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Articles 5851 - 5880 of 6128

Full-Text Articles in Public Health

Promoting Marriage As Welfare Policy: Looking At A Public Role In Private Lives, Jane Koppelman Feb 2002

Promoting Marriage As Welfare Policy: Looking At A Public Role In Private Lives, Jane Koppelman

National Health Policy Forum

This issue brief discusses the interest in and politics surrounding government's using welfare reform legislation to carve out a stronger role in promoting marriage. It examines trends in family formation, their impact on society, and the effect of single parenting, divorce, and stepparenting on child well-being. The paper also looks at the treatment of marriage in current government programs, new state activities to promote marriage, proposals for a stronger government role, and marriage experts' expectations for the success of marriage education programs.

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From Diagnosis To Payment: The Dynamics Of Coding Systems For Hospital, Physician, And Other Health Services, Karen Matherlee Jan 2002

From Diagnosis To Payment: The Dynamics Of Coding Systems For Hospital, Physician, And Other Health Services, Karen Matherlee

National Health Policy Forum

This background paper reviews the two principal coding systems used to describe health services in the United States: ICD-9-CM and HCPCS, a combination of CPT-4 and national and local codes. It probes the relationships of these coding systems to payment policy, administrative simplification under HIPAA, and other concerns. The paper also addresses four coding issues: governance of CPT; adoption of ICD-10-CM; the appropriateness, accuracy, and responsiveness to change of the codes themselves; and the degree of documentation needed to monitor health services and determine payment.

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Who Will Be There To Care? The Growing Gap Between Caregiver Supply And Demand, Nora Super Jan 2002

Who Will Be There To Care? The Growing Gap Between Caregiver Supply And Demand, Nora Super

National Health Policy Forum

This paper examines the increasing demand for long-term care services and the concurrent decrease in the supply of paid and unpaid caregivers. It considers workforce trends for paraprofessionals, such as certified nursing assistants, home health aides, and personal care attendants, as well as several public and private efforts to address staff shortages and quality-of-care. The paper explores the sociodemographic factors that have affected the demand for and supply of informal care provided by family and friends. It also reviewes policy proposals designed to provide support for family caregivers and/or to give choices to consumers.

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Managed Care: As Good As It Gets? (Los Angeles), Lisa Sprague Jan 2002

Managed Care: As Good As It Gets? (Los Angeles), Lisa Sprague

National Health Policy Forum

This site visit was a return trip to southern California to examine the state of managed care. Between the Forum's last visit (in late 1998) and this one, the marketplace underwent considerable change, including significant movement away from global capitation, the collapse of physician practice management firms, and the development of new insurance products. Site visitors were briefed on managed care trends in the state, and panel discussions focused on issues related to physician group solvency, employer and consumer expectations, managed care regulation, and plan and provider strategies for surviving and prospering in the difficult southern California market. Site visitors …

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Report On A Formative Evaluation Conducted For The Youth Against Tobacco Counter Marketing Campaign, Lorelei Cropley, F Mitchell, Peter B. Anderson Jan 2002

Report On A Formative Evaluation Conducted For The Youth Against Tobacco Counter Marketing Campaign, Lorelei Cropley, F Mitchell, Peter B. Anderson

Educational Leadership, Counseling, and Foundations

This paper reports the formative evaluation findings of a tobacco counter-marketing campaign and recommendations based on those findings. Focus groups were used w determine reactions to four messages for the Youth Against Tobacco (YAT) campaign. Participants aged eleven to eighteen years old, who resided in the metropolitan New Orleans area. were selected from area schools usiNg convenience sampling. Results indicated that while reactions w the messages were positive overall, some aspects of the messages seemed too complex to be used effectively in the campaign. These results helped to guide modification and selection of messages prior to use in the campaign.

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Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health Jan 2002

Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health

Reproductive Health

In September 1999, the Zimbabwe National Family Planning Council (ZNFPC) and the Population Council initiated a one-year study to assess the performance of ZNFPC’s community-based distribution (CBD) program. A continual decline in the program’s productivity, combined with the expanding HIV/AIDS epidemic, indicated a need to reconsider ZNFPC’s objectives and revise the roles and responsibilities of its full-time, salaried CBD agents. The study examined the productivity, costs, and potential sustainability of the CBD program. Researchers gathered information by reviewing program documents through 1999. They also interviewed program managers, district and community nurses, and community leaders and CBD agents from eight regions. …

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Health-Seeking Behavior Of Karachi Women With Reproductive Tract Infections, Lubna Ishaq Bhatti, Fariyal F. Fikree Jan 2002

Health-Seeking Behavior Of Karachi Women With Reproductive Tract Infections, Lubna Ishaq Bhatti, Fariyal F. Fikree

Community Health Sciences

To explore the contextual factors influencing health-seeking behavior of women in Karachi regarding reproductive tract infections, 18 women with reproductive tract infections from different clinics and community settings were identified and in-depth interviews were conducted. Physicians in our study diagnosed a woman to have lower reproductive tract infection if she complained of malodorous vaginal discharge with or without perineal itching; and to have pelvic inflammatory disease or upper reproductive tract infection if she had any two of the following complaints: malodorous vaginal discharge, menstrual irregularities, lower abdominal pain or dyspareunia. Women consulted a variety of healthcare providers in their pursuit …

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A Harm Reduction Intervention For Drinking Games, Nicholas A. Lind Dec 2001

A Harm Reduction Intervention For Drinking Games, Nicholas A. Lind

All-Inclusive List of Electronic Theses and Dissertations

Binge drinking is not only responsible for the leading cause of death of 18-21 year olds (alcohol-related accidents), but is also associated with alcohol dependence, sexual assault, and school failure. Little research has addressed one of the major contexts in which college binge drinking occurs, namely participation in drinking games. The current study used a quasiexperimental pre-post design to examine the effectiveness of a drinking game intervention based on Marlatt's (1996) Harm Reduction model of prevention. Six male residence hall floors and seven fraternities were randomly identified as experimental groups and three floors and three fraternities were designated as controls. …

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Meeting Employees' Information Needs In An Evolving Health Care Marketplace, Lise Rybowski Nov 2001

Meeting Employees' Information Needs In An Evolving Health Care Marketplace, Lise Rybowski

National Health Policy Forum

This background paper explores the role of information in an evolving health care marketplace. It notes that, in a softening economy, many employers seeking relief from escalating health care expenses shift costs onto employees. Some try to make their retreat more palatable by offering employees both more options for how and where they receive health care and more control over how and where the money is spent. This paper discusses the changes that are likely to occur over the next decade in the ways that people make decisions about health plans and providers, the implications for consumers' information needs, and …

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The Disappearing State Surpluses: How Come, How Long, And How Will They Affect Social Service Programs?, Randy Desonia Oct 2001

The Disappearing State Surpluses: How Come, How Long, And How Will They Affect Social Service Programs?, Randy Desonia

National Health Policy Forum

This issue brief focuses on the impact of budget shortfalls being experienced by many states after several years of strong revenue growth. It describes the structure and sources of state revenues and spending and the causes of the shortfall. It also summarizes the fiscal trends and federal policies that could result in significant budget shortfalls in the future.

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Injury Mortality In Texas And The Lower Rio Grande Valley, 1980-1998, Jan M. H. Risser, Carrie Shapiro, William Spears Oct 2001

Injury Mortality In Texas And The Lower Rio Grande Valley, 1980-1998, Jan M. H. Risser, Carrie Shapiro, William Spears

Population and Public Health Sciences Faculty Publications

Aims: To compare age-adjusted injury mortality rates between Lower Rio Grande Valley (LRGV) Hispanics, Texas Hispanics and Texas Whites. Methods: Using data from the Texas Department of Health, we examined deaths from injuries including: motor vehicle accidents, homicide, and suicide from 1980 through 1998. Results: Injury deaths are the fourth leading cause of death in Texas. Mortality rates for all-cause injuries among LRGV Hispanics were 25% lower than rates among Texas Whites. Traffic accident mortality were quite similar among the study groups. From 1980, the average mortality from traffic accidents per 100,000 persons was 21.9 among Whites and 27.2 among …

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Primary Care Case Management: Lessons For Medicare?, Lisa Sprague Oct 2001

Primary Care Case Management: Lessons For Medicare?, Lisa Sprague

National Health Policy Forum

This issue brief looks at primary care case management (PCCM) as a tool that states have used to manage the delivery of care to their Medicaid populations, an alternative to contracting with commercial managed care plans. (States had found PCCM a flexible means of advancing state policy goals, including quality improvement, disease management, and coverage of special-needs populations.) The issue brief considers provider and beneficiary perspectives on PCCM as well as state agency objectives and accomplishments. Finally, it raises the question of adapting the PCCM model for Medicare.

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Patterns Of Recent Alcohol, Tobacco, And Other Drug Use Among Caucasian, Black, And Hispanic Students Attending Racially Homogeneous And Heterogeneous School Districts, Matthew J. Cook, Jane A. Ungemack, Hal Mark Oct 2001

Patterns Of Recent Alcohol, Tobacco, And Other Drug Use Among Caucasian, Black, And Hispanic Students Attending Racially Homogeneous And Heterogeneous School Districts, Matthew J. Cook, Jane A. Ungemack, Hal Mark

SoM Presentations

No abstract provided.

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Emergency Preparedness From A Health Perspective: Preparing For Bioterrorism At The Federal, State, And Local Levels, Robin J. Strongin Oct 2001

Emergency Preparedness From A Health Perspective: Preparing For Bioterrorism At The Federal, State, And Local Levels, Robin J. Strongin

National Health Policy Forum

Despite the good intentions prior to and in the aftermath of the terrorist attacks of September 11, 2001, the existence of significant gaps in the country's preparedness became increasingly clear in the weeks that followed. This background paper provides an overview of the state of bioterrorism preparedness at all levels of government, identifying both the gaps and the steps being taken to close them. A series of reference materials, including a suggested reading list and Web site addresses, are listed at the end of the paper.

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Health Insurance Family Style: Public Approaches To Reaching The Uninsured, Jennifer Ryan Sep 2001

Health Insurance Family Style: Public Approaches To Reaching The Uninsured, Jennifer Ryan

National Health Policy Forum

This issue brief explores existing and potential opportunities to further expand the availability of health coverage for the uninsured and the underinsured, given downturns in the economy and the resulting state budget shortfalls. It also considers the implications of the Health Insurance Flexibility and Accountability (HIFA) initiative announced in August 2001 by the Centers for Medicare and Medicaid Services. Finally, the issue brief describes legislative options for health care reform being debated in Washington, including tax credit incentives, employer-based coverage subsidies and the potential for additional federal funding for public coverage expansions through Medicaid and the State Children's Health Insurance …

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Mission Possible? Maintaining The Safety Net In Urban And Rural Colorado, Karen Matherlee Aug 2001

Mission Possible? Maintaining The Safety Net In Urban And Rural Colorado, Karen Matherlee

National Health Policy Forum

This site visit examined urban safety-net concerns in Denver and rural safety-net issues in three communities in the eastern part of Colorado. The Denver segment featured Denver Health, an integrated health system that provides a continuum of services to diverse vulnerable populations. It explored delivery and financing issues for the system itself and in relation to payers, providers, and consumers (particularly through Community Voices) in its catchment area. The eastern Colorado segment focused on delivery and financing issues in Rocky Ford (community health center/migrant health services concerns), Limon (certified rural health center topics), and Hugo (critical-access hospital matters). The visit …

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W-2 In 2001: Wisconsin Works At Welfare Reform, Jennifer Ryan, Randy Desonia Aug 2001

W-2 In 2001: Wisconsin Works At Welfare Reform, Jennifer Ryan, Randy Desonia

National Health Policy Forum

This site visit took federal participants to Wisconsin, widely regarded as one of the pioneers of welfare reform. This site visit focused on Wisconsin Works (W-2), a statewide effort to reduce the state's welfare caseload and send clients to work. In particular, site visitors examined welfare reform policy, service delivery, and financing issues in Milwaukee, at that time the home of 85 percent of W-2 participants. Site visit participants heard from state officials, private-sector representatives, researchers, and advocates on the structure of W-2, its operating policies, and the effects of program implementation on low-income families. They toured a variety of …

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Medicare Coverage: Lessons From The Past, Questions For The Future, Robin J. Strongin Aug 2001

Medicare Coverage: Lessons From The Past, Questions For The Future, Robin J. Strongin

National Health Policy Forum

This paper describes the Medicare coverage process for emerging technologies and the ways it has changed over time. Issues addressed include both the national coverage process and local medical review policies, which account for 90 percent of the coverage determinations. The paper also includes a discussion of the relationship between the coverage process and technology assessment, payment systems and the ongoing debate over coverage criteria and levels of evidence.

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Income Support Policy And The U.S. Child Support System, Jane Koppelman Jul 2001

Income Support Policy And The U.S. Child Support System, Jane Koppelman

National Health Policy Forum

This paper examines the economic profile of custodial and noncustodial parents and the status of the federal/state child support enforcement system. It discusses the reasons for the historically low rate of child support collection; the prospects for new computerized systems to improve the rates of both paternities established and payments collected; ways the system can sustain funding; and the extent to which child support payments can improve the well-being of low-income families.

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Pharmacy Benefit Managers: A Model For Medicare?, Veronica V. Goff Jul 2001

Pharmacy Benefit Managers: A Model For Medicare?, Veronica V. Goff

National Health Policy Forum

This issue brief uses large-employer experiences with pharmacy benefit managers (PBMs) to shed light on their potential as Medicare outpatient drug benefit administrators. PBM management techniques are discussed, as well as employer perspectives on PBM strengths and weaknesses and lessons learned. Considerations for Medicare policy are also examined. The brief built on a previous NHPF issue brief entitled The ABCs of PBMs.

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Federal And State Perspectives On Gme Reform, Karen Matherlee Jun 2001

Federal And State Perspectives On Gme Reform, Karen Matherlee

National Health Policy Forum

This issue brief examines financial support of graduate medical education (GME), a standard budget item in the federal Medicare program and in some state Medicaid programs. It looks at objections to the way in which GME dollars are distributed, especially in terms of variations in Medicare GME payments across states. It explores various reform proposals that are circulating to address this and other GME problems and the odds for major reform.

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Nurse Workforce: Condition Critical, Wakina Scott Jun 2001

Nurse Workforce: Condition Critical, Wakina Scott

National Health Policy Forum

This issue brief provides an overview of the current nursing shortage. It discusses the multiple factors that make this shortage in the nurse workforce different from earlier ones. It also examines steps taken by nursing schools, the health care industry, the federal government, and states to address this issue.

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Health Status Of Adult Montanans In Supported And Semi-Independent Living Arrangements, Meg A. Traci Ph.D., Sarah Geurts B.S., Tom Seekins Ph.D., Rebecca Burke M.S., Kathleen Humphries, Lisa Brennan M.L.S., University Of Montana Rural Institute Jun 2001

Health Status Of Adult Montanans In Supported And Semi-Independent Living Arrangements, Meg A. Traci Ph.D., Sarah Geurts B.S., Tom Seekins Ph.D., Rebecca Burke M.S., Kathleen Humphries, Lisa Brennan M.L.S., University Of Montana Rural Institute

Health and Wellness

This study reports on the prevalence and severity of secondary conditions in adults with developmental disabilities living in 33 Montana counties. "Secondary conditions" are additional health problems acquired by an individual with a disability. Although the personal, social, and financial costs of these secondary conditions are extraordinarily high, they are frequently preventable. Ten of the top twelve secondary conditions reported by survey respondents involved issues that can be addressed by wellness activities or lifestyle management. In particular, survey ratings of “Communication,” “Weight,” and “Physical Fitness” problems suggest that these areas may contribute to other problems. Efforts to improve communication skills, …

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Living Well Could Save $31 Million Annually, Craig Ravesloot Ph.D., Catherine Ipsen, Tom Seekins Ph.D., University Of Montana Rural Institute Jun 2001

Living Well Could Save $31 Million Annually, Craig Ravesloot Ph.D., Catherine Ipsen, Tom Seekins Ph.D., University Of Montana Rural Institute

Health and Wellness

Behavior change can improve health status for many adults. Further, for adults with chronic illness and permanent injuries, a growing body of literature identifies health promotion as both effective in improving health and cost-effective compared to treatment alternatives. Yet third-party payers (Medicaid, Medicare, and private insurance) typically do not reimburse health promotion interventions. This is a problem for many individuals with disabilities who have significant health care costs and cannot pay for health promotion programs. For more than a decade, the Office on Disability and Health at the Centers for Disease Control and Prevention has supported research culminating in the …

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Youth Violence Prevention: How Does The Health Care Sector Respond?, Anthony S. Raden Jun 2001

Youth Violence Prevention: How Does The Health Care Sector Respond?, Anthony S. Raden

National Health Policy Forum

This background paper examines the health care sector's response to the complex problems associated with youth violence, identifies the unique challenges health professionals face in dealing with young victims and perpetrators of violence, and raises questions about the ability of health professionals in various types of practice settings to assume a more proactive role in preventing youth violence.

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State-Based Pharmaceutical Assistance Programs: Temporary Fix Or Lessons For Medicare?, Robin J. Strongin Apr 2001

State-Based Pharmaceutical Assistance Programs: Temporary Fix Or Lessons For Medicare?, Robin J. Strongin

National Health Policy Forum

By early 2001, more than one-half of the states had established some type of pharmaceutical assistance programs for the elderly. This issue brief considers specific program parameters, such as eligibility criteria, cost-sharing arrangements, program administration, and marketing and outreach. It also considers programs in the broader context of a future Medicare outpatient prescription drug benefit.

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Tanf And Work Support Services: On The Job In Greater Philadelphia, Lisa Sprague Apr 2001

Tanf And Work Support Services: On The Job In Greater Philadelphia, Lisa Sprague

National Health Policy Forum

This site visit looked at programs in the greater Philadelphia area to move welfare recipients into employment and support services aimed at keeping them employed. Four years after implementation of the Personal Responsibility and Work Opportunity Reconciliation Act, welfare caseloads were much reduced, but challenges remained. Pennsylvania officials described their plans to assist beneficiaries who would reach their five-year lifetime cash assistance limit beginning in 2002. Site visitors met with state and county assistance office staff, employers, consumer advocates, and employment and training contractors. They participated in discussions of how work support services, such as medical assistance, child care, and …

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Quality In The Making: Perspectives On Programs And Progress, Lisa Sprague Apr 2001

Quality In The Making: Perspectives On Programs And Progress, Lisa Sprague

National Health Policy Forum

This background paper considered the evolution of quality evaluation efforts, tracing their development from early initiatives to keep track of patients after surgery through the various guidelines, surveys, and measurement tools currently in use. It looked at both quality assurance and quality improvement strategies, highlighting the different philosophies that guide them. The paper examined the roles of purchasers, providers, consumers, and governments in furthering a quality agenda. Both regulatory and voluntary approaches were assessed.

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The Health Care Safety Net In A Time Of Fiscal Pressures, Richard Hegner Apr 2001

The Health Care Safety Net In A Time Of Fiscal Pressures, Richard Hegner

National Health Policy Forum

This background paper reviewed the role played by the health care safety net in serving the nation's uninsured, underinsured, and indigent populations as well as those Americans who experience problems in obtaining access to health care. Against the backdrop of the March 2000 Institute of Medicine report, America's Health Care Safety Net: Intact But Endangered, the paper examined the recurrent choice in U.S. health policy between underwriting public insurance and subsidizing direct provision of health care. It recounted a number of reasons for direct federal interest in the safety net — including the important role played by Medicaid, the major …

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Promoting Healthy Behavior Change In Skin Cancer Risk Reduction Using The Transtheoretical Stages Of Change Model, Sherry L. Pagoto Apr 2001

Promoting Healthy Behavior Change In Skin Cancer Risk Reduction Using The Transtheoretical Stages Of Change Model, Sherry L. Pagoto

Dissertations

Skin cancer is the most commonly diagnosed cancer in the United States with 20% of people developing some form of skin cancer in their lifetime (American Cancer Society, 1999). In spite of the high incidence of skin cancer, it is highly preventable. Approximately 90% of the cases are caused by exposure to ultraviolet radiation from the sun (Skin Cancer Foundation, 1992). The effect of an intervention aimed at reducing skin cancer risk was compared to a survey only control group in 99 Chicago beach-goers. The intervention was based on the Transtheoretical Stages of Change Model (TTM) and included sun sensitivity …

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