Health and Medical Administration Commons^™

Intake Of Coffee And Tea And Risk Of Ovarian Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

There is some evidence from case-control studies that coffee consumption might be positively associated with ovarian cancer risk, whereas the epidemiologic evidence regarding tea consumption and ovarian cancer is inconsistent. To date, there have been few prospective studies of these associations. Therefore, we examined ovarian cancer risk in association with both coffee and tea intake in a prospective cohort study of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending …

What's Happening: December, 2007, Maine Medical Center

What's Happening

No abstract provided.

Complementary And Alternative Medicine: Opportunities And Challenges, William Martin, Hugh Long

Publications – Dreihaus College of Business

Health care finance is complex in all sectors of the health care industry. This article highlights both the challenges and opportunities of financing and reimbursing care with a focus on CAM providers and CAM provider organizations.

Ferric Gluconate Yields Cost-Savings In Hemodialysis Patients With High Ferritin And Low Tsat: Results From The Drive Studies, Laura T. Pizzi, Thomas J. Bunz, David S. Goldfarb, Daniel W. Coyne, Ajay K. Singh

College of Population Health Lectures, Presentations, Workshops

Purpose: One third of hemodialysis patients have high serum ferritin levels and low transferrin saturation (TSAT). The purpose of this analysis was to determine the cost effectiveness of administering 1g of sodium ferric gluconate complex (SFGC: also referred to as ferric gluconate) to patients with serum ferritin >500ng/mL and TSAT ≤25% based on the Dialysis Patients Response to IV Iron with Elevated Ferritin (DRIVE) study and its 6-week observational extension (DRIVE-II). In these studies, IV iron administration resulted in reduced epoetin requirements.

Methods: Decision analysis was performed using a time horizon of 12 weeks, consistent with the combined duration of …

What's Happening: November, 2007, Maine Medical Center

What's Happening

No abstract provided.

Complementary And Alternative Medicine: Opportunities And Challenges, William Marty Martin, Hugh Long

William Marty Martin

Health care finance is complex in all sectors of the health care industry. This article highlights both the challenges and opportunities of financing and reimbursing care with a focus on CAM providers and CAM provider organizations.

Resource Utilization Due To Breakthrough Pain In Patients With Chronic Painful Conditions, L. T. Pizzi, S. P. Lee, D. Richardson, N. Cobb, B. Leas, R. Toner, V. Pracilio, S. K. Ballas, A. Ashkenazi, C. T. Derk, D. Wang, E. Desousa

College of Population Health Lectures, Presentations, Workshops

Objectives
Primary: To capture healthcare resource consumption and work loss in a population of patients with chronic pain who have pain flares from one or more non-cancer conditions.

Secondary: To explore the relationship between anxiety, depression, and pain in this population.

Perception Of Breakthrough Pain In Patients With Chronic Painful Conditions, L. T. Pizzi, S. P. Lee, D. Richardson, N. Cobb, B. Leas, R. Toner, V. Pracilio, S. K. Ballas, A. Ashkenazi, C. T. Derk, D. Wang, E. Desousa

College of Population Health Lectures, Presentations, Workshops

Objective: To understand how patients with chronic non-cancer pain define and describe pain flares.

Knowledge Integration: The Iaims Experience At Lvh., Donald L. Levick Md, Linda M. Schwartz Mde, Ahip, Cm, Bryan G. Kane Md

Administration & Leadership

No abstract provided.

What's Happening: October, 2007, Maine Medical Center

What's Happening

No abstract provided.

The Realization Of The Rights To Health, Education And Social Welfare Among Disabled Youth In Ingwavuma And Bhambanana, Kwazulu Natal, Ali Mumford

Independent Study Project (ISP) Collection

This practicum based study was completed in an effort to explore the realization of the rights to health, education and social welfare for disabled children in Ingwavuma and Bhambana, KwaZulu Natal. Very little research has been done on disabled children in South Africa, and estimations of prevalence range from 3.3-6.4%. The absence of accurate data creates a situation where implementation of policy and delivery of services is slow and does not always address the most urgent needs. The new South Africa aimed to bring rights and freedom to all groups of people, but the question which this study attempts to …

Children's Behavioral Health Services In Baltimore: Walking The Continuum, Jennifer Ryan

National Health Policy Forum

This site visit explored the range of behavioral health services available for children in the city of Baltimore and in the state more broadly. Like many states, the policy community in Maryland has been working hard to meet the challenges of providing an effective continuum of care in the context of complex financing incentives and an overburdened educational and public health care system. Several promising practices have emerged, including the Wraparound practice model that offers individualized, comprehensive services and natural supports to achieve a positive set of outcomes for the child and family. The wraparound model incorporates both traditional services …

Medicare Advantage Payment Policy, Mark Merlis

National Health Policy Forum

Medicare Advantage (MA) plans have become a source of supplemental benefits for many Medicare beneficiaries. In many cases, MA plans are able to finance these extra benefits only because Medicare is paying them more than it would have spent to cover the same beneficiaries on a fee-for-service basis. As Congress considers curbing MA plan payments, this background paper explains how MA plans are paid and reviews recent trends in plan participation and enrollment. It then considers key issues raised by proposals to change the payment system.

Physician Profiling: Can Medicare Paint An Accurate Picture?, Laura A. Dummit

National Health Policy Forum

Physician profiling, that is, the comparison of the health care services used by a physician’s patients to average service use or another benchmark, has been proposed as a way to improve Medicare. It has been used by private health plans and physician groups to identify both efficient practice patterns and the physicians who practice efficiently. The Medicare Payment Advisory Commission (MedPAC) and the Government Accountability Office (GAO) have recommended that Medicare adopt physician profiling to slow spending growth and improve efficiency. Recent legislation would mandate that Medicare employ profiling. This issue brief reviews MedPAC and GAO’s analyses of profiling, concerns …

What's Happening: September, 2007, Maine Medical Center

What's Happening

No abstract provided.

Medicare's Use Of Risk Adjustment, Gerald F. Kominski

National Health Policy Forum

Medicare accounts for expected differences in resource needs of patients or health plan enrollees by risk-adjusting the payments it makes to health care facilities, such as hospitals, skilled nursing facilities, and home health agencies, and the premiums it pays to health plans. Risk adjustment is intended to ensure that payments or premiums are adequate for patients or plan enrollees who require more resources than average in order to protect beneficiary access as well as the financial condition of the provider or plan. At the same time, risk adjustment lowers payments or premiums for beneficiaries who are expected to use fewer …

Medicaid And State Budgets: Clearing Storm, Foggy Forecast, Courtney Burke

National Health Policy Forum

This issue brief examines the recent history and trends in state budgets and considers how those trends have influenced the role of the Medicaid program. The paper offers several indicators for predicting the future of states’ fiscal standing, cautioning that, although the “stormy” period from 2001 to 2003 is over, states face many challenges in the near future. This issue brief also poses several questions regarding the appropriate roles of state and federal governments in administering the Medicaid program. These questions become particularly important as the population ages and states increasingly take the lead in developing solutions for covering the …

Practice Notes: Strategies In Health Education Program, “Full Service”: Talking About Fighting Prostate Cancer—In The Barber Shop!, Lisa D. Lieberman, Mario C. Browne, Barbara Hager

Department of Public Health Scholarship and Creative Works

The purpose of this project is to promote prostate cancer screening, education about disease risk and the importance of early detection, and survivorship among African American males who frequent African American–owned barber shops.

Community-Based Long-Term Care: Wisconsin Stays Ahead, Judith D. Moore, Carol O'Shaughnessy, Lisa Sprague

National Health Policy Forum

This report describes a site visit to Wisconsin in August 2007 that focused on the use of home and community-based services, both public and private, to delay or avoid the need for institutional care. Wisconsin was chosen because it has long been a leader among states in developing such services for the elderly and persons with disabilities. At the time of the visit, a managed long-term care program, Family Care, was operating on a pilot basis in five counties. The Partnership Program, a four-site demonstration integrating acute and long-term care for the dual eligible population (both frail elderly and younger …

Shrinking Inpatient Psychiatric Capacity: Cause For Celebration Or Concern?, Eileen Salinsky, Christopher Loftis

National Health Policy Forum

This issue brief examines reported capacity constraints in inpatient psychiatric services and describes how these services fit within the continuum of care for mental health treatment. The paper summarizes the type and range of acute care services used to intervene in mental health crises, including both traditional hospital-based services and alternative crisis interventions, such as mobile response teams. It reviews historical trends in the supply of inpatient psychiatric beds and explores the anticipated influence of prospective payment for inpatient psychiatric services under Medicare. The paper also considers other forces that may affect the need for and supply of acute mental …

What's Happening: August, 2007, Maine Medical Center

What's Happening

No abstract provided.

Health Information Technology Adoption Among Health Centers: A Digital Divide In The Making?, Adil Moiduddin, Daniel S. Gaylin

National Health Policy Forum

This background paper describes the current status of efforts to implement health information technology in community health centers. It summarizes the benefits experienced by health centers that have pioneered the use of information technology and examines the challenges that have hindered wider adoption. The paper identifies a range of policy options that have been considered to promote broader use of information technology by health centers.

A Relationship Between Us Healthcare Worker Smallpox Vaccination Rates In 2003 And Presidential Election Results In 2004, F. Matthew Mihelic, David G. Schultz Jr., Melinda R. Mihelic

Faculty Publications

A statistical relationship exists between state per capita smallpox vaccination rates of healthcare workers in 2003 and state presidential election results in 2004. The potential implications of political influence on national biosecurity decision making are discussed.

Virtual Community Health Promotion, Richard Crespo

Family and Community Health

The “wiki” and open-source phenomena are transforming the way knowledge is generated and shared around the world. The word wiki is from the Hawaiian term wiki-wiki, which means to do something quickly (1). The term became prominent because of the online encyclopedia Wikipedia (www.wikipedia.org), which now has more than 2 million articles contributed by tens of thousands of people. People in so many fields are using Internet communities that the term wiki has come to refer to an online group that collectively works on a project. In the business world, the wiki concept is called wikinomics (1). Even U.S. spy …

What's Happening: July, 2007, Maine Medical Center

What's Happening

No abstract provided.

Implementing Lean Six Sigma Methodologies In The Radiology Department Of A Hospital Healthcare System, Jamie Workman-Germann, Heather (Woodward) Hagg

RCHE Publications

Increased focus is being placed on the quality of care provided by Hospitals and Healthcare Systems around the country. Caught in the middle between tightening govenment standards, stricter compliance guidelines for insurance companies, and the basic mission to serve those in need with quality and compassion, hospitals are searching for ways to improve their processes and services for the benefit of all. CT (Computed Tomography - CAT Scan) and MRI (Magnetic Resonance Imaging) services in the hospital radiology departments are revenue generating areas. The reimbursement rates for these services are very high, the scan times (especially in CT) are relatively …

Factors Associated With Integrating Self-Management Support Into Primary Care, Richard Crespo, Molly Shrewsberry

Family and Community Health

Purpose

The purpose of this article is to expand the understanding of self-management support by describing factors that contribute to implementing a comprehensive self-management program in primary care.

Methods

Four rural health centers in medically underserved areas participated in a study to document the implementation of a self-management program. This program consisted of a social marketing plan and decision-making tools to guide patients in making self-management behavior changes. The stages of change constructs of the transtheoretical model were used to design the social marketing plan. Key informant interviews were conducted at 6-month and 9-month intervals to document the implementation process. …

Trading Places: Real Choice Systems Change Grants And The Movement To Community-Based Long-Term Care Supports, Cynthia Shirk

National Health Policy Forum

The Real Choice Systems Change grant program was created to help states transform their long-term care service systems from ones that rely on institutions to ones that are more community-based. The grants are intended to help states develop the infrastructure needed for seniors and individuals with disabilities to live in integrated community settings. This issue brief provides information about Systems Change grants and the kinds of activities state Medicaid agencies have undertaken to transform their institutionally based systems. In addition, this paper reports on some of the qualitative and quantitative responses to the changes. This brief also raises critical policy …

The Prescription Drug Safety Net: Access To Pharmaceuticals For The Uninsured, Jack Hoadley

National Health Policy Forum

This background paper provides an overview of organized programs that provide access to prescription drug products for uninsured persons, with an emphasis on manufacturer-sponsored pharmacy assistance programs (PAPs) and the federal 340B drug pricing program. It summarizes the chief characteristics of these programs and reviews concerns regarding the reach and efficiency of these efforts. The paper begins with a brief examination of the number of people who lack insurance coverage for prescription drugs and discusses the influence of this gap in coverage on health status. The paper also describes informal mechanisms providers frequently use to help uninsured patients fill their …

What's Happening: May, 2007, Maine Medical Center

What's Happening

No abstract provided.