Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Population Programs”

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 1,549 records · Page 86Linked to original sources
PubMed1996

Capitation adjustment for pediatric populations.

OBJECTIVE: The objective of this study is to assess the predictive performance of current claims-based capitation adjustment methods for pediatric populations. Medicaid programs and other insurers may increasingly use these systems for capitation rate setting, physician profiling, and other purposes. METHODS: Five leading models, a demographic model, ambulatory care groups, ambulatory diagnostic groups, diagnostic cost groups, and payment amounts for capitated systems, were tested by using use and expenditure data for children enrolled in the Maryland Medicaid program and a private nonprofit health maintenance organization in Minnesota. The models were tested at the individual level by using multiple regression methods and at the group level by using split-half validation to create both random and nonrandom groups. One of the nonrandom groups was created to represent children with chronic conditions. RESULTS: The findings indicate that although each of the alternative methods offers an improvement over a demographic model, significant underpayment remained for high-risk children, regardless of the capitation adjustment method used. CONCLUSIONS: It is concluded that children with chronic conditions would probably remain at risk for discrimination in a competitive health care market under all models tested. Limitations associated with current alternatives suggest the need for further research in the area of pediatric capitation adjustment methods.

Adolescent↗
PubMed1996

The effectiveness of weekly iron supplementation regimen in improving the iron status of Chinese children and pregnant women.

It is evident that intermittent iron supplementation is better than daily supplementation in two aspects: iron absorption is more efficient and has insignificant side effects in contrast to the daily dose. The significantly higher daily iron loss observed in the daily iron supplemented groups rats also suggests alterations in total body iron metabolism. Based on serum ferritin distribution patterns, intermittent iron supplementation avoids temporary iron overload with daily iron supplemented. We conclude that weekly iron supplementation scheme is safer and easier to administer. This feasible strategy for the control of iron deficient anemia in pregnant women and children would be an effective iron-supplementation program (Baily et al., 1993).

Animals↗
PubMed1996

Effects of prepubertal gonadectomy on physical and behavioral development in cats.

OBJECTIVE: To determine the effect of prepubertal gonadectomy on physical and behavioral development in cats. DESIGN: Prospective controlled study of kittens randomly assigned to 3 treatment groups: group 1, neutered at 7 weeks of age; group 2, neutered at 7 months of age; and group 3, sexually intact controls. ANIMALS: 31 clinically normal male and female kittens. PROCEDURE: Age at distal radial physeal closure and mature radius length were determined radiographically. Six behavioral characteristics were recorded monthly. At 1 year of age, body weight was recorded and thickness of the falciform ligament was measured from a lateral abdominal radiographic view. Secondary sex characteristics were also examined at 1 year of age. RESULTS: There were no differences between group-1 and group-2 cats for any of the study variables. Sexually intact cats (group 3) weighted significantly less than group-2 cats and had less falciform fat and earlier distal radial physeal closure than cats of both neutered groups. Group-3 cats manifested greater intraspecies aggression, less affection, and greater development of secondary sex characteristics than neutered cats. CLINICAL IMPLICATIONS: Neutering cats at 7 weeks of age had similar effects on physical and behavioral development, compared with neutering at the more traditional age of 7 months. These data lend support to the concept of prepubertal gonadectomy, already performed by many animal shelters/humane organizations, as a method of enhancing the effectiveness of pet population control programs.

Age Factors↗
PubMed1997

Seroepidemiological study of measles after the 1992 nationwide MMR revaccination program in Taiwan.

The incidence of measles declined rapidly in Taiwan after the introduction of the measles vaccine into the routine immunization schedule in 1978. However, an epidemic still occurred every 3-5 years until recently. A nationwide measles-mumps-rubella (MMR) revaccination program for school and preschool children has been in place since 1992 to control the indigenous transmission of measles. In order to understand the current immune status after this recent nationwide revaccination program, we determined the presence of measles IgG antibodies by enzyme-linked immunosorbent assay (ELISA) in 1,281 blood samples from healthy persons aged from 2 months to above 30 years collected between 1993 and 1995, and also in another batch of 90 sera samples from children aged 2 years collected before 1992. The results showed that 1) the measles antibody seropositive rate (36.4%) was lowest in children aged 5-7 months and rose to an unexpectedly high level of 85.8% at the age of 12-14 months, 2) the seropositive rate rose further to between 85.9% and 95.1% after 2 years of age and remained high in adults and pregnant women, and 3) the seropositive rate of the 2-year-old children collected before 1992 was 61.4%, which was significantly lower than the rate of the same age group collected after the nationwide MMR revaccination program. We conclude that the national revaccination program has promoted effectively measles immunity in Taiwan. This immunity explains the rarity of reported measles cases since the last epidemic in 1989. This revaccination program should continue and be extended to all preschool children and young adults so that indigenous measles can be eliminated by the year 2000.

Adult↗
PubMed1997

Devolving authority for health care in Canada's provinces: 2. Backgrounds, resources and activities of board members.

OBJECTIVE: To obtain information from the members of the boards of devolved health care authorities and evaluate their orientations in meeting the expectations of provincial governments, local providers and community members. DESIGN: Mail survey, conducted in cooperation with the devolved authorities, in the summer of 1995. SETTING: Three provinces (Alberta, Saskatchewan and Prince Edward Island) with established boards and 2 (British Columbia and Nova Scotia) with immature boards. PARTICIPANTS: All 791 members of boards of devolved authorities in the 5 provinces, of whom 514 (65%) responded. OUTCOME MEASURES: Sociodemographic background, training, experience and activities of board members as well as their use of information. RESULTS: There were systematic differences between established and immature boards in regard to training, information use and actual and desired activities. Members spent 35 hours per month, on average, on work for their board. Members were largely middle-aged, well educated and well off. Only 36% were employed full time. Nine out of 10 had previous experience on boards, more often in health care than in social services. They were least pleased with their training in setting priorities and assessing health care needs and most pleased with their training in participating effectively in meetings and understanding their roles and responsibilities. The information for decision-making most available to them was information on service costs (68% said it was available "most of the time" or "always") and utilization (64%); the least available information was that on key informants' opinions (47%), service benefits (37%) and citizens' preferences (28%). Board activity was dominated by setting priorities and assessing needs, secondarily occupied with ensuring the effectiveness and efficiency of services and allocating funds, and least concerned with delivering services and raising revenue. The match between activities desired by members and actual activities was significantly poorer for members of immature boards than for those of established boards. CONCLUSIONS: The responses concerning these structural variables suggest that board members are most likely to meet the expectations of provincial governments. Fewer appear well equipped to accommodate the views of their providers and even fewer to incorporate the perspectives of their community.

Adult↗
PubMed1996

[Health care reform in Chile].

This is a document presented to the Chilean Academy of Medicine by the Health Minister, the economist Carlos Massad, First of all, he refers to the general context of the reform, that he considers a process and not a breakpoint. Afterwards, he enumerates the change task: a) to generate awareness of the change and to convert health in a State issue; b) to adequate programs to population's new health profile; c) to install new management instruments in the health system; d) to decentralize decisions and to promote the participation of beneficiaries; e) to establish incentives and to flexibilize the Health System and f) to introduce correctives to private health insurance. He believes that Chile must drift to a economical protection system for universal and solidary health events. The additional assurances that people wants to buy, must be delimited.

Chile↗
PubMedDate not supplied

Primary care physicians' perceptions of adolescent pregnancy and STD prevention practices in a Nova Scotia county.

INTRODUCTION: This study was carried out to determine the predisposing, enabling, and reinforcing factors related to practice behaviors in the prevention of adolescent pregnancy and sexually transmitted diseases (STDs), and to assess physicians' "ideal" history taking and service provision versus their actual practice in this clinical area. METHODS: Twenty-six of 37 physicians in a single county in Nova Scotia took part in a face-to-face interview. RESULTS: Analysis of predisposing factors found that, for seven of 10 areas related to knowledge of the epidemiology of adolescent pregnancy and STDs, fewer than 50% of male physicians were able to give correct responses. All physicians believed this to be an important area for prevention, and 89% that prevention is possible, but only 62% believed that their own prevention efforts are effective. Respondents were about equally likely to view schools and physicians as having responsibility for prevention of adolescent pregnancy and STDs. Significant enabling factors included high levels of perceived personal comfort and skill, but time factors and opportunities to interact with adolescents sufficiently frequently to carry out prevention were seen as barriers. Most physicians (68%) agreed that the physician fee schedule was a negative reinforcing factor. Male physicians and those in rural practice were significantly more likely to have larger gaps between those preventive practices they saw as desirable and those they actually performed.

Adolescent↗
PubMed1997

The Wellcome Trust population initiative.

This paper describes what the Wellcome Trust has done and aims to do through its population initiative. The Trust is required to spend its funds to improve the physical welfare of mankind, and in this context there can be no more important issue than the rapid changes that are occurring in the human population. The Trust's first involvement was to help fund the New Delhi population summit covered by the world's scientific academics in 1993 and, following discussions with authorities in the field, initiated its funding programme in 1995. Through this programme, the Trust hopes to bring about improved understanding of the relationship between reproductive health, population growth, and sustainable development and create cadres of high quality research scientists in relevant disciplines. Uniquely, funding is available under this programme to suitably qualified applicants from any country other than the USA.

Africa↗
PubMed1997

[Assessment of long-term needs and expenditures development for rehabilitation services of the BfA with reference to the growth and occupational rehabilitation regulation (WFG)].

Based on a Prognos Model projection (1998 to 2040), the number of medical and occupational rehabilitation service treatments required will increase by about 70,000 between 1998 and 2015, reaching 500,000. Thereafter, the situation improves and the number drops to between 370,000 and 430,000. The WFG law provides a 2.7 billion DM budget for the entire time period which results in a growing deficit, reaching 1.7 billion DM by 2015, and enabling the provision of only 50% of the treatments required in the western states, if it is assumed that a reduction of treatment in the eastern states is precluded. This service deficit makes an increase in early retirements probable, thereby, generating costs on balance which exceed any potential savings in the areas of rehabilitation. It is, therefore, necessary to adapt the WFG law to the demands of real needs so that the BfA may continue to fulfill its legal obligation, "rehabilitation before retirement" to the accustomed and necessary extent.

Aged↗
PubMed1997

Categorical funding to seamless systems of care: the challenge for community-based primary care providers.

Integrating categorical funding to design "seamless systems of care" for individual patients is a challenge faced by many local community-based providers. Providers may choose to develop separate site-specific categorical programs for patients with human immunodeficiency virus (HIV) [e.g., specialized treatment site or a homeless clinic] or integrate these programs with their general primary care population. Regardless of program location, providers have developed patterns for finding the most appropriate medical home for a patient with multiple categorical risks. Medical records reviews and patient interviews indicate the importance of case managers in service coordination, although clinical issues appear more readily coordinated than situational ones. Provider dependence solely on case managers for service coordination, across sites and programs may become problematic in the era of managed care without a supportive information system that tracks client use and a records system that integrates clinical and social service notes. Local providers have encountered difficulties in exchanging essential medical information, even within a single agency, under state statutes regarding confidentiality of HIV test results.

Case Management↗