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Results for “Health Plan Implementation”

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At least 1,711 records · Page 95Linked to original sources
PubMed1997

Projecting corporate health plan utilization and charges from annual ICD-9-CM diagnostic rates: a value-added opportunity for pathologists.

OBJECTIVE: To develop an allocation method for corporate health plan resources and expenditures based on annual International Classification of Disease, 9th revision, Clinical Modification (ICD-9-CM) diagnostic rate stratification as a surrogate for disease incidence. DESIGN: A data-mining process was applied to a self-insured corporate health plan database. Annual membership rates of Current Procedural Terminology (CPT) procedure utilization and charges between 1990 and 1994 for a cohort of 7216 continuously employed plan members were stratified according to the annual rates of the 19 major ICD-9-CM diagnostic classifications. The stratified annual CPT utilization and charge rates were analyzed by correlation analysis and one-tailed t test. RESULTS: Laboratory and pathology procedure utilization and charge rates were highly correlated with specific rankings of ICD-9-CM diagnostic classifications. The health plan diagnostic rate, laboratory utilization rate, and all charge rates increased significantly during the 5 study years. CONCLUSION: Although all procedure utilization and charge rates in this health plan increased each year, their proportionality consistently was maintained among diagnostically related groups of patients. By restraining global expenditures, managed health plans conflict with historical utilization and charge patterns. Treating ICD-9-CM diagnostic groups as disease management services within a managed care plan allows procedures and expenses to be allocated according to medical necessity in the context of total membership benefits. For pathologists, who recently were mandated by the Health Care Financing Administration and the Office of Inspector General of the Department of Health and Human Services to become stewards of ICD-9-CM coding, this is a unique opportunity to lead an initiative to perfect managed care. The process will require permanent patient numbers, computerized longitudinal patient records, and standardized coded medical terminology.

Adult↗
PubMed1997

Tuberculosis control--is DOTS the health breakthrough of the 1990s?

The resurgence of tuberculosis in recent years has made an effective control strategy indispensable. The strategy exists and is called DOTS--Directly Observed Treatment, Short-course. It has proved its effectiveness and now needs to be used worldwide on a much larger scale.

Adult↗
PubMed2004

[An interview survey for health promotion for older residents in T District, Sendai City].

OBJECTIVE: To plan a program for promoting health and improving quality of life among the older residents in T District, Miyagino Ward, Sendai City. SUBJECTS & METHOD: T District has the highest rate of aged individuals and the largest number of elderly living alone in the Ward. Based upon our community-based health and welfare activities, we recognized that many older residents in T District had health and social problems. In order to grasp these problems and plan a program for health promotion, we conducted an interview survey (using the Esnographic method) of resource persons and older residents in the District. The information obtained at interviews was analyzed by the KJ method. RESULTS: The interview survey indicated the most prominent needs for the older residents were extension of the network for human relationships and increase in opportunities for communication and meeting each other. The older residents did not have enough information on the health and welfare services provided by Miyagino Public Health and Welfare Center, and we realized the importance of promoting communication between residents, private organizations and our Center. We informed the residents of these results, and discussed the strategies to promote health and improving quality of life among the older residents in T District in 2001. Based upon the survey and discussion, we started to publish and circulate "Community Information for Older Residents", established a class for residents to become supporters of the needy older population in T District, and facilitated their active participation in the community activities. CONCLUSION: The interview survey using the Esnographic approach and analysis with the KJ method were useful tools for us to plan and implement a program for health promotion for older residents.

Aged↗
PubMed1993

Construction of a socio-economic index to facilitate analysis of health data in developing countries.

In order to plan, implement and monitor health interventions for the most deprived sector of the population, it is necessary to identify socioeconomic groups at risk. Multiple Correspondence Analysis was used to construct a socio-economic index based on data collected from a sample of 2698 households in South-West district of the Ugandan Republic in 1988. This study is a part of the baseline survey done by the Government of Uganda in collaboration with UNICEF. Its aim was to reduce the incidence of death of children below 5 years from diarrhea. Two factorial axes, representing respectively the socio-cultural and the anthropological conditions, explained more than 80% of the total variability. Among the 11 variables employed the most useful in characterizing the socio-economic classification were: father's occupation, parent's literacy, father's professional position and ownership of a radio. A classification in 7 levels was obtained. The first two levels are characterized as professionals and civil servants. The bottom two levels include households where both parents are illiterate and where father's primary activity is agricultural at a subsistence level. The three middle levels represent a transitional situation. In order to classify the family into the different levels, the other related variables, such as father's professional position or ownership of radio or father's religion or presence of latrine proved to be very useful. A flow chart which identifies which level a household belongs to was constructed. A general and valid observation is that families classified into the last two levels (6 and 7) constituted the population at risk for health conditions.

Adult↗
PubMedDate not supplied

Evaluation of worksite health enhancement programs.

Although many corporations are planning and implementing health-promotion programs for their employees, few have attempted rigorous and thorough evaluative studies of program impact. This creates a void which properly trained health educators can fill. This article provides health educators with some basic points to consider when evaluating worksite health-enhancement programs. The six key points outlined provide basic concepts to guide the evaluation of worksite health-promotion programs.

Cost Control↗
PubMed2000

Developing the Guide to Community Preventive Services--overview and rationale. The Task Force on Community Preventive Services.

When the GUIDE TO COMMUNITY PREVENTIVE SERVICES: Systematic Reviews and Evidence-Based Recommendations (the Guide) is published in 2001, it will represent a significant national effort in encouraging evidence-based public health practice in defined populations (e.g., communities or members of specific managed care plans). The Guide will make recommendations regarding public health interventions to reduce illness, disability, premature death, and environmental hazards that impair community health and quality of life. The Guide is being developed under the guidance of the Task Force on Community Preventive Services (the Task Force)-a 15-member, nonfederal, independent panel of experts. Subject matter experts, methodologists, and scientific staff are supporting the Task Force in using explicit rules to conduct systematic literature reviews of evidence of effectiveness, economic efficiency, and feasibility on which to base recommendations for community action. Contributors to the Guide are building on the experience of others to confront methodologic challenges unique to the assessment of complex multicomponent intervention studies with nonexperimental or nonrandomized designs and diverse measures of outcome and effectiveness. Persons who plan, fund, and implement population-based services and policies to improve health at the state and local levels are invited to scrutinize the work in progress and to communicate with contributors. When the Guide is complete, readers are encouraged to consider critically the value and relevance of its contents, the implementation of interventions the Task Force recommends, the abandonment of interventions the Task Force does not recommend, and the need for rigorous evaluation of the benefits and harms of promising interventions of unknown effectiveness.

Decision Making↗
PubMedDate not supplied

The status and scope of health communication.

We examine the field of health communication with a multimethodological analysis, presenting a brief historical synopsis of the academic literature as well as the results of a survey administered to academicians who identified communication and health to be major fields of interest. After this descriptive backdrop of health communication, we offer a prescription for an ideal health communicator--that is, one with an interdisciplinary background--to use ethical, persuasive means to craft, deliver, and evaluate campaigns that promote good health and disease prevention; to plan, influence, and implement health policy; and to employ ethical decision making that will enhance the quality of life for individuals and communities throughout the globe.

Communication↗
PubMed1996

Catalonia WHO Demonstration Project on Palliative Care Implementation 1990-1995: results in 1995.

A global, comprehensive, publicly planned and financed program to implement palliative care was designed by the Department of Health of Catalonia (6 million inhabitants. Planned in collaboration with the cancer unit of the WHO in 1989, the program was implemented in 1990-1995. It included specific services, measures general resources, education and training, organizational and educational standards, opioid availability, legislation and evaluation. The aims included coverage for cancer, AIDS, geriatric and other conditions, equity, quality, reference, and satisfaction for patients, families, and professionals. The results in 1995 include the implementation of 18 hospital support teams and 19 Units, with a total of 350 beds, 42 home-care teams. The coverage for cancer and AIDS is around 40%, and 44/55 (80%) districts have a specific team. Palliative care implementation has been completely publicly financed, with a total yearly investment of 2,200 million ptas. Eighty percent of this has been saved through radical changes in costs and the pattern of the use of resources. Palliative care implementation has demonstrated efficacy in the care of the patients and families, efficiency in the provision of care, and cost-benefit in the regional global approach. It adds qualitative and organizational values to the health-care system. Its implementation must be prioritized and planned by the health administration, not only to improve the quality of care for advanced and terminal patients, but also to improve the global efficiency and appropriate use of resources in the public health system.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Health care reform and the role of public health agencies.

Experience in developing a local public health program, covering a period of approximately 45 years, is described. Included are the assessment and analysis of problems, policy formulation, plan development, and program implementation. A study of problems of seasonal farm workers, particularly those who migrate, is described, as well as a health services delivery program based on this study. Attention is given to incorporation of medical care with core public health services, and the use of a multidisciplinary team. Special features required to overcome cultural, language, educational, and other barriers are outlined. Adaption of knowledge gained from the migrant health project toward meeting needs of the county's medically underserved population is described. Involvement of the community, including representatives of private and public sectors, in the development and implementation of plans is emphasized. Maintaining appropriate emphasis on preventive aspects is discussed, together with mobilization of financial and other support. The importance of qualified public health staff is also emphasized: residency programs for physicians and dentists and training for other personnel are described.

Florida↗
PubMed2006

[Participatory planning in health organizations: the case of the Bonsucesso General Hospital, Rio de Janeiro, Brazil].

This article presents the experience with participatory planning in the Bonsucesso General Hospital in Rio de Janeiro, Brazil, from 2003 to 2004. The participatory and communicative characteristics and the resulting institutional format are identified for guaranteeing the implementation of collective decisions from the planning workshops. The limits of implementation in participatory planning and management proposals are argued from the perspective of change and power relations in these institutions. The results support the notion that projects involving changes in hospitals and failing to take into account the different internal rationalities and power relations end up having reduced potential for implementation.

Brazil↗