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Value-Based Coverage Policy In The United States And The United Kingdom: Different Paths To A Common Goal, Wilhelmine Miller

National Health Policy Forum

This background paper traces the development within American health care of two interrelated trends and activities: an evidence-based approach to medical practice and the critical evaluation of new technologies with respect to their costs and effectiveness. Over the past 35 years each of these developments has increasingly shaped the coverage decisions of public and private health insurers, and their importance for coverage policy is certain to grow. The paper also contrasts the different approaches to such “evidence-” or “value-based” coverage policy in the mixed public and private U.S. health care enterprise with the approach taken in Great Britain’s single-payer National …

Updating Medicare's Physician Fees: The Sustainable Growth Rate Methodology, Laura A. Dummit

National Health Policy Forum

Medicare’s method to annually update the fees it pays physicians has been under fire for some time—specifically, since the method determined that physician fees should be reduced rather than increased. The update method, called the sustainable growth rate (SGR), was implemented to control the growth in Medicare physician spending. Yet Congress, in response to physician concerns about beneficiary access to care, has acted to avert physician fee cuts since 2003. Although this signals dissatisfaction with the SGR methodology, there is yet to be a widely accepted physician fee update proposal that balances federal budgetary realities with the need to ensure …

The Nuts And Bolts Of Pdps, Mary Ellen Stahlman

National Health Policy Forum

This issue brief provides an overview of Medicare prescription drug plans (PDPs), with a focus on fundamentals such as enrollment, premiums, formularies, cost sharing, prices, payment, cost management, and appeals and grievance processes. It also highlights major changes to the PDP landscape between 2006 and 2007.

Studi Kasus : Evaluasi Sistem Penanggulangan Kebakaran Pt. Indogravure, Theresia Audrey Angela

Kesmas

Kebakaran yang terjadi tak terduga akibat kelalaian manusia dan kondisi lingkungan dapat menyebabkan kerugian materi dan fisik serta rasa khawatiran yang menurunklan kondisi kerja. Kebakaran dapat terjadi akibat aliran listrik hubungan singkat, gesekan rol mesin dan gesekan mekanis mesin sehingga perlu diamati secara ketat. Oleh sebab itu, tiap bangunan dan tempat kerja perlu memiliki fasilitas dan tim penanggulangan kebakaran yang memadai. Sebagai perusahaan industri percetakan pembungkus produk, PT. Indogravure (PTI) mengolah bahan unsur kimia dan plastik yang mudah terbakar, antara lain adalah bahan cair (tinta, lem, solar dan bahan bakar) dan bahan padat (plastik, kertas dan besi). PTI memiliki sistem …

Prevalensi Dan Determinan Hipertensi Di Pulau Jawa, Tahun 2004, Zamhir Setiawan

Kesmas

Hipertensi merupakan faktor risiko utama kardiovaskuler yang merupakan penyebab utama kematian di seluruh dunia. Peningkatan umur harapan hidup dan perubahan gaya hidup meningkatkan faktor risiko hipertensi di berbagai negara. Tujuan penelitian ini (1) Mengetahui prevalensi hipertensi dan penyebarannya di Pulau Jawa tahun 2004. (2) Mengetahui faktor-faktor sosiodemografi yang berhubungan dengan kejadian hipertensi. (3) Mengetahui kontribusi dan dampak potensial masing masing faktor tersebut. Penelitian dengan rancangan studi Ekologi Multilevel ini menggabungkan variabel tingkat pengukuran individu dengan tingkat pengukuran ekologi dalam analisis bersama, dengan unit analisis individu. Analisis kontekstual dilakukan melalui kerangka konsep hipertensi, menggunakan metode analisis regresi logistik ganda, dengan status …

Pengembangan Sistem Informasi Program Kusta Berbasis Geografis Di Kabupaten Cirebon Tahun 2005, Haeria Haeria

Kesmas

Kusta yang disebabkan oleh infeksi Mycobacterium leprae merupakan penyakit menular dengan masalah yang sangat kompleks. Tiga tahun terakhir, Kabupaten Cirebon yang melaporkan 1.207 penderita kusta (Prevalence 1,69/10.000 penduduk), belum mencapai tahap eliminasi sehinga penularan masuh berlansung. Tujuan penelitian mengembangan sistem informasi kusta berbasis geografis yang dapat dijadikan solusi percepatan eliminasi kusta di Kabupaten Cirebon. Metoda yang digunakan adalah System Development Life Cycle, yaitu planning, analysis, design, implementation, maintenance dan evaluation system. Hal tersebut dilakukan dengan memadukan konsep Data Base Management System dan data spasial. Hasil analisis sistem dapat mengidentifikasi masalah manajemen penanggulangan kusta serta alternatif solusi pada level …

La Ley De Maternidad Gratuita En Intag: Su Aplicación, Educación Y Uso, Stephanie Lewis

Independent Study Project (ISP) Collection

The country of Ecuador has a high rate of infant and maternal mortality, as well as problems with malnutrition. The Minister of Public Health responded to these problems with a law to provide the public with different types of free medical attention. The Minister’s hope is to reduce these problems with the law. The law is called the Law of Free Motherhood and Attention for Infants (Ley de Maternidad Gratuita y Atención a la Infancia), and includes free attention and vitamins for pregnant women, free birth and post-birth care, and vitamins, attention and vaccinations for children under 5 years of …

Individual Responsibility Concerning Hiv Transmission Among Msm: A Comparative Study Of The Effectiveness Of Ngo Intervention Policies And Their Practical Applications Within The United Kingdom, Australia, And The Netherlands, Martha Kienbaum

Independent Study Project (ISP) Collection

This study investigates the complexities involved in utilizing the terms of individual responsibility for the construction of HIV prevention campaigns that target men who have sex with men. Four health workers in the Netherlands were interviewed about their personal opinions regarding HIV intervention, and these interviews were analyzed qualitatively for their points of comparison and contrast. Then, campaign materials from organizations in the United Kingdom and Australia were analyzed for their use of the language of responsibility, their portrayal of MSM, their balance between promoting disclosure and communication, their focus on individual groups within the MSM community, and their overall …

What Is Available Vs. What Is Accessible: An Evaluation Of Resources For Kwazulu Natal Diabetics Based On The Data Of Kwazulu Natal Experts And Cato Manor Diabetics, Mollie Gurian

Independent Study Project (ISP) Collection

The objective of this study was to learn about the resources available to a diabetic and the actual ability of diabetics to access these resources. I found that two ideal paradigms of care were consistently mentioned by experts in KwaZulu Natal and at the World Diabetes Congress (WDC), the international conference on diabetes that I attended in Cape Town. The first is self-management of the disease and a patient centered approach to care. The second is a collaborative team approach to treating diabetics which involves a number of experts besides a physician. These two concepts are connected in that a …

Promoting Physical Activity In Children And Youth: A Leadership Role For Schools: A Scientific Statement From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism (Physical Activity Committee) In Collaboration With The Councils On Cardiovascular Disease In The Young And Cardiovascular Nursing, Russell R. Pate, Michael G. Davis, Thomas N. Robinson, Elaine J. Stone, Thomas L. Mckenzie, Judith C. Young

Faculty Publications

No abstract provided.

Faktor-Faktor Yang Berhubungan Dengan Pemberian Asi Satu Jam Pertama Setelah Melahirkan, Setiyowati Rahardjo

Kesmas

Di Indonesia, Angka Kematian Bayi (AKB) masih yang tertinggi di negara-negara ASEAN. Penyebab utama kematian anak balita tersebut adalah penyakit infeksi saluran nafas dan diare yang dapat dicegah antara lain dengan pemberian ASI secara benar dan tepat. Pada periode 2002-2003, sekitar 95,9% balita sudah mendapat ASI, tetapi hanya 38,7 % balita mendapat ASI pertama satu jam setelah lahir. Tujuan penelitian ini adalah untuk mengetahui berbagai faktor yang berhubungan dengan pemberian ASI dalam satu jam pertama setelah melahirkan. Penelitian ini menggunakan sumber data sekunder SDKI 2002-2003 dengan desain cross sectional. Sampel berjumlah 6.018 terdiri dari ibu yang memiliki anak berusia 0 …

Effects Of Food Marketing To Kids: I'M Lovin' It?, Eileen Salinsky

National Health Policy Forum

This issue brief reviews key findings and recommendations from the Institute of Medicine study on food marketing and its effects on childhood obesity. The brief describes the childhood obesity epidemic, discusses key trends associated with rising childhood obesity rates, and considers the relative role of marketing practices on diet and obesity within the broader context of complex contributory factors. The brief also summarizes the current legal framework for regulating marketing directed at children; discusses voluntary, self-regulatory mechanisms; and highlights proposals to re-orient marketing practices to combat childhood obesity.

A Closer Look At The Medicare Part D Low–Income Benchmark Premium: How Low Can It Go?, Mary Ellen Stahlman

National Health Policy Forum

This issue brief explains how the Medicare Part D low–income benchmark premium is calculated, what factors influence the level of the low-income benchmark premium in any given year, and the implications of the benchmark amount for Medicare drug plans and beneficiaries as it changes from year to year. The paper provides a simplified, two-year example of how the low-income benchmark premium is calculated in order to illustrate the key factors that influence it.

Characteristics Of Marijuana Users Compared To Multiple Drug Users, Swateja Nimkar

Masters Theses & Specialist Projects

This study examines drug use behavior in a self-described sample of users. Comparisons are made between subjects whose only illicit drug use is marijuana and those who use both marijuana and other drugs. Data are from the DRUGNET study (1996, 1998, 1999), a multi-panel study conducted over the internet from 1996 - 1998. This sample was predominately white, male, young, and college educated. The majority of respondents were employed with incomes in the $50,000 - $60,000 (USD) range. A subset of respondents to the DRUGNET survey was selected for this analysis. Respondents had to be at least 18 years of …

Body Image And Weight Related Behaviors: The Role Of Gender, Ethnicity, And Immigration, Tina Hoover

Masters Theses & Specialist Projects

Obesity rates have aggressively climbed in both children and adults, and notably for particular ethnic and lower socioeconomic status groups. National data from 1999-2002 have shown that approximately one-half of African-American women were obese, as compared to one-third of Caucasian women. It has been substantiated that a significant portion of overweight or obese children will become obese adults, with a number of factors identified that may influence obesity in children including gender, ethnicity, and environment. This study analyzed secondary data from The Youth Behavioral Risk Factor Survey administered to students at BGHS to identify variations in body image for particular …

Examining The Structural Covariates Of Methamphetamine Use: A Social Disorganization Perspective, Justin Smith

Masters Theses

There have been many anecdotal accounts describing the characteristics of individuals involved in methamphetamine use, trafficking and production. However, prior to the current study there was yet to be a macro-level analysis of methamphetamine use. The extant macro-level literature on drug use has suggested that areas with high levels of social disorganization experience high rates of drug use. It was expected that school-districts with low SES and high rates of ethnic heterogeneity, residential instability and family disruption will experience high rates of methamphetamine use. In addition, it was expected that rural school districts would show higher rates than urban and …

The Clinical Research Forum And Association Of American Physicians Disagree With Criticism Of The Nih Roadmap, William Crowley Jr, John Courtney, Larry Jameson, Herbert Pardes, Jay Moskowitz, Eugene Orringer, Arthur Rubenstein, Alastair Wood, Richard Rettig, Dennis Ausiello, David Brenner, Francis Collins, Jack Elias, Warner Greene, Ralph Horowitz, Larry Jameson, Elliott Kieff, Craig Thompson, Judith Swain

Faculty Publications

No abstract provided.

An Experimental Study Of The Effectiveness Of Three Safety Training Delivery Methods And The Knowledge Gained During A Workplace Violence Safety Program, Shoji Nakayama

All-Inclusive List of Electronic Theses and Dissertations

Due to the numerous advantages of electronic media, many companies have begun to incorporate online courses as a means of delivering corporate training, including corporate safety training. Consequently, researchers are beginning to investigate the effectiveness of online training over traditional face-to-face training methods. Many studies have indicated that results of training programs conducted over the Internet are equivalent to those results obtained from traditional face-to-face training. At the same time, other literature indicates that face-to-face training is better than Internet training due to the level of interaction between students and instructor. Some investigations on this subject have been conducted within …

Relative Risk Regression In Medical Research: Models, Contrasts, Estimators, And Algorithms, Thomas Lumley, Richard Kronmal, Shuangge Ma

UW Biostatistics Working Paper Series

The relative risk or prevalence ratio is a natural and familiar summary of association between a binary outcome and an exposure or intervention. For rare events, the relative risk can be approximately estimated by logistic regression. For common events estimation is more difficult. We review proposed estimation algorithms for relative risk regression. Some of these give inconsistent estimates or invalid standard errors. We show that the methods that give correct inference can be viewed as arising from a family of quasilikelihood estimating functions for the same generalized linear model, differing in their efficiency and in their robustness to outlying values …

Investigating Mediation When Counterfactuals Are Not Metaphysical: Does Sunlight Uvb Exposure Mediate The Effect Of Eyeglasses On Cataracts?, Brian Egleston, Daniel O. Scharfstein, Beatriz Munoz, Sheila West

Johns Hopkins University, Dept. of Biostatistics Working Papers

We investigate the degree to which a reduction in ocular sunlight ultra-violet B (UVB) exposure mediates a relationship between wearing eyeglasses and a decreased risk of cataracts. An estimand is proposed in which causal effects are estimated locally within strata based on potential UVB exposure without glasses and the degree to which glasses use reduces UVB exposure. We take advantage of the structure of the data in which the counterfactual UVB exposures if the participants in the study who wore glasses had not worn glasses are considered observable.

Whyy Seeks Guidance From Healthcare And Community Leaders, Sara L. Thier

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Institute For Healthcare Improvement’S 100,000 Lives Campaign , Kristy Alvarez, Christopher N. Sciamanna

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Relationship Between High Sensitivity C-Reactive Protein, Metabolic Syndrome And Exercise, Micheline A. Vargas

Loma Linda University Electronic Theses, Dissertations & Projects

Background: It is well known that regular physical activity is associated with lower risk of chronic diseases such as diabetes and cardiovascular disease. Physical activity is also considered an important determinant of metabolic syndrome. All levels of metabolic syndrome, diabetes, and cardiovascular disease are thought to involve inflammation. Physical activity may reduce risk, at least in part, by modifying the inflammatory process. Recent studies have demonstrated an inverse relationship between inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and physical activity. Elevated hs-CRP appears to be an independent predictor of both CVD and diabetes. Recent evidence also suggests that …

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Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Hospital Quality Report Cards: Ready For Prime Time?, Susan Wynne, Richard Wells

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Knowledge, Attitude And Misconceptions Regarding Tuberculosis In Pakistani Patients, Javaid Ahmed Khan, Muhammad Irfan, Amna Zaki, Madiha Beg, Syed Fayyaz Hussain, Nadeem Rizvi

Section of Pulmonary & Critical Care

Objective:

To assess knowledge of patients with tuberculosis; about their disease and misconceptions regarding TB.

Methods:

A cross sectional study was conducted at Out-patient clinics of two teaching hospitals (private and public) in Karachi, Pakistan. A questionnaire was filled for the purpose.

Results:

A total of 170 patients were interviewed, 112 from private and 58 from a public sector hospital. Cough, fever, bloody sputum and chest pain were recognized as the common symptoms of TB. Eleven (7%) patients thought TB was not an infectious disease and 18 (10.6%) did not consider it a preventable disease. Contaminated food was considered the …

A Coprological View Of Ancestral Pueblo Cannibalism, Karl Reinhard

Karl Reinhard Publications

As the object of my scientific study, I’ve chosen coprolites. It’s not a common choice, but to a paleonutritionist and archaeoparasitologist, a coprolite—a sample of ancient feces preserved by mineralization or simple drying—is a scientific bonanza. Analysis of coprolites can shed light on both the nutrition of and parasites found in prehistoric cultures. Dietary reconstructions from the analysis of coprolites can inform us about, for example, the origins of modern Native American diabetes. With regard to parasitology; coprolites hold information about the ancient emergence and spread of human infectious disease. Most sensational, however, is the recent role of coprolite analysis …

La Story: Improving Care Management For The Chronically Ill And Chronically Underserved, Eileen Salinsky, Jessamyn Taylor

National Health Policy Forum

This Los Angeles-based site visit examined safety net and private sector efforts to improve care coordination for underserved and vulnerable populations, including the homeless, the uninsured, the undocumented, and individuals with chronic conditions like diabetes, asthma, and severe mental illness. The visit highlighted challenges and innovations in the use of disease management programs, information systems, performance incentives, and managed care as tools for improving care coordination.

Acute Health Effects Of The Tasman Spirit Oil Spill On Residents Of Karachi, Pakistan, Naveed Zafar Janjua, Pashtoon Murtaza Kasi, Haq Nawaz, Sadia Zohra Farooqui, Urooj Bakht Khuwaja, Najam-Ul-Hassan, Syed Nadim Jafri, Shahid Ali Lutfi, Muhammad Masood Kadir, Nalini Sathiakumar

Community Health Sciences

Background: On July 27 2003, a ship carrying crude oil ran aground near Karachi and after two weeks released 37,000 tons of its cargo into the sea. Oil on the coastal areas and fumes in air raised health concerns among people. We assessed the immediate health impact of oil spill from the tanker Tasman Spirit on residents of the affected coastline in Karachi, Pakistan.Methods: We conducted a study consisting of an exposed group including adults living in houses on the affected shoreline and two control groups (A and B) who lived at the distance of 2 km and 20 km …

Cultural/Interpersonal Values And Smoking In An Ethnically Diverse Sample Of Southern California Adolescents, C. Anderson Johnson, Paula Palmer, Jennifer B. Unger, Sohaila Shakib, Peggy Gallaher, Anamara Ritt-Olson, Michele Mouttapa

CGU Faculty Publications and Research

In ethnically diverse school contexts, values from multiple cultures might influence adolescents' attitudes and behaviors. This study developed scales to assess cultural values among Southern California 6- grade adolescents (N=2281) and evaluated the associations between values and smoking. The scales assessed values salient in many Hispanic and Asian cultures: Respect for Adults (e.g., filial piety, respeto). Interpersonal Harmony (e.g., saving face, simpatia), and Differentiated Gender Roles (e.g., machismo). In cross-sectional and one-year longitudinal models. Respect for Adults and Interpersonal Harmony were associated with a lower risk of lifetime smoking. The associations were significant even after controlling for demographic characteristics, friends' …