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At least 955 records · Page 53Linked to original sources
PubMed1992

Covering the costs of care in neonatal intensive care units.

The continued rise of health care costs, despite private and governmental control efforts, has sustained cost containment as a central issue for health care researchers and policy makers. In keeping with these concerns, the Florida Health Care Cost Containment Board conducted a study of neonatal intensive care units (NICUs) in Florida to ascertain the costs, charges, and net revenues associated with NICU services in individual hospitals, to document cost shifting and cross-subsidization as a means of financing NICU care for indigent populations, and to assess the fiscal impact of NICUs in state-sponsored vs non-state-sponsored Regional Perinatal Intensive Care Center hospitals providing NICU care. Hospitals in the state-sponsored program reported a loss of approximately $16.5 million in contrast to the non-state-sponsored hospitals, which reported a gain of $1 million. Payment being generated by private-pay patients amounted to almost 60% of total revenues but constituted less than one third of the costs in state-sponsored hospitals, indicating a high level of cost shifting. Government support of state-sponsored NICUs, while substantial, has been insufficient; increasing constraints on this funding source would likely worsen the deficit and increase the necessity of cost shifting.

Ancillary Services, Hospital↗
PubMed1986

Health and medical care in Sweden.

The Swedish health care system is funded by a government-sponsored health insurance scheme and is structured on a regional basis. This system has provided a high level of care, reflecting a continuing commitment by the major political parties. Private practice does persist on a limited scale.

Hospitals↗
PubMed2006

Meeting the need for state-level estimates of health insurance coverage: use of State and Federal survey data.

OBJECTIVE: Critically review estimates of health insurance coverage available from different sources, including the federal government, state survey initiatives, and foundation-sponsored surveys for use in state policy research. STUDY SETTING AND DESIGN: We review the surveys in an attempt to flesh out the current weaknesses of survey data for state policy uses. The main data sources assessed in this analysis are federal government surveys (such as the Current Population Survey's Annual Social and Economic Supplement, and the National Health Interview Survey), foundation-supported surveys (National Survey of America's Families, and the Community Tracking Survey), and state-sponsored surveys. PRINCIPAL FINDINGS: Despite information on estimates of health insurance coverage from six federal surveys, states find the data lacking for state policy purposes. We document the need for state representative data on the uninsured and the recent history of state data collection efforts spurred in part by the Health Resources Services Administration State Planning Grant program. We assess the state estimates of uninsurance from the Current Population Survey and make recommendations for a new consolidated federal survey with better state representative data. CONCLUSIONS: We think there are several options to consider for coordinating a federal and state data collection strategy to inform state and national policy on coverage and access.

Data Collection↗
PubMed2005

Legislating "sound science": the role of the tobacco industry.

In the late 1990s, in an effort to dispute the link between secondhand smoke and lung cancer, Philip Morris initiated a campaign to legislate "sound science." The campaign involved enacting data access and data quality laws to obtain previously confidential research data in order to re-analyze it based on industry-generated data quality standards. Philip Morris worked with other corporate interests to form coalitions and work-groups, develop a "data integrity" outreach program, sponsor symposia on "research integrity," and draft language for the new acts. The tobacco industry played a role in establishing laws that increase corporate influence on public health and regulatory policy decisions.

Expert Testimony↗
PubMed2001

Allowing small businesses and the self-employed to buy health care coverage through public programs.

The large number of uninsured working Americans and the extent of public support enjoyed by employment-based health insurance argues for a coverage initiative that fosters access to affordable benefits through employment. This proposal, which reflects models in both Massachusetts and Michigan, entails the development of publicly organized and subsidized group health insurance for small firms with low-wage workers. States would provide overall administration and subsidies to both employers and employees. Employers would enroll workers, select insurers, pay premiums, and report data on employment status. The program would be a legislative extension of the State Children's Health Insurance Program (SCHIP), with federal financing to participating states at each respective SCHIP rate. Anti-crowd-out provisions would be included. This program is both administratively and politically feasible. It is also consistent with current thinking regarding public/private partnerships and the desirability of preserving a voluntary employer-sponsored health insurance system.

Adult↗
PubMed1979

Cost-effectiveness considerations in planning a preventive dental programme for British Columbia.

The Government of British Columbia, Canada, with organized dentistry, in 1974, sponsored research towards the introduction of a comprehensive children's dental programme. Dental care was at that time primarily provided by private practitioners on a personal fee-for-service basis, which system was working close to capacity. Educational and preventive dental programmes in school and health centres were sponsored by governments. Utilization of treatment services by children was estimated at a maximum of 60 per cent per annum. For the improvement of overall dental health, it was adjudged this should be at least 90 per cent. Approximately 45 per cent of children's treatment was related to dental caries. Four possible dental care delivery systems were costed. It was essential that the comprehensive programmed include proven anti-cariogenic measures and that they be the most effective in cost and in the utilization of professional personnel. Techniques for measurement of effectiveness were reviewed. Using a modified Davies cost-benefit ratio, four professionally applied and four self-administered topical fluoride systems were compared. The Knutson-Szwejda technique scored highest when used by community dental health programmes. In a private practice system or in large paediatric clinics the annual application of acidulated phosphate fluoride would be preferable. In British Columbia, experience has indicated problems with continuing school cooperation in mouth rinse programmes. Statistical proof of the effectiveness of "brush-in" programmes was adjudged as inconclusive but hopeful.

Adolescent↗
PubMed2000

Thomas Hodgkin: social activist.

Thomas Hodgkin's discovery of a lymph gland disorder is merely one event in a life of unusually varied public activities in the social reform and humanitarian movements of the mid-19th century. He wrote pamphlets on medical care for the working-class poor, public health, housing, sanitation, and the relief of cold, hunger, and unemployment. Hodgkin wrote about the problems arising from urban renewal and suburban development. His contributions to geographic explorations, anthropology, ethnology, and foreign affairs are virtually unknown today. Hodgkin's opposition to slavery and the slave trade involved him in the development of settlements in Africa for freed slaves and disputes with the abolitionists in America. He fought for social justice and human rights for native populations being oppressed by British foreign policy in South Africa and New Zealand. His criticism of the exploitation of Indians by the Hudson's Bay Company's fur trade contributed to a professional conflict in the highly politicized environment of Guy's Hospital and blocked advancement of his medical career. Closer to home he advocated reform of medical education and practice and sponsored adult education programs. As a member of its Senate, he helped in establishing London University, the first nonsectarian institution of higher learning in England. He lectured to working people on the means of preserving and promoting health and advocated prepaid medical care for the working poor. Concerned about unequal distribution of medical care, he opposed medical contracts to the lowest bidder and price-determined government plans for health care. He consistently maintained that the basic problems of the poor were not medical but socioeconomic. Since charity leaves nothing behind in exchange, Hodgkin was certain that greater benefits would result if charitable money was used to provide jobs. He denounced the evils of tobacco, practices of trade unions, and barbarous prize fights. On a trip to Jerusalem with Sir Moses Montefiore in 1866, Hodgkin contracted dysentery and died. He is buried in a protestant cemetery in Jaffa. His epitaph is fitting: "Nothing human was alien to him."

England↗
PubMed1998

The use of ACE inhibitors for congestive heart failure among Delaware Medicare beneficiaries.

The analysis upon which this publication is based was performed under Contract Number 500-96-P603, entitled, Utilization and Quality Control Peer Review Organization for the State of Delaware, as sponsored by the Health Care Financing Administration (HCFA), Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The author assumes full responsibility for the accuracy and completeness of the Health Care Quality Improvement Program initiated by HCFA, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore, required no special funding on the part of this Contractor. Ideas and contributions to the author concerning experience in engaging with issues presented are welcomed.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2001

The NCI-Ireland consortium: a unique international partnership in cancer care.

The Ireland-Northern Ireland-National Cancer Institute Cancer Consortium was launched in October of 1999, at a conference in Belfast, Northern Ireland, for the development of cancer programs in Ireland and Northern Ireland, where cancer is a significant cause of mortality and morbidity. Cancer services there have undergone major restructuring as a result of several government reports. Specifically, the National Strategy Document for Cancer proposed that cancer treatment services should be centered around primary care services, regional services, and a national coordinating structure where supra-regional centers would deliver specialist surgery, medical and radiation oncology, rehabilitation, and specialist palliative care. Therefore, this was an opportune time to bring the National Cancer Institute (NCI) on board in a determined effort to redevelop and significantly improve services and outcomes for cancer patients throughout the island. During the NCI All Ireland Cancer Consortium, initial major goals were established as follows: A) To share best available technology and enhance clinical research; B) conduct joint clinical research studies involving people from all jurisdictions; C) sponsor formal training exchanges for Irish and American scholars in cancer programs in partner institutions; D) implement the use of teleconferencing, telesynergy, and other information technology capabilities to facilitate education, and E) consolidate the Cancer Registries of Ireland and Northern Ireland and learn more about cancer incidence and trends on the entire island. In the past year, significant advances have been made in all these areas. Plans are already under way for the second NCI All Ireland Cancer Conference which will be held in late 2002 and feature speakers from Ireland, Northern Ireland, the U.S., and other areas. It will be open to all oncologists, researchers, nurses, students, and other health care professionals interested in learning and enhancing cancer care and research.

Adolescent↗
PubMed1999

ACE inhibitor/CHF interim report. West Virginia Medical Institute.

The analysis upon which this publication is based was performed under Contract 500-96-P603, entitled, "Utilization and Quality Control Peer Review Organization for the State of Delaware," sponsored by the Health Care Financing Administration (HCFA), Department of Health and Human Services. The content of this publication does not necessarily reflect the views of or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The author assumes full responsibility for the accuracy and completeness of the Health Care Quality Improvement Program initiated by HCFA, which has encouraged the identification of quality improvement projects derived from analysis of patterns of care, and therefore, required no special funding on the part of this Contractor. Ideas and contributions to the author concerning experience in engaging with issues presented are welcome.

Angiotensin-Converting Enzyme Inhibitors↗
PubMedDate not supplied

[The human genome project: reflections of an expert].

Just about five years have elapsed since a handful of leading scientists began to discuss the opportunity to launch the Human Genoma Program, an international organized effort to characterise all the genetic material--DNA--of the human organism. Today, the project is well under way with the participation of tens of thousands investigators from all over the world and the direct involvement of major sponsoring bodies such as the United States Department of Energy and the National Institutes of Health, the European Economic Council, the USSR Academy of Sciences and the Governments of France, Great Britain, Italy, Japan and Spain. Yet, the reactions of the general public to the Project is, to say the least, very diverse. Some are sure of its positive impact on the prevention and cure of inherited diseases, some fear its infringence on individual privacy, but the majority remains totally indifferent. Since the lack of adequate information is the common denominator at the root such different reactions, this Editorial will try to summarise the major issues of the Project and their impact on Society.(ABSTRACT TRUNCATED AT 250 WORDS)

Human Genome Project↗
PubMed1996

Business, households, and government: health spending, 1994.

During the 1990s, growth in health care costs slowed considerably, helping to lessen the spending strain on business, government, and households. Although cost growth has slowed, the Federal Government continues to pay an ever-increasing share of the total health care bill. This article reviews important health care spending trends, and for the first time, provides separate estimates of the employer and employee share of the premium costs for employer-sponsored private health insurance. This article also highlights some of the emerging trends in the employer-sponsored insurance market, including managed care, cost-sharing, and employment shifts.

Data Collection↗
PubMed2005

The utilization of dental hygiene students in school-based dental sealant programs.

Early detection of childhood caries is important to childrens' overall health. Untreated childhood caries can lead to pain, as in abscesses from prolonged neglect; altered dietary intake; and delays in the development of the permanent teeth if the primary teeth are prematurely lost. In the summer of 2000, funds were provided to various oral health care provider organizations by the Illinois Department of Public Health, Division of Oral Health, to purchase portable equipment to deliver preventive services (i.e., exams, sealants, and oral hygiene education) to second-grade and sixth-grade children who qualified for Medicaid and/or free and reduced-cost lunch programs. The Dental Sealant Grant Program at Southern Illinois University in Carbondale was a unique program that utilized dental hygiene students as the primary human resource. Within the state, the Dental Sealant Grant Program was, at the time of this report, the only grantee sponsored by a stand-alone dental hygiene program (not affiliated with a dental school). Other positive aspects of the dental hygiene-sponsored sealant program were that the supervising dentist was the primary Medicaid provider and a member of the dental hygiene faculty; dental hygiene faculty participated actively as site coordinators and clinicians; and dental hygiene students were given the opportunity to volunteer for the program as a service-learning option.

Child↗
PubMed1970

The role of a medical faculty in reorganizing family practice to meet current community needs.

There exists a crisis in the delivery of medical services, particularly by family doctors of whom there is an apparent shortage.A STUDY OF FAMILY PRACTICE IN KINGSTON, ONTARIO, AND IN THE NEARBY COUNTRYSIDE INDICATES THREE CRITICAL NEEDS IN FAMILY PRACTICE: professional assistants for the family doctors, efficient office facilities and new methods of delivering family medical care in rural areas. The Faculty of Medicine at Queen's University has involved itself in a study of these matters and is developing a program to help solve them, by research into the nature of the problems and into methods for alleviating them, by keeping practising physicians informed through research reports and the continuing education program of the Medical School, by the development of pilot projects, and by the evaluation of new services aimed at these problems, independently launched by physicians in the community. Pilot projects to date include two designed to study the use of registered nurses as doctor assistants and another which involves the organization and operation of a university-sponsored community health centre. Last, but by no mean least, the Provincial Government is continually briefed on all these activities.

Attitude of Health Personnel↗
PubMed1979

Hospital-sponsored positive health programs.

Several kinds of positive health programs, ranging from efforts to identify cases of hypertension to the establishment of prenatal and well baby clinics, can be advantageous to the community hospital and to those it serves. Catholic hospitals, with their commitment to social justice, can use their unique positions as community centers of health care to pioneer the development of such programs.

Catholicism↗
PubMed1996

Provider-sponsored networks. Physicians organize for direct contracting.

The Provider Service Network (PSN) concept is part of a wider movement by physicians to restructure for managed care to improve bargaining leverage for America's more than 600,000 active medical practitioners. Direct contracting has a simple appeal--no intermediaries. Imagine managed care contracts without the costs or hassles of an HMO or third-party intermediary. The PSN is a new form of managed care organization, but without the middleman. Savvy, self-insured employers, business coalitions, and government health programs are the potential "buyers." Doctors and hospitals are the "sellers," organizing provider networks on a regional and statewide basis. Up for grabs are over 225 million consumers whose health benefits are currently managed by insurance plans, HMOs, and third parties. This new marketplace of direct contracting may sound to doctors like the Garden of Eden, but there is plenty of opposition. PSNs will not become a national trend without a fight.

Case Management↗
PubMedDate not supplied

The tax code at the bedside.

Last June, Washington's Heritage Foundation sponsored a symposium called ¿Restoring the Doctor-Patient Relationship: The Challenge of Third-Party Payment and Government Regulation.¿ This article, adapted from those proceedings, argues that tax fairness and choice are critical underpinnings of ethical medicine in the managed care era.

Ethics, Medical↗
PubMed1998

PSO requirements taking shape.

Federal legislation recently established a new type of managed care plan known as a provider sponsored organization. As a result, hospitals, physicians and other providers can now contract directly with the federal government for Medicare members rather than through health maintenance organizations. Standards for the new health plans are being developed, including the contentious solvency standards.

Contract Services↗