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At least 1,207 records · Page 67Linked to original sources
PubMed1998

Improving oral health for people with special needs through community-based dental care delivery systems.

A community-based dental care delivery system is described. This system has been used in a number of communities in California to improve oral health for people with special needs. It includes oral health assessment, coalition building, development and networking of local resources, training of dental professionals, and utilization of preventive dentistry training materials. Also discussed are challenges of the future that will need to be met to continue to make oral health a priority and reality for people with special needs in California.

Adolescent↗
PubMedDate not supplied

Assuring access to dental care for low-income families in North Carolina. The NC Institute of Medicine Task Force Study.

Following publication of the Task Force's recommendations for improving dental care access among low-income populations, North Carolina has taken several steps forward. The Division of Medical Assistance and the NC Dental Society are forming an advisory committee (comprising Medicaid patients, providers, and representatives from all elements of organized dentistry in the state) to review dental coverage and reimbursement rates. Using existing state funds, the NC Office of Research, Demonstrations and Rural Health Development has recruited 15 additional dentists and 1 dental hygienist to practice in community facilities serving low-income and uninsured patients. In 1999, the NC General Assembly revised the NC Dental Practice Act. Now, under the general direction of a licensed public health dentist, specially trained public health dental hygienists can perform oral health screenings and preventive and educational services outside the public school setting. The NC Institute of Medicine has begun exploring how to use dental hygienists to expand preventive dental services to underserved populations in federally-funded community or migrant health centers, state-funded health clinics, and the not-for-profit clinics that serve predominantly Medicaid, low-income or uninsured populations. A report is to be sent to the Governor and the Joint Legislative Commission on Governmental Operations no later than May 1, 2000. In 1999, the General Assembly directed the NC State Board of Dental Examiners to establish a procedure for streamlined licensing of dentists and dental hygienists who have been practicing in other states. This should increase the number of qualified dental practitioners in the state. The proposed rules governing the new licensing pathway are to be prepared by May 15, 2000. The Board of Dental Examiners will determine which new procedures will be needed to allow less burdensome and more timely entry of qualified out-of-state licensed applicants, while still affording the public the same protection as under current law and procedures. The NC Institute of Medicine is organizing a work group to study the feasibility of new residency programs in pediatric dentistry in addition to the current program located in Chapel Hill. The Institute will present a report to the General Assembly, no later than May 1, 2000. On April 1, 1999, the state Medicaid program authorized use of ADA Procedure Code 1203, which allows reimbursement for the application of dental fluoride varnishes without a full prophylaxis. It also authorized pediatricians, nurse practitioners, or physician's assistants to apply these varnishes to the teeth of young children, allowing more rapid dissemination of this proven preventive procedure among the state's low-income children. Implementation began in Carolina Access II and III project sites in the fall, 1999, and should spread statewide in 2000. Furthermore, the General Assembly's 1999 session expanded NC Health Choice to cover dental sealants, fluoride treatment, simple extractions, stainless steel crowns, and pulpotomies. Since publication of the Task Force Report in May 1999, considerable forward movement has taken place. It was apparent that the problems associated with poor dental care were severe, of immediate concern, and needed a broad, nonpolitical analysis followed by action from public and private-sector policy makers and shapers. The key recommendation of the Task Force (to increase the level of payment to dentists for services provided to Medicaid beneficiaries) was not acted on in the 1999 session of the General Assembly, but it was seriously discussed in legislative hearings and will be considered further in the year 2000 legislative session. Given the number of problems surrounding adequate health care for North Carolina's low-income populations, inquiries such as that described here can point the way to the concrete and feasible steps that need to be taken. (ABSTRACT TRUNCATED)

Adolescent↗
PubMed2000

[Breast cancer mass screening in the Province of Liege. Results after 8 years].

Breast cancer mass screening by mobile units started in 1992 in the Province of Liège (Belgium). This project is developed for rural areas and interests all women between 40-69 years old not regularly X-rayed in traditional breast cancer diagnosis centers. Despite lots of efforts population participation is low (25%). Nevertheless, the experiment results are encouraging: in a series of 31,443 women, 213 cancers were diagnosed, corresponding to a rate of 6.9/1000, 75% of which are of good prognosis. After an 8 years experiment, it is hoped that the population concerned becomes more sensitive to this mass screening project and one should expect a better collaboration with the other actors in the field of breast diseases diagnosis.

Adult↗
PubMed2001

Why provider-sponsored health plans don't work.

Integrated delivery systems (IDSs) that assume risk directly by starting their own health plans need to ensure that they have set realistic goals. Many provider-health plan integrations fail because either the conditions under which they are started are not optimal or the integration is faulty. Successful provider-plan integrations generally have developed in rural areas where they faced limited competition, had higher utilization rates, and enjoyed greater profit margins because of lower price competition and employers' acceptance of premium rates. These factors are uncommon today. IDDSs sponsoring health plans can face problems in partnering with physicians, who may not demonstrate concern for the success of the healthcare system as a whole. For these and other reasons, IDDSs should consider partnering with existing health plans rather than starting their own plans.

Delivery of Health Care, Integrated↗
PubMedDate not supplied

Evaluation of the Nigerian population policy--myth or reality?

The National Population Policy (NPP) was promulgated to improve the living standards and quality of life of Nigerians by reducing the persistently high level of fertility and population growth, and achieving an even rural-urban development. The aim of this study was to review Nigeria's demographic patterns in the last decade against the 1995 and AD 2000 benchmarks stipulated in the NPP. The results revealed that the total fertility rate fell significantly to 6.2 in the earlier half of the decade but is still far from the targeted figure of 4.0. The infant mortality rate had risen in the past five years, and although the crude death rate declined by 21.49% in 1995, it has remained stagnant since then. There has been no appreciable decline in the rate of natural increase which was expected to fall by 31.03% in AD 2000. The current contraceptive prevalence rate of 11.0% is a far cry from the targeted 80% set in the population policy. In general, the situation that influenced the decision to promulgate the NPP in 1988 has not improved much: the national decline in fertility is not appreciable neither is the increase in welfare significant. The key issues in the reproductive health sectors include the limited availability and poor quality of services, which lead to high maternal and infant mortality rates, inadequate adolescent outreach, and limited use of contraceptives. This evaluation of the policy's targets and objectives in the light of the 1995 and AD 2000 benchmarks reveals that the NPP has failed due to an underestimation of the huge financial resources required for implementation, lack of political will, poor and uncoordinated organisation, 'gender-divide' and the prolonged political instability in the country.

Birth Rate↗
PubMedDate not supplied

[Introduction].

Explore the source record for details and available documents.

Demography↗