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PubMed1980

Health Care Financing Administration--Federal health insurance for the aged and disabled; quality control and proficiency testing standards for laboratories in Medicare hospitals. Final rule.

These amendments revise the Medicare regulations to provide that the quality control and proficiency testing requirements used by the American Osteopathic Association (AOA) in accrediting hospital laboratories are now equivalent to those established by the Department. This change reflects the results of a reevaluation made by the Department of upgraded standards adopted by AOA and the actions taken by AOA to implement these standards. The Department (Center for Disease Control) will monitor AOA's performance in applying the standards. The monitoring function shall include the review and transcription of laboratory survey data in AOA's offices which are necessary to the completion of this task. The finding of CDC/PHS monitoring will be used by HCFA to verify the equivalence of the AOA standards to the Federal standards. The amendments will eliminate the need for State health agency inspection of AOA accredited hospital laboratories.

Accreditation↗
PubMed1998

Health-based payment for HIV/AIDS in Medicaid managed care programs.

In recent years, State Medicaid programs have begun adopting health-based payment systems to help ensure quality care for people living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), and to ensure equity for the managed care organizations (MCOs) in which these people are enrolled. In this article, the authors discuss reasons why such payment systems are needed and describe AIDS-specific capitation rates that have been adopted in several State Medicaid waiver programs. The authors also examine comprehensive risk-adjustment systems both within Medicaid and outside the program. Several research questions needing further work are discussed.

Capitation Fee↗
PubMed1999

[Chronic low back pain in 40-year olds in 12 Norwegian counties].

In this study, a questionnaire and a short interview were used to estimate the prevalence of chronic low back pain alone and low back pain together with other musculo-skeletal pains among 40-year-old women and men in 12 Norwegian counties (a total of 67,338 persons). On average 2.4% of men and 1.7% of women had only chronic low back pain, while 5.7% of men and 9.2% of women in addition had other pains as well. Persons with low back pain only were approximately equally distributed across the counties. Greater variations across the counties and between the sexes were found in persons with additional pain. The duration of the pain did not vary significantly between the sexes or across the counties, but the duration was on average two years longer in cases of multi-cause pain. Reduced capacity for work because of pain was approximately equally distributed between the sexes and the groups. More women than men were unable to do their daily work. About one third in both groups (more men than women) had been absent from work because of pain during the last year. More women than men in both groups received national insurance benefits. Persons with only low back pains were approximately equally represented across all levels of education and regardless of marital status, while people with multi-cause pain were overrepresented among those with low levels of education and among the divorced.

Adult↗
PubMed1999

[Effects exercised by the new federal German social legislation SGB III on assessing the incapacity to work by the medical experts of German statutory sickness insurance bodies].

The rules laid down in Volume III of German social legislation have a direct bearing on expertising on the incapacity to work. The article explains the new tolerance limits and the unrestricted validity of the relevant paragraphs of the German social laws and points out the differences in respect of other areas of social care legislation.

Germany↗
PubMed1999

[Differential indications for ambulatory and inpatient medical rehabilitation--results of an expert survey].

Medical rehabilitation in the Federal Republic of Germany has been provided in an almost exclusively inpatient setting up to now. However, in view of an intensified development of outpatient rehabilitation programs there are new challenges to confront. As to indication criteria, new preconditions and handling directives have to be defined in order to refer patients to those rehabilitation programs from which they can profit the most. Up to now, there has been a considerable lack of knowledge as to what kind of criteria must be considered in the transfer process. The present study represents results of expert interviews (Delphi method) regarding this topic. 50 experts from inpatient and outpatient rehabilitation facilities, from the Medical Services of health insurance funds and the pension insurance system, from rehabilitation agencies as well as rehabilitation research, have been questioned since they take important stands on these questions and since their assessment has a guiding quality. An additional study had been directed at the factors which determine present decision-making in terms of inpatient vs. outpatient rehabilitation. The results show that the experts stress the importance of a multitude of different aspects; however, there still is but little consensus concerning the criteria that should invariably be considered in making these rehabilitation decisions.

Adult↗