Digital Commons Network^™

Journey To Destination 2005, Andra Gumbus, Bridget M. Lyons, Dorothy E. Bellhouse

WCBT Faculty Publications

Bridgeport Hospital and Healthcare Services (BHHS) in Bridgeport, Conn., a part of the Yale New Haven Health System (YNHHS), embraced the balanced scorecard because it had been experiencing a loss in revenue and income due to managed care penetration in the local marketplace. This hospital is not alone in facing financial pressures. The balanced scorecard provides the framework for measuring performance in a complex and changing medical environment. Still retaining financial measures, the following drivers of financial success are incorporated into Bridgeport's scorecard: quality clinical outcomes; expert clinical care providers; satisfied patients, doctors, and staff; and volume and market-share growth. …

Dose Coefficient (Dc) Methodology Report, John P. Shanahan, Phillip W. Patton, Mark Rudin

Transmutation Sciences Physics (TRP)

The purpose of this report is to present the methodology developed to calculate internal and external dose coefficients for radionuclides produced in the spallation process. Much of the information regarding computer codes in this report comes from various technical manuals and professional papers. References are provided at the beginning of each section for documentation and for the user who requires more specific information. The report also includes the results of applying the methodology to determine dose coefficients for five radionuclides. This effort identified potential areas of concern that will need to be addressed when the methodology is used in the …

Federal Child Care Funding For Low-Income Families: How Much Is Needed?, Jane Koppelman

National Health Policy Forum

With reauthorization of the 1996 welfare reform law being debated, this paper looks at the Temporary Assistance for Needy Families block grant and the Child Care and Development Fund — key components of congressional proposals to set a dollar amount for government spending on child care. This issue brief provides background on current child care use, arrangements, and cost, as well as research findings on the measurement of quality in child care programs.

Justification For The Continuance Of A Pediatric Physician's Office Laboratory, Veronica C. Santilli

Seton Hall University Dissertations and Theses (ETDs)

The continued viability of the Physician's Office Laboratory (POL) has been questioned because of barriers imposed by managed care organizations, oversight by regulatory agencies and competition for professionally trained laboratory staff. Pediatricians view the POL as an important adjunct to quality healthcare services for children and do not consider the POL as a "profit center", whose priority is generation of revenues for the The practice. parents of pediatric patients consider an on-site laboratory a convenience and valuable service. Through an analysis of patients' satisfaction, physicians' perceptions of enhancement to quality care, managed care reimbursement data and costs associated with maintenance …

Retirees And Pharmaceutical Costs: Is There Really A Crisis?, Justine Maiello

Seton Hall University Dissertations and Theses (ETDs)

.

Aha Guidelines For Primary Prevention Of Cardiovascular Disease And Stroke: 2002 Update - Consensus Panel Guide To Comprehensive Risk Reduction For Adult Patients Without Coronary Or Other Atherosclerotic Vascular Diseases, Thomas A. Pearson, Steven N. Blair, Stephen R. Daniels, Robert H. Eckel, Joan M. Fair, Stephen F. Fortmann, Barry A. Franklin, Larry B. Goldstein, Philip Greenland, Scott M. Grundy, Yuling Hong, Nancy Houston-Miller, Ronald M. Lauer, Ira S. Ockene, Ralph L. Sacco, James F. Sallis, Sidney C. Smith Jr., Neil J. Stone, Kathryn A. Taubert

Faculty Publications

No abstract provided.

Direct Service Staff Turnover In Supported Living Arrangements: Preliminary Results And Observations, Steve Seninger Ph.D., Meg A. Traci Ph.D., University Of Montana Rural Institute Rural Institute

Health and Wellness

High turnover rates mean that community providers of services to individuals with developmental disabilities may be replacing almost their entire direct service workforces each year. This instability imposes significant costs on each provider for recruiting, screening, and training replacement workers. It also adversely affects the quality of care provided to individuals served by community providers. Although the relationship requires further study, caregiver continuity appears to be an important factor in the health of an individual with developmental disabilities. The following observations are based on completed Corporation Questionnaires from seven Montana developmental disabilities service providers.

Attitudes And Beliefs Of Successful Adult Illicit Drug Users: A Qualitative Analysis Of Drugnet Survey Respondents, Kathryn Steward

Masters Theses & Specialist Projects

America is a drug-oriented society. For many years people have used drugs for recreational purposes. However, there has been ongoing controversy regarding drug abuse and drug use. The purpose of this study was to assess attitudes and beliefs of successful adult drug users as it relates to drug reform, effectiveness of current drug laws, and problem experiences that they may have encountered as a result of their drug use. A qualitative study utilizing three open-ended questions regarding the aforementioned areas was conducted to analyze the 156 individuals' responses. The respondents were found to be in agreement on the ineffectiveness of …

Reducing Childhood Pedestrian Injuries: Proceedings Of A Multidisciplinary Conference, Richard A. Schieber, Maria Vegega

United States Public Health Resources

EXECUTIVE SUMMARY
Motor vehicle crashes are associated with one of every five deaths among children 1 to 14 years of age in the United States, and pedestrian injuries account for a third of them. Compared with occupant injuries, pedestrian injuries are more severe; death is five times more likely to occur among those injured. In 1999, 533 child pedestrians were killed, and at least 30,000 children were nonfatally injured in traffic. Another 200 were killed in non-traffic areas, including driveways, sidewalks, and parking lots. Traumatic brain injury accounts for more than half the fatalities.
Dr. Schieber noted that the decline …

School-Based Health Centers And Managed Care Arrangements: A Review Of State Models And Implementation Issues, Jennel Harvey, Lissette Vaquerano, Lea Nolan, Colleen Sonosky

Health Policy and Management Faculty Publications

No abstract provided.

Building Jefferson's Future, Douglas J. Macmaster Jr., Paul C. Brucker

Thomas Jefferson University Administrative Documents and Reports

2002 Annual report of Thomas Jefferson University.

Jefferson Medical College Annual Report, 2002, Thomas J. Nasca

Jefferson Medical College Administrative Documents and Reports

No abstract provided.

Preventing Worker Electrocutions, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

No abstract provided.

15-Year-Old Dies In Utility Golf Cart Overturn, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

A fifteen-year-old golf course worker (the victim) was killed when the utility golf cart he was operating overturned. The victim was employed by the golf club adjacent to which he and his family resided and had driven the utility golf cart to his home located at the top of a hill to change clothes. Before leaving work for his residence, he contacted a friend who then came to his house on a regular course golf cart (not a utility cart). After the victim changed clothes, he and his friend left the victim’s home. Then on their respective carts, traveled downhill …

Brick Mason Dies From Fall Through Scaffolding, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 62 year-old male brick mason (victim) died after he fell approximately 55 feet through masonry scaffolding. He worked for a masonry subcontracting company contracted to do the masonry work on a new building. The victim was performing ongoing work laying brick at the construction site. At approximately 7:15 AM the victim entered the building he was bricking and ascended to the 4th floor where he reached his workstation. He stepped out of an opening from the building onto the scaffolding outside. As he did so, he stepped over two mason boards (20 inches combined width), which were closest to …

Hatch-Waxman, Generics, And Patents: Balancing Prescription Drug Innovation, Competition, And Affordability, Robin J. Strongin

National Health Policy Forum

This paper explores the complex connections among intellectual property protection, competition, and access to affordable prescription drug products. It focuses on several provisions of the Drug Price Competition and Patent Term Restoration Act of 1984 (Hatch-Waxman) and discusses the debate swirling around its reform. An overview of landmark intellectual property laws and a description of the generic drug approval process are also included.

Managing Advanced Illness: A Quality And Cost Challenge To Medicare, Medicaid, And Private Insurers, Karen Matherlee

National Health Policy Forum

This issue brief examines approaches to delivering and financing health services for persons with advanced chronic illness. It focuses on the nature and structure of the Medicare hospice benefit and its use as a model for Medicaid and other federal programs. The paper also looks at palliative-care approaches along the continuum of inpatient and post-acute services and raises cost, quality, and access issues for end-of-life care. In addition, it provides an overview of coverage through private insurance, including indemnity, point-of-service, and preferred-provider-organization products.

1115 Ways To Waive Medicaid And Schip Rules, Jennifer Ryan

National Health Policy Forum

This issue brief explores the history and context of the Section 1115 Medicaid waiver authority, discusses the Health Insurance Flexibility and Accountability (HIFA) initiative under way in the Bush administration, and considers some of the potential impacts that HIFA could have on state budgets and access to health care for low-income families. Finally, it considers the future of Section 1115 waivers as a vehicle for modifying Medicaid and the State Children's Health Insurance Program.

Improving Oral Health: Promise And Prospects, Jennifer Ryan

National Health Policy Forum

This background paper examines the variety of issues affecting access to oral health care in the United States. It considers the possibilities and challenges presented by public financing sources for dental care for low-income children and families—including Medicaid, the State Children’s Health Insurance Program, and other safety net programs—and reviews a sampling of privately funded efforts at improving oral health access. The paper illustrates some of the major barriers to dental care, particularly the shortage of dentists willing to serve low-income and uninsured patients and the overall lack of growth in the dental workforce. It also considers the changing roles …

Will The Nation Be Ready For The Next Bioterrorism Attack? Mending Gaps In The Public Health Infrastructure, Eileen Salinsky

National Health Policy Forum

This paper provides an overview of critical weaknesses in public health preparedness capabilities and discusses policy initiatives to address these shortcomings. It examines developmental needs related to communication and coordination, information systems, laboratories, the development and distribution of vaccines and other countermeasures, emergency medical preparedness and response, and the public health workforce. The paper summarizes the status of federal and state plans to respond to these developmental needs and touches on the challenges likely to emerge as these plans are implemented.

Average Wholesale Price For Prescription Drugs: Is There A More Appropriate Pricing Mechanism?, Dawn Gencarelli

National Health Policy Forum

This paper defines the average wholesale price (AWP), an important benchmark for prescription drug pricing and reimbursement. The paper briefly explains the AWP's various uses in the pricing of prescription drugs, highlights some of the problems that have emerged as a result of the way it is reported and used, and explores some of the possibilities for reform. The paper also contains a glossary of commonly used terms, as well as an appendix that lists the state Medicaid reimbursement formulas.

Contracting For Quality: Medicare's Quality Improvement Organizations, Lisa Sprague

National Health Policy Forum

This paper examines the role of quality improvement organizations (QIOs, formerly known as PROs, or peer review organizations) in improving the quality of medical care delivered to Medicare beneficiaries in both fee-for-service and managed care environments. It looks at the expansion of the QIOs' portfolio in their seventh contract cycle to include quality improvement activities in nursing homes, home health services, and physicians' offices as well as responsibilities for public education. The paper explores the evolution of QIOs, changes in their priorities over time, and the projects in which they are engaged. It also considers their role in the formulation …

The Impact Of The State Children's Health Insurance Program (Schip) On Community Health Centers, Lea Nolan, Jennel Harvey, Karen Jones, Lissette Vaquerano, Ann Zuvekas

Health Policy and Management Faculty Publications

Nearly 12 million children in the United States do not have health insurance, and therefore often lack access to health care. In response, Congress enacted the State Children’s Health Insurance Program (SCHIP) in August 1997, the largest expansion of health insurance coverage since the inception of the Medicare and Medicaid programs. The SCHIP provides states with federal matching funds for children’s insurance either by expanding the existing Medicaid program, by creating a separate state program, or a combination of both.

The George Washington University’s Center for Health Services Research and Policy (CHSRP) was funded by the Health Resources and Services …

Commencement Program 2002, Loma Linda University

Commencement Programs

CONTENTS

2 | 2002 Events of Commencement

3 | The Academic Procession

4 | Significance of Academic Regalia

5 | The Speakers

11 | The University Honorees

18 | The School Honorees

27 | The Programs

• School of Medicine, 28
• School of Dentistry, 35
• Graduate School, 43
• School of Nursing, 53
• School of Allied Health Professions - Physical Therapy, 58
• School of Allied Health Professions, 66
• School of Public Health, 75

Transportation: A Crucial Issue For Adult Day Care In Vermont, Francis G. Caro, Regula H. Robnett, Jennifer Higgins

Gerontology Institute Publications

Transportation arrangements are an integral but fragile element in the effectiveness of adult day care services in Vermont and nationwide. Almost by definition, adult day center participants generally cannot drive due to cognitive and/or physical limitations. Since adult day care services are congregate in nature and serve community-residing elders, this long-term care option is feasible only when there are arrangements to transport elders to and from service centers. Transportation is therefore a major issue for adult day care services.

The aim of this report is to call attention to transportation issues in adult day care services in Vermont. The report …

Whose Duty Is It Anyway?: The Kennedy Krieger Opinion And Its Implications For Public Health Research, Diane E. Hoffmann, Karen H. Rothenberg

Faculty Scholarship

In this article, the authors discuss the Maryland Court of Appeals decision in the case of Grimes v. Kennedy Krieger Institute, Inc. and its implications for the tort duty owed by researchers, in particular public health researchers, to their subjects. The Opinion resulted from two lawsuits alleging lead poisoning of children enrolled in a study conducted by the Kennedy Krieger Institute, a world renown pediatric research and treatment facility. The opinion shocked the research establishment with its scathing characterization of researchers and its apparent holding that in Maryland a parent cannot consent to the participation of a child in "nontherapeutic …

Evaluation Of A Comprehensive Diabetes Disease Management Program: Progress In The Struggle For Sustained Behavior Change, Janice Clarke, Albert Crawford, David B. Nash

College of Population Health Faculty Papers

The successful management of diabetes with a goal of achieving near-normoglycemia requires patients to make multiple lifestyle changes as part of an intensive, complex, and coordinated therapeutic regimen aimed at reducing the risk of complications associated with the disease. The difficulty in creating and sustaining these lifestyle behavior changes is a major stumbling block in achieving the desired therapeutic goal. An underlying assumption of comprehensive disease management is that regular, personal contact with nurses and ancillary health professionals will facilitate these lifestyle behavior changes for program participants. The results of a survey of self-reported data from 750 participants in a …

The Federal-State Struggle Over Medicaid Matching Funds: An Update, Karen Matherlee

National Health Policy Forum

This background paper updates NHPF Issue Brief No. 760, "The Federal-State Medicaid Match: An Ongoing Tug-of-War over Practice and Policy," December 15, 2000. The paper presents actions taken since then by the Centers for Medicare and Medicaid Services, Department of Health and Human Services, to address what the Bush administration calls abusive funding practices used by states to draw federal Medicaid matching funds. Tracing the Clinton and Bush administrations' policies, the document reviews final regulations, published in January 2001 and January 2002, on these practices. The paper also reports on a lawsuit filed in federal court to block …

Development Of Dose Coefficients For Radionuclides Produced In Spallation Neutron Sources, Phillip W. Patton

Transmutation Sciences Physics (TRP)

A research consortium comprised of representatives from several universities and national laboratories has been established as part of this on-going project to generate internal and external dose conversion coefficients for radionuclides produced in spallation neutron sources. Information obtained from this multi-year study will be used to support the siting and licensing of future accelerator-driven nuclear initiatives within the U.S. Department of Energy complex, including the Spallation Neutron Source (SNS) and Accelerator Production of Tritium (APT) Projects. Determination of these coefficients will also fill data gaps for several hundred radionuclides that exist in Federal Guide Report No. 11 and in Publications …

A Case Study Of An Ergonomic Evaluation For A Shop Floor Facility, Ivan Siguencia

Theses

The aim of this paper is to discuss and recommend solutions for the ergonomic hazards present in a shop floor type of manufacturing facility. This type of study is important since the ergonomic issues that concern the shop floor worker are different than those faced by the assembly line worker. The shop floor employee for the most part enjoys work satisfaction, task variety, and is able to control his own work pace. From an ergonomic standpoint, this is the preferred work environment.

The focus of this paper is a case study. This study is a one-day ergonomic assessment of a …