Los Angeles County from 1990 through 1994 (n = 9442). The generalized linear model assessed how victim, incident, and suspect characteristics related to coverage. RESULTS: Even when multiple variables were taken into account, some homicides (those with female, child, or elderly victims; those in which the suspect was a stranger to the victim; those in wealthier neighborhoods) received more coverage and others (those with Black or Hispanic victims or victims with less than a high school education; those committed with nonfirearm weapons; those in which the suspect was an intimate of the victim) received less coverage than expected. CONCLUSIONS: Some homicides are more newsworthy than others. Potential implications of not providing the public with representative data are discussed.

Adolescent↗
PubMed1999

Children on the move and vaccination coverage in a low-income, urban Latino population.

OBJECTIVES: The purpose of this study was to determine the impact of childhood moves and foreign birth on vaccination coverage among Latino children in New York City. METHODS: Vaccination coverage was assessed in a survey of 314 children younger than 5 years at 2 immunization clinics. RESULTS: Forty-seven percent of the study children had moved abroad. After adjustment for health insurance, regular source of care, and country of birth, child moves had no independent effect on vaccination coverage. Foreign-born children had diphtheria-pertussis-tetanus, oral polio vaccine, and measles-mumps-rubella vaccination coverage rates similar to those of US-born children, but they were underimmunized in regard to Haemophilus influenzae type b and hepatitis B. CONCLUSIONS: Foreign birth, but not childhood moves, is a barrier to vaccinations among low-income, urban Latino children.

Adolescent↗
PubMed1997

Cost effectiveness of smoking-cessation therapies. Interpretation of the evidence-and implications for coverage.

Smoking cessation has been called the 'gold standard' of healthcare cost effectiveness, producing additional years of life at costs that are well below those estimated for a wide range of healthcare interventions. However, the most effective approaches to smoking cessation are not the most cost effective. As we move from the least resource-intensive interventions (e.g distribution of self-help cessation guides) to those that are most resource-intensive (e.g. medical treatments, including the use of nicotine replacement products), both cost and effectiveness increase, but cost increases more rapidly. Nevertheless, it must be considered that different interventions are effective for different people. Resource-intensive treatments may actually be far more cost effective for many people who may not respond to less-intensive interventions. A considered review of the evidence recommends support of all of the major forms of smoking-cessation intervention; even the most expensive are highly cost effective compared with the majority of medical practices that have been studied. Despite their cost effectiveness, smoking-cessation services are not covered by many healthcare providers. This review concludes that such coverage is warranted, primarily because much less cost-effective secondary and tertiary care is covered, encouraging its utilisation, rather than primary prevention. However, the argument favouring coverage is not as clear-cut as might be assumed. Coverage of smoking cessation amounts to a direct subsidy for smokers who want to quit. It is not health 'insurance' in the theoretical meaning of the term. The distinction is important as healthcare systems contemplate future coverage of a range of behaviour-related preventive interventions.

Animals↗
PubMed2003

Vaccine coverage of pre-school age children in France in 2000.

This article presents results of the main measures on vaccine coverage carried out in France in children up to six years of age. Vaccine coverage is very high for diphtheria, tetanus, pertussis, and poliomyelitis, and satisfactory for vaccination against Haemophilus influenzae b invasive infections. It will be necessary, however, to increase vaccine coverage against measles, mumps and rubella in infants and to ensure efficient catch up. Hepatitis B vaccine coverage is deficient in infants and could be improved when the vaccine is available in a combined form.

BCG Vaccine↗
PubMed1999

Immunisation coverage in Australian children: a systematic review 1990-1998.

The Australian Childhood Immunisation Register (ACIR) commenced operation in January 1996 and provides a comprehensive database of children's immunisations in Australia. The ACIR enables implementation of an immunisation recall and reminder system and improved surveillance and reporting of immunisation coverage. Before the introduction of the ACIR, the methods used in assessing coverage varied widely in design and quality, with few studies measuring coverage at national or statewide level. This is a systematic review of the scope and reliability of estimates of immunisation coverage available in Australia from 1990 to 1998. A total of 108 studies were identified of which 51 were classified as higher quality based on a range of criteria including whether they had a response rate of 50% or better.

Adolescent↗
PubMed2000

A re-evaluation of immunisation coverage estimates from the Australian Childhood Immunisation Register.

Immunisation coverage reporting using data from the Australian Childhood Immunisation Register is likely to underestimate immunisation uptake. Since 1997, several initiatives have been introduced to improve both immunisation uptake and notification of immunisation encounters. These initiatives seemed likely to have changed previous coverage estimates. Re-calculation of immunisation coverage estimates for the previously reported cohorts was undertaken. This used current Australian Childhood Immunisation Register data--especially the immunisation history form and the impact of catch-up immunisations--to evaluate delayed reporting. Previous coverage estimates published in Communicable Diseases Intelligence were shown to be at least 2% to 4% below estimates based on data now held by the Australian Childhood Immunisation Register, with greater differences observed in particular jurisdictions.

Algorithms↗
PubMed2000

Improving pneumococcal vaccination coverage among older people in Victoria.

Although pneumococcal vaccine is recommended by the National Health and Medical Research Council and is cost-effective in preventing invasive pneumococcal disease, it is the only vaccine on the standard schedule that is not nationally funded through public health grants to the States. In Victoria, the Department of Human Services has provided free pneumococcal vaccine to people aged 65 years and over since 1998. Pneumococcal vaccination was given in conjunction with the annual influenza vaccination program; 28.5% of the eligible cohort (95% CI, 24.8%-32.1%) received pneumococcal vaccine in 1998, giving an estimated cumulative coverage of 42% (13.4% had received it in 1997). We expect coverage will continue to increase over time, but revaccination every five years will present a substantial financial burden; access to vaccine is critical to improving coverage. Our experience in Victoria suggests that a nationally funded program, administered similarly to the influenza vaccination program, would dramatically increase pneumococcal vaccination coverage at a national level.

Adolescent↗
PubMed1990

Quarterly listing of program issuances and coverage determinations--HCFA. General notice.

This notice lists HCFA manual instructions, interpretative rules, statements of policy, and national coverage determinations that were published during July, August and September 1989 that relate to the Medicare program. Section 1871 (c) of the Social Security Act requires that we publish a list of our Medicare issuances in the Federal Register every three months. We also are providing the contents of several revisions to the Medicare Coverage Issues Manual. On August 21, 1989 we published (42 FR 34555) the content of the Manual and indicated that we will publish quarterly any updates. Adding the Coverage Issues Manual changes to this listing allows us to fulfill this requirement in a manner that facilitates easy identification of coverage and other changes in our manuals.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Alternatives for expanding health insurance coverage.

In March 1990, nearly 14 percent of the U.S. population was without health insurance. This article examines five approaches to increase coverage: tax credits for the purchase of private insurance; changes in the regulation of the private insurance market; additional requirements on employers to provide employment-based insurance; expansion of Medicaid to selected groups; and a universal public health insurance program. Coverage would be most improved under a universal public insurance plan, and least improved by regulatory changes in the private insurance market. Significant but incomplete increases in coverage could be achieved through either new employer mandates or expansion of Medicaid. A tax credit could increase coverage appreciably only if it was substantial relative to the cost of insurance, and even then most of the credits would go to those who would have purchased insurance anyway.

Data Collection↗
PubMed1992

The need for tail coverage in medical malpractice insurance.

In today's litigious society, it is more important than ever that physicians purchase "tail" coverage--that is, insurance for claims asserted after the period covered by their basic insurance arising from occurrences during the insured period. This article describes the tail of a medical malpractice insurance policy, the need for and purpose of tail coverage, the methods of pricing such coverage, and the problems associated with the tail coverage provisions of medical professional liability insurance.

Actuarial Analysis↗
PubMed1993

Employer health coverage for domestic partners--identifying the issues.

Several well-known companies now offer employees the opportunity to provide health coverage to gay, lesbian, or opposite-sex domestic partners, and others are considering doing so. This article examines the practical, tax, and other legal issues that employers need to consider as they make decisions about this benefit. Issues include the criteria that employees and their domestic partners must meet in order for coverage to be available, the cost of coverage, and how coverage is taxed in different situations.

Decision Making, Organizational↗
PubMed1994

Medicare program; Medicare coverage of screening mammography--HCFA. Final rule.

This final rule revises interim final regulations on Medicare coverage of screening mammography that were published in the Federal Register on December 31, 1990 (55 FR 53510). Those regulations implemented section 4163 of the Omnibus Budget Reconciliation Act of 1990, setting forth payment limitations and conditions for coverage of screening mammography. The conditions consist of quality standards to ensure the safety and accuracy of screening mammography services performed by qualified physicians and other suppliers of these services. As a result of the implementation of the Mammography Quality Standards Act of 1992 (MQSA) by the Food and Drug Administration (FDA), we are conforming the conditions for coverage to the applicable FDA certification requirements that all Medicare suppliers of services must meet effective October 1, 1994. The revisions in this final rule also respond to certain comments we received on the interim final rule published on December 31, 1990; they provide clarification of certain of its provisions; and they establish conditions for coverage of diagnostic mammography that are similar to those we have established for screening mammography. In addition, this final rule reflects changes resulting from the final rule on the fee schedule for physicians' services, which was published in the Federal Register on December 2, 1993 (58 FR 63626).

Ambulatory Care Facilities↗
PubMedDate not supplied

Technology assessment and coverage decision making.

In the health care decision-making cascade, technology assessment renders the initial evaluative judgement about the contribution of a technology to patient care. As such, it has a major impact on coverage policy, clinical guidelines and utilization management. This impact necessitates that technology assessment have a scientific, defensible process. There are four basic components of a scientific, defensible process for both clinical and coverage decision making. These are: 1. Outcomes data that are derived preferably from controlled clinical trials and that support the safety and effectiveness of a specific indication 2. Evidence of acceptance by the practicing medical community of specific applications of a technology 3. A rigorous, evaluative process that synthesizes and analyzes outcomes data and expert opinion 4. Consistency in the use of terminology, as it is translated from the technology assessment process to coverage policy The process must be designed to assure scientific and methodological defensibility. Also, it must be designed to facilitate and substantiate the medical and coverage decision-making processes. Finally, it must be designed to enable and expedite the implementation of the managed care philosophy (i.e., outcomes-based decision making) within a particular health plan.

Cost-Benefit Analysis↗