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At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

The accessibility of abortion services in the United States.

Abortion services are provided in hospitals, doctors' offices and various types of clinics, but about two-thirds of procedures are performed in specialized abortion clinics. While this system appears to work well for most women, some women seeking abortion face obstacles related to distance, cost, harassment and special medical conditions. Nine percent of nonhospital abortion patients must travel more than 100 miles and 18 percent travel 50 to 100 miles for services. The average woman having a first-trimester nonhospital abortion paid $251 in 1989. Fees were higher in facilities with small abortion caseloads. An abortion at 10 weeks' gestation in a hospital cost an average of $1,757. Charges for abortions at 16 weeks averaged $509 in abortion clinics, compared with $1,539 in hospitals for curettage and $2,246 for instillation procedures. Some women face other barriers: Only 43 percent of all abortion facilities offer services past 12 weeks, and 27-37 percent of nonhospital facilities say they do not treat patients who test positive for the human immunodeficiency virus (HIV), the virus that causes AIDS. Women who need special services such as an administration of Rh immunoglobulin, general anesthesia or HIV testing usually pay extra for these services. In addition, 85 percent of nonhospital facilities that serve 400 or more abortion patients a year reported some form of antiabortion harassment in 1988, most commonly picketing; there was virtually no change in this proportion between 1985 and 1988.

Abortion, Legal↗
PubMedDate not supplied

Medicaid and non-Medicaid prenatal care by nurse-midwives. Comparison of risk, time, care coordination, and reimbursement.

The purpose of the study was to compare high-risk pregnant women with medical assistance payment (HRMA) and those with private insurance payment (HRPI) on use of provider time, care coordination activities, and financial reimbursement. Comparisons were also conducted for the same factors between the high-risk and low-risk women (LRMA) that received medical assistance payment for their care. Total time spent by care providers in giving antepartum, intrapartum, and postpartum care was highest for the HRPI women. However, the two medical assistance groups started prenatal care significantly later and had fewer visits, and one-third did not return for their 6-weeks postpartum visit. The HRPI group also had a higher cesarean birth rate. Rates of care coordination activities such as calls, referrals, and consultations were significantly higher for the HRPI and HRMA women compared with those for the LRMA women. However, the HRMA women have limited financial and psychosocial resources that require additional provider management and referrals. Reimbursement rate was highest for the HRPI group in which approximately 73% of the total amount billed was collected compared with approximately 56% among medical assistance women. Recommendations for policy, practice, and further research are offered.

Adolescent↗
PubMed1998

Exploratory analysis of factors associated with teens' repeated childbearing.

This study was designed to explore the factors regarding unique determinants of repeat childbearing among teens. The influence that key people have on subsequent teen childbearing is examined. Data for this research were gathered in focus groups with teen mothers and parents of teen mothers who access the Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Georgia. Based on the results, repeated childbearing appears to occur within the context of poor parent-child relations, conflicting support for the roles teen mothers are expected to assume, limited social pressures for effective fathering, and limited access to social services for all family members. Pregnancy prevention efforts by agencies for teen mothers should coordinate services for the teen mother, her parent, and her partner.

Adolescent↗
PubMedDate not supplied

The effect of operations research on program changes in Bangladesh.

This article is based on the ten-year experience of an operations research project in Bangladesh. It assesses how, and under what circumstances, research-based advice and results of pilot projects contribute to change in large-scale public programs. It discusses project research on issues facing the national family planning program: recruitment and training of field-workers; delivery of injectable contraceptives; management information; field-workers' use of service registers; field supervision; satellite clinics; and contraceptive user fees. These issues are used to illustrate the advantages and disadvantages of a long-term institutionalized project, and to describe the diversity of means for communication with policymakers. The analysis shows that research, policy decision, and implementation can occur in any sequence. Policy advice that disrupts long-standing power relationships and organizational culture takes a great deal of effort to implement. Operations research can produce useful changes in organizational behavior, even when large-scale problems remain.

Bangladesh↗
PubMed1997

Making unofficial inventory official. Financial managers who record and control unofficial inventory make the most of a valuable asset.

All healthcare organizations maintain supplies in their facilities that have not been booked as assets on their general ledgers. This unofficial inventory is often overlooked because it is not as significant a cost-driver as salaries and capital equipment. But unofficial inventory can affect an organization's bottom line when it is not reflected as an asset on statements of activities. Healthcare financial managers, working with their organization's materials managers, and other department personnel, can take steps to correct the problem of unofficial inventory by identifying locating, and controlling such inventory throughout the facility. Appropriate accounting procedures to handle the conversion of unofficial inventory to official inventory status also should be implemented.

Accounting↗
PubMed1986

Medical technology and developing countries: the case of Brazil.

Developing countries, faced with severe resource limitations, are trying to develop modern health care services that deliver sensible medical technologies. Because of their lack of development, these countries must import much technology, while often lacking the expertise to make wise choices. In this article, the case of Brazil is examined. Brazil has shared many of the problems of other developing countries, including inadequate access of the population to health services, maldistribution and excessive use of technology, a relatively weak national industry for production of drugs and medical devices, a weak policy structure for dealing with medical technology, and little tradition of using research or policy analysis as a guide to action. Since the election in 1985 that returned Brazil to democratic rule, the government has taken active steps to address many of these problems. The example of Brazil is important for all of the developing world to examine and follow, where applicable. In addition, North American and European aid programs could play a much more constructive role in helping less developed countries develop their health care services. International organizations such as the World Health Organization must also be active in assisting such countries to improve their decisions concerning medical technology.

Brazil↗
PubMed1992

Battling AIDS through home care in Uganda and Zambia.

Innovative home care programs, providing a variety of services to persons with HIV infection and their families and reflecting different health, political, cultural, social, and philosophical concepts, have been developed in Africa, starting in 1987. In 1989 the World Health Organization (WHO) Global Programme on AIDS conducted a descriptive study of some of these programs. It is hoped that these experiences will assist planners and health care providers in their decision making and thereby benefit persons with HIV infection and their families. The lessons learned about the context, backgrounds, structure, process, and outcome of the six selected home care programs can be used and adapted by policymakers and program planners in their own settings when deciding on "their" model of home care.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Adolescent use of Norplant implants: clinic services, policies and barriers to use.

INTRODUCTION: The purpose of this article is to review the experiences of family planning clinic providers in making Norplant available to adolescents. We look specifically at the proportions of women receiving the implant from these providers who are teenagers, the policies adopted regarding implant education and whether or not parental consent is required for minors. Pricing policies and the implications of high method cost for teenagers are discussed. Finally, some of the policies adopted by state agencies related to adolescent use of the implant are reviewed. METHODS: The data come from two national surveys conducted by the Alan Guttmacher Institute (AGI). The first, a survey of family planning agencies, collected data from 616 family planning providers of clinic services (response rate 69%). The second surveyed the Medicaid, health and welfare agencies in all 51 jurisdictions about policies related to Norplant. RESULTS: Over one-quarter of all contraceptive implants inserted by family planning agencies were provided to teenagers. Teenagers were routinely informed about the implant in about 85% of those clinics offering implant services. Few state agencies notify women about the implant. Twenty-three percent of all family planning agencies providing implant services report that parental consent must be obtained prior to implant insertion. The Medicaid program has paid for a majority of implant insertions at family planning agencies. CONCLUSIONS: Teenagers who rely on publicly funded family planning clinics for contraceptive services face a variety of barriers in obtaining Norplant. High method cost, parental consent requirements and issues related to Medicaid eligibility are likely to deter some teenagers who might otherwise choose Norplant.

Adolescent↗
PubMed1988

Decree of the National Institute of Perinatology, 14 July 1988.

This Decree sets forth the organization and functioning of Mexico's National Institute of Perinatology. The objectives of the Institute are the following: 1) to support the functioning and consolidation of the National Health System and to contribute to the fulfillment of the right to health protection with respect to perinatal care; 2) to support the execution of sectoral health programs within the scope of the System's functions and services; 3) to provide health services to women experiencing high risk pregnancies, in particular, services related to preventive and curative medicine and surgical procedures; 4) to provide medical consultation and hospital assistance, as well as services for human reproduction, growth, and development, in the installations created for this purpose; these services will either be free of charge or the charge will be based on the social and economic conditions of the users; 5) to provide measures of social assistance for those patients who lack economic resources; 6) to conduct studies and clinical research in the biomedical field and related sciences for the prevention, diagnosis, and treatment of perinatal diseases and in compliance with the provisions of the General Health Law and applicable regulations; 7) to provide technical and scientific information on health findings and improvements as well as to publish the outcome of studies and work undertaken; 8) to promote and hold meetings and carry out scientific national or international exchange programs with similar institutions; 9) to advise and deliver opinions to the Health Secretary when requested; 10) to function as an advisory committee for the relevant institutions of the Federal Public Administration and social and private institutions in this field; 11) to exploit specialized human resources for attention to perinatal problems in compliance with the applicable regulations; 12) to organize and implement educational and professional programs in the field of perinatal care for the professional, technical, and auxiliary staff; 13) to confer academic awards and give recognition to studies in compliance with applicable regulations; 14) to promote the execution of health protection activities according to the applicable regulations; 15) to provide all other services and necessary activities to fulfill the goals of this Decree and other applicable regulations. Further provisions of the Decree deal with the duties of the Governing Board and the Director General, among other things.

Americas↗
PubMed1997

Population control II: The population establishment today.

Although population assistance represents a relatively small share of official development assistance, it influences many other aspects of development planning. The organizations that comprise the population establishment have a common purpose--the reduction of population growth in the Third World--but they are not homogeneous and sometimes have conflicting goals and strategies. National governments, multilateral agencies, nongovernmental organizations, foundations, academic centers, and pressure groups all contribute to creating and sustaining what has become a virtual population control industry. Through scholarships, travel grants, awards, and favorable publicity, Third World elites have been encouraged to join the population establishment. The World Bank, the U.S. Agency for International Development, and the U.N. Fund for Population Activities have pursued explicit strategies for pressuring Third World governments to design and implement population policies, most recently in Africa.

Coercion↗
PubMed1988

[The financing of medico-technical activities. The example of a scanner in France (1986)].

To analyse the french methods for financing technical-medical activities as CT scanners, and to assess if they can face, or not, the management constraints of such activities a financial simulation has been executed. First, current expenditures are totalized (including depreciations and financial charges) with variations according to the number of examinations per year. Costs are classified especially according to fixed and variable charges: the weight of fixed charges, especially equipment charges, is the most significant. It's very high in yearly expenditures. Most, that involves a very fast decreasing cost with increasing number of procedures. Second, consequences of such accounts are analyzed: on private CT scanners, Payed with a charge per examination whatever would be the factor's cost; on public CT scanners, payed with an annual allowance; in this case charges equal receipts whatever would be the cost for a procedure. Third, a break point is defined; either the annual activity is higher: there would be an excedent; either it is lower: there would be a deficit. Then, those results are reported to CT-scanners activity's data in France (1986). After all, we discuss about financing systems themselves, and suggest a few hypothesis to explain those desadjustments between charges and their financing way.

Financial Management↗
PubMed1991

Age structure of the population in Belgium and social security.

The effects of demographic aging and of various socioeconomic factors on the social security system in Belgium are explored. "Special attention is given to the impact of the ageing of the population on the pension problem. Based on a simple formula a series of percentages of taxation have been calculated as a function of shifts in the proportion of retired vs. active population and in the proportion of the average income vs. the average amount of pension. One of the conclusions is that the progressive ageing of the population will become the most significant factor in the growth of social expenditures."

Belgium↗
PubMedDate not supplied

[Socioeconomic characteristics of the labor force in Brazil (1976-1981)].

"This paper studies the main changes in the Brazilian labor force from 1976 to 1981. Several aspects concerning... Brazilian labor market dynamics, such as activity levels, employment, income distribution and social security, are examined. The paper takes into account the short-run effects of...economic policy on the Brazilian labor force." (summary in ENG)

Americas↗
PubMed1997

Are you getting the right data to track your risk contracts?

Are you collecting the right data? Your organization may be collecting claims payment profiles, stop loss and recovery reports, financial statements, activity reports, and reconciliation reports ... but are you sure you're collecting and presenting the right data to encourage improvement in clinical practice? Here's point-by-point advice, plus laundry lists of essential data reports and some benchmark data.

Capitation Fee↗
PubMed1995

Trade restrictions, migration, and economic geography.

"This paper investigates why Third World cities have been growing in the last several decades much more quickly than cities in industrialized countries. For this purpose, we develop a Krugman-type model of economic geography with two continents, North and South, each of which consisting of two regions, East and West. We study the impact different levels of transport costs and tariffs exert on the distribution of economic activities among the regions. We find that lower costs for transport between the regions in the South, for instance, induced by an improved infrastructure, as well as lower tariffs on intercontinental trade tend to lead to less concentrated economies." (SUMMARY IN GER AND FRE)

Demography↗