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Community Health and Preventive Medicine Commons™

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1999

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Articles 1 - 30 of 32

Full-Text Articles in Community Health and Preventive Medicine

Northwest Tribal Registry--Seattle Indian Health Board Record Linkage Project., J. Bettles, D. Robertson, F.C. Romero, T. Becker, P. Stehr-Green Nov 1999

Northwest Tribal Registry--Seattle Indian Health Board Record Linkage Project., J. Bettles, D. Robertson, F.C. Romero, T. Becker, P. Stehr-Green

Native Health Database Full Text

In the last ten years several reports using a variety of health data sets have shown a high proportion of racial misclassification for Northwest American Indians and Alaskan Natives (AI/ANs). The result of this has been an underestimation of the burden of various diseases among Northwest AI/ANs. To address health issues related to misclassification, the Northwest Tribal Epidemiology Center has developed the Northwest Tribal Registry (NTR), which contains a demographic data set of 135,060 Northwest AI/ANs, and which can be used for record linkage studies to ascertain accurate disease rates for Northwest AI/ANs.

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Medicare Competitive Pricing: Lessons Being Learned In Phoenix And Kansas City, Nora Super Nov 1999

Medicare Competitive Pricing: Lessons Being Learned In Phoenix And Kansas City, Nora Super

National Health Policy Forum

Written as policymakers scrutinized two Medicare competitive bidding demonstration projects set to take place in Phoenix and Kansas City, this issue brief analyzes two demonstration projects designed to test whether Medicare could pay health plans in a competitive manner. The brief reviews decisions made by the Competitive Pricing Advisory Commission (CPAC), including design considerations such as plan eligibility and participation, the standard benefit package, the bidding process, and the government contribution to premiums. It also looks at the reasons for opposition to the project and the relationship of this demonstration to broader efforts to reform the Medicare program.

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The Public Stake In Biomedical Research: A Policy Perspective, Karen Matherlee Nov 1999

The Public Stake In Biomedical Research: A Policy Perspective, Karen Matherlee

National Health Policy Forum

An introduction to a Forum series on biomedical research policy issues, this paper provides background on the organization and structure of both public and private research entities. It outlines the federal components, from the National Institutes of Health (NIH) to the Department of Veterans Affairs. It also looks at the rapid growth in pharmaceutical, biotechnology, and medical device research and development and the varying responses from managed care plans, practice-based research networks, and contract research organizations. After laying out various tensions in the field, such as competition among disease-oriented advocates, alignment of different priorities, allocation of dollars between basic and …

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The Abcs Of Pbms, Robin J. Strongin Oct 1999

The Abcs Of Pbms, Robin J. Strongin

National Health Policy Forum

This issue brief describes the evolution of the pharmacy benefit manager (PBM) industry since the late 1960s and outlines current business practices in the areas of payment, services, drug formularies, and rebates. Tools of the trade, such as cost-sharing and generic substitution, used to control costs and improve quality are also discussed.

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Chip And Medicaid Outreach And Enrollment: A Hands-On Look At Marketing And Applications, Judith D. Moore Oct 1999

Chip And Medicaid Outreach And Enrollment: A Hands-On Look At Marketing And Applications, Judith D. Moore

National Health Policy Forum

The State Children's Health Insurance Program (SCHIP or CHIP), enacted as part of the Balanced Budget Act (BBA) in 1997, has enrolled eligible low-income children in innovative ways and tackled a variety of challenges to make sure that families know about the new program. This issue brief describes the outreach, application, and enrollment process for both SCHIP and Medicaid, analyzing the difficulty in simplifying applications, and noting problems that states must solve around systems design, immigration issues, and the stigma sometimes associated with government programs.

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Site Visit To Baltimore And Fort Detrick, Maryland — Preparing For A Bioterrorist Incident: Linking The Public Health And Medical Communities, Robin J. Strongin Oct 1999

Site Visit To Baltimore And Fort Detrick, Maryland — Preparing For A Bioterrorist Incident: Linking The Public Health And Medical Communities, Robin J. Strongin

National Health Policy Forum

As follow-up to the NHPF's February 1999 session entitled "Biological Terrorism: Is the Health Care Community Prepared?" the Forum organized a site visit on October 4 and 5, 1999, to Baltimore and Fort Detrick, Maryland. The site visit provided federal congressional and agency staff with the opportunity to learn first-hand how one local area is preparing for the possibility of a bioterrorist incident. Several themes were stressed throughout the two days, including the following: distinguishing bioterrorism from chemical terrorism, understanding the relationships between various agencies and institutions and their related funding streams, determining how the federal government can …

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A Chicken (Nugget?) In Every Pot: What's At Stake In The Budget Debate, Karl Polzer Sep 1999

A Chicken (Nugget?) In Every Pot: What's At Stake In The Budget Debate, Karl Polzer

National Health Policy Forum

This paper explores various aspects of the 1999 budget debate fueled in large part by federal agencies' projection of a $2.9 trillion surplus over 10 years. The tax bill, which would provide about $400 billion in tax relief, is also discussed; special attention is given to the health care provisions of this legislation.

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The Nursing Center In Concept And Practice: Delivery And Financing Issues In Serving Vulnerable People, Karen Matherlee Sep 1999

The Nursing Center In Concept And Practice: Delivery And Financing Issues In Serving Vulnerable People, Karen Matherlee

National Health Policy Forum

This issue brief looks at ways in which nurse-managed centers — with support from the Health Resources and Services Administration and private foundations — are carving a role in providing preventive and primary care to vulnerable populations. Two case studies — one in Philadelphia and the other in the Utah-Nevada border area — llustrate nursing centers' mission, outreach, services, workforce, payment concerns, and educational tie-ins.

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Mental Health Coverage Parity: Separating Wheat From Chaff, Karl Polzer Jul 1999

Mental Health Coverage Parity: Separating Wheat From Chaff, Karl Polzer

National Health Policy Forum

This paper examines the issue of mandating parity in coverage of mental health services in the context of the growing use by private-sector employers of managed behavioral health care providers. Existing parity laws are reviewed, along with estimates of the costs of parity. The tools used by behavioral health care firms to manage care and costs are also discussed.

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Access To Home Health Services Under Medicare's Interim Payment System, Nora Super Jul 1999

Access To Home Health Services Under Medicare's Interim Payment System, Nora Super

National Health Policy Forum

This issue brief explores the impact of the interim payment system (IPS) for home health agencies established under the Balanced Budget Act of 1997 (BBA). IPS was intended to constrain program outlays by imposing limits on spending per beneficiary and spending per visit in the existing cost-based reimbursement system. This issue brief examines the impact of the IPS on access to home health care, including home health agencies' responses to the payment system and its impact on provider availability and, ultimately, access to care for the sickest or most expensive populations

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Implementing The Bba: The Challenge Of Moving Medicare Post-Acute Services To Pps, Karen Matherlee Jul 1999

Implementing The Bba: The Challenge Of Moving Medicare Post-Acute Services To Pps, Karen Matherlee

National Health Policy Forum

This issue brief examines the challenge of putting skilled nursing facilities (SNFs), medical rehabilitation units, and home health under prospective payment, requiring the development of classification systems for each. It looks at the three-year phase-in of SNF resource utilization groups (RUGs) that began July 1, 1998 and the debate over classification systems for medical rehabilitation facilities and home health. The paper goes beyond issues of classification to consider coordination problems in placing these post-acute services under Medicare PPS.

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Canada's Generalist Training: Are There Lessons For The United States?, Lee Hawkins Jun 1999

Canada's Generalist Training: Are There Lessons For The United States?, Lee Hawkins

National Health Policy Forum

Addressing the premise of an inappropriate skewing of the U.S. medical education system toward specialty medicine, this issue brief compares and contrasts the U.S. and Canadian graduate medical education (GME) systems, including the organization and financing of each. The issue brief also explores various lessons that might be learned from the Canadian GME system, such as full integration of primary care and GME and the use of incentives to achieve desired policy goals.

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Photonovels: Educational Resources To Prevent Agricultural Illnesses And Injuries, M. Susan Jones, Carol A. Koetke Jun 1999

Photonovels: Educational Resources To Prevent Agricultural Illnesses And Injuries, M. Susan Jones, Carol A. Koetke

Nursing Faculty Publications

Photonovels use photographs and a story featuring people from the community, familiar settings, and a simple text to deliver an educational message. This unique educational tool lends itself to a wide variety of topics and targets audiences including farmers, farm workers and their families. Information on how to design, create and use photonovels to prevent agricultural injuries and illnesses will be presented.

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Reducing Medical Error: Can You Be As Safe In A Hospital As You Are In A Jet?, Lisa Sprague May 1999

Reducing Medical Error: Can You Be As Safe In A Hospital As You Are In A Jet?, Lisa Sprague

National Health Policy Forum

This issue brief looks at the incidence of error in the health care system, opportunities for a systems-based approach to error reduction, and changes needed in health system culture and training. The lessons of human factors research are considered, with examples of their application in the aviation industry. The paper reviews some error-reduction and patient-safety initiatives undertaken by private-sector organizations and by the Veterans Health Administration.

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Turnover Of Personal Assistants And The Incidence Of Injury Among Adults With Developmental Disabilities, Meg A. Traci Ph.D., Ann Szalda-Petree Ph.D., Steve Seninger Ph.D., University Of Montana Rural Institute May 1999

Turnover Of Personal Assistants And The Incidence Of Injury Among Adults With Developmental Disabilities, Meg A. Traci Ph.D., Ann Szalda-Petree Ph.D., Steve Seninger Ph.D., University Of Montana Rural Institute

Health and Wellness

Relatively little is known about the incidence and prevalence of injuries and other secondary conditions experienced by adults with developmental disabilities. Understanding the risk factors for secondary conditions and strategies for their prevention is important to people with disabilities, rehabilitation providers, and public health agencies. Many secondary condition prevention strategies require direct involvement of the individual with a disability. However, the nature of some disabling conditions requires help from an intermediary facilitator, frequently known as a “Personal Care Attendant” (PCA) or a “Personal Assistant” (PA).

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Substance Abuse Prevention: Could An Improved D.A.R.E. Program Help Bridge The Gap Between Research And Practice?, Colomba Sirica Apr 1999

Substance Abuse Prevention: Could An Improved D.A.R.E. Program Help Bridge The Gap Between Research And Practice?, Colomba Sirica

National Health Policy Forum

This issue brief provides background information on the popular Drug Abuse Resistance Education (D.A.R.E.) program, begun in 1983 and supported by education and law enforcement communities throughout the country to provide drug abuse prevention programs in schools. It describes recent efforts to conduct evaluative studies to assess the short- and long-term impact of the D.A.R.E. curriculum on drug-using behavior of children and youth and the new dialogue opening between D.A.R.E. proponents and the research community.

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Hipaa As A Regulatory Model: Early Experiences And Future Prospects, Karl Polzer Apr 1999

Hipaa As A Regulatory Model: Early Experiences And Future Prospects, Karl Polzer

National Health Policy Forum

In the context of the debate over bolstering consumer protection in health care without imposing excessive costs or onerous regulatory requirements, this paper examines the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as a regulatory model. The paper reviews the provisions of the legislation, examines the roles of the Department of Labor and the Health Care Financing Administration in implementing HIPAA, raises issues surrounding implementation and enforcement, and examines the usefulness of the HIPAA model as a vehicle for applying consumer protection measures.

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Margins As Measures: Gauging Hospitals' Financial Health, Karen Matherlee Mar 1999

Margins As Measures: Gauging Hospitals' Financial Health, Karen Matherlee

National Health Policy Forum

Recognizing the considerable controversy over ways to measure hospitals' financial viability, this issue brief reviews various ways to assess their fiscal strength. The paper looks first at operating margins, traditional measures that some experts say are inadequate when considered alone. It then explores several recommendations: (a) net income, liquidity and cash flow, and debt burden, suggested by the National Advisory Panel; (b) factors that determine year-to-year changes in hospitals costs, such as hospital input price inflation, changes in care patterns, and the complexity of patients treated, put forth by the Medicare Payment Advisory Commission; and (c) 35 financial indicators and …

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Examining The Links Between Retirement And Health Insurance: Implications For Medicare Eligibility, Nora Super Mar 1999

Examining The Links Between Retirement And Health Insurance: Implications For Medicare Eligibility, Nora Super

National Health Policy Forum

This issue brief examines trends in labor force participation and health care coverage for early retirees, as well as the relationship between retirement and health insurance and health status.

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Providing Outpatient Prescription Drugs Through Medicare: Can We Afford To? Can We Afford Not To?, Robin J. Strongin Mar 1999

Providing Outpatient Prescription Drugs Through Medicare: Can We Afford To? Can We Afford Not To?, Robin J. Strongin

National Health Policy Forum

The continuing debate over the issue of Medicare coverage for outpatient prescription drugs gave rise to this background paper, which discussed several key questions: Whose responsibility is it to provide coverage? Who should be covered? What should be covered? Who should pay for prescription drug coverage? How should costs be controlled? In addition, the paper explored options for structuring a Medicare outpatient prescription drug benefit. It also contained a glossary.

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Tribal Environmental & Natural Resource Assistance Handbook, White House Domestic Policy Council, Native American Fish & Wildlife Society Mar 1999

Tribal Environmental & Natural Resource Assistance Handbook, White House Domestic Policy Council, Native American Fish & Wildlife Society

Native Health Database Full Text

This handbook was developed by the Domestic Policy Council Working Group on American Indians and Alaska Natives (Working Group). This handbook is intended to provide a central location for federal sources of both technical and financial assistance available to Tribes for environmental management.

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Welfare Reform And Its Impact On Medicaid: An Update, Judith D. Moore Feb 1999

Welfare Reform And Its Impact On Medicaid: An Update, Judith D. Moore

National Health Policy Forum

Welfare reform, enacted in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), had a profound impact on the Medicaid program, delinking Medicaid from the new TANF program and for the first time allowing Medicaid eligibility to be divorced from welfare status. This paper reviews the national impact of this decoupling, describing research, implementation activities, and the impact of new state welfare programs on health programs in general.

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Biological Terrorism: Is The Health Care Community Prepared?, Robin J. Strongin Feb 1999

Biological Terrorism: Is The Health Care Community Prepared?, Robin J. Strongin

National Health Policy Forum

This issue brief provides an overview of biological warfare and discusses the role of the Centers for Disease Control (CDC) and state health departments in detecting biologic agents. The brief also highlights the issue of threat assessment and discusses ways to improve the current level of preparedness as well as steps needed to convert the public health system into our best form of civil defense.

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Medicare Hmo Pullouts: What Do They Portend For The Future Of Medicare+Choice?, Nora Super Feb 1999

Medicare Hmo Pullouts: What Do They Portend For The Future Of Medicare+Choice?, Nora Super

National Health Policy Forum

National policymakers became alarmed in the fall of 1998 when, contrary to expectations, nearly 100 Medicare HMOs announced their decisions to pull out of Medicare in certain areas or to reduce their service areas. This issue brief explores the reasons plans withdrew from certain areas, the Balanced Budget Act of 1997 provisions that most directly influenced these decisions, the impact of the withdrawals on Medicare beneficiaries, and policy options for ensuring the viability of the Medicare+Choice program.

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Filling The Geriatric Gap: Is The Health System Prepared For An Aging Population?, Janet Firshein Jan 1999

Filling The Geriatric Gap: Is The Health System Prepared For An Aging Population?, Janet Firshein

National Health Policy Forum

This issue brief explores the field of geriatrics, the ways practitioners meet the health care needs of the elderly, training gaps, and the impact of Medicare payment policies on the delivery of health care to older Americans.

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Housing And Population Health: A Review Of The Literature, Stephen Hwang, Esme Fuller-Thomson, J. David Hurlchanski, Toba Bryant, Youssef Habib, Wendy C. Regoeczi Jan 1999

Housing And Population Health: A Review Of The Literature, Stephen Hwang, Esme Fuller-Thomson, J. David Hurlchanski, Toba Bryant, Youssef Habib, Wendy C. Regoeczi

Sociology & Criminology Faculty Publications

Research into the relationship between housing and health has frequently been narrowly focused, fragmented, and of marginal practical relevance to either housing or health studies. Population health research, in its reference to the importance of the social and physical environment, rarely mentions housing. While it has been recognized for some time that there is a need for the development of a co-ordinated, integrated and cumulative body of housing and health research, there is still very little formal co-ordination between housing policy and population health policy. More attention needs to be paid to measuring the nature and extent to which better …

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Native Outreach: A Report To American Indian, Alaska Native And Native Hawaiian Communities, C.S. Glover, F.S. Hodge Jan 1999

Native Outreach: A Report To American Indian, Alaska Native And Native Hawaiian Communities, C.S. Glover, F.S. Hodge

Native Health Database Full Text

The National Cancer Institute (NCI) is presenting a monograph written specifically for community leaders, health professionals and lay health workers serving Native American communities. Native Americans have higher mortality rates than the general U.S. population for several major cancer sites. This publication focuses on the need to reduce those rates through effective interventions at the grassroots level.

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American Indians And Crime, Bureau Of Justice Statistics, U.S. Department Of Justice, L.A. Greenfeld, S. Smith Jan 1999

American Indians And Crime, Bureau Of Justice Statistics, U.S. Department Of Justice, L.A. Greenfeld, S. Smith

Native Health Database Full Text

This report represents a compilation and new analysis of data on the effects and consequences of violent crime among American Indians. The report uses data from a wide variety of sources, including statistical series maintained by the Bureau of Justice Statistics (BJS), the FBI, and the Bureau of the Census. Data are reported from American Indian crime victims on how they were affected by the victimization and about who victimized them. The report also includes the first BJS estimates of the total number of American Indians under the custody or supervision of the justice system.

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Alaska Native Cancer Survival Report, A.P. Lanier, P. Holck, J. Kelly, B. Smith, T. Mcevoy Jan 1999

Alaska Native Cancer Survival Report, A.P. Lanier, P. Holck, J. Kelly, B. Smith, T. Mcevoy

Native Health Database Full Text

This report presents Alaska Native cancer survival rates and stage of disease at diagnosis. Data on survival and stage at diagnosis are given for all cancers combined, and for select primary cancer sites (the organ in which the cancer first began). Survival rates are given for only those cancers for which there were enough patients to calculate reliable estimates. The focus is on five-year relative survival rates because these rates are most commonly used in the cancer literature and most appropriate for comparisons between populations.

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Editorial: Mental Health Needs Assessments Performed By Four Urban American Indian Organizations, D.K. Novins Jan 1999

Editorial: Mental Health Needs Assessments Performed By Four Urban American Indian Organizations, D.K. Novins

Native Health Database Full Text

In 1991, the Indian Health Service funded a nationwide initiative with the goal of determining the need for culturally appropriate mental health services among American Indian people residing in urban areas. In the author's opinion, the assessment method used in this initiative is a valuable, fresh approach that is a significant change from flawed attempts to make these assessments in the past.

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