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PubMed1999

[Periodic health examination in its historical perspectives].

The origin of the periodic health examination can be traced to Horace Dobell, a British physician. The periodic health examination became popular in the early 20th century with many advocates such as the life insurance companies, private corporate industry, medical professionals, and the prepaid health care in North America. The contents and legitimacy of periodic health examination has changed markedly over time according to the objectives. There were various objectives of the periodic health examination according to the advocates: reduction of morbidity and mortality, scientific knowledge, economic savings, professional empowerment, the patient-physician relationship, satisfaction of patient demand, and efficient administration. Recent remarkable changes led by Canadian Task Force and U.S. Preventive Services Task Force were the emphasis of reduction of disease-specific morbidity and mortality, risk adjusted application, and the inclusion of counseling, immunization, and chemoprophylaxis. Health screening has become a promising medical practice in Korea. The main environment of the periodic health examination in Korea is fee-for-service system, the national medical insurance system, and Korean cultural background. However, the consensus of Korean government and society for controlling medical cost will limit the irrational prosperity of periodic health examination in near future.

History, 20th Century↗
PubMed2001

Flasch: provider-owned plan focuses on quality, growth, and new technology.

H. Michael Flasch, FHFMA, is vice president of claims/administrative services and support for Detroit, Michigan-based Health Alliance Plan (HAP), a subsidiary of Henry Ford Health System (HFHS), which also comprises a dozen owned or affiliated hospitals, 25 medical centers, and numerous other health services. His responsibilities at HAP encompass benefits coordination, configuration of information services, and the claims function. He also has played a key role in HAP's acquisition and integration of an HMO, SelectCare, in March 2001. Flasch joined HFHS in 1984 as associate controller and senior director of patient financial services. He served as vice president of managed care for HFHS and COO of Alliance Health and Life Insurance Company for HAP from 1995 until 2000, when he assumed his current position. Before Joining HFHS, Flasch worked for Hospital Corporation of America in Nashville, Tennessee, and other hospitals in Cincinnati.

Catchment Area, Health↗
PubMed1975

Epidemiology of lumbar disc lesions in the military in World War II.

A study was carried out in 1095 first Army hospital admissions for lumbar herniation of the nucleus pulposus (HNP) who were individually matched on age and period of service during World War II to holders of Army National Service Life Insurance policies. For both the cases and the comparison group, data were obtained from military records, particularly records of induction into service. Factors showing a statistically significant positive association (p less than 0.05) with admission for HNP in the entire sample and also among enlisted cases matched to enlisted members of the comparison group were: occupation of craftsman or foreman, married status, rural residence, excess height, excess weight, heavy frame, good posture, defects relating to back or legs, military occupation specialty of ground combat, and rank of sergeant or staff sergeant. Factors showing a negative association with admission for HNP in these same groups were: clerical occupation, two or more battle stars earned and officer rank. Essentially the same relationships were found among cases with surgically confirmed diagnoses of HNP, less than 30 years old at hospital admission, and with recent onset of symptoms, when the cases in these groups were compared with their matches in the comparison group. Mechanical factors related to body build as evaluated by height and weight measurements appear to be of significance in the etiology of HNP. Occupational factors also appear to be of importance. Some cases and some controls were hospitalized prior to the first hospital admission of the case for a disease possibly related to HNP. For that time period there were no remarkable differences between cases and controls in service hospital diagnoses, including those of trauma.

Age Factors↗
PubMed1988

Family planning measures, February 1988.

In early 1988, family planning (FP) measures were announced by Mr. Liang Jimin, spokesman for the Chinese State FP Commission. The major points of the measures include: 1) stressing the leading role of the recent reform in general, 2) stabilizing FP policies, and 3) strengthening the organizational frameworks at the grassroots level and improving program performance in backward regions. The policies were explained in detail as follows: "1) to introduce a 'FP contract responsibility system' throughout the country, in order to guarantee the fulfillment of government targets of population plans, such as contracts between governments at different levels, contracts between local government and FP departments; 2) to include the performance of local FP programs as one of the criteria for evaluating the achievements of government officials at various levels, such as relevant provisions in officials' term contracts; 3) to sign FP contracts between couples at reproductive ages and local governments, such as local governments responsible for allocating birth quotas, providing contraceptive equipment and services, and paying incentives and subsidies; the couples would be responsible for using contraceptives and planning births; 4) to improve social security schemes with respect to FP, such as old-age pensions for couples with one child who have undertaken sterilization, only-child life insurance, and contraceptive operation insurance; 5) to increase the proportion of only children among all births and strictly control the quota of authorized second-births in rural areas; 6) to improve education and FP services by relying on community FP associations or "Key Households of FP", to help increase the use rate and reduce the failure rate of contraceptives, increase the quality of contraceptive operations, and reduce the incidence of induced abortion; 7) to adopt measures to eliminate early marriage and early reproduction and introduce population education in middle schools; 8) to enact new laws and regulations, such as 'regulations concerning FP administration at the grassroots level units' and 'regulations concerning FP administration of the highly mobile population'; 9) to increase international exchange and cooperation and import advanced technology and equipment for contraception."

Adult↗
PubMed1999

Partnership with private sector -- Dr. Anthony Pramualratana.

Dr. Anthony Pramualratana, executive director of the Thailand Business Coalition on AIDS, spoke about the NGO response to HIV/AIDS. He cited examples of Business Houses around Asia cooperating to prevent the stigma of HIV/AIDS in the workplace. He said that special groups had now been setup in several countries to help business and industrial houses to deal with the HIV/AIDS situation which includes education/training, a nondiscriminatory approach, no compulsory testing, assistance to staff living with HIV/AIDS, and support of the continuation of life insurance. Dr. Pramualratana explained the goals of his organization: to promote a society where people with HIV/AIDS and their families can live normal lives, free from discrimination and undue physical and mental suffering, where their human rights are protected and they receive the necessary welfare and social support needed to maintain their livelihoods and their dignity as individuals and families; to strengthen and extend the network and capacity of NGOs working on HIV/AIDS and PHA groups in promoting and supporting a society that is understanding, accepting and supportive toward people with HIV/AIDS and their families.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Small solute clearances and nutrition indices in obese patients on continuous peritoneal dialysis.

To investigate the relationship between obesity, small-solute clearances, and nutrition in continuous peritoneal dialysis (CPD), we compared clearances and nutrition indices between 270 obese and 502 normal-weight CPD patients. Degree of obesity was classified by the ratio of body weight (W) to desired weight (DW) at the first clearance study. The DWs were obtained from the tables of the Metropolitan Life Insurance Company, assuming a medium skeletal frame. The obese patients (group I) had W/DW > 1.2 (1.38 +/- 0.17), and the normal-weight patients (group II) had 0.9 < or = W/DW < or = 1.2 (1.05 +/- 0.08). Nutrition indices derived from urea nitrogen and creatinine excretion were normalized by both W and DW. The following variables differed between group I (first value) and group II: sex (women: 48.2% vs. 33.9%), W (87.6 +/- 14.4 kg vs. 68.2 +/- 8.7 kg), body surface area (1.95 +/- 0.22 m2 vs. 1.77 +/- 0.16 m2), body water by method of Watson (41.2 +/- 7.7 L vs. 36.3 +/- 5.5 L), body mass index (31.8 +/- 3.9 vs 24.3 +/- 2.0), protein nitrogen appearance (PNA: 62.9 +/- 17.6 kg in 24 h vs. 57.7 +/- 15.7 kg in 24 h), PNA normalized to DW (1.08 +/- 0.29 g/kg in 24 h vs. 0.96 +/- 0.26 g/kg in 24 h), creatinine excretion (CrEx: 1111 +/- 396 mg in 24 h vs. 991 +/- 348 mg in 24 h), CrEx/W (12.6 +/- 3.7 g/kg in 24 h vs. 15.4 +/- 4.5 g/kg in 24 h), CrEx/DW (17.3 +/- 5.3 g/kg in 24 h vs. 15.1 +/- 4.8 g/kg in 24 h), lean body mass (LBM: 49.3 +/- 13.8 kg vs. 43.6 +/- 11.9 kg), LBM/W (0.56 +/- 0.12 vs. 0.64 +/- 0.15), and LBM/DW (0.77 +/- 0.18 vs 0.67 +/- 0.16), all at p < or = 0.034. Marginal differences (0.10 > p > 0.05) were found in the diabetes prevalence (53.0% vs. 40.8%), height (165.9 +/- 11.7 cm vs. 167.4 +/- 9.8 cm), and serum albumin (3.64 +/- 0.55 g/dL vs. 3.53 +/- 0.62 g/dL). No differences were found in age, duration of CPD until the first clearance study, percent of subjects with anuria, Kt/V urea, creatinine clearance, blood urea nitrogen, serum creatinine, and PNA normalized to W. Obese CPD patients tend to have better nutrition indices than do normal-weight CPD patients with similar small-solute clearances. In obese subjects, normalization by W creates inappropriately low values for nutrition indices derived from urea nitrogen and creatinine excretion. Normalization of those indices by DW appears preferable.

Anthropometry↗
PubMed2003

Intention to pursue genetic testing for breast cancer among women due for screening mammography.

Because few studies have addressed the intention to pursue testing for breast cancer susceptibility among women in the general population, we examined whether women due for routine mammography would want such testing and what factors might impact on their decision to pursue testing. A questionnaire was mailed to women > or =50 years of age who had undergone a screening mammogram 12 to 14 months before the study. Univariate and multivariable analyses were conducted to identify factors associated with intention to pursue genetic testing. Approximately 41% of respondents probably or definitely intended to pursue testing. In univariate analysis, the intention to undergo testing was not significantly associated with age, education, marital status, potential effects on health or life insurance, or physician recommendation. Although significant in univariate analysis, family history of breast cancer and ethnicity were not significant in multivariable analysis. In both univariate and multivariable analysis, factors significantly associated with intention to undergo testing included awareness of genetic testing, cancer worry, and insurance coverage of testing cost. Intention also was associated with the respondent wanting to know whether she possessed the susceptibility gene, even if that knowledge would not impact on options for early detection or treatment. Given the relatively high level of interest in testing among women at average risk of breast cancer, these results may help health care professionals educate and counsel women regarding the appropriate use of genetic testing as well as breast cancer risk factors.

Aged↗
PubMed2003

The changing world of ancillary benefits.

Amid salary and health care benefit cuts, ancillary benefits such as dental, life insurance, long-term disability and vision coverage can communicate employers' concern for their employees as well as serve as recruitment and retention tools. These benefits can be funded by the employer, the employee or both.

Dental Care↗
PubMed1964

THE FUNCTIONING OF A PRIVATE PSYCHIATRIC CLINIC.

SOME OF THE CLINICAL ADVANTAGES OF A PRIVATE PSYCHIATRIC CLINIC ORGANIZED FOR GROUP PRACTICE ARE: Readily available consultations with colleagues; cross-referral with better communication; more evenly filled hours; larger pools of patients for establishing and maintaining group therapy; better off-duty coverage; ready availability of the three disciplines, psychiatry, psychology and social work; satisfaction to the private psychiatrist of being able to arrange competent and prompt treatment for patients unable to meet usual fees; and cooperative research.Financial advantages include economies of time and money, a profit sharing plan, and availability of group life insurance, health benefits and social security.

California↗
PubMed2003

Arterial pressure waveforms in hypertension.

Measurement of arterial pressure waveforms in hypertension enhances information on underlying disease and mechanisms, since it provides all information in the waveform, and not just the extreme limits of the waveform (systolic and diastolic pressure) which are obtained from the brachial artery with a cuff sphygmomanometer. Such studies of the waveform reawaken the clinical use of sphygmography which was used in clinical practice and for life insurance examinations before the cuff sphygmomanometer was introduced by Riva-Rocci in 1896. Modern advances include use of accurate electronic tonometers for pressure recording, application of knowledge on wave transmission in the upper limb, and use of computer techniques to manipulate, store and retrieve data. It is now possible to determine the aortic pressure waveform, and so, left ventricular pressure throughout systole, with an accuracy which is limited only by the inaccuracy of the sphygmomanometer cuff. Clinical application assists in recognition of spurious systolic hypertension as a condition which needs no treatment, and in grading the severity of hypertension for any given value of cuff systolic and diastolic pressure. Application also permits tailoring of drug therapy for the underlying abnormality of increased peripheral resistance or increased stiffness of the large elastic arteries. Information obtained also assists in prognosis.

Age Factors↗
PubMed1992

A benefit-to-cost analysis of a work-site health promotion program.

An analysis of the benefit-to-cost ratio of a major health promotion program was conducted for the years 1986 through 1990, with projections to the year 2000. Program costs for personnel, capital expenses, materials, and rent were determined and compared with program benefits (discounted to account for increasing pension liability) for heath care cost savings, increased productivity, decreased absenteeism, decreased life insurance claims, and program-generated income. After adjusting future monies to net present value, a benefit-to-cost ratio of 3.4 was estimated for the program. Despite the limitations of the study design, the authors concluded that the program realizes a positive return on its investment. Several program recommendations are presented to increase the probability of achieving positive benefit-to-cost ratios in future program offerings.

Absenteeism↗
PubMed1992

[Suicide in psychologically healthy patients].

Suicide of mentally healthy persons is of special interest for life insurance. The different positions of suicide research are founded in different definitions of disease in psychiatry and general medicine. The definitions of sickness and mental health are also of importance for emergency medicine and care for the dying. It's fact that most people commit suicide self responsible.

Ethics, Medical↗
PubMed2004

Understanding long-term care insurance.

Your clients who want to purchase a long-term care insurance (LTC-I) policy will need to consider many factors in their decision making. In this brief we discuss the different types of LTC-I policies and explain the benefits available when applying for a policy.

Aged↗