Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health Plan Implementation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,081 records · Page 60Linked to original sources
PubMed1989

Principles of development of model health care programmes. WHO Working Group.

A WHO Working Group consisting of clinicians, people with experience in the development of model health care programmes (MHCP), health care administrators, national health authorities and researchers met in 1982 to discuss the development of MHCPs and to apply principles thus identified to the case of a specific health problem--low back pain. The report identifies the improvement in the quality of care as the main motive for developing MHCPs. Other factors such as rational use of resources, improved planning and decision making and clearer distribution of labour between different levels of health care, institutions and groups of health personnel have also contributed to the current interest in MHCPs. After having briefly described different types of models and their contents, the report moves on to use low back pain as an example suggesting a ten point framework for developing an MHCP. The two last sections deal with the introduction of an MHCP, at the national or local level and the final report once the MHCP has been developed, implemented and evaluated. The two annexes describe concrete experiences in the development of MHCPs. The first annex is the account of a large scale project in Finland launched by the national health authorities and the Finnish hospitals. Relying heavily on the involvement of, and consultation with, all the concerned groups, the project produced a number of MHCPs. A preliminary evaluation showed that they were well accepted. The time span was too short to evaluate their impact on the actual care. The other annex describes in general terms how an MHCP for stroke was developed.

Back Pain↗
PubMed2005

Workplace-based return-to-work interventions: optimizing the role of stakeholders in implementation and research.

INTRODUCTION: The challenges of engaging and involving stakeholders in return-to-work (RTW) intervention and research have not been well documented. METHODS: This article contrasts the diverse paradigms of workers, employers, insurers, labor representatives, and healthcare providers when implementing and studying workplace-based RTW interventions. RESULTS: Analysis of RTW stakeholder interests suggests that friction is inevitable; however, it is possible to encourage stakeholders to tolerate paradigm dissonance while engaging in collaborative problem solving to meet common goals. We review how specific aspects of RTW interventions can be instrumental in resolving conflicts arising from differing paradigms: calibration of stakeholders' involvement, the role of supervisors and of insurance case managers, and procedural aspects of RTW interventions. The role of the researcher in engaging stakeholders, and ethical aspects associated with that process are discussed. CONCLUSIONS: Recommendations for future research include developing methods for engaging stakeholders, determining the optimal level and timing of stakeholder involvement, expanding RTW research to more diverse work settings, and developing RTW interventions reflecting all stakeholders' interests.

Community Participation↗
PubMed2000

School-based mental health program development: a case study of interorganizational collaboration.

Because of increased competition and financial pressure, more and more contemporary health care organizations are forming (or attempting to form) collaborative ventures. In the early 1980s, the New York City Board of Education and the New York City Department of Mental Health planned and implemented a collaborative program in the city's schools for an on-site school mental health program. In this article, I explore the difficult and attenuated process of interorganizational collaboration--including attention to the organizational, political, and interprofessional context within which such ventures are implemented--to examine how such cooperative program development can be successfully accomplished in today's competitive and complex health care arena.

Adolescent↗
PubMed2003

Implementing DRGs in Slovenia: why the Australian variant was selected.

Slovenia is embarking on an ambitious health sector reform program, a small part of which involves implementing the categorization of acute inpatients by DRG for payment purposes. I summarise the leading DRG variants, and describe the process of selecting one of them. I argue that the Slovenian decision to use the Australian DRG variant as a starting point was sensible in terms of cost, speed of implementation, and usefulness of the resultant information. More time and effort could have been spent on the appraisal process, but I suspect it would not have led to a different outcome.

Australia↗
PubMed2004

Public-private mix for DOTS implementation: what makes it work?

OBJECTIVE: To compare processes and outcomes of four public-private mix (PPM) projects on DOTS implementation for tuberculosis (TB) control in New Delhi, India; Ho Chi Minh City, Viet Nam; Nairobi, Kenya; and Pune, India. METHODS: Cross-project analysis of secondary data from separate project evaluations was used. Differences among PPM project sites in impact on TB control (change in case detection, treatment outcomes and equity in access) were correlated with differences in chosen intervention strategies and structural conditions. FINDINGS: The analysis suggests that an effective intervention package should include the following provider-side components: (1) orienting private providers (PPs) and the staff of the national TB programme (NTP); (2) improving the referral and information system through simple practical tools; (3) the NTP adequately supervising and monitoring PPs; and (4) the NTP providing free anti-TB drugs to patients treated in the private sector. CONCLUSION: Getting such an intervention package to work requires that the NTP be strongly committed to supporting, supervising and evaluating PPM projects. Further, using a local nongovernmental organization or a medical association as an intermediary may facilitate collaboration. Investing time and effort to ensure that sufficient dialogue takes place among all stakeholders is important to help build trust and achieve a high level of agreement.

Communicable Disease Control↗
PubMed2006

Health plan pay-for-performance strategies.

OBJECTIVE: To examine health plan strategies, planning, development, and implementation of pay-for-performance programs (financial incentives for hospitals and physicians tied to quality and efficiency) at the community level, focusing on differences across markets. STUDY DESIGN: A fifth round of site visits to 12 nationally representative metropolitan areas between January 2005 and June 2005, based on more than 1000 protocol-driven interviews with representatives from health plans, provider organizations, employers, and policy makers. METHODS: In each of 12 communities, we interviewed several executives from 35 health plans, including chief executive officers, marketing executives, and network contracting directors. Additional perspectives were obtained from representatives of employers, large medical groups, and hospital systems. RESULTS: Growing numbers of health plans are developing and implementing pay-for-performance programs for physicians and hospitals. Although in their early stages, plans' customized programs show substantial design variation within and across markets. This design variation reflects local conditions that include information technology capabilities, data availability, relative leverage of health plans and providers, willingness of providers to participate, and employer influence. The concerns of providers include the administrative burden of health plans' customized programs and the potential for conflicting financial incentives. CONCLUSIONS: Most health plans are committed to pay-for-performance programs. Although providers would prefer health plans in their communities to use a single standardized set of measures and methods, this is unlikely given local market environments. A national effort directed at standardization might significantly reduce the extent of customization but also may limit the opportunities for local collaboration with providers.

Administrative Personnel↗
PubMed2003

The effects of implementation of the Agency for Health Care Policy and Research urinary incontinence guidelines in primary care practices.

OBJECTIVES: To determine whether a multifaceted intervention based on the Agency for Health Care Policy and Research (AHCPR) Clinical Practice Guidelines for Urinary Incontinence would increase primary care physician screening for and management of urinary incontinence (UI). DESIGN: Group randomized trial, conducted from 1996 to 1997. SETTING: Internal medicine and family medicine community practices. PARTICIPANTS: Forty-one primary care practices, including 57 physicians and their staff and 1,145 patients aged 60 and older. INTERVENTION: Twenty of the 41 primary care practices in North Carolina were randomized to a composite intervention that included a 3-hour continuing medical education accredited course, training in management of UI, patient educational materials, and on-site physician and office support. The remaining 21 practices served as "usual care" controls. Telephone surveys of UI status and quality of life were obtained from 1,145 patients before the intervention. At 1 year, patients and physicians were contacted by telephone and mail to determine the effect of the educational intervention. MEASUREMENTS: Patients completed telephone surveys to assess screening for UI, UI status, treatment interventions, and quality of life. Physicians completed surveys related to UI treatment and practice patterns. RESULTS: Baseline and endpoint telephone surveys were completed by 668 of 1,145 (58%) of patients, who were cared for by 45 physicians (10 internists, 35 family medicine). Physician screening rates for UI were 22% for those patients who did not report UI. UI was reported by 39.5% of patients at baseline, of whom 30% reported being asked about UI by their primary care physician during the study. Rates of assessment and management of existing UI were low in both the control and intervention groups. Additional historical questioning indicated that 54.2% reported that they had ever undergone assessment, including history, urinalysis, or testing, or had had management of their UI by any physician. CONCLUSION: Attempts at increasing screening and management of UI by primary care physicians using the AHCPR standardized guidelines using a multifaceted system of educational and logistical support were not successful. These guidelines may not be the best approach to treating UI in the primary care setting.

Aged↗
PubMed2003

Implementation of HIPAA.

Explore the source record for details and available documents.

Health Insurance Portability and Accountability Ac↗
PubMed2002

Planning and implementing a program of renovations of emergency obstetric care facilities: experiences in Rajasthan, India.

Even though many governments and donors are now putting resources into upgrading facilities, the study of the renovation process is one of the most neglected aspects of quality improvement in emergency obstetric care (EmOC). In a previous publication, we discussed basic concepts and simple techniques to assess, plan and implement renovations. Here we focus on actual in-the-field experiences of the renovation process initiated by the health system in Rajasthan, India and the valuable lessons obtained from it. With the advice of the technical members of the Averting Maternal Death and Disability Program (AMDD) and the United Nations Population Fund (UNFPA), the facilities achieved noticeable changes in the physical infrastructure. As a result, the quality of EmOC services improved. We analyze these experiences critically and draw out lessons which may be instructive for future renovation efforts.

Emergency Medical Services↗
PubMed1985

Microcomputers enhance student health fairs.

To stimulate student interest in learning about health, faculty assigned students the task of planning and implementing a university health fair. Two questions were posed: (1) Could sophomore students effectively plan and implement a health fair as a learning opportunity? (2) Could microcomputers be used appropriately to influence client participation and to enhance the nurse-client interactions? Literature regarding the efficacy of the health fair as a mode of health care delivery and as a student learning opportunity and literature addressing the advantages of microcomputer use were reviewed. Two health fairs were piloted. Microcomputers were employed in three areas: nutrition, stress, and substance abuse. Students, with faculty guidance, developed educational materials using principles of teaching, learning, and health promotion. Clients rated the health fair as congruent with their health needs. Students identified learning gained from the experience. Students and clients were receptive to computer use. Future directions are discussed.

Community Participation↗
PubMed2001

Advances create opportunities: implementing the major tenets of the new unstable angina guidelines in the emergency department.

Of all the clinical syndromes with which emergency physicians must deal, chest pain of coronary cause has benefited from the most striking recent advances both in diagnostic approach (cognitive and technologic) and in therapeutic options. Chest pain evaluation and management have become important foci of research in emergency medicine, and entire units are dedicated to its clinical prosecution in emergency departments and elsewhere in the hospital. New diagnostic tools are proposed and studied on a regular basis. Antiplatelet, antithrombin, and fibrinolytic agents unknown in clinical practice as recently as 5 years ago have secured places in the emergency physician's armamentarium for treating acute coronary syndrome. Many of these diagnostic and therapeutic tools have been developed in the coronary care unit and in the cardiac catheterization laboratory. Although intuitively they may also be useful outside of those settings, they have unreliably been brought to the ED for implementation and resultant appropriate prompt and early care of the coronary patient who does not meet fibrinolytic criteria. As emergency physicians seek to bring accurate chest pain risk stratification into their practice and begin to use new therapeutic agents to minimize myocardial damage before turning the patient's care over to other specialists, it is essential that they are familiar with the data supporting these approaches. In this commentary, we seek to place the American College of Cardiology/American Heart Association unstable angina guidelines into the clinical context of the ED.

Algorithms↗