Health Services Research Commons^™

Toward Improved Support For Research On Delivery Of Home- And Community-Based Long-Term Care, Francis G. Caro

Gerontology Institute Publications

Stronger and more consistent support is needed for research on long-term care. A greater investment in research will strengthen the ability of public and private organizations to provide effective and efficient assistance to people with disabilities and their informal caregivers. This paper provides a rationale for stronger research funding for the field and outlines several options to strengthen research.

Mental Health Parity: National And State Perspectives 2000: A Report To The Florida Legislature, Bruce Lubotsky Levin, Ardis Hanson, Richard Coe, Sara A. Kuppin

Ardis Hanson

By failing to appropriately treat adults and children with severe mental illness, we incur enormous social costs through payments for disability benefits (Medicaid, SSI, SSDI), increased medical expenses, accidents and suicides, avoidable criminal justice proceedings, lost productivity, and increased need for homeless shelters and services. People who are underinsured are forced by arbitrary caps and limits to increasingly rely on the public sector. By providing parity for mental health, Florida will bring mental health into the mainstream of health care and become a leader in dispelling the prejudice that surrounds treatment of persons with severe mental illness.

Providing Low-Cost Assistive Equipment Through Home Care Services: The Massachusetts Assistive Equipment Demonstration, Alison S. Gottlieb, Francis G. Caro

Gerontology Institute Publications

This report describes the Massachusetts Assistive Equipment Demonstration, a collaborative project funded by the Robert Wood Johnson’s Home Care Research Initiative and carried out collaboratively by the Gerontology Institute at the University of Massachusetts Boston and the Executive Office of Elder Affairs (EOEA). The purpose of the demonstration was to systematically encourage the use of low-cost assistive equipment among elderly clients through existing case management resources, thereby extending the effectiveness of the Massachusetts home care program by supplementing formal services with expanded use of assistive equipment.

Nursing Homes To Medicare Waiver Programs In Vermont, Joseph Murray

New England Journal of Public Policy

This research examines the differences between nursing home residents and those who were able to leave nursing homes with the help of the Medicaid Waiver Program in Vermont. Ninety individuals who reentered the community with the aid of such waivers were compared with a random sample of nursing home residents through the use of the Nursing Home Minimum Data Set. The researchers found divergence in four key areas: cognition, continence, treatment categories, and desire to return to the community. Typically, those who left nursing homes for the community were cognitively intact, had moderate continence, received rehabilitative or clinically complex treatments, …

Sexual And Reproductive Health And Health Sector Reform In Latin America And The Caribbean: Challenges And Opportunities, Ana Langer, Gustavo Nigenda, Sandra G. Garcia, Rosario Valdez, Emanuel Orozco, Jennifer Catino

Reproductive Health

Most countries in Latin America and the Caribbean (LAC) are at varying stages of a reform process to improve the response capacity of health systems by upgrading the effectiveness and sustainability of programs and services. Changes promoted by the reform focus on priority health needs and underprivileged society groups. Some problems, such as sexual and reproductive health (SRH), can be tackled with cost-effective technologies. Reform projects offer a unique opportunity to reconsider policies, programs, and services aimed at facing the issues encompassed in the term SRH. Nonetheless, the formulation of a strategy and the identification of concrete measures represent a …

From The Home To The Clinic: The Next Chapter In Bangladesh's Family Planning Success Story Rural Sites, Linda Bates, Md. Khairul Islam, Sidney Ruth Schuler, Md. Alauddinn

Reproductive Health

This study reports on Bangladesh’s new program model for reproductive health service delivery and people's reactions to it. NGOs in Bangladesh have discontinued door-to-door contraceptive distribution in response to the government’s integrated, clinic-focused approach. The findings from this study strongly support these policy changes: clients and communities are responding favorably to many aspects of the new model, and there do not seem to be intractable social barriers to service utilization. As the NGOs and the Bangladesh government proceed with implementation of the integrated, essential health services model, additional strategies will be needed to erode the paternalistic service delivery culture that …

An International Comparison Of Cancer Survival: Metropolitan Toronto, Ontario, And Honolulu, Hawaii, Kevin M. Gorey

Social Work Publications

OBJECTIVES: Comparisons of cancer survival in Canadian and US metropolitan areas have shown consistent Canadian advantages. This study tests a health insurance hypothesis by comparing cancer survival in Toronto, Ontario, and Honolulu, Hawaii.

METHODS: Ontario and Hawaii registries provided a total of 9190 and 2895 cancer cases (breast and prostate, 1986-1990, followed until 1996). Socioeconomic data for each person's residence at the time of diagnosis were taken from population censuses.

RESULTS: Socioeconomic status and cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Honolulu, residents of low-income areas in …