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At least 19 recordsLinked to original sources
PubMed1993

The appropriateness of hysterectomy. A comparison of care in seven health plans. Health Maintenance Organization Quality of Care Consortium.

OBJECTIVE: To develop and test a method for comparing the appropriateness of hysterectomy use in different health plans. DESIGN: Retrospective cohort study. SETTING: Seven managed care organizations. PATIENTS: Random sample of all nonemergency, non-oncological hysterectomies performed in the seven managed care organizations over a 1-year period. Patients who were not continuously enrolled in a plan for 2 years prior to their hysterectomy were excluded. MAIN OUTCOME MEASURES: Proportion of women undergoing hysterectomy in each plan for inappropriate clinical reasons according to ratings derived from a panel of managed care physicians. RESULTS: Overall, about 16% of women underwent hysterectomy for reasons judged to be clinically inappropriate. Only one plan had significantly more hysterectomies rated inappropriate compared with the group mean (27%, unadjusted). Adjusting for age and race did not affect the rankings of the plans and had little effect on the numeric results. CONCLUSION: The rates of inappropriate use of hysterectomies are similar to those for other procedures and vary to a small degree among health plans. This information may be useful to purchasers when they consider which health plans to offer their employees.

Adult↗
PubMed1983

Health maintenance organizations; Midwest Health Plan--Health Resources and Services Administration.

On January 21, 1983, the Office of Health Maintenance Organizations (OHMO) notified Midwest Health Plan (MHP), 3415 Bridgeland Drive, Bridgeton, Missouri 63044, a federally qualified health maintenance organization (HMO), that MHP had successfully reestablished compliance with its assurances to the Secretary that it would (1) maintain a fiscally sound operation, and (2) maintain satisfactory administrative and managerial arrangements. This determination took effect on January 1, 1983.

Health Maintenance Organizations↗
PubMedDate not supplied

Strategic planning: health plan perspective.

The managed care industry is one of the most dynamic industries in the health care business. The development of new products, formation of alliances, changes in legislation and other types of changes are regular occurrences. This kind of dynamic environment makes it more important than ever to use strategic planning to guide management decisions.

Health Benefit Plans, Employee↗
PubMedDate not supplied

Child and adolescent health in Northern Ontario: a quantitative profile for public health planning.

Health in Northern Ontario is poorer than in the province of Ontario. Late childhood is the period in which adult habits and health behaviours are solidified, thus, health indicators are important to guide the development and implementation of disease prevention strategies. The Northern Ontario Child and Youth Health Report evaluated the health of children in Northern Ontario. The importance of public health planning is presented with the value of health status information for youth. The hospitalization rate for Northern Ontario youths was higher than for Ontario. In both areas, injuries and poisonings were the leading cause of hospitalization (7-13 year olds), however rates in the North were higher. Hospitalizations for injuries and poisonings were double the provincial rate in 14-19 year olds. The mortality rate for all youth was significantly higher. Health risk behaviour prevalence (e.g., alcohol consumption) was higher in the region. Current data emphasize the need for primordial and primary prevention in regional health planning and are also useful in secondary and tertiary prevention. Data for public health planning is critical to address population health needs and prevent chronic diseases.

Adolescent↗
PubMed1990

[Health indicators and public health planning].

Health indicators are considered to be fundamental to the public health planning process. To a large extent, programs and services relevancy depends on indicators used for planning. Based upon a review of the literature, criteria for judging the acceptability of available indicators are presented and described. The principal health indicators developed for planning health programmes and services are then analysed in terms of these criteria. The dimensions of health measured by the various indicators are noted together with the relevancy and limits of each group of indicators analysed.

Activities of Daily Living↗
PubMed1985

The utility of synthetic and regression estimation. Techniques for local health planning.

Health planning agencies have long had a need for local area data on issues such as health status, utilization, and preventive care. Synthetic estimation and regression techniques have been advanced for use in adjusting national or regional data from the NCHS Health Interview Survey (HIS) to the local area based on demographic and other pertinent variables. To evaluate the accuracy and utility of these techniques for local health planning, estimates of certain key HIS variables were obtained from a telephone survey of 2,500 randomly selected households located in the Central Maryland Health Systems Agency (CMHSA). This paper presents results of the comparison between these telephone estimates and the corresponding estimates derived from the national HIS. The techniques are evaluated on the basis of data generally available to local planning agencies.

Catchment Area, Health↗
PubMed1996

Health planning and health care for the poor: the internal ethic of public health.

Health planning involves assessing health care needs of a defined population, setting priorities, then developing, implementing,m and evaluating programs that address priority needs. The concepts of health planning are central to the 1988 report of the Institute of Medicine on the Future of Public Health, which defined the three core functions of public health as assessment, policy development, and assurance. Generally, when health planning is instituted, poor people are identified as having the poorest health status and the greatest need. An internal ethic is therefore created for public health to focus on the health care needs of those in poverty. This internal ethic of public health health can become the driving force for reforming the present U.S. health care system. A reformed health care system would be guided by the principle of care according to need, which not only has a basis in health planning, but in social justice as well.

Adult↗
PubMed2000

Do consumer reports of health plan quality affect health plan selection?

OBJECTIVE: To learn whether consumer reports of health plan quality can affect health plan selection. DATA SOURCES: A sample of 311 privately insured adults from Los Angeles County. STUDY DESIGN: The design was a fractional factorial experiment. Consumers reviewed materials on four hypothetical health plans and selected one. The health plans varied as to cost, coverage, type of plan, ability to keep one's doctor, and quality, as measured by the Consumer Assessment of Health Plans Study (CAHPS) survey. DATA ANALYSIS: We used multinomial logistic regression to model each consumer's choice among health plans. PRINCIPAL FINDINGS: In the absence of CAHPS information, 86 percent of consumers preferred plans that covered more services, even though they cost more. When CAHPS information was provided, consumers shifted to less expensive plans covering fewer services if CAHPS ratings identified those plans as higher quality (59 percent of consumers preferred plans covering more services). Consumer choices were unaffected when CAHPS ratings identified the more expensive plans covering more services as higher quality (89 percent of consumers preferred plans covering more services). CONCLUSIONS: This study establishes that, under certain realistic conditions, CAHPS ratings could affect consumer selection of health plans and ultimately contain costs. Other studies are needed to learn how to enhance exposure and use of CAHPS information in the real world as well as to identify other conditions in which CAHPS ratings could make a difference.

Adolescent↗
PubMed1996

[The limits of health reporting in health planning].

Health reporting differs from traditional health statistics in (1) its claim to prospectively determine priorities and goals in the health sector, and (2) the expansion of the target group to include political decision makers and interested citizens. To date, neither has the prognostic element of health reporting been developed to satisfaction, nor has satisfactory access to the target population been gained. Forecasting requires suitable methods, an in-focus description of problems and targets, and performance control with regard to its aims. Effective access to a target population is a general problem not unique to health reporting. Forecasting and successful communication with target groups are crucial to the influence of health reporting on health planning. Both factors should be prominent goals in the future development of health reporting.

Germany↗
PubMed1980

National guidelines for health planning: Public Health Service, HHS. Notice of proposed rulemaking.

This Notice proposes to add national health planning goals to the National Guidelines for Health Planning under section 1501 of the Public Health Service Act. These goals concern health status outcomes, disease prevention and health promotion and personnel resources and systems of care. They supplement Subparts A and C of the Guidelines published as final regulations on March 28, 1978, which addressed standards for nine types of health services and facilities. Later issuances will provide additional goals and standards.

Goals↗
PubMed1998

Interim rules for group health plans and health insurance issuers under the Newborns' and Mothers' Health Protection Act--IRS; DoL; HCFA. Interim rules with request for comments.

This document contains interim rules governing the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA). The interim rules provide guidance to employers, group health plans, health insurance issuers, and participants and beneficiaries relating to new requirements for hospital lengths of stay in connection with childbirth. The rules contained in this document implement changes to the Employee Retirement Income Security Act of 1974 (ERISA) and the Public Health Service Act (PHS Act) made by NMHPA, and changes to the Internal Revenue Code of 1986 (Code) enacted as part of the Taxpayer Relief Act of 1997 (TRA '97). Interested persons are invited to submit comments on the interim rules for consideration by the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services (Departments) in developing final rules.

Centers for Medicare and Medicaid Services, U.S.↗