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At least 19 recordsLinked to original sources
PubMed1976

Health services, health status, and work loss.

The numbers of workdays lost because of illness, coupled with records of health service utilization patterns, were studied to establish possible links between health status and different forms of prepayment coverage. The records of industrial workers at four branches of the same company were analyzed. Records of employees with broad-benefit coverage were compared with those who had less-comprehensive indemnity coverage. A free choice of providers was available to the study population. Data for workers covered by the broader plans revealed fewer medical admissions to hospitals, more surgical admissions, and more outpatient physician visits. As hypothesized, their number of days absent from work were lower. Because few of these results were statistically significant, caution is necessary in their interpretation. Some aspects of the project warranting further consideration are discussed. Data suggest a positive correlation between breadth of health plan coverage and health status, with possible economic benefits to be derived from such coverage. The data also indicate the desirability of additional investigations to be based on employers' and health plan records, that involve other types of populations and other benefit options.

Absenteeism↗
PubMed1990

[Present problems in health services and health care].

In order to deal with and resolve contemporary problems of the health services and health care it is important to outline their concept, contents and definition as well as those of their fundamental constituents--the material, technical basis, workers and their activities, which determine the state health policy. The author analyzes from this aspect the hitherto accomplished development with regard to all basic constituents and discusses the problem of the relationship of the intensity and extensity of activities of the health services and health care. A foremost part is played by medical is played by medical science--medicine, its state, knowledge assembled by students during their undergraduate studies and medical graduates during their postgraduate training. A substantial and decisive component of the health services as regards therapeutic and preventive care is formed by health workers and the quality of their work which depends on objective as well as subjective factors which are analyzed. Health services do not comprise only practical activities but social medicine and the organization of health services are very important scientific disciplines which participate in the quality of activities. This scientific discipline was founded by prominent personalities. It must be stated that in practical medical work leading authorities do not always respect the scientific character of the discipline and thus very complicated problems arise as regards scientific control. All these problems from the aspect of the department of social medicine and organization of health services as well as subjective and scientific control must be resolved from the aspect of reconstruction of society.

Czechoslovakia↗
PubMed1990

Young adults with special health care needs: prevalence, severity, and access to health services.

Health care needs of disabled young adults and access to care are analyzed using the 1984 National Health Interview Survey, a nationally representative sample of 10,394 randomly selected noninstitutionalized young adults aged 19 to 24. In 1984, 1.4 million young adults (almost 6%) suffered from disabilities. The leading cause of disability was diseases of the musculoskeletal system and connective tissue. Young adults living in poverty, in households where the family reference person had less than a high school education, and who were male were at elevated risk of disability. Disabled young adults made almost three times as many physician contacts and were hospitalized for close to six times as many days as nondisabled young adults. One of every 5 disabled young adults was uninsured in 1984. Forty-one percent of disabled Hispanic 19- to 24-year-olds and 51% of disabled young adults of other races were uninsured compared with 19% of whites and blacks. Research and financing policy implications are discussed.

Activities of Daily Living↗
PubMed1989

Modern health services and health care behavior: a survey in Kathmandu, Nepal.

The most important problem regarding health service utilization in Third World countries is that established indigenous forms of health care are readily available and compete with modern health care. Thus, in addition to understanding the components of the decision to seek medical help, we must understand the conditions that affect the choice of a specific health care system. This study examines the impact of medical pluralism on the use of modern forms of health care in Nepal. The findings show that the presence of medical pluralism is a significant factor which delays use of modern health services. Policy implications are discussed, and the need for more research in this area is stressed.

Attitude to Health↗
PubMed1992

The fate of mental health services in health care reform: I. A system in crisis.

The U.S. health care system is in the midst of a severe crisis. More than 50 million Americans are uninsured or underinsured. Medicare and Medicaid are not adequately serving populations in need. Analyses and reform proposals are often based on biased interpretations of data, resulting in confusion and heated debate. To avoid jeopardizing psychiatric care in a national health care reform movement, we must understand the causes of the national crisis. In the first part of a two-part paper, the author describes factors such as demographic trends and limitations in public health coverage that have contributed to the crisis. Outcomes of the current system include higher morbidity and mortality among the uninsured and a high prevalence of untreated illness. The author reviews direct and indirect costs of health care and concludes that in attempts to solve the difficult equation of access, cost, and quality, mental health services are in serious jeopardy.

Cost Control↗
PubMed1990

The provision of home health services through health maintenance organizations: the role of the physician.

The authors report the results of a comprehensive national study of the provision of home health care (HHC) through health maintenance organizations (HMOs), funded by a 1987 grant from the National Center for Health Services Research. The initial study included a literature review, interviews of 125 HHC providers and researchers, case studies of 6 HMOs, and a survey of 103 HMOs with Medicare contracts (as of March 1988). Upon discovery of controversy over the role of the HMO physician, the authors conducted an additional substudy of 30 primary care physicians. The article focuses on findings concerning the HMO physician in HHC and the implications for physicians generally, in light of what the larger study and additional data (January 1989-January 1990) show about HMO development and home health care.

Attitude of Health Personnel↗
PubMed1992

The fate of mental health services in health care reform: II. Realistic solutions.

In the second part of a two-part paper, the three major proposals for U.S. health care reform--the government-sponsored model, the employment-based model, and the market reform model--are reviewed. Barriers to their success include the current economic crisis, the lack of a clear consensus, and the high costs of the proposals. Most proposals limit the extent of psychiatric coverage; some exclude such coverage from minimum benefit packages, an area of concern for clinicians. The author concludes that any substantial health care reform is unlikely in the near future. A thoughtful, realistic, and yet vigorous strategic plan is needed now to forestall the possible exclusion of significant mental health coverage. The basic elements of such a plan are reviewed.

Cost Control↗