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Articles 5041 - 5070 of 5349

Full-Text Articles in Public Health

How Vulnerable Is The Nation's Food Supply? Linking Food Safety And Food Security, Robin J. Strongin May 2002

How Vulnerable Is The Nation's Food Supply? Linking Food Safety And Food Security, Robin J. Strongin

National Health Policy Forum

This paper reviews the food safety regulatory apparatus in place today, especially the activities of the two lead agencies in assuring food safety — the Food and Drug Administration within the Department of Health and Human Services and the Food Safety and Inspection Service within the Department of Agriculture. It examines the system's strengths and vulnerabilities, particularly in light of the post–September 11 environment that includes the heightened threat of terrorism. The paper also touches upon legislative and budgetary proposals aimed at improving food security, including the growing but debated interest in a single food safety agency.


Applying Managed Fee-For-Service Delivery Models To Improve Care For Dually Eligible Beneficiaries, Stuart Bratesman, Paul Saucier May 2002

Applying Managed Fee-For-Service Delivery Models To Improve Care For Dually Eligible Beneficiaries, Stuart Bratesman, Paul Saucier

Disability & Aging

No abstract provided.


Public Health Emergency Preparedness: Fundamentals Of The "System", Eileen Salinsky Apr 2002

Public Health Emergency Preparedness: Fundamentals Of The "System", Eileen Salinsky

National Health Policy Forum

This paper examines the existing public health infrastructure, with an emphasis on the resources and activities necessary for public health emergency preparedness and response. It provides a brief historical overview of the evolution of public health and contrasts public health interventions with medicine and health care services. The paper summarizes the broad range of activities that constitute public health practice today and provides a more detailed review of functions and services that are critical to emergency response capabilities. It explores the legal foundation for public health authorities, discussing constitutional, federal, and state public health law. The paper also summarizes how …


Child And Family Health Initiatives In The Bay Area, Jennifer Ryan, Wakina Scott Apr 2002

Child And Family Health Initiatives In The Bay Area, Jennifer Ryan, Wakina Scott

National Health Policy Forum

This site visit to the San Francisco Bay Area provided an opportunity to study locally based health initiatives in Santa Clara, Alameda, and San Francisco Counties that were designed to reach beyond the existing structures of the Medi-Cal and Healthy Families programs. Site visitors had the opportunity to interact with health care providers, state officials, and consumer advocates, as well as leaders in health coverage innovation. They also met with many of the leaders of the three local initiatives; visited Asian Health Services (AHS), a local clinic that has been serving the Asian community for over 25 years; and toured …


Pharmacy Benefits: New Concepts In Plan Design, Veronica V. Goff Mar 2002

Pharmacy Benefits: New Concepts In Plan Design, Veronica V. Goff

National Health Policy Forum

This issue brief examines changes to prescription drug benefit coverage in large-employer plans and implications for a Medicare prescription drug benefit. The brief discusses reasons behind employer benefit plan redesign and recent coverage trends, as well as potential paths to modernize benefits.


Transitions Along The Continuum Of Care: Elderly And Disabled Persons In New York, Lisa Sprague, Nora Super Mar 2002

Transitions Along The Continuum Of Care: Elderly And Disabled Persons In New York, Lisa Sprague, Nora Super

National Health Policy Forum

This site visit examined transitions along the continuum of care for elderly and disabled persons in New York. The state offers its residents an extensive array of services, including nursing homes, home health care, personal care, and community-based services. New York spends more than any other state on its Medicaid program, which is reflected in a comprehensive benefit package, full-cost reimbursement of hospitals, high nursing home rates, and extensive coverage of personal care services. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed transitions …


Measuring Health Status And Quality Of Life In Disease Management Programs, Dea Belazi Mar 2002

Measuring Health Status And Quality Of Life In Disease Management Programs, Dea Belazi

College of Population Health Faculty Papers

Current medical practice is largely disease and problem focused, concentrating on the diagnosis and treatment of anatomic or physiologic problems. This approach assumes that physiologic parameters accurately reflect the patient's status of health. It also assumes that, when a patient's disease is ameliorated, his or her quality of life will improve. Many health services researchers find these parameters to be imperfect determinates for good outcomes of patients' perceived health status. However, there are many valid and reliable methods to measure patients' health status and quality of life. Recently available survey tools that measure quality of life are based on modern …


Welfare Reform In Maryland: Flexibility In Action, Jennifer Ryan, Judith D. Moore Feb 2002

Welfare Reform In Maryland: Flexibility In Action, Jennifer Ryan, Judith D. Moore

National Health Policy Forum

This site visit took federal participants on a tour around Maryland, providing a three-way comparison of suburban, urban, and rural service delivery in a diverse state. The site visit focused on the Family Investment Program, a statewide effort to reduce the state's welfare caseload through temporary cash assistance (TCA) and other needed supports to help customers become self-sufficient. In particular, site visitors examined rural perspectives on reform, substance abuse assessment and treatment innovations, and fatherhood and family support initiatives. The group heard from state officials, researchers, advocates, and a variety of direct service providers about the successes and challenges of …


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.


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.


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.


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 …


Mainecare Enrollees With Disabilities Work Experience: Results From A 2002 Survey, Sara T. Salley, Larry Glantz Jan 2002

Mainecare Enrollees With Disabilities Work Experience: Results From A 2002 Survey, Sara T. Salley, Larry Glantz

Disability & Aging

No abstract provided.


The Hand Center: Considerations Related To The Design, Planning, Staffing, And Marketing, Marcia L. Miller Jan 2002

The Hand Center: Considerations Related To The Design, Planning, Staffing, And Marketing, Marcia L. Miller

Community & Environmental Health Theses & Dissertations

A therapist intent on planning a hand therapy center has no resources that are specific to this specialty area of practice. There are contributions utilized to plan occupational and physical therapy departments that can be synthesized to a degree in the planning of a hand therapy center. The practice of hand therapy incorporates a high degree of physical interaction, with close proximity to the patient and handling by the therapist. This paper explores the unique requirements of a hand therapy department. In order to determine hand therapists' preferences for equipment and space utilization a survey was developed and distributed to …


Designing Hiv/Aids Intervention Studies: An Operations Research Handbook, Andrew A. Fisher, James R. Foreit, John E. Laing, John E. Stoeckel, John Townsend Jan 2002

Designing Hiv/Aids Intervention Studies: An Operations Research Handbook, Andrew A. Fisher, James R. Foreit, John E. Laing, John E. Stoeckel, John Townsend

HIV and AIDS

This handbook has several objectives and uses. First, it is designed to help HIV/AIDS researchers develop and write a detailed operations research proposal. An appropriate use of the handbook is as a resource in workshops or courses on research design and proposal development. Thus, the organization of the handbook follows that of a research proposal, starting with identifying, defining, and justifying a research problem, and ending with how to prepare a budget. Although the handbook is not an academic textbook on research methods, it does provide a review of many key concepts and important methods essential for conducting HIV/AIDS field …


Greater Involvement Of Plha In Ngo Service Delivery: Findings From A Four-Country Study, Horizons Program Jan 2002

Greater Involvement Of Plha In Ngo Service Delivery: Findings From A Four-Country Study, Horizons Program

HIV and AIDS

At the conclusion of the Paris AIDS Summit in 1994, 42 governments issued a declaration supporting the greater involvement of people living with HIV/AIDS (PLHA) in policy formulation and service delivery. Despite growing recognition of its importance, there has been little research that examines PLHA involvement in the delivery of prevention, care, and support services in developing countries and its effects on PLHA, others affected by HIV/AIDS, and nongovernmental organizations (NGOs). To address this gap, the Horizons Program and the International HIV/AIDS Alliance conducted a study of PLHA involvement in NGOs in Burkina Faso, Ecuador, Maharashtra State, India, and Zambia …


Midline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Barbara Mensch, Wesley H. Clark, Shahina Begum, Bela Patel Uttekar, Sohini Roychowdhury Jan 2002

Midline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Barbara Mensch, Wesley H. Clark, Shahina Begum, Bela Patel Uttekar, Sohini Roychowdhury

Reproductive Health

The Population Council in collaboration with CARE India has been conducting an operations research (OR) study to investigate the impact of adding a livelihoods component to the Action for Slum Dwellers' Reproductive Health, Allahabad (ASRHA) Project in Uttar Pradesh run by CARE India. The ASRHA Project selected peer educators from the slums and trained them in providing reproductive health (RH) information, communication skills, and group formation techniques. After the peer educators completed training, they conducted group sessions about livelihoods and savings. RH sessions were held alongside vocational counseling sessions. Population Council staff provided vocational training courses, both in the slums …


Baseline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Wesley H. Clark, Barbara Mensch, Bela Patel Uttekar Jan 2002

Baseline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Wesley H. Clark, Barbara Mensch, Bela Patel Uttekar

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program and Policy Research Division, in collaboration with CARE India, is conducting an operations research study of an intervention designed to improve the lives and prospects of young women in several urban slum areas of Allahabad, Uttar Pradesh. The project aims to take a preexisting reproductive health program for adolescents and test the feasibility and impact of adding four additional components to it: 1) counseling about savings formation and livelihoods, 2) training in vocational skills, 3) assistance in opening savings accounts, and 4) follow-up support. CARE India is managing the larger adolescent reproductive …


Peer Education As A Strategy To Increase Contraceptive Prevalence And Reduce The Rate Of Stis/Hiv Among Adolescents In Cameroon, Institut De Recherche Et Des Etudes Des Comportements (Iresco) Jan 2002

Peer Education As A Strategy To Increase Contraceptive Prevalence And Reduce The Rate Of Stis/Hiv Among Adolescents In Cameroon, Institut De Recherche Et Des Etudes Des Comportements (Iresco)

Reproductive Health

The Institute for Behavioral Studies and Research completed an operations research project entitled “Among Youth” targeting adolescents in the Mokolo neighborhood of Yaoundé, Cameroon. The results presented in this report show that adolescents in Mokolo, more often than their counterparts in the control site, adopted behavioral changes to prevent STI/HIV transmission and unwanted pregnancies as a result of the intervention. The report concludes that peer education combined with mass media campaigns form an important strategy for targeting youth with reproductive health and family planning messages and can help adolescents translate knowledge into healthy lifestyles. Integration of reproductive health messages into …


Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil Jan 2002

Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil

Reproductive Health

The Center for Development in Primary Health Care (CDPHC), in collaboration with the Population Council’s FRONTIERS program, developed a 19-month training program to strengthen and improve existing maternal and children’s health and family planning services and to promote the establishment of the standardized basic package of services at Pilot Health Project (PHP) clinic sites in the West Bank and Gaza. There were four key start-up activities, including: 1) an assessment of standards of care provided at PHP clinics; 2) a review of formative research; 3) the development of clinical training manuals and curricula; and 4) the development of behavior change …


How Physicians Feel About Assisting Female Victims Of Intimate-Partner Violence, Ramani N. Garimella, Stacey B. Plichta, Clare Houseman, Laurel Garzon Jan 2002

How Physicians Feel About Assisting Female Victims Of Intimate-Partner Violence, Ramani N. Garimella, Stacey B. Plichta, Clare Houseman, Laurel Garzon

Community & Environmental Health Faculty Publications

Purpose. To assess the feelings of physicians about assisting female victims of intimate-partner violence (IPV), and to examine factors related to positive and negative feelings about assisting victims of IPV.

Method. In 1998, a total site sample of 150 physicians practicing in a large general hospital in the area of Virginia Beach, Virginia, was surveyed by questionnaire via the mail. Four specialties were represented: emergency medicine, family practice, obstetrics-gynecology, and psychiatry. The questionnaire asked about medical training and training in assisting victims of IPV The physicians' feelings about working with victims of IPV were measured on a nine-item, five-point …


A Decentralized, Patient-Centered Approach To Diabetes Disease Management In The Primary Care Setting, Michael Toscani, John P. O'Connor, David B. Nash Dec 2001

A Decentralized, Patient-Centered Approach To Diabetes Disease Management In The Primary Care Setting, Michael Toscani, John P. O'Connor, David B. Nash

College of Population Health Faculty Papers

Although many disease management programs have been developed for diabetes, no single design has proved best for all providers and patient populations. Cost effectiveness is especially relevant to diabetes programs because significant costs of the disease may come from complications that occur later in life, while the costs of the program are incurred immediately. For this reason, diabetes disease management programs with positive outcomes and low implementation costs are of particular importance. We report here on the outcomes of a pilot test of the Steps to Health program developed by Abbott Laboratories. The Steps to Health program was designed to …


From Product Dispensing To Patient Care: The Role Of The Pharmacist In Providing Pharmaceutical Care As Part Of An Integrated Disease Management Approach, Laura T. Pizzi, Jean M. Menz, Geneen R. Graber, Dong-Churl Suh Dec 2001

From Product Dispensing To Patient Care: The Role Of The Pharmacist In Providing Pharmaceutical Care As Part Of An Integrated Disease Management Approach, Laura T. Pizzi, Jean M. Menz, Geneen R. Graber, Dong-Churl Suh

College of Population Health Faculty Papers

During the past decade, the profession of pharmacy has changed dramatically. The Doctor of Pharmacy degree has replaced the Bachelor of Science degree as the first professional degree offered at most accredited U.S. pharmacy schools. Advanced clinical training is now a mainstay of pharmacy training, and this has enabled pharmacists to contribute to disease management efforts. In addition, technological improvements in prescription processing have afforded pharmacists more time to participate in disease management activities. This paper describes how the role of the pharmacist has changed and reviews the results of programs involving pharmacists as disease management providers in the areas …


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 …


The Importance Of Individualized Pharmaceutical Therapy In The Treatment Of Diabetes Mellitus, David B. Nash, Jennifer B. Koenig, Karen D. Novielli, Renee Liberoni, Miriam Reisman Nov 2001

The Importance Of Individualized Pharmaceutical Therapy In The Treatment Of Diabetes Mellitus, David B. Nash, Jennifer B. Koenig, Karen D. Novielli, Renee Liberoni, Miriam Reisman

College of Population Health Faculty Papers

Individualized pharmaceutical care for patients with diabetes is necessary for several reasons. First, diabetes is a highly complex disease caused by the interplay among genetic, physiological, and environmental factors that vary from individual to individual. Second, the profile of patients with diabetes has evolved to include people of all ages and socioeconomic backgrounds, with varying medical histories and health behaviors. Third, diabetes often occurs concurrently with other medical conditions, especially in certain groups, such as the elderly. While the treatment goals for all patients with diabetes are the sameto stabilize and maintain healthy blood glucose levels to prevent serious complicationsthe …


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.


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.


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.


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 …


Pain Control In Healthcare Organizations: Developing Effective Disease Management Programs, C. Richard Chapman, Stephen D. Lande, Bill H. Mccarberg, David B. Nash Sep 2001

Pain Control In Healthcare Organizations: Developing Effective Disease Management Programs, C. Richard Chapman, Stephen D. Lande, Bill H. Mccarberg, David B. Nash

College of Population Health Faculty Papers

Although medicine possesses the knowledge and technology for preventing or relieving most pain, poor pain control is still widespread. Unrelieved pain causes unnecessary suffering and increases health care expenditures. Among the barriers to improving pain control are poor provider education in pain management, misguided beliefs about the inevitability of pain and the dangers of pain medication, provider resistance to changing practice patterns, and administrative resistance to implementing improvements that incur short-term costs but lead to long-term savings. In short, poor pain relief in America's health care institutions is a system issue, and improvement requires a system-wide change. An effective program …