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PubMedDate not supplied

Vaccination coverage assessment survey in Mangalore (urban), Karnataka.

A vaccination coverage assessment survey regarding the U.I.P. vaccines, among 210 children aged 12-23 months and 210 mothers of infants was undertaken in Mangalore (urban) in February--March 1991, with the specific objectives of assessing the extent of achievement here of the U.I.P. objectives for the vaccine coverages, and identifying the reasons for immunization failures as well the sources of immunization. The sample population was selected by the standard WHO. 30 cluster sampling technique. A door-to-door survey was undertaken in the study population and the data was elicited by interview of mothers (and confirmed from vaccination cards or registers if available). The investigator inquired about DPT 3, OPV 3, one dose each of BCG and Measles vaccine and TT2/B for mothers. The coverages for the individual vaccines were observed as follows (and indicated in parentheses) DPT 3 (91.9%) OPV 3 (92.3%), BCG (91%), Measles vaccine (69.5%) and TT2/B for mothers (94.7%). The drop-out rates from first to third dose of both DPT and OPV were observed to be 2.5%. The major reasons for immunization failures were reported to be unawareness of need, illness of child, and fear of side reaction. Hospitals were availed of more than private sources for immunization services. The universal immunization coverage in Mangalore (urban) was found to be highly satisfactory.

Child Health Services↗
PubMedDate not supplied

Coverage errors of two shade guides.

Dental shade guides contain a limited selection of colors compared to those found in human teeth. An error in shade selection is thus introduced, since many tooth colors must be defined by approximation to the nearest shade of the guide. The Bioform and Vita Lumin guides, and a combination of the two, were spectrophotometrically compared to the published colors of 335 human teeth. The minimum CIE L*a*b* color difference was calculated for each tooth using each shade guide. The average of these color differences was defined as the coverage error. The Bioform and Vita shade guide coverage errors were not significantly different, but the coverage error was significantly lower when the combination was used. The use of both guides in shade selection is recommended to reduce the coverage error.

Color↗
PubMed1990

Coverage of sixty core veterinary medical journals by ten indexing and abstracting tools.

Ten indexing and abstracting reference sources were examined for their coverage of 60 core veterinary medical journals. The costs of the indexes also were compared. Coverage of the 60 core veterinary journals ranged from 8 of 60 journals by Current Contents--Life Sciences to 57 of 60 by Index Veterinarius. Based on yearly costs, format, and coverage of the 60 core veterinary journals, Small Animal Practice and the 2 editions of Veterinary Reference Service were determined to be the most useful for private practitioners. The Index Veterinarius gives the most complete coverage of the core veterinary journals for veterinary research workers who have access to a library.

Abstracting and Indexing↗
PubMed1990

Immunization coverage evaluation surveys in rural Narela zone and city zone areas of Delhi.

A major purpose of the immunization coverage evaluation surveys to document the vaccination status of children aged 1-2 years was to determine the true picture of the immunization status of the target population and to identify areas which need strengthening. Immunization coverage evaluation surveys were carried out for a 2.4 lakh rural and 2.2 lakh urban population of Delhi by the cluster sampling method. A total of 210 and 212 children, respectively aged 12 to 23 months, were included in the study in 30 randomly selected clusters in each zone. The percentage of children immunized with DPT3/OPV3/BCG was 70.0 and 73.1 in the rural and city zones, respectively while those immunized with DPT3/OPV3/BCG/Measles was only 30.0 and 37.3% in the two zones. Dropout rate for DPT and OPV, I to III was 16-18%. The drop out rate between DPT and OPV II and III was higher than that between DPT and OPV II and II. Percentage of non-immunized children was significantly higher in rural (8.0%) as compared to urban areas (2.3%). Maximum immunizations were done by the Health Centres. Done on a periodic basis, a coverage evaluation survey will show whether or not vaccination coverage objectives have been met.

Child, Preschool↗
PubMed1990

Vaccination--coverage of under-fives, validity of records, and the impact of mass campaigns in the Edendale/Vulindlela district of KwaZulu.

Recent epidemics of poliomyelitis and measles in the Edendale/Vulindlela district of KwaZulu spurred an investigation into the causes of vaccination failure. Vaccination coverage achieved by routine clinic services and by two mass campaigns was assessed. The validity of routine clinic vaccination records was also determined. Using a modified 30 x 7 random cluster sampling technique, 224 children aged 1-5 years were studied. Of these, 62% had a 'Road to Health' card. Best estimates show that 87% had had BCG, 62% three doses of diphtheria, pertussis and tetanus and polio, and 55% measles vaccine. The mass campaigns raised coverage for measles by 26%, and that for polio by 27%. Coverage estimates made from routine clinic data were consistently 13-25% higher than from this survey. This discrepancy is unfortunate, since it could lead to complacency if certain targets are apparently achieved using only clinic records, and points to the need for regular population-based surveys in all but the best organised health services. Inadequate vaccination coverage alone can explain the epidemics of polio and measles. The reasons for this, in the presence of an adequate clinic infrastructure, need to be assessed urgently to prevent further outbreaks.

Child, Preschool↗
PubMed1990

[Vaccination coverage in a pediatric population attended by a primary health care center].

It is hereby presented a quality control study of a systematic vaccination program developed in an urban primary care center. Target population were children between 0 and 8 years attended in the center. They were considered as having a correct vaccination coverage those cases in which it was possible to verify documented accomplishment of the local vaccination schedule. Out of the 538 children included in our study, 168 (31%) were founded not to have appropriate vaccination coverage evidenced in their clinical records, and their families were requested for an interview: 126 (75%) attended de appointment. In 93 of them it was founded a recording mistake, and 33 cases were verified as no correctly covered. Vaccination coverage rate was 86%, being inverse relationship between age and coverage rate. They are discussed corrective actions derived from the quality control.

Child↗
PubMed1990

Florida orthopedic surgeons react to liability concerns. Lower insurance coverage, protect assets, avoid trauma.

Three hundred thirty-six Florida orthopedic surgeons, an estimated 40% of those in active private practice, responded in a survey regarding liability effects on their practice. They indicated an average of 1.9 suits per surgeon, up from an average of 1.3 two years previously. Seventeen percent reported no professional liability coverage and combined with those who had dropped "tail" coverage to lower their premium, 29% are partially or completely uninsured. Half the surgeons responding reported $250,000 coverage or less; many more indicated their intention to reduce or eliminate coverage soon. Sixty-three percent have carried out estate planning asset protection steps. Responding to liability threats, 70% report significant recent practice style changes, the most common being avoidance of trauma patients and increasing the number of x-rays and tests ordered for patients. Origin of patients who subsequently became plaintiffs was usually the emergency room; however, the alleged injury usually occurred in the operating room later in that hospitalization.

Adult↗
PubMed1989

Overview of the Medicare Catastrophic Coverage Act of 1988 and its impact on health-care delivery.

The Medicare Catastrophic Coverage Act of 1988 is described, and its impact on health-care delivery is discussed. The act will expand Medicare coverage of inpatient hospital care and will also provide payment for outpatient prescription drugs and home i.v. therapy. For the prescription drug benefit, deductible and coinsurance payments will be phased in, and Medicare will establish payment limits. A per diem fee schedule will be established to pay for the supplies and services used in home i.v. therapy. Providers of home therapy must have qualifications specified by the act. Pharmacists will have an important role in ensuring that patients understand and comply with their drug therapy once they leave the hospital. As members of the home health-care team, pharmacists will be involved in identifying candidates for home care, instructing patients in the use of sophisticated medical equipment, and monitoring the safety and efficacy of therapy. Medicare beneficiaries will help finance the new coverage by paying a flat premium; in addition, all individuals eligible for Medicare will pay supplemental premiums based on their federal income tax liability. Congress, however, will come under pressure to lower or freeze these premiums. Hospitals and pharmacists should cooperate in urging Congress to provide adequate funding for services specified by the catastrophic coverage act.

Catastrophic Illness↗
PubMed1988

Estimating vaccination coverage: routine information or sample survey?

The manager of a district immunization programme needs to regularly assess vaccination coverage. This case study from Zimbabwe describes how routine information can be used for this purpose. The number of children and their location in the district was estimated from several sources using a variety of methods. This suggested that under-enumeration at the 1982 census was probably as high as a third and was a particular problem among children aged under 1 year. Routinely collected figures of the number of vaccinations were then used to calculate coverage levels for different health unit catchment areas within the district. These levels varied considerably and were lowest in areas with significant numbers of Apostolics, a group who often reject immunization on religious grounds. Comparisons between estimates of coverage obtained from routine information and a sample cluster survey raised several issues. These included accuracy of routine information, precision of sample surveys, estimating differential coverage in the district, management uses of estimates and the cost of data collection.

Adolescent↗
PubMed1985

Health insurance coverage amongst families with school aged children.

The level of private medical insurance coverage was studied in a sample of 1106 seven year old children and their families who were participants in the Christchurch Child Development Study. In the last seven years, there has been a rapid increase in the number of families who were covered by private medical insurance: in 1977 an estimated 18% of families had coverage and by 1984, this figure had risen to 43%. Levels of coverage were correlated with a large number of factors associated with family social background including single parenthood, low income, poor parental education, Polynesian ethnicity, depressed living standards, family size and parental age. However, multivariate analysis suggested that the primary determinants of insurance coverage were family earning power and family structure. The social implications of these findings are discussed.

Child↗
PubMed1983

Primary versus delayed soft tissue coverage for severe open tibial fractures. A comparison of results.

Thirty-six Types III and IIIa open fractures of the tibial shaft are presented with a treatment protocol based on early, aggressive wound management and fracture coverage utilizing muscle, myocutaneous, or free flap techniques. There were five amputations, seven deep infections, three nonunions, and no cases of chronic osteomyelitis in the series. The criteria for inclusion in the series were definitive wound coverage by 30 days after injury and end-result records including time of union. Wound coverage was classified as early (0-7 days) or late (8-30 days). Major and minor wound healing disturbances were found in 20.8% of the early and 83.3% of the late groups, with mean union times of 4.0 months and 6.4 months, respectively. Extensive and serial debridements, coverage within five to seven days, and early bone grafting produce a viable soft tissue envelope and a favorable mesenchymal milieu for the healing of complex open fractures. This significantly improves end results with respect to union, tissue loss from infection, healing time, and cost of hospitalization and rehabilitation.

Debridement↗
PubMed1980

Coverage for meningococcal disease in the Norwegian morbidity and mortality statistics. With reference to incidence and fatality trends.

The case coverage for meningococcal (MC) disease in the old notification system (ending 1974) in Norway was estimated at 52%. In contrast, an estimate for the new system (MSIS) is 76%. The latter is considered to verify the 72% found earlier. Adjustments for coverage resulted in a 160% increase in incidence from 1967-73 to 1974-79, whereas the unadjusted figure was 246%. A new estimate of MC death registration coverage is 78%, which verifies the 82% found earlier. Case fatality ratios in the two periods are 10.9% and 10.5% when adjusted, compared with 17.1% and 12.4% when unadjusted. Coverage estimates seem relatively stable, but if they were to be put under surveillance with the help of a sampling scheme, broader application and more appropriate confidence levels might be obtained for routine data.

Adolescent↗
PubMed1980

Report of the Universal Social Security Coverage Study Group: executive summary.

Authorized under the 1977 amendments to the Social Security Act, the Universal Social Security Coverage Study Group was established at the direction of Congress by the Secretary of Health, Education, and Welfare in 1978. Its 2-year mission was to examine the feasibility and desirability of mandating coverage under the social security program for Federal workers and for noncovered employees of State and local governments and private nonprofit organizations. The group reviewed the coverage held by workers who would be affected, developed options for and alternatives to mandatory coverage, analyzed the effects of each option and alternative, and consulted with other Government agencies and with members of the public. To assess public attitudes, testimony was received from private citizens, public officials, and representatives of interested organizations at public hearings held in seven locations. In the following executive summary, sections refer to chapters in the full report.

Feasibility Studies↗
PubMed1994

Complete-crown and partial-coverage tooth preparation designs for bonded cast ceramic restorations.

A new concept for tooth preparation design for complete- and partial-coverage all-ceramic restorations is presented. Because of the efficacy of third-generation dentinal bonding agents, the preparations for complete-coverage and partial-coverage restorations can be made with less emphasis on retentive form. For partial-coverage restorations, cavosurface angles should be large so that the resultant configuration of the enamel rods is conducive to optimal bonding. The new preparations are simple, with extremely tapered axial walls, to allow maximum thickness of the ceramic material. These types of preparations result in finished restorations that are stronger and have better margins and less chance of microleakage. Long-term success of these types of restorations will be determined by the success or failure of the dentinal bonding agent and resin cement system used.

Crowns↗
PubMed1995

Understanding the factors behind the decision to purchase varying coverage amounts of long-term care insurance.

OBJECTIVE: This article examines the factors related to an individual's decision to purchase a given amount of long-term care insurance coverage. DATA SOURCE AND STUDY SETTING: Primary data analyses were conducted on an estimation sample of 6,545 individuals who had purchased long-term care (LTC) insurance policies in late 1990 and early 1991, and 1,248 individuals who had been approached by agents but chose not to buy such insurance. Companies contributing the two samples represented 45 percent of total sales during the study year. STUDY DESIGN: A two-stage logit-OLS (ordinary least squares) choice-based sampling model was used to examine the relationship between the expected value of purchased coverage and explanatory variables that included: demographic traits, attitudes, risk premium, nursing home bed supply, and Medicaid program configurations. DATA COLLECTION: Mail surveys were used to collect information about individuals' reasons for purchase, attitudes about long-term care, and demographic characteristics. Through an identification code, information on the policy designs chosen by these individuals was linked to each of the returned mail surveys. The response rate to the survey was about 60 percent. PRINCIPAL FINDINGS: The model explains about 47 percent of the variance in the dependent variable-expected value of policy coverage. Important variables negatively associated with the dependent variable include advancing age, being married, and having less than a college education. Variables positively related include being male, having more income, and having increasing expected LTC costs. Medicaid program configuration also influences the level of benefits purchased: state reimbursement rates and the presence of comprehensive estate recovery programs are both positively related to the expected value of purchased benefits. Finally, as the difference between the premium charged and the actuarially fair premium increases, individuals buy less coverage. CONCLUSIONS: An important finding with implications for policymakers is that changes in Medicaid policy affect the decisions of consumers regarding the acquisition of private LTC policies as well as the level of protection chosen. This is particularly important to states interested in pursuing public-private partnerships in long-term care financing.

Actuarial Analysis↗
PubMed1994

Coverage of genetic technologies under national health reform.

This article examines the extent to which the technologies expected to emerge from genetic research are likely to be covered under Government-mandated health insurance programs such as those being proposed by advocates of national health reform. Genetic technologies are divided into three broad categories; genetic information services, including screening, testing, and counseling; experimental technologies; and gene therapy. This article concludes that coverage of these technologies under national health reform is uncertain. The basic benefits packages provided for in the major health reform plans are likely to provide partial coverage of experimental technologies; relatively broad coverage of information services; and varying coverage of gene therapies, on the basis of an evaluation of their costs, benefits, and the degree to which they raise objections on political and religious grounds. Genetic services that are not included in the basic benefits package will be available only to those who can purchase supplemental insurance or to those who can purchase the services with personal funds. The resulting multitiered system of access to genetic services raises serious questions of fairness.

Federal Government↗
PubMed1994

Vaccination coverage of 2-year-old children--United States, third quarter, 1993.

In 1993, the Childhood Immunization Initiative (CII) was instituted to increase vaccination coverage among 2-year-old children to at least 90% by 1996 for four of the five vaccines routinely recommended for children* and to at least 70% for three doses of hepatitis B vaccine (1). To monitor progress toward these goals, national estimates of vaccination coverage are needed. This report presents national estimates of vaccination coverage among 2-year-old children derived from provisional data from the National Health Interview Survey (NHIS) for the third quarter of 1993 and describes the trend in vaccination coverage since 1992, the baseline year.

Child, Preschool↗
PubMed1993

Ask and you shall be given: practice based immunisation coverage information.

AIMS: To investigate a method for obtaining immunisation information, and investigate the variation in immunisation coverage levels between practices. METHOD: The Wellington Area Health Board computer identified all children born in the first half of 1990 with a general practitioner in the Wellington district. The general practitioner provided the child's immunisation status, if still with the practice. The characteristics of the practice were tested for association with the immunisation coverage level. RESULTS: The method identified approximately 80% of the target population. Most (97%) of the general practitioners agreed to provide immunisation information on the identified children. Immunisation information was obtained on 841 children, or about 65% of the total cohort. The percentage of the children fully immunised in each practice varied from 0% to 100%. An index of neediness of the children in the practice, was the only identified factor which explained variation between practices. Recall systems were neither necessary nor sufficient for obtaining high coverage in these practices. CONCLUSIONS: The study method could form the basis of a system of gathering immunisation coverage information which assists general practitioners with immunisation recall.

Child, Preschool↗