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PubMed1992

Health care reform a priority in the new legislative year. Congressional leaders outline their agendas on today's vital health issues.

The issue of health care reform set against the backdrop of an election year promises to make 1992 one of the most interesting and significant years in the history of health care policy. This special issue of Hospitals, which coincides with the annual meeting of the American Hospital Association in Washington, DC, brings together the viewpoints of some of the major players in the legislative arena. Congressional leaders expect the 102nd Congress to take unprecedented steps in terms of action on health care reform. Many in the health care field agree that now is the time for action: Among other groups, the AHA considers the status quo unacceptable and is pushing for change. No one knows what the eventual outcome will be, but the mood is shifting toward immediate action. This may be a benchmark year for health care policy.

Budgets↗
PubMed1991

[Quality assurance after the Health Reform Legislation].

The German Health Insurance Reform including a recodified legislation on sickness insurance, is often mainly discussed from the viewpoint of cost reduction. But the reform also creates important incentives to safeguard the quality of health care. A description of the quality assurance system based on the German statutory sickness insurance is given and completed by references to practical approaches to attain the political goals.

Delivery of Health Care↗
PubMed1991

Tap water burn prevention: the effect of legislation.

Five years after a 1983 Washington State law required new water heaters to be preset at 49 degrees C (120 degrees F), 77% of homes (84% of homes with postlaw and 70% of homes with prelaw water heaters) had tap water temperatures of less than 54 degrees C. In 1977, 80% of homes had tap water temperatures greater than 54 degrees C. Mean temperature in 1988 was 50 degrees C compared with 61 degrees C in 1977. Both changes were significant compared with 1977 temperatures. Few people increased their heater temperature after installation. Eighteen burn victims were identified from July 1979 through May 1988, for an average admission rate of 2.4 per year, compared with 5.5 per year in the 1970s. Compared with the 1970s, total body surface area burned, mortality, grafting, scarring, and length of hospital stay were all reduced, while the likelihood that scald burns were the result of child abuse increased to 50%. Both education campaigns and legislation have resulted in significantly safer water temperatures. Further, this change seems to have resulted in a reduction in frequency, morbidity, and mortality of tap water burn injuries in children. Lower water heater settings proved acceptable to the consumer.

Adolescent↗
PubMedDate not supplied

[Organ transplant. The legislative response in Latin America].

This study first examines the ethical and legal aspects of various regulations that govern the procurement and transplantation of organs in 16 countries of Latin America, and reviews the declarations formulated on the subject by the World Health Organization. It then goes on to discuss specific problems concerning postmortem and inter vivo organ donations. The issues cited in connection with the former include donor consent, determination of death, and conflicts of interest on the part of persons involved in donation procedures. The latter refer to such issues as donor consent and compensation, selection of the recipient and commercialization, as well as the international exchange of organs. It is concluded that these countries need to develop more comprehensive government legislations in order to ensure solution of the problems analyzed.

Brain Death↗
PubMed1990

Legislation, litigation, health policy and optometry.

Significant changes in health policy have occurred during the past 25 years. Directed primarily by congressional legislation and judicial opinion, many of these changes have resulted from efforts to control costs, improve quality and increase access. Optometric parity, reimbursement reform, freedom of choice, mandated benefits, commercial speech, self-insurance, competition and peer review are some of the issues that surround many of the more recent attempts at change in the health care market. Optometry has been and will continue to be affected by changes in health policy, especially with regard to issues of cost, quality and access.

Cost Control↗
PubMed1990

AIDS prevention: legislative options.

This article reviews legislative options to prevent the transmission of HIV infection. It distinguishes between pre-exposure measures designed to prevent initial exposure, and post-exposure measures aimed at preventing infected individuals from exposing others. Part I identifies education as the key component of a comprehensive prevention program, and reviews options for pre-exposure education programs designed to avoid or minimize exposure. Part II reviews post-exposure prevention measures, focusing on reporting and contact tracing provisions. Mandatory reporting by name of individuals testing HIV positive and mandatory contact tracing are opposed as counterproductive prevention measures; voluntary partner notification is supported. Part III examines various prevention efforts for settings where there may be either a real or perceived risk of transmission of HIV infection. Part IV sets out conclusions.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[The legislative requirements for radioprotection in dental offices equipped with apparatus for dental radiodiagnosis and orthopantomography].

The paper summarises the new legislation which is expected to be introduced concerning the use of dental radiodiagnostic and orthopantomographic equipment. The above modifications are partly the responsibility of the employer responsible for the dental practice, the qualified expert and, if present, the authorized doctor. A summary is given of the development of Italian regulations which are being brought into line with EEC standards.

Dental Offices↗
PubMedDate not supplied

[Effects of health legislation against HIV in blood donation in Guadalajara, Mexico].

In México, since may 1986, the mandatory detection of antibodies against HIV in blood and derivates for the use by humans was legislated, one year later the prohibition of blood trade took effect. The impact of the Sanitary Normativity in the seroprevalence of anti HIV antibodies between blood donors one year before and one year after it took result was compared. A sample was taken from 4743 serums of donors of 6 blood banks in Guadalajara between june 1986 and june 1988; 4020 in the first year and 723 the next. In all the samples the presence of anti HIV antibodies was determined by the ELISA assay and the positive ones were confirmed by indirect immunofluorescence and by Western blot. During the first year, the seroprevalence fluctuated between 2.02 and 30.15 percent depending on different factors, differing from the second year where the seroprevalence was 0.14 percent. It is concluded that the mandatory detection of antibodies against HIV and the prohibition of blood trade, have been definitive factors to decrease the incidence of HIV in blood donors.

Adult↗
PubMed1990

Tort reform legislation: can it help hospitals?

Tort reform is not just an esoteric debate for health care executives. On the local level, the medical malpractice liability crisis is having a very real effect on many hospitals. Although malpractice insurance premiums have moderated, access to care is being restricted in communities where obstetricians and family practitioners have decided to give up delivering babies. Nor does the future look any brighter. Experts predict that medical students will shun obstetrical and other high-risk specialties to avoid the high cost of malpractice insurance. On the national level, President Bush has expressed concern that the liability situation is adding to the high cost of health care. And a number of congressmen have responded with legislation.

American Medical Association↗
PubMed1990

Assessment of occupational fitness in the context of human rights legislation.

The potential applications of occupational fitness assessment are briefly reviewed in the general context of recent human rights legislation. Limiting tasks in an industrial process must be examined, and bona fide occupational requirements must be defined in terms of psychomotor ability and physiological capacity. Heavy work may demand a high level of aerobic power, muscular strength, or tolerance of adverse environments. Such criteria can define an action limit, above which the task must be redesigned, or workers must be specially selected and trained. The courts may accept the results of field performance tests more readily than laboratory measurements of aerobic power or muscular strength. However, neither type of test currently has the reliability and validity needed to characterize the individual, or to distinguish a good worker from a poor worker. If the concern is public safety, employment must thus be based upon average data for a given population, while if the concern is employment equity, the only recourse seems a probationary period of employment.

Adult↗
PubMedDate not supplied

A population survey on legislative measures to restrict smoking in Ontario: 4. Variables related to knowledge of active and passive smoking health effects and to predicted behavior of smokers and nonsmokers.

Results from the further analysis of a population survey on legislative measures to restrict smoking revealed that identification of subgroups of smokers is more reliable than identification of subgroups of nonsmokers when a variety of attitudes were the measures of interest. A similar pattern emerged when analyses were carried out on knowledge of active and passive smoking health effects and on predicted personal and general compliance. Because distinct sets of variables were found to be related to distinct outcomes, program planning for changes in knowledge and behavior might, of necessity, have to be different. Media messages might be useful for changes in knowledge, while actual experience might be more important for attitude and behavior change.

Data Collection↗
PubMed1989

[Experience with improving the sanitary legislation concerning the prevention of occupational mercury poisoning].

The purpose of the study is to generalize the experience of the improvement of sanitary legislation on prevention of occupational mercurialism. The results of the research specific to differentiated standards of permissible content of mercury and its nonorganic compounds in the workplace air are presented along with the data on substantiation of new effective measures on prevention and reduction of mercury steam release into the workplace air, development of the means of protection of building constructions, equipment and furniture from mercury penetration. Some legal normative methodological documents, regulating safety requirements for those working with mercury and its compounds, are described.

Air Pollution↗
PubMed1989

Medicare recoupment: a legal and legislative update.

In 1987, the Texas Medical Association and 20 other plaintiffs filed suit against the US Department of Health and Human Services (HHS) over the federal government's effort to recoup $14 million from physicians and patients for alleged overpayments during July 1985 through March 31, 1986. A federal district court judge granted a preliminary injunction that halted the recoupment pending a full hearing on the merits of the case and a decision. In June 1989 the Court of Appeals overturned the district court's decision, and TMA turned to the US Congress for relief. This article summarizes recent judicial and legislative progress in halting the recoupment.

Medicare↗
PubMedDate not supplied

New legislative efforts to improve child health and decrease infant mortality. Interview by Veronica Feeg.

Senator Bill Bradley (D-NJ) recently introduced the Infant Mortality and Children's Health Act of 1989, a bill that requires states to provide Medicaid coverage to pregnant women and infants living below 185% of the federal poverty level. In this article, Senator Bradley answers questions for Pediatric Nursing readers about this new federal legislative initiative.

Child↗
PubMed1989

Survey of cancer control attitudes among Missouri state legislators.

A number of cancer control efforts, while proven to be effective, require significant support from state and local lawmakers in order to be successful. This survey of state legislators' attitudes toward health risks and risk reduction measures that could be undertaken shows a favorable outlook for cancer control programs in Missouri.

Attitude to Health↗
PubMed1988

A case study involving prospective payment legislation, DRGs, and certified registered nurse anesthetists.

The fixed-price system for hospital care for Medicare patients has major implications for institutional and individual health care providers. This article discusses the basic characteristics of the prospective payment system (PPS), its impact on certified registered nurse anesthetists, and the response of the American Association of Nurse Anesthetists to the PPS legislation.

Anesthesia Department, Hospital↗