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Sample records for beneficiary survey mcbs

  1. Medicare Current Beneficiary Survey - Limited Data Set

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a representative national sample of the Medicare population. There are two...

  2. MCBS Highlights: Ownership and Average Premiums for Medicare Supplementary Insurance Policies

    Science.gov (United States)

    Chulis, George S.; Eppig, Franklin J.; Poisal, John A.

    1995-01-01

    This article describes private supplementary health insurance holdings and average premiums paid by Medicare enrollees. Data were collected as part of the 1992 Medicare Current Beneficiary Survey (MCBS). Data show the number of persons with insurance and average premiums paid by type of insurance held—individually purchased policies, employer-sponsored policies, or both. Distributions are shown for a variety of demographic, socioeconomic, and health status variables. Primary findings include: Seventy-eight percent of Medicare beneficiaries have private supplementary insurance; 25 percent of those with private insurance hold more than one policy. The average premium paid for private insurance in 1992 was $914. PMID:10153473

  3. MCBS Access to Care PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MCBS 2013 Access to Care public use file (MCBS PUF) provides the first publically available MCBS file for researchers interested in the health, health care use,...

  4. Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries.

    Science.gov (United States)

    Gross, D J; Alecxih, L; Gibson, M J; Corea, J; Caplan, C; Brangan, N

    1999-04-01

    To estimate out-of-pocket health care spending by lower-income Medicare beneficiaries, and to examine spending variations between those who receive Medicaid assistance and those who do not receive such aid. DATA SOURCES AND COLLECTION: 1993 Medicare Current Beneficiary Survey (MCBS) Cost and Use files, supplemented with data from the Bureau of the Census (Current Population Survey); the Congressional Budget Office; the Health Care Financing Administration, Office of the Actuary (National Health Accounts); and the Social Security Administration. We analyzed out-of-pocket spending through a Medicare Benefits Simulation model, which projects out-of-pocket health care spending from the 1993 MCBS to 1997. Out-of-pocket health care spending is defined to include Medicare deductibles and coinsurance; premiums for private insurance, Medicare Part B, and Medicare HMOs; payments for non-covered goods and services; and balance billing by physicians. It excludes the costs of home care and nursing facility services, as well as indirect tax payments toward health care financing. Almost 60 percent of beneficiaries with incomes below the poverty level did not receive Medicaid assistance in 1997. We estimate that these beneficiaries spent, on average, about half their income out-of-pocket for health care, whether they were enrolled in a Medicare HMO or in the traditional fee-for-service program. The 75 percent of beneficiaries with incomes between 100 and 125 percent of the poverty level who were not enrolled in Medicaid spent an estimated 30 percent of their income out-of-pocket on health care if they were in the traditional program and about 23 percent of their income if they were enrolled in a Medicare HMO. Average out-of-pocket spending among fee-for-service beneficiaries varied depending on whether beneficiaries had Medigap policies, employer-provided supplemental insurance, or no supplemental coverage. Those without supplemental coverage spent more on health care goods and

  5. Medicare Current Beneficiary Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Characteristics and Perceptions of the Medicare Population Data from the 2010 Medicare Current Beneficiary Survey is a series of source books based on the...

  6. Ever Enrolled Medicare Population Estimates from the MCBS..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Findings reported in Ever Enrolled Medicare Population Estimates from the MCBS Access to Care (ATC) Files, published in Volume 4, Issue 2 of the Medicare and...

  7. National Beneficiary Survey (NBS) Round 3

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of social security beneficiaries age 18-64 receiving disability benefits in active pay status as of...

  8. National Beneficiary Survey (NBS) Round 4

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of social security beneficiaries age 18-64 receiving disability benefits in active pay status as of...

  9. National Beneficiary Survey (NBS) Round 2

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of 4,864 social security beneficiaries age 18-64 receiving disability benefits in active pay status as...

  10. National Beneficiary Survey (NBS) Round 1

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of 6,520 social security beneficiaries age 18-64 receiving disability benefits in active pay status as...

  11. Inhaled anticholinergic use and all-cause mortality among elderly Medicare beneficiaries with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2013-06-01

    Full Text Available Mayank Ajmera,1 Chan Shen,2 Xiaoyun Pan,1 Patricia A Findley,3 George Rust,4 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA; 3School of Social Work, Rutgers University, New Brunswick, NJ, USA; 4Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA, USA Background: The purpose of this study was to examine the association between use of inhaled anticholinergics and all-cause mortality among elderly individuals with chronic obstructive pulmonary disease (COPD, after controlling for demographic, socioeconomic, health, functional status, smoking, and obesity. Methods: We used a retrospective longitudinal panel data design. Data were extracted for multiple years (2002–2009 of the Medicare Current Beneficiary Survey (MCBS linked with fee-for-service Medicare claims. Generic and brand names of inhaled anticholinergics were used to identify inhaled anticholinergic utilization from the self-reported prescription medication files. All-cause mortality was assessed using the vital status variable. Unadjusted group differences in mortality rates were tested using the chi-square statistic. Multivariable logistic regressions with independent variables entered in separate blocks were used to analyze the association between inhaled anticholinergic use and all-cause mortality. All analyses accounted for the complex design of the MCBS. Results: Overall, 19.4% of the elderly Medicare beneficiaries used inhaled anticholinergics. Inhaled anticholinergic use was significantly higher (28.5% among those who reported poor health compared with those reporting excellent or very good health (12.7%. Bivariate analyses indicated that inhaled anticholinergic use was associated with significantly higher rates of all-cause mortality (18.7% compared with nonusers (13.6%. However

  12. Sample Loss and Survey Bias in Estimates of Social Security Beneficiaries: A Tale of Two Surveys.

    OpenAIRE

    John L. Czajka; James Mabli; Scott Cody

    2008-01-01

    Data from the Census Bureau’s Survey of Income and Program Participation (SIPP) and the Current Population Survey (CPS) provide information on current and potential beneficiaries served by Social Security Administration (SSA) programs. SSA also links administrative records to the records of survey respondents who provide Social Security numbers. These matched data expand the content of the SIPP and CPS files to fields available only through SSA and Internal Revenue Service records—such as l...

  13. Patient Satisfaction and Perceived Quality of Care Among Older Adults According to Activity Limitation Stages

    Science.gov (United States)

    Bogner, Hillary R.; de Vries McClintock, Heather F.; Hennessy, Sean; Kurichi, Jibby E.; Streim, Joel E.; Xie, Dawei; Pezzin, Liliana E.; Kwong, Pui L.; Stineman, Margaret G.

    2016-01-01

    OBJECTIVE To examine whether patient satisfaction and perceived quality of medical care was related to stages of activity limitations among older adults. DESIGN Cross-sectional study. SETTING Medicare Current Beneficiary Survey (MCBS) for calendar years 2001-2011. PARTICIPANTS A population-based sample (n= 42,584) of persons 65 years of age and older living in the community. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) MCBS questions were categorized under 5 patient satisfaction and perceived quality dimensions: care coordination and quality, access barriers, technical skills of primary care physicians, interpersonal skills of primary care physicians, and quality of information provided by primary care physicians. Persons were classified into a stage of activity limitation (0-IV) derived from self-reported difficulty levels performing activities of daily living (ADLs) and instrumental activities of daily living (IADLs). RESULTS Compared to older beneficiaries with no limitations at ADL Stage 0, the adjusted odds ratios (OR) (95% confidence intervals (CI)) for Stage I (mild) to Stage III (severe) for satisfaction with care coordination and quality ranged from OR = 0.85 (95% CI: 0.80-0.92) to OR = 0.79 (95% CI: 0.70-0.89). Compared to ADL Stage 0, satisfaction with access barriers ranged from OR = 0.81 (95% CI: 0.76-0.87) at Stage I (mild) to a minimum of OR = 0.67 (95% CI: 0.59-0.76) at Stage III (severe). Similarly, compared to older beneficiaries at ADL Stage 0, perceived quality of the technical skills of their primary care physician ranged from OR = 0.87 (95% CI: 0.82-0.94) at Stage I (mild) to a minimum of OR = 0.81 (95% CI: 0.72-0.91) at Stage III (severe). CONCLUSIONS Medicare beneficiaries at higher stages of activity limitation although not necessarily the highest stage of activity limitation reported less satisfaction with medical care. PMID:26119464

  14. Assessing Medicare beneficiaries' willingness-to-pay for medication therapy management services.

    Science.gov (United States)

    Woelfel, Joseph A; Carr-Lopez, Sian M; Delos Santos, Melanie; Bui, Ann; Patel, Rajul A; Walberg, Mark P; Galal, Suzanne M

    2014-02-01

    To assess Medicare beneficiaries' willingness-to-pay (WTP) for medication therapy management (MTM) services and determine sociodemographic and clinical characteristics influencing this payment amount. A cross-sectional, descriptive study design was adopted to elicit Medicare beneficiaries' WTP for MTM. Nine outreach events in cities across Central/Northern California during Medicare's 2011 open-enrollment period. A total of 277 Medicare beneficiaries participated in the study. Comprehensive MTM was offered to each beneficiary. Pharmacy students conducted the MTM session under the supervision of licensed pharmacists. At the end of each MTM session, beneficiaries were asked to indicate their WTP for the service. Medication, self-reported chronic conditions, and beneficiary demographic data were collected and recorded via a survey during the session. The mean WTP for MTM was $33.15 for the 277 beneficiaries receiving the service and answering the WTP question. WTP by low-income subsidy recipients (mean ± standard deviation; $12.80 ± $24.10) was significantly lower than for nonsubsidy recipients ($41.13 ± $88.79). WTP was significantly (positively) correlated with number of medications regularly taken and annual out-of-pocket drug costs. The mean WTP for MTM was $33.15. WTP for MTM significantly varied by race, subsidy status, and number of prescription medications taken. WTP was significantly higher for nonsubsidy recipients than subsidy recipients, and significantly positively correlated with the number of medications regularly taken and the beneficiary rating of the delivered services.

  15. Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits?

    Science.gov (United States)

    Jacobs, Paul D; Buntin, Melinda B

    2015-07-01

    To evaluate the sensitivity of Medicare beneficiaries to premiums and benefits when selecting healthcare plans after the introduction of Part D. We matched respondents in the 2008 Medicare Current Beneficiary Survey to the Medicare Advantage (MA) plans available to them using the Bid Pricing Tool and previously unavailable data on beneficiaries' plan choices. We estimated a 2-stage nested logit model of Medicare plan choice decision making, including the decision to choose traditional fee-for-service (FFS) Medicare or an MA plan, and for those choosing MA, which specific plan they chose. Beneficiaries living in areas with higher average monthly rebates available from MA plans were more likely to choose MA rather than FFS. When choosing MA plans, beneficiaries are roughly 2 to 3 times more responsive to dollars spent to reduce cost sharing than reductions in their premium. We calculated an elasticity of plan choice with respect to the monthly MA premium of -0.20. Beneficiaries with lower incomes are more sensitive to plan premiums and cost sharing than higher-income beneficiaries. MA plans appear to have a limited incentive to aggressively price their products, and seem to compete primarily over reduced beneficiary cost sharing. Given the limitations of the current plan choice environment, policies designed to encourage the selection of lower-cost plans may require increasing premium differences between plans and providing the tools to enable beneficiaries to easily assess those differences.

  16. Self-reported Function, Health Resource Use, and Total Health Care Costs Among Medicare Beneficiaries With Glaucoma.

    Science.gov (United States)

    Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; Blumberg, Dana M

    2016-04-01

    The effect of glaucoma on nonglaucomatous medical conditions and resultant secondary health care costs is not well understood. To assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma. Longitudinal observational study of 72,587 Medicare beneficiaries in the general community using the Medicare Current Beneficiary Survey (2004-2009). Coding to extract data started in January 2015, and analyses were performed between May and July 2015. Self-reported health, the use of health care services, adjusted mean annual total health care costs per person, and adjusted mean annual nonoutpatient costs per person. Participants were 72,587 Medicare beneficiaries 65 years or older with (n = 4441) and without (n = 68,146) a glaucoma diagnosis in the year before collection of survey data. Their mean age was 76.9 years, and 43.2% were male. Patients with glaucoma who responded to survey questions on visual disability were stratified into those with (n = 1748) and without (n = 2639) self-reported visual disability. Medicare beneficiaries with glaucoma had higher adjusted odds of inpatient hospitalizations (odds ratio [OR], 1.27; 95% CI, 1.17-1.39; P total health care costs and $2599 (95% CI, $1985-$3212; P total and nonoutpatient medical costs. Perception of vision loss among patients with glaucoma may be associated with depression, falls, and difficulty walking. Reducing the prevalence and severity of glaucoma may result in improvements in associated nonglaucomatous medical conditions and resultant reduction in health care costs.

  17. How Medicare Could Provide Dental, Vision, and Hearing Care for Beneficiaries.

    Science.gov (United States)

    Willink, Amber; Shoen, Cathy; Davis, Karen

    2018-01-01

    The Medicare program specifically excludes coverage of dental, vision, and hearing services. As a result, many beneficiaries do not receive necessary care. Those that do are subject to high out-of-pocket costs. Examine gaps in access to dental, vision, and hearing services for Medicare beneficiaries and design a voluntary dental, vision, and hearing benefit plan with cost estimates. Uses the Medicare Current Beneficiary Survey, Cost and Use File, 2012, with population and costs projected to 2016 values. Among Medicare beneficiaries, 75 percent of people who needed a hearing aid did not have one; 70 percent of people who had trouble eating because of their teeth did not go to the dentist in the past year; and 43 percent of people who had trouble seeing did not have an eye exam in the past year. Lack of access was particularly acute for poor beneficiaries. Because few people have supplemental insurance covering these additional services, among people who received care, three-fourths of their costs of dental and hearing services and 60 percent of their costs of vision services were paid out of pocket. We propose a basic benefit package for dental, vision, and hearing services offered as a premium-financed voluntary insurance option under Medicare. Assuming the benefit package could be offered for $25 per month, we estimate the total coverage costs would be $1.924 billion per year, paid for by premiums. Subsidies to reach low-income beneficiaries would follow the same design as the Part D subsidy.

  18. Activity Limitation Stages Are Associated With Risk of Hospitalization Among Medicare Beneficiaries.

    Science.gov (United States)

    Na, Ling; Pan, Qiang; Xie, Dawei; Kurichi, Jibby E; Streim, Joel E; Bogner, Hillary R; Saliba, Debra; Hennessy, Sean

    2017-05-01

    Activity limitation stages based on activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are associated with 3-year mortality in elderly Medicare beneficiaries, yet their associations with hospitalization risk in this population have not been studied. To examine the independent association of activity limitation stages with risk of hospitalization within a year among Medicare beneficiaries aged 65 years and older. Cohort study. Community. A total of 9447 community-dwelling elderly Medicare beneficiaries from the Medicare Current Beneficiary Survey for years 2005-2009. Stages were derived for ADLs and IADLs separately. Associations of stages with time to first hospitalization and time to recurrent hospitalizations within a year were assessed with Cox proportional hazards models, with which we accounted for baseline sociodemographics, smoking status, comorbidities, and the year of survey entry. Time to first hospitalization and time to recurrent hospitalizations within 1 year. The adjusted risk of first hospitalization increased with greater activity limitation stages (except stage III). The hazard ratios (95% confidence intervals) for ADL stages I-IV compared with stage 0 (no limitations) were 1.49 (1.36-1.63), 1.61 (1.44-1.80), 1.54 (1.35-1.76), and 2.06 (1.61-2.63), respectively. The pattern for IADL stages was similar. For recurrent hospitalizations, activity limitation stages were associated with the risk of the first hospitalization but not with subsequent hospitalizations. Activity limitation stages are associated with the risk of first hospitalization in the subsequent year among elderly Medicare beneficiaries. Stages capture clinically interpretable profiles of ADL and IADL functionality and describe preserved functions and activity limitation in an aggregated measure. Stage can inform interventions to ameliorate disability and thus reduce the risk of a subsequent hospitalization in this population. IV. Copyright © 2017

  19. Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in traditional Medicare.

    Science.gov (United States)

    Mittler, Jessica N; Landon, Bruce E; Zaslavsky, Alan M; Cleary, Paul D

    2011-10-14

    Medicare beneficiaries' awareness of Medicare managed care plans is critical for realizing the potential benefits of coverage choices. To assess the relationships of the number of Medicare risk plans, managed care penetration, and stability of plans in an area with traditional Medicare beneficiaries' awareness of the program. Cross-sectional analysis of Medicare Current Beneficiary Survey data about beneficiaries' awareness and knowledge of Medicare managed care plan availability. Logistic regression models used to assess the relationships between awareness and market characteristics. Traditional Medicare beneficiaries (n = 3,597) who had never been enrolled in Medicare managed care, but had at least one plan available in their area in 2002, and excluding beneficiaries under 65, receiving Medicaid, or with end stage renal disease. Traditional Medicare beneficiaries' knowledge of Medicare managed care plans in general and in their area. Having more Medicare risk plans available was significantly associated with greater awareness, and having an intermediate number of plans (2-4) was significantly associated with more accurate knowledge of Medicare risk plan availability than was having fewer or more plans. Medicare may have more success engaging consumers in choice and capturing the benefits of plan competition by more actively selecting and managing the plan choice set. Public Domain.

  20. A profile of social security child beneficiaries and their families: sociodemographic and economic characteristics.

    Science.gov (United States)

    Tamborini, Christopher R; Cupito, Emily; Shoffner, Dave

    2011-01-01

    Using a rich dataset that links the Census Bureau's Survey of Income and Program Participation calendar-year 2004 file with Social Security benefit records, this article provides a portrait of the sociodemographic and economic characteristics of Social Security child beneficiaries. We find that the incidence ofbenefit receipt in the child population differs substantially across individual and family-level characteristics. Average benefit amounts also vary across subgroups and benefit types. The findings provide a better understanding of the importance of Social Security to families with beneficiary children. Social Security is a major source of family income for many child beneficiaries, particularly among those with low income or family heads with lower education and labor earnings.

  1. Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries.

    Science.gov (United States)

    Lochner, Kimberly A; Wynne, Marc

    2011-12-21

    Data from the Medicare Current Beneficiary Survey, 2009. • Overall, 73% of Medicare beneficiaries aged 65 years and older reported receiving a flu shot for the 2008 flu season, but vaccination rates varied by socio-demographic characteristics. Flu vaccination was lowest for beneficiaries aged 65-74 years old, who were non-Hispanic Blacks and Hispanics, were not married, had less than a high school education, or who were eligible for Medicaid (i.e., dual eligibles). • Healthcare utilization and personal health behavior were also related to vaccination rates, with current smokers and those with no hospitalizations or physician visits being less likely to be vaccinated. • Among those beneficiaries who reported receiving a flu shot, 59% received it in a physician's office or clinic, with the next most common setting being in the community (21%); e.g., grocery store, shopping mall, library, or church. • Among those beneficiaries who did not receive a flu shot, the most common reasons were beliefs that the shot could cause side effects or disease (20%), that they didn't think the shot could prevent the flu (17%), or that the shot wasn't needed (16%). Less than 1% reported that they didn't get the flu shot because of cost. Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths occurring among the elderly (Fiore et al., 2010). Most physicians recommend their elderly patients get a flu shot each year, and many hospitals inquire about elderly patient's immunization status upon admission, providing a vaccination if requested. The importance of getting a flu shot is underscored by the Department of Health and Human Services' Healthy People initiative, which has set a vaccination goal of 90% for the Nation's elderly by the year 2020 (Department of Health and Human Services [DHHS], 2011). Although all costs related to flu shots are covered by Medicare, requiring

  2. 5 CFR 1651.10 - Deceased and non-existent beneficiaries.

    Science.gov (United States)

    2010-01-01

    ... beneficiary form dies before the participant, the beneficiary's share will be paid equally to other living beneficiaries bearing the same relationship to the participant as the deceased beneficiary. However, if the... descendants, if any. If there are no other beneficiaries bearing the same relationship or, in the case of...

  3. 38 CFR 9.4 - Beneficiaries and options.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Beneficiaries and options... SERVICEMEMBERS' GROUP LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.4 Beneficiaries and options. Any designation of beneficiary or election of settlement options is subject to the provisions of 38 U.S.C. 1970...

  4. How Do Pharmacists Assist Medicare Beneficiaries with Limited Income? A Cross-Sectional Study of Community Pharmacies in Alabama.

    Science.gov (United States)

    Westrick, Salisa C; Hastings, Tessa J; McFarland, Stuart J; Hohmann, Lindsey A; Hohmann, Natalie S

    2016-09-01

    Many Medicare beneficiaries have limited income and report problems paying for their medications. Programs are available to assist these low-income individuals. However, these programs are underused because of lack of general awareness and perceived complexity of program applications. To (a) determine the frequency of encounters by pharmacists with Medicare beneficiaries who cannot afford prescription drugs; (b) identify strategies that pharmacists use to assist Medicare beneficiaries who cannot afford prescription drugs; and (c) explore what pharmacists know about programs for Medicare beneficiaries with limited income. This study used a mixed-mode survey of 350 randomly sampled community pharmacies located in 32 counties in Alabama with a high proportion of Medicare beneficiaries who were potentially eligible for low-income subsidy programs. Measures included frequency of encounters by pharmacists with Medicare beneficiaries who could not afford their medications, strategies used to assist Medicare beneficiaries, and pharmacists' knowledge of programs for Medicare beneficiaries with limited income. Of 350 surveys sent, 12 were nondeliverable, and 151 were completed (response rate=44.6%). About 50% of respondents reported encountering Medicare beneficiaries who could not afford their medications at least weekly. Various strategies were reported, including refiling claims that were previously denied every day (40.7%), contacting insurance companies at least once per week (43.2%), and loaning medications at least 2-3 times per month (29.1%). Only 12.6% reported referring beneficiaries to the Aging and Disability Resource Centers (ADRCs) to assess eligibility for limited-income programs. When asked about programs for beneficiaries with limited income, the answers were predominantly "don't know for sure." Several strategies were used by pharmacists in an attempt to help limited-income Medicare beneficiaries obtain their medications. Lack of knowledge about financial

  5. Recessions and seniors' health, health behaviors, and healthcare use: analysis of the Medicare Current Beneficiary Survey.

    Science.gov (United States)

    McInerney, Melissa; Mellor, Jennifer M

    2012-09-01

    A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994-2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Comparing the Health Care Experiences of Medicare Beneficiaries with and without Depressive Symptoms in Medicare Managed Care versus Fee-for-Service.

    Science.gov (United States)

    Martino, Steven C; Elliott, Marc N; Haviland, Amelia M; Saliba, Debra; Burkhart, Q; Kanouse, David E

    2016-06-01

    To compare patient experiences and disparities for older adults with depressive symptoms in managed care (Medicare Advantage [MA]) versus Medicare Fee-for-Service (FFS). Data came from the 2010 Medicare CAHPS survey, to which 220,040 MA and 135,874 FFS enrollees aged 65 and older responded. Multivariate linear regression was used to test whether case-mix-adjusted associations between depressive symptoms and patient experience differed for beneficiaries in MA versus FFS. Dependent measures included four measures of beneficiaries' experiences with doctors (e.g., reports of doctor communication) and seven measures of beneficiaries' experiences with plans (e.g., customer service). Beneficiaries with depressive symptoms reported worse experiences than those without depressive symptoms regardless of coverage type. For measures assessing interactions with the plan (but not for measures assessing interactions with doctors), the disadvantage for beneficiaries with versus without depressive symptoms was larger in MA than in FFS. Disparities in care experienced by older Medicare beneficiaries with depressive symptoms tend to be more negative in managed care than in FFS. Efforts are needed to identify and address the barriers these beneficiaries encounter to help them better traverse the managed care environment. © Health Research and Educational Trust.

  7. Patient-Centered Medical Home Features and Health Care Expenditures of Medicare Beneficiaries with Chronic Disease Dyads.

    Science.gov (United States)

    Philpot, Lindsey M; Stockbridge, Erica L; Padrón, Norma A; Pagán, José A

    2016-06-01

    Three out of 4 Medicare beneficiaries have multiple chronic conditions, and managing the care of this growing population can be complex and costly because of care coordination challenges. This study assesses how different elements of the patient-centered medical home (PCMH) model may impact the health care expenditures of Medicare beneficiaries with the most prevalent chronic disease dyads (ie, co-occurring high cholesterol and high blood pressure, high cholesterol and heart disease, high cholesterol and diabetes, high cholesterol and arthritis, heart disease and high blood pressure). Data from the 2007-2011 Medical Expenditure Panel Survey suggest that increased access to PCMH features may differentially impact the distribution of health care expenditures across health care service categories depending on the combination of chronic conditions experienced by each beneficiary. For example, having no difficulty contacting a provider after regular hours was associated with significantly lower outpatient expenditures for beneficiaries with high cholesterol and diabetes (n = 635; P = 0.038), but it was associated with significantly higher inpatient expenditures for beneficiaries with high blood pressure and high cholesterol (n = 1599; P = 0.015), and no significant differences in expenditures in any category for beneficiaries with high blood pressure and heart disease (n = 1018; P > 0.05 for all categories). However, average total health care expenditures are largely unaffected by implementing the PCMH features considered. Understanding how the needs of Medicare beneficiaries with multiple chronic conditions can be met through the adoption of the PCMH model is important not only to be able to provide high-quality care but also to control costs. (Population Health Management 2016;19:206-211).

  8. Measuring coding intensity in the Medicare Advantage program.

    Science.gov (United States)

    Kronick, Richard; Welch, W Pete

    2014-01-01

    In 2004, Medicare implemented a system of paying Medicare Advantage (MA) plans that gave them greater incentive than fee-for-service (FFS) providers to report diagnoses. Risk scores for all Medicare beneficiaries 2004-2013 and Medicare Current Beneficiary Survey (MCBS) data, 2006-2011. Change in average risk score for all enrollees and for stayers (beneficiaries who were in either FFS or MA for two consecutive years). Prevalence rates by Hierarchical Condition Category (HCC). Each year the average MA risk score increased faster than the average FFS score. Using the risk adjustment model in place in 2004, the average MA score as a ratio of the average FFS score would have increased from 90% in 2004 to 109% in 2013. Using the model partially implemented in 2014, the ratio would have increased from 88% to 102%. The increase in relative MA scores appears to largely reflect changes in diagnostic coding, not real increases in the morbidity of MA enrollees. In survey-based data for 2006-2011, the MA-FFS ratio of risk scores remained roughly constant at 96%. Intensity of coding varies widely by contract, with some contracts coding very similarly to FFS and others coding much more intensely than the MA average. Underpinning this relative growth in scores is particularly rapid relative growth in a subset of HCCs. Medicare has taken significant steps to mitigate the effects of coding intensity in MA, including implementing a 3.4% coding intensity adjustment in 2010 and revising the risk adjustment model in 2013 and 2014. Given the continuous relative increase in the average MA risk score, further policy changes will likely be necessary.

  9. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic Control Specialists (ATCS) of the FAA when appropriate authorization has been furnished by the FAA...

  10. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    admin

    Abstract. Background: Ethiopia is amongst the African countries that have received significant food aid. Nonetheless, the common micronutrient deficiencies among food aid beneficiaries are not well documented. Objective: To find out the common micronutrient deficiencies among food aid beneficiaries in the country based ...

  11. Beneficiary contact moderates relationship between authentic leadership and engagement

    Directory of Open Access Journals (Sweden)

    Caren B. Scheepers

    2016-07-01

    Full Text Available Orientation: Beneficiary contact moderates the relationship between authentic leadership and work engagement. Research purpose: The objective of this study was to examine the moderating effect of the breadth, depth and frequency of employee interaction with the beneficiaries of their work on the positive impact of authentic leadership on work engagement. Motivation for the study: Investigating the boundary conditions of the relationship between leaders and followers is vital to enhance the positive effect of leadership. Authentic leadership has not previously been examined with respect to beneficiary contact as a specific situational factor. The researchers therefore set out to ascertain whether beneficiary contact has a strengthening or weakening effect on the impact of authentic leadership on work engagement. Research design, approach and method: The researchers administered the Authentic Leadership Questionnaire (ALQ, the Utrecht Work Engagement Scale (UWES-9 and Grant’s scale on Beneficiary Contact. Main findings: The findings showed that beneficiary contact had a weakening effect on the positive relationship between authentic leadership and work engagement. Practical/managerial implications: Ideally, organisations create environments conducive to work engagement in which leadership plays an important role. This study found that one factor in the work environment, namely beneficiary contact, might have an adverse effect on the positive relationship that authentic leadership has on work engagement. Leaders should therefore take organisational contextual realities into account, such as regular, intense interaction of employees with the beneficiaries of their work. This situation could create strain for individual employees, requiring additional organisational support. Contribution/value-add: Organisations need to recognise the impact of beneficiary contact on the relationship between authentic leadership and work engagement. The researchers

  12. Medicare Beneficiary Knowledge of the Part D Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare Beneficiary Knowledge of the Part D Program and Its Relationship with Voluntary Enrollment According to findings appearing in Medicare Beneficiary Knowledge...

  13. U.S. Preventive Services Task Force recommendations and cancer screening among female Medicare beneficiaries.

    Science.gov (United States)

    Salloum, Ramzi G; Kohler, Racquel E; Jensen, Gail A; Sheridan, Stacey L; Carpenter, William R; Biddle, Andrea K

    2014-03-01

    Medicare covers several cancer screening tests not currently recommended by the U.S. Preventive Services Task Force (Task Force). In September 2002, the Task Force relaxed the upper age limit of 70 years for breast cancer screening recommendations, and in March 2003 an upper age limit of 65 years was introduced for cervical cancer screening recommendations. We assessed whether mammogram and Pap test utilization among women with Medicare coverage is influenced by changes in the Task Force's recommendations for screening. We identified female Medicare beneficiaries aged 66-80 years and used bivariate probit regression to examine the receipt of breast (mammogram) and cervical (Pap test) cancer screening reflecting changes in the Task Force recommendations. We analyzed 9,760 Medicare Current Beneficiary Survey responses from 2001 to 2007. More than two-thirds reported receiving a mammogram and more than one-third a Pap test in the previous 2 years. Lack of recommendation was given as a reason for not getting screened among the majority (51% for mammogram and 75% for Pap). After controlling for beneficiary-level socioeconomic characteristics and access to care factors, we did not observe a significant change in breast and cervical cancer screening patterns following the changes in Task Force recommendations. Although there is evidence that many Medicare beneficiaries adhere to screening guidelines, some women may be receiving non-recommended screening services covered by Medicare.

  14. Patient Satisfaction and Prognosis for Functional Improvement and Deterioration, Institutionalization, and Death Among Medicare Beneficiaries Over 2 Years.

    Science.gov (United States)

    Bogner, Hillary R; de Vries McClintock, Heather F; Kurichi, Jibby E; Kwong, Pui L; Xie, Dawei; Hennessy, Sean; Streim, Joel E; Stineman, Margaret G

    2017-01-01

    To examine how patient satisfaction with care coordination and quality and access to medical care influence functional improvement or deterioration (activity limitation stage transitions), institutionalization, or death among older adults. National representative sample with 2-year follow-up. Medicare Current Beneficiary Survey from calendar years 2001 to 2008. Community-dwelling adults (N=23,470) aged ≥65 years followed for 2 years. Not applicable. A multinomial logistic regression model taking into account the complex survey design was used to examine the association between patient satisfaction with care coordination and quality and patient satisfaction with access to medical care and activities of daily living (ADL) stage transitions, institutionalization, or death after 2 years, adjusting for baseline socioeconomics and health-related characteristics. Out of 23,470 Medicare beneficiaries, 14,979 (63.8% weighted) remained stable in ADL stage, 2508 (10.7% weighted) improved, 3210 (13.3% weighted) deteriorated, 582 (2.5% weighted) were institutionalized, and 2281 (9.7% weighted) died. Beneficiaries who were in the top quartile of satisfaction with care coordination and quality were less likely to be institutionalized (adjusted relative risk ratio [RRR], .68; 95% confidence interval [CI], .54-.86). Beneficiaries who were in the top quartile of satisfaction with access to medical care were less likely to functionally deteriorate (adjusted RRR, .87; 95% CI, .79-.97), be institutionalized (adjusted RRR, .72; 95% CI, .56-.92), or die (adjusted RRR, .86; 95% CI, .75-.98). Knowledge of patient satisfaction with medical care and risk of functional deterioration may be helpful for monitoring and addressing disability-related health care disparities and the effect of ongoing policy changes among Medicare beneficiaries. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Recent Health Care Use and Medicaid Entry of Medicare Beneficiaries.

    Science.gov (United States)

    Keohane, Laura M; Trivedi, Amal N; Mor, Vincent

    2017-10-01

    To examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. We identified Medicare beneficiaries without full Medicaid or use of hospital or nursing home services in 2008 (N = 2,163,387). A discrete survival analysis estimated beneficiaries' monthly likelihood of entry into the full Medicaid program between January 2009 and June 2010. During the 18-month study period, Medicaid entry occurred for 1.1% and 3.7% of beneficiaries who aged into Medicare or originally qualified for Medicare due to disability, respectively. Among beneficiaries who aged into Medicare, 49% of new Medicaid participants had no use of inpatient, skilled nursing facility, or nursing home services during the study period. Individuals who recently used inpatient, skilled nursing facility or nursing home services had monthly rates of 1.9, 14.0, and 38.1 new Medicaid participants per 1,000 beneficiaries, respectively, compared with 0.4 new Medicaid participants per 1,000 beneficiaries with no recent use of these services. Although recent health care use predicted greater likelihood of Medicaid entry, half of new Medicaid participants used no hospital or nursing home care during the study period. These patterns should be considered when designing and evaluating interventions to reform health care delivery for dual-eligible beneficiaries. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Observation Status, Poverty, and High Financial Liability Among Medicare Beneficiaries.

    Science.gov (United States)

    Goldstein, Jennifer N; Zhang, Zugui; Schwartz, J Sanford; Hicks, LeRoi S

    2018-01-01

    Medicare beneficiaries hospitalized under observation status are subject to cost-sharing with no spending limit under Medicare Part B. Because low-income status is associated with increased hospital use, there is concern that such beneficiaries may be at increased risk for high use and out-of-pocket costs related to observation care. Our objective was to determine whether low-income Medicare beneficiaries are at risk for high use and high financial liability for observation care compared with higher-income beneficiaries. We performed a retrospective, observational analysis of Medicare Part B claims and US Census Bureau data from 2013. Medicare beneficiaries with Part A and B coverage for the full calendar year, with 1 or more observation stay(s), were included in the study. Beneficiaries were divided into quartiles representing poverty level. The associations between poverty quartile and high use of observation care and between poverty quartile and high financial liability for observation care were evaluated. After multivariate adjustment, the risk of high use was higher for beneficiaries in the poor (Quartile 3) and poorest (Quartile 4) quartiles compared with those in the wealthiest quartile (Quartile 1) (adjusted odds ratio [AOR], 1.21; 95% confidence interval [CI], 1.13-1.31; AOR, 1.24; 95% CI, 1.16-1.33). The risk of high financial liability was higher in every poverty quartile compared with the wealthiest and peaked in Quartile 3, which represented the poor but not the poorest beneficiaries (AOR, 1.17; 95% CI, 1.10-1.24). Poverty predicts high use of observation care. The poor or near poor may be at highest risk for high liability. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. 42 CFR 424.54 - Payment to the beneficiary's legal guardian or representative payee.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to the beneficiary's legal guardian or... Ordinarily Made § 424.54 Payment to the beneficiary's legal guardian or representative payee. Medicare may pay amounts due a beneficiary to the beneficiary's legal guardian or representative payee. ...

  18. Factors influencing Poverty Alleviation among Women Credit Beneficiaries in Tanzania: A Case Study of FINCA’s Women Credit beneficiaries in Mwanza

    Directory of Open Access Journals (Sweden)

    Samuel Nyambega Nyang’au

    2014-04-01

    Full Text Available Many credit schemes in Tanzania channel their funds to womenwith the objective of alleviating poverty among them. Despite this, majority ofwomen in the country continue to wallow in poverty. The present research wascarried out among the Foundation for International Community Assistance’s womencredit beneficiaries in Mwanza. The study set out to address the followingobjectives: to analyze the influence of the husband’s cooperation, relevanttraining and interest rate on poverty alleviation among women creditbeneficiaries in Tanzania taking Foundation for International CommunityAssistance in Mwanza as a case study. Using simple regression model, resultsshowed that cooperation from the husband as well as relevant training influencespoverty alleviation among women credit beneficiaries in Tanzania by 56 and 36percent respectively. But interest rate was found to have no significantinfluence at all. The paper recommends that seminars be conducted so thathusbands can be taught the importance of cooperating with their wives. Aboveall giving training to women credit beneficiaries will go a long way insharpening their business skills. Future researchers should research onlaziness and complacency among women credit beneficiaries and the influence onpoverty.

  19. Changes in agri-business outcomes among the dairy beneficiaries ...

    African Journals Online (AJOL)

    This study compared changes in uptake of agri-business practices, productivity and wealth creation between dairy beneficiaries and non-beneficiaries of Contracted Extension Service Delivery Model (CESDM) implemented by Kenya Agricultural Productivity and Agribusiness Project (KAPAP) in selected counties of Kenya ...

  20. Beneficiary price sensitivity in the Medicare prescription drug plan market.

    Science.gov (United States)

    Frakt, Austin B; Pizer, Steven D

    2010-01-01

    The Medicare stand-alone prescription drug plan (PDP) came into existence in 2006 as part of the Medicare prescription drug benefit. It is the most popular plan type among Medicare drug plans and large numbers of plans are available to all beneficiaries. In this article we present the first analysis of beneficiary price sensitivity in the PDP market. Our estimate of elasticity of enrollment with respect to premium, -1.45, is larger in magnitude than has been found in the Medicare HMO market. This high degree of beneficiary price sensitivity for PDPs is consistent with relatively low product differentiation, low fixed costs of entry in the PDP market, and the fact that, in contrast to changing HMOs, beneficiaries can select a PDP without disrupting doctor-patient relationships.

  1. Chronic Conditions among Medicare Beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data used in the chronic condition reports are based upon CMS administrative enrollment and claims data for Medicare beneficiaries enrolled in the...

  2. [Characteristics of beneficiaries of a GP-centred health care contract in Germany].

    Science.gov (United States)

    Freund, Tobias; Szecsenyi, Joachim; Ose, Dominik

    2010-11-01

    Since 2004, primary care in Germany has increasingly been provided in special general practitioner (GP)-centred health care contracts (HZV). To date there is limited evidence about the characteristics of their beneficiaries regarding morbidity burden and health care utilization. We analysed insurance claims data from all beneficiaries of the "Allgemeine Ortskrankenkasse (AOK) Baden-Württemberg" listed in 10 general practices that contracted in a special GP-centred health care contract (HZV). We compared beneficiaries enrolled in the HZV with those who were not enrolled in the contract. Comparisons included the number of hospital admissions in 2007-2008 and the Charlson comorbidity index. Insurance claims data of 6,026 beneficiaries were available for analysis. In the third quarter of 2009, 51% (3,066) of the beneficiaries were enrolled in the HZV. They were significantly older (mean 61 years [SD 18 years] vs. 49 years [SD 22 years]; p contract tended to be older and suffered from a higher morbidity burden when compared with beneficiaries of the same health care fund who were not enrolled in the contract. Besides, beneficiaries of the contract had higher numbers of hospital admissions during the two year period before enrolment. These findings have substantial implications for individualized care management approaches that may be offered to beneficiaries of GP-centred health care contracts.

  3. MBS Native Plant Communities

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data layer contains results of the Minnesota County Biological Survey (MCBS). It includes polygons representing the highest quality native plant communities...

  4. 7 CFR 1710.104 - Service to non-RE Act beneficiaries.

    Science.gov (United States)

    2010-01-01

    ... GUARANTEES Loan Purposes and Basic Policies § 1710.104 Service to non-RE Act beneficiaries. (a) To the... made to finance electric facilities to serve consumers that are not RE Act beneficiaries. (b) Loan...

  5. Fadama III Beneficiaries' Adherence to Project Guidelines in Ogun ...

    African Journals Online (AJOL)

    It was recommended that the implementers should keep up their efforts at sensitising beneficiaries on the implementation guidelines of the project, re-work their strategies at addressing procurement and FUEF inadequacies among the beneficiaries and fast-track the delivery of project benefits in the communities. Key words: ...

  6. The Influence of Co-Morbidity and Other Health Measures on Dental and Medical Care Use among Medicare beneficiaries 2002

    Science.gov (United States)

    Chen, Haiyan; Moeller, John; Manski, Richard J.

    2011-01-01

    Objective To assess the impact of co-morbidity and other health measures on the use of dental and medical care services among the community-based Medicare population with data from the 2002 Medicare Current Beneficiary Survey. Methods A co-morbidity index is the main independent variable of our study. It includes oral cancer as a co-morbidity condition and was developed from Medicare claims data. The two outcome variables indicate whether a beneficiary had a dental visit during the year and whether the beneficiary had an inpatient hospital stay during the year. Logistic regressions estimated the relationship between the outcome variables and co-morbidity after controlling for other explanatory variables. Results High scores on the co-morbidity index, high numbers of self-reported physical limitations, and fair or poor self-reported health status were correlated with higher hospital use and lower dental care utilization. Similar results were found for other types of medical care including medical provider visits, outpatient care, and prescription drugs. A multiple imputation technique was used for the approximate 20% of the sample with missing claims, but the resulting co-morbidity index performed no differently than the index constructed without imputation. Conclusions Co-morbidities and other health status measures are theorized to play either a predisposing or need role in determining health care utilization. The study’s findings confirm the dominant role of these measures as predisposing factors limiting access to dental care for Medicare beneficiaries and as need factors producing higher levels of inpatient hospital and other medical care for Medicare beneficiaries. PMID:21972460

  7. 5 CFR 1651.4 - How to change or cancel a designation of beneficiary.

    Science.gov (United States)

    2010-01-01

    ... of beneficiary, the participant must submit to the TSP record keeper a new TSP designation of beneficiary form meeting the requirements of § 1651.3 to the TSP record keeper. If the TSP receives more than... the participant. A participant may change a TSP beneficiary at any time, without the knowledge or...

  8. 26 CFR 1.501(c)(8)-1 - Fraternal beneficiary societies.

    Science.gov (United States)

    2010-04-01

    ... beneficiary societies. (a) A fraternal beneficiary society is exempt from tax only if operated under the lodge system or for the exclusive benefit of the members so operating. Operating under the lodge system means... parent organization and largely self-governing, called lodges, chapters, or the like. In order to be...

  9. Beneficiary Activation in the Medicare Population

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Beneficiary Activation in the Medicare Population, published in Volume 4, Issue 4 of the Medicare and Medicaid Research Review,...

  10. Analysis of Satisfaction Degree of the Public Insurance System Beneficiaries

    Directory of Open Access Journals (Sweden)

    Manuela PANAITESCU

    2013-08-01

    Full Text Available The public insurance system provides financial benefits to individuals that are obtained by collecting the due contributions. The analysis of satisfaction degree of the beneficiaries of the system was carried out to determine the challenges the system is facing and for determining the needs of the beneficiaries. In order to reduce the financial constraints the public insurance system is facing, it is necessary to create an appropriate insurance system that meets the needs of the beneficiaries. The research took into account that the public insurance system determines the quality of life of the population and has a strong influence on the economy, particularly on the labour market and the capital market.

  11. Reforming Access: Trends in Medicaid Enrollment for New Medicare Beneficiaries, 2008-2011.

    Science.gov (United States)

    Keohane, Laura M; Rahman, Momotazur; Mor, Vincent

    2016-04-01

    To evaluate whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. Medicare enrollment records for years 2007-2011. We used a multinomial logistic model with state fixed effects to examine the annual change in limited and full Medicaid enrollment among new Medicare beneficiaries for 2 years before and after the reforms (2008-2011). We identified new Medicare beneficiaries in the years 2008-2011 and their participation in Medicaid based on Medicare enrollment records. The percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability (p < .001). There was no significant difference in the size of enrollment increases between states with and without concurrent limited Medicaid eligibility expansions. Our findings suggest that streamlining financial assistance programs may improve Medicare beneficiaries' access to benefits. © Health Research and Educational Trust.

  12. Hospice utilization of Medicare beneficiaries in Hawai‘i compared to other states

    Directory of Open Access Journals (Sweden)

    Deborah Taira

    2017-11-01

    Full Text Available The objective is to examine hospice utilization among Medicare beneficiaries in Hawai‘i compared to other states. Data were from the 2014 Medicare Hospice Utilization and Payment Public Use File, which included information on 4,025 hospice providers, more than 1.3 million hospice beneficiaries, and over $15 billion in Medicare payments. Multivariable linear regression models were estimated to compare hospice utilization in Hawai‘i to that of other states. Control variables included age, gender, and type of Medicare coverage. Medicare beneficiaries using hospice in Hawai‘i differed significantly from beneficiaries in other states in several ways. Hawai‘i beneficiaries were more likely to be Asian (57% vs. 1%, p < .001 and “other race” (10% vs. 0.1%, p < .001, and less likely to be White (28% vs. 84%, p < .001. Hawai‘i beneficiaries were also more likely to have Medicare Advantage (55% vs. 30%, p = .05. Regarding primary diagnoses, hospice users in Hawai‘i were significantly more likely to have a primary diagnosis of stroke (11% vs. 8%, p = .03 and less likely to have respiratory disease (5% vs. 11%, p = .003. In addition, hospice users in Hawai‘i were more likely to use services in their homes (74% vs. 52%, p = .03. Hawai‘i hospice users were also less likely to die while in hospice (42% vs. 47%, p = .002. Characteristics of Medicare beneficiaries in Hawai‘i differ from those in other states, regarding demographic characteristics, type of coverage, primary diagnoses, likelihood of using services in their homes, and death rates. Further research is needed to better understand factors affecting these differences and whether these differences warrant changes in policy or practice.

  13. Are Press Depictions of Affordable Care Act Beneficiaries Favorable to Policy Durability?

    Science.gov (United States)

    Chattopadhyay, Jacqueline

    2015-01-01

    If successfully implemented and enduring, the Affordable Care Act (ACA) stands to expand health insurance access in absolute terms, reduce inter-group disparities in that access, and reduce exposure to the financial vulnerabilities illness entails. Its durability--meaning both avoidance of outright retrenchment and fidelity to its policy aims--is thus of scholarly interest. Past literature suggests that social constructions of a policy's beneficiaries may impact durability. This paper first describes media portrayals of ACA beneficiaries with an eye toward answering three descriptive questions: (1) Do portrayals depict beneficiaries as economically heterogeneous? (2) Do portrayals focus attention on groups that have acquired new political relevance due to the ACA, such as young adults? (3) What themes that have served as messages about beneficiary "deservingness" in past social policy are most frequent in ACA beneficiary portrayals? The paper then assesses how the portrayal patterns that these questions uncover may work both for and against the ACA's durability, finding reasons for confidence as well as caution. Using manual and automated methods, this paper analyzes newspaper text from August 2013 through January 2014 to trace portrayals of two ACA "target populations" before and during the new law's first open-enrollment period: those newly eligible for Medicaid, and those eligible for subsidies to assist in the purchase of private health insurance under the ACA. This paper also studies newspaper text portrayals of two groups informally crafted by the ACA in this timeframe: those gaining health insurance and those losing it. The text data uncover the following answers to the three descriptive questions for the timeframe studied: (1) Portrayals may underplay beneficiaries' economic heterogeneity. (2) Portrayals pay little attention to young adults. (3) Portrayals emphasize themes of workforce participation, economic self-sufficiency, and insider status. Health

  14. OASDI Beneficiaries by State and County, 2011

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  15. OASDI Beneficiaries by State and County, 2010

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  16. OASDI Beneficiaries by State and County, 2014

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  17. OASDI Beneficiaries by State and County, 2003

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  18. OASDI Beneficiaries by State and County, 2002

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  19. OASDI Beneficiaries by State and County, 2009

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  20. OASDI Beneficiaries by State and County, 1999

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population - people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  1. OASDI Beneficiaries by State and County, 2013

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  2. OASDI Beneficiaries by State and County, 2000

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  3. OASDI Beneficiaries by State and County, 2008

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  4. OASDI Beneficiaries by State and County, 2015

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  5. OASDI Beneficiaries by State and County, 2007

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  6. OASDI Beneficiaries by State and County, 2016

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  7. OASDI Beneficiaries by State and County, 2006

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  8. OASDI Beneficiaries by State and County, 2005

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  9. OASDI Beneficiaries by State and County, 2001

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  10. OASDI Beneficiaries by State and County, 2004

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  11. The Use of Ambulatory Blood Pressure Monitoring Among Medicare Beneficiaries in 2007-2010

    Science.gov (United States)

    Shimbo, Daichi; Kent, Shia T; Diaz, Keith M; Huang, Lei; Viera, Anthony J; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    The US Centers for Medicaid and Medicare Services reimburses ambulatory blood pressure monitoring (ABPM) for suspected white coat hypertension. We estimated ABPM use between 2007 and 2010 among a 5% random sample of Medicare beneficiaries (≥ 65 years). In 2007, 2008, 2009 and 2010, the percentage of beneficiaries with ABPM claims was 0.10%, 0.11%, 0.10%, and 0.09% respectively. A prior diagnosis of hypertension was more common among those with versus without an ABPM claim (77.7% versus 47.0%). Among hypertensive beneficiaries, 95.2% of those with an ABPM claim were taking antihypertensive medication. Age 75-84 versus 65-74 years, having coronary heart disease, chronic kidney disease, multiple prior hypertension diagnoses, and having filled multiple classes of antihypertensive medication were associated with an increased odds for an ABPM claim among hypertensive beneficiaries. ABPM use was very low among Medicare beneficiaries and was not primarily used for diagnosing white coat hypertension in untreated individuals. PMID:25492832

  12. OASDI Beneficiaries and Benefits by State, 2014

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  13. OASDI Beneficiaries and Benefits by State- 2015

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  14. Racial disparities in poverty account for mortality differences in US medicare beneficiaries

    Directory of Open Access Journals (Sweden)

    Paul L. Kimmel

    2016-12-01

    Full Text Available Higher mortality in Blacks than Whites has been consistently reported in the US, but previous investigations have not accounted for poverty at the individual level. The health of its population is an important part of the capital of a nation. We examined the association between individual level poverty and disability and racial mortality differences in a 5% Medicare beneficiary random sample from 2004 to 2010. Cox regression models examined associations of race with all-cause mortality, adjusted for demographics, comorbidities, disability, neighborhood income, and Medicare “Buy-in” status (a proxy for individual level poverty in 1,190,510 Black and White beneficiaries between 65 and 99 years old as of January 1, 2014, who had full and primary Medicare Part A and B coverage in 2004, and lived in one of the 50 states or Washington, DC.Overall, black beneficiaries had higher sex-and-age adjusted mortality than Whites (hazard ratio [HR] 1.18. Controlling for health-related measures and disability reduced the HR for Black beneficiaries to 1.03. Adding “Buy-in” as an individual level covariate lowered the HR for Black beneficiaries to 0.92. Neither of the residential measures added to the predictive model. We conclude that poorer health status, excess disability, and most importantly, greater poverty among Black beneficiaries accounts for racial mortality differences in the aged US Medicare population. Poverty fosters social and health inequalities, including mortality disparities, notwithstanding national health insurance for the US elderly. Controlling for individual level poverty, in contrast to the common use of area level poverty in previous analyses, accounts for the White survival advantage in Medicare beneficiaries, and should be a covariate in analyses of administrative databases. Keywords: USA, Poverty, Socioeconomic status, Mortality, Race, Neighborhood, Disability, Disparities, Buy-in, Dual-eligible, Medicare, Medicaid, USRDS

  15. 78 FR 53507 - Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form...

    Science.gov (United States)

    2013-08-29

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form) Activity Under OMB Review AGENCY: Veterans Health... Control No. 2900- NEW (Beneficiary Travel Mileage Reimbursement Application Form)'' in any correspondence...

  16. Promoting pneumococcal immunizations among rural Medicare beneficiaries using multiple strategies.

    Science.gov (United States)

    Johnson, Elizabeth A; Harwell, Todd S; Donahue, Peg M; Weisner, M'liss A; McInerney, Michael J; Holzman, Greg S; Helgerson, Steven D

    2003-01-01

    Vaccine-preventable diseases among adults are major contributing causes of morbidity and mortality in the United States. However, adult immunizations continue to be underutilized in both urban and rural areas. To evaluate the effectiveness of a community-wide education campaign and mailed reminders promoting pneumococcal immunizations to rural Medicare beneficiaries. We implemented a community-wide education campaign, and mailed reminders were sent to Medicare beneficiaries in 1 media market in Montana to increase pneumococcal immunizations. In a second distinct media market, mailed reminders only were sent to beneficiaries. The proportion of respondents aged 65 years and older aware of pneumococcal immunizations increased significantly from baseline to follow-up among respondents both in the education-plus-reminder (63% to 78%, P = 0.04) and the reminder-only (64% to 74%, P = 0.05) markets. Overall from 1998 to 1999, there was a 3.7-percentage-point increase in pneumococcal immunization claims for Medicare beneficiaries in the education-plus-reminder market and a 1.5-percentage-point increase in the reminder-only market. Medicare beneficiaries sent reminders in the education-plus-reminder market compared to those in the reminder-only market were more likely to have a claim for pneumococcal immunization in 1999 (odds ratio 1.18, 95% confidence interval 1.08 to 1.28). The results suggest that these quality improvement strategies (community education plus reminders and reminders alone) modestly increased pneumococcal immunization awareness and pneumococcal immunization among rural adults. Mailed reminder exposure was associated with an increased prevalence of pneumococcal immunizations between 1998 and 1999 and was augmented somewhat by the education campaign.

  17. Patient satisfaction and loyalty among military healthcare beneficiaries enrolled in a managed care program.

    Science.gov (United States)

    Jennings, B M; Loan, L A

    1999-11-01

    A study was performed to evaluate military beneficiaries' motivation for choosing to change from a civilian managed care system to the military managed care system. Concerns about healthcare cost, quality, and access underpin major reform in military healthcare. The military health system (MHS) is implementing managed care through an initiative known as TRICARE. Patient choice and satisfaction are highly relevant to all healthcare delivery systems; they are being explored aggressively in the MHS as TRICARE evolves. This descriptive study was conducted using a telephone survey consisting of 63 items derived from four pre-existing instruments as well as five facility-specific questions and demographics. The population of interest targeted military beneficiaries on a TRICARE waiting list who, at the time of enrollment, indicated a desire to receive care at the military facility. Consumers were inclined to return to the military system because of loyalty. Also, this study provided evidence that staff courtesy is important to those who seek healthcare. Good quality and accessibility were verified as essential elements in sustaining a consumer's positive view of and attraction to a particular healthcare system. Cost was proven to be a less substantial factor of consumer decision making. Surveys such as this give healthcare providers more information about aspects of care, such as patient loyalty and interpersonal dynamics, that attract people to their healthcare delivery systems. For healthcare systems to thrive, consumer influence and the power of patient dissatisfaction must be understood.

  18. Costs and Clinical Quality Among Medicare Beneficiaries..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors of Costs and Clinical Quality Among Medicare Beneficiaries - Associations with Health Center Penetration of Low-Income Residents, published in Volume 4,...

  19. 42 CFR 411.51 - Beneficiary's responsibility with respect to no-fault insurance.

    Science.gov (United States)

    2010-10-01

    ...-fault insurance. 411.51 Section 411.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PAYMENT Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance § 411.51 Beneficiary's responsibility with respect to no-fault insurance. (a) The beneficiary is...

  20. Medicare Part D is associated with reducing the financial burden of health care services in Medicare beneficiaries with diagnosed diabetes.

    Science.gov (United States)

    Li, Rui; Gregg, Edward W; Barker, Lawrence E; Zhang, Ping; Zhang, Fang; Zhuo, Xiaohui; Williams, Desmond E; Soumerai, Steven B

    2013-10-01

    Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries. To examine the effect of Part D on the financial burden of persons with diagnosed diabetes. We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income). For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place. Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.

  1. Assessment of Factors Influencing Beneficiary Participation in ...

    African Journals Online (AJOL)

    ISSN 0794-5698. Assessment of Factors Influencing Beneficiary Participation in Fadama II Project ... project implementation (80%) in the stages of project development. Women .... the project as they appeared to have more family burden to ...

  2. Depression Following Thrombotic Cardiovascular Events in Elderly Medicare Beneficiaries: Risk of Morbidity and Mortality

    Directory of Open Access Journals (Sweden)

    Christopher M. Blanchette

    2009-01-01

    Full Text Available Purpose. Depression and antidepressant use may independently increase the risk of acute myocardial infarction and mortality in adults. However, no studies have looked at the effect of depression on a broader thrombotic event outcome, assessed antidepressant use, or evaluated elderly adults. Methods. A cohort of 7,051 community-dwelling elderly beneficiaries who experienced a thrombotic cardiovascular event (TCE were pooled from the 1997 to 2002 Medicare Current Beneficiary Survey and followed for 12 months. Baseline characteristics, antidepressant utilization, and death were ascertained from the survey, while indexed TCE, recurrent TCE, and depression (within 6 months of indexed TCE were taken from ICD-9 codes on Medicare claims. Time to death and first recurrent TCE were assessed using descriptive and multivariate statistics. Results. Of the elders with a depression claim, 71.6% had a recurrent TCE and 4.7% died within 12 months of their indexed TCE, compared to 67.6% and 3.9% of those elders without a depression claim. Of the antidepressant users, 72.6% experienced a recurrent TCE and 3.9% died, compared to 73.7% and 4.6% in the subset of selective serotonin reuptake inhibitor (SSRI users. Depression was associated with a shorter time to death (P=.008 in the unadjusted analysis. However, all adjusted comparisons revealed no effect by depression, antidepressant use, or SSRI use. Conclusions. Depression was not associated with time to death or recurrent TCEs in this study. Antidepressant use, including measures of any antidepressant use and SSRI use, was not associated with shorter time to death or recurrent TCE.

  3. Home Health Agency Characteristics and Quality Outcomes for Medicare Beneficiaries With Rehabilitation-Sensitive Conditions.

    Science.gov (United States)

    Mroz, Tracy M; Meadow, Ann; Colantuoni, Elizabeth; Leff, Bruce; Wolff, Jennifer L

    2018-06-01

    To examine associations between organizational characteristics of home health agencies (eg, profit status, rehabilitation therapy staffing model, size, and rurality) and quality outcomes in Medicare beneficiaries with rehabilitation-sensitive conditions, conditions for which occupational, physical, and/or speech therapy have the potential to improve functioning, prevent or slow substantial decline in functioning, or increase ability to remain at home safely. Retrospective analysis. Home health agencies. Fee-for-service beneficiaries (N=1,006,562) admitted to 9250 Medicare-certified home health agencies in 2009. Not applicable. Institutional admission during home health care, community discharge, and institutional admission within 30 days of discharge. Nonprofit (vs for-profit) home health agencies were more likely to discharge beneficiaries to the community (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.13-1.33) and less likely to have beneficiaries incur institutional admissions within 30 days of discharge (OR, .93; 95% CI, .88-.97). Agencies in rural (vs urban) counties were less likely to discharge patients to the community (OR, .83; 95% CI, .77-.90) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.24; 95% CI, 1.18-1.30) and within 30 days of discharge (OR, 1.15; 95% CI, 1.10-1.22). Agencies with contract (vs in-house) therapy staff were less likely to discharge beneficiaries to the community (OR, .79, 95% CI, .70-.91) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.09; 95% CI, 1.03-1.15) and within 30 days of discharge (OR, 1.17; 95% CI, 1.07-1.28). As payers continue to test and implement reimbursement mechanisms that seek to reward value over volume of services, greater attention should be paid to organizational factors that facilitate better coordinated, higher quality home health care for beneficiaries who may benefit from rehabilitation. Copyright © 2017

  4. Classification of the financial sustainability of health insurance beneficiaries through data mining techniques

    Directory of Open Access Journals (Sweden)

    Sílvia Maria Dias Pedro Rebouças

    2016-09-01

    Full Text Available Advances in information technologies have led to the storage of large amounts of data by organizations. An analysis of this data through data mining techniques is important support for decision-making. This article aims to apply techniques for the classification of the beneficiaries of an operator of health insurance in Brazil, according to their financial sustainability, via their sociodemographic characteristics and their healthcare cost history. Beneficiaries with a loss ratio greater than 0.75 are considered unsustainable. The sample consists of 38875 beneficiaries, active between the years 2011 and 2013. The techniques used were logistic regression and classification trees. The performance of the models was compared to accuracy rates and receiver operating Characteristic curves (ROC curves, by determining the area under the curves (AUC. The results showed that most of the sample is composed of sustainable beneficiaries. The logistic regression model had a 68.43% accuracy rate with AUC of 0.7501, and the classification tree obtained 67.76% accuracy and an AUC of 0.6855. Age and the type of plan were the most important variables related to the profile of the beneficiaries in the classification. The highlights with regard to healthcare costs were annual spending on consultation and on dental insurance.

  5. Use of gonioscopy in medicare beneficiaries before glaucoma surgery.

    Science.gov (United States)

    Coleman, Anne L; Yu, Fei; Evans, Stacy J

    2006-12-01

    The American Academy of Ophthalmology Preferred Practice Patterns for angle closure and open-angle glaucoma (OAG) patients recommends performing bilateral gonioscopy upon initial presentation to evaluate the possibility of narrow angle or angle-closure glaucoma (ACG) and then repeating the examination at least every 5 years. This study aims to assess how commonly eye care providers perform gonioscopy before planned glaucoma surgery in OAG, anatomic narrow angle, and ACG in the Medicare population. Data obtained from a 5% random sample of Medicare beneficiaries undergoing glaucoma surgery in the United States in 1999 were retrospectively reviewed. The proportion of patients with evidence of at least one gonioscopic examination before glaucoma surgery was determined for the period of 1995 to 1999. Demographic and clinical factors potentially influencing the decision to perform gonioscopy were also examined. Overall, gonioscopy is apparently performed in 49% of Medicare beneficiaries during the 4 to 5 years preceding glaucoma surgery. This rate was significantly lower (P gonioscopy rates (P Gonioscopy examination before glaucoma surgery in Medicare beneficiaries is underused, undercoded, and/or miscoded, given current recommendations. Underuse is of particular concern in patients undergoing laser iridotomy as it is the diagnostic test of choice in ACG.

  6. Who are the beneficiaries?

    Science.gov (United States)

    Tännsjö, Torbjörn

    1992-10-01

    Is it defensible that society spends money on medical or research projects intended to help people solve their fertility problems? Suppose that we want to answer this question from the point of view of a utilitarian cost-benefit analysis. The answer to the question then depends, of course, on how expensive these projects turn out to be, relative to the costs of other possible projects. But it depends also on how we assess the benefits of these projects. To whom do they accrue? Who are the beneficiaries of these projects?

  7. U.S. Outpatient Beneficiary Satisfaction at Korean Hospitals

    National Research Council Canada - National Science Library

    Hayman, Alex L

    2008-01-01

    .... The analysis measured overall patient satisfaction as it relates to beneficiary category, gender and command sponsorship. The project data was utilized to verify and/or identify potential target areas of patient satisfaction.

  8. Basic Stand Alone Skilled Nursing Facility Beneficiary PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Skilled Nursing Facility (SNF) Beneficiary Public Use Files (PUF) with information from Medicare SNF claims. The...

  9. 42 CFR 423.6 - Cost-sharing in beneficiary education and enrollment-related costs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Cost-sharing in beneficiary education and enrollment-related costs. 423.6 Section 423.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... BENEFIT General Provisions § 423.6 Cost-sharing in beneficiary education and enrollment-related costs. The...

  10. 32 CFR 728.59 - Peace Corps beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... beneficiaries seeking dental care will be requested, whenever possible, to furnish advanced authorization. (5... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE... sponsor. (4) Dental care. Limit dental care to emergencies. Render only that care essential to relieve...

  11. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    Results: Vitamin A and iron deficiencies were the most prevalent micronutrient deficiencies among food aid beneficiaries. Other probable deficiencies prevailing were zinc, vitamins thiamine, riboflavin, niacin folate, cyano-cobalamine, ascorbic acid vitamin D and calcium because of the low intake of dairy products and meat.

  12. Cataract surgery among Medicare beneficiaries.

    Science.gov (United States)

    Schein, Oliver D; Cassard, Sandra D; Tielsch, James M; Gower, Emily W

    2012-10-01

    To present descriptive epidemiology of cataract surgery among Medicare recipients in the United States. Cataract surgery performed on Medicare beneficiaries in 2003 and 2004. Medicare claims data were used to identify all cataract surgery claims for procedures performed in the United States in 2003-2004. Standard assumptions were used to limit the claims to actual cataract surgery procedures performed. Summary statistics were created to determine the number of procedures performed for each outcome of interest: cataract surgery rates by age, sex, race and state; surgical volume by facility type and surgeon characteristics; time interval between first- and second-eye cataract surgery. The national cataract surgery rate for 2003-2004 was 61.8 per 1000 Medicare beneficiary person-years. The rate was significantly higher for females and for those aged 75-84 years. After adjustment for age and sex, blacks had approximately a 30% lower rate of surgery than whites. While only 5% of cataract surgeons performed more than 500 cataract surgeries annually, these surgeons performed 26% of the total cataract surgeries. Increasing surgical volume was found to be highly correlated with use of ambulatory surgical centers and reduced time interval between first- and second-eye surgery in the same patient. The epidemiology of cataract surgery in the United States Medicare population documents substantial variation in surgical rates by race, sex, age, and by certain provider characteristics.

  13. Access to Care for Medicare-Medicaid Dually Eligible Beneficiaries: The Role of State Medicaid Payment Policies.

    Science.gov (United States)

    Zheng, Nan Tracy; Haber, Susan; Hoover, Sonja; Feng, Zhanlian

    2017-12-01

    Medicaid programs are not required to pay the full Medicare coinsurance and deductibles for Medicare-Medicaid dually eligible beneficiaries. We examined the association between the percentage of Medicare cost sharing paid by Medicaid and the likelihood that a dually eligible beneficiary used evaluation and management (E&M) services and safety net provider services. Medicare and Medicaid Analytic eXtract enrollment and claims data for 2009. Multivariate analyses used fee-for-service dually eligible and Medicare-only beneficiaries in 20 states. A comparison group of Medicare-only beneficiaries controlled for state factors that might influence utilization. Paying 100 percent of the Medicare cost sharing compared to 20 percent increased the likelihood (relative to Medicare-only) that a dually eligible beneficiary had any E&M visit by 6.4 percent. This difference in the percentage of cost sharing paid decreased the likelihood of using safety net providers, by 37.7 percent for federally qualified health centers and rural health centers, and by 19.8 percent for hospital outpatient departments. Reimbursing the full Medicare cost-sharing amount would improve access for dually eligible beneficiaries, although the magnitude of the effect will vary by state and type of service. © Health Research and Educational Trust.

  14. Substantial Physician Turnover And Beneficiary 'Churn' In A Large Medicare Pioneer ACO.

    Science.gov (United States)

    Hsu, John; Vogeli, Christine; Price, Mary; Brand, Richard; Chernew, Michael E; Mohta, Namita; Chaguturu, Sreekanth K; Weil, Eric; Ferris, Timothy G

    2017-04-01

    Alternative payment models, such as accountable care organizations (ACOs), attempt to stimulate improvements in care delivery by better alignment of payer and provider incentives. However, limited attention has been paid to the physicians who actually deliver the care. In a large Medicare Pioneer ACO, we found that the number of beneficiaries per physician was low (median of seventy beneficiaries per physician, or less than 5 percent of a typical panel). We also found substantial physician turnover: More than half of physicians either joined (41 percent) or left (18 percent) the ACO during the 2012-14 contract period studied. When physicians left the ACO, most of their attributed beneficiaries also left the ACO. Conversely, about half of the growth in the beneficiary population was because of new physicians affiliating with the ACO; the remainder joined after switching physicians. These findings may help explain the muted financial impact ACOs have had overall, and they raise the possibility of future gaming on the part of ACOs to artificially control spending. Policy refinements include coordinated and standardized risk-sharing parameters across payers to prevent any dilution of the payment incentives or confusion from a cacophony of incentives across payers. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Outcomes associated with comorbid atrial fibrillation and heart failure in Medicare beneficiaries with acute coronary syndrome.

    Science.gov (United States)

    Chen, Shih-Yin; Crivera, Concetta; Stokes, Michael; Boulanger, Luke; Schein, Jeff

    2014-02-20

    Atrial fibrillation (AF) and heart failure (HF) are both common comorbid conditions of elderly patients with acute coronary syndrome (ACS), but published data on their associated clinical and economic outcomes are limited. Our study included patients from the Medicare Current Beneficiary Survey with an incident hospitalization for ACS between 03/01/2002 and 12/31/2006. Applying population weights, we identified 795 incident ACS patients, representing more than 2.5 million Medicare beneficiaries. Of this population, 13.1% had comorbid AF, and 22.9% had HF, which were identified from Medicare claims during the 6 months prior to the first ACS event (index date) Subsequent cardiovascular (CV) hospitalizations and mortality were compared using Kaplan-Meier curves. Cox proportional hazards regressions were used to estimate the relative risk of AF and HF on CV events and mortality. Healthcare costs were summarized for the calendar year in which the incident ACS event occurred. HF was associated with a 41% higher risk of mortality (HR = 1.41; 95% confidence interval [CI] 1.05-1.89). Both AF (HR = 1.46; 95% CI 1.14-1.87) and HF (HR = 1.61; 95% CI 1.26-2.06) were associated with higher risks of subsequent CV events. During the year of the incident ACS event, ACS patients with comorbid AF or HF had approximately $18,000 higher total healthcare costs than those without these comorbidities. Using a nationally representative sample of Medicare beneficiaries, we observed a significantly higher clinical and economic burden of patients hospitalized for ACS with comorbid AF and HF compared with those without these conditions.

  16. The affordable care ACT on loyalty programs for federal beneficiaries.

    Science.gov (United States)

    Piacentino, Justin J; Williams, Karl G

    2014-02-01

    To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries. The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed. Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.

  17. Direct observation of Medicaid beneficiary attempts to fill prescriptions for nicotine replacement medications.

    Science.gov (United States)

    Richter, Kimber P; Shergina, Elena; Grodie, Amanda; Massey, Justin K; Ellerbeck, Edward F; Applegate, Amanda; Faseru, Babalola

    2018-04-21

    Although many states have expanded Medicaid coverage of cessation medications, utilization remains low. Anecdotal reports suggest that beneficiaries are at times denied coverage of cessation medications at the pharmacy counter. We conducted an observational community-wide case study of Medicaid beneficiary attempts to fill over-the-counter nicotine replacement therapy at pharmacies. We recruited tobacco-using beneficiaries from a Federally Qualified Health Center, whose providers wrote paper prescriptions for nicotine patches. Study staff escorted beneficiaries to all eligible pharmacies (n = 18) in a Midwestern community to observe fill attempts. Study staff recorded encounters via smartphone into a secure database on a university server. Seven of 18 pharmacies (39%) did not fill the prescription on the day of the attempt. Of these, 6 offered to order the patch for pick-up at a later date. All (4/4) chain pharmacies filled the prescription; 2/3 mass merchant pharmacies failed to fill. Combining successful same-day fills with offers to order for pick-up, 17/18 (94%) would ultimately have been able to obtain patches. This pilot study found that many beneficiaries left pharmacies without a prescription in hand. Successful same-day fills varied markedly by store type. For people with low incomes, transportation presents a major barrier for delayed pick-up. In addition, delays can fuel ambivalence toward quitting. Future research based on this pilot study might address whether patients who fail to secure a same-day prescription ever fill the prescription and, if not, the degree to which this barrier contributes to success or failure in quitting. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  18. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Science.gov (United States)

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  19. Tax system competition – instruments and beneficiaries

    OpenAIRE

    Krzysztof Biernacki

    2014-01-01

    Tax competition among states and jurisdictions has already been examined many times in the economic literature. However, the main scope of the research was focused on a tax rates competition in income taxes and its consequences in bringing direct investments. This scripture/commentary tries to analyze various instruments and beneficiaries of the tax system competition and provide a general overview on this subject.

  20. 29 CFR 4.133 - Beneficiary of contract services.

    Science.gov (United States)

    2010-07-01

    ... service and laundry and dry cleaning service for personnel at military installations. Furthermore, there... 29 Labor 1 2010-07-01 2010-07-01 true Beneficiary of contract services. 4.133 Section 4.133 Labor Office of the Secretary of Labor LABOR STANDARDS FOR FEDERAL SERVICE CONTRACTS Application of the...

  1. Smoking Patterns and Smoking Cessation Willingness—A Study among Beneficiaries of Government Welfare Assistance in Poland

    Directory of Open Access Journals (Sweden)

    Katarzyna Milcarz

    2017-01-01

    Full Text Available This study examines the prevalence and tobacco use patterns among adult social assistance beneficiaries and their interest in quitting. The results are based on data collected in a cross-sectional survey conducted among adults in the Piotrkowski district. A sample of 3636 social assistance beneficiaries produced a total of 1817 respondents who completed face-to-face questionnaires. Overall, 37.1% of the respondents, including 52.8% men and 29.6% women, were current smokers. Over one third of the smokers reported their willingness to quit. In the study population, several characteristics were significantly associated with the current daily smoking: male gender, low educational attainment, unemployment or temporary employment, lack of awareness of smoking-associated health risks, use of e-cigarettes, and exposure to environmental tobacco smoke (ETS. The intention to quit smoking among the daily smokers was positively correlated with their awareness of smoking-associated health risks, lack of previous quit attempts, and low exposure to ETS. Smoking prevalence among social assistance recipients tends to be higher than in the general population, but more than half of the smokers are willing to quit. There is an urgency to develop policies tailored to the needs of these disadvantaged population groups.

  2. Examining differences in characteristics between patients receiving primary care from nurse practitioners or physicians using Medicare Current Beneficiary Survey data and Medicare claims data.

    Science.gov (United States)

    Loresto, Figaro L; Jupiter, Daniel; Kuo, Yong-Fang

    2017-06-01

    Few studies have examined differences in functional, cognitive, and psychological factors between patients utilizing only nurse practitioners (NPs) and those utilizing only primary care medical doctors (PCMDs) for primary care. Patients utilizing NP-only or PCMD-only models for primary care will be characterized and compared in terms of functional, cognitive, and psychological factors. Cohorts were obtained from the Medicare Current Beneficiary Survey linked to Medicare claims data. Weighted analysis was conducted to compare the patients within the two care models in terms of functional, cognitive, and psychological factors. From 2007 to 2013, there was a 170% increase in patients utilizing only NPs for primary care. In terms of health status, patients utilizing only NPs in their primary care were not statistically different from patients utilizing only PCMDs. There is a perception that NPs, as compared with PCMDs, tend to provide care to healthier patients. Our results are contrary to this perception. In terms of health status, NP-only patients are similar to PCMD-only patients. Results of this study may inform research comparing NP-only care and PCMD-only care using Medicare and the utilization of NPs in primary care. ©2017 American Association of Nurse Practitioners.

  3. 45 CFR 205.25 - Eligibility of supplemental security income beneficiaries for food stamps or surplus commodities.

    Science.gov (United States)

    2010-10-01

    ... beneficiaries for food stamps or surplus commodities. 205.25 Section 205.25 Public Welfare Regulations Relating....25 Eligibility of supplemental security income beneficiaries for food stamps or surplus commodities... XVI of the Social Security Act, the State agency shall make the following determinations: (1) The...

  4. 42 CFR 478.40 - Beneficiary's right to a hearing.

    Science.gov (United States)

    2010-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.40 Beneficiary's right to a... under the Hospital Insurance Program, of part 405 of this chapter apply to hearings and appeals under...

  5. The Use of Ambulatory Blood Pressure Monitoring Among Medicare Beneficiaries in 2007-2010

    OpenAIRE

    Shimbo, Daichi; Kent, Shia T; Diaz, Keith M; Huang, Lei; Viera, Anthony J; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    The US Centers for Medicaid and Medicare Services reimburses ambulatory blood pressure monitoring (ABPM) for suspected white coat hypertension. We estimated ABPM use between 2007 and 2010 among a 5% random sample of Medicare beneficiaries (≥ 65 years). In 2007, 2008, 2009 and 2010, the percentage of beneficiaries with ABPM claims was 0.10%, 0.11%, 0.10%, and 0.09% respectively. A prior diagnosis of hypertension was more common among those with versus without an ABPM claim (77.7% versus 47.0%)...

  6. Economic burden of hospitalizations of Medicare beneficiaries with heart failure

    Directory of Open Access Journals (Sweden)

    Kilgore M

    2017-05-01

    Full Text Available Meredith Kilgore,1 Harshali K Patel,2 Adrian Kielhorn,2 Juan F Maya,2 Pradeep Sharma1 1Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 2Amgen, Inc., Thousand Oaks, CA, USA Objective: The objective of this study was to assess the costs associated with the hospitalization and the cumulative 30-, 60-, and 90-day readmission rates in a cohort of Medicare beneficiaries with heart failure (HF.Methods: This was a retrospective, observational study based on data from the national 5% sample of Medicare beneficiaries. Inpatient data were gathered for Medicare beneficiaries with at least one HF-related hospitalization between July 1, 2005, and December 31, 2011. The primary end point was the average per-patient cost of hospitalization for individuals with HF. Secondary end points included the cumulative rate of hospitalization, the average length of hospital stay, and the cumulative 30-, 60-, and 90-day readmission rates.Results: Data from 63,678 patients with a mean age of 81.8 years were included in the analysis. All costs were inflated to $2,015 based on the medical care component of the Consumer Price Index. The mean per-patient cost of an HF-related hospitalization was $14,631. The mean per-patient cost of a cardiovascular (CV-related or all-cause hospitalization was $16,000 and $15,924, respectively. The cumulative rate of all-cause hospitalization was 218.8 admissions per 100 person-years, and the median length of stay for HF-related, CV-related, and all-cause hospitalizations was 5 days. Also, 22.3% of patients were readmitted within 30 days, 33.3% were readmitted within 60 days, and 40.2% were readmitted within 90 days.Conclusion: The costs associated with hospitalization for Medicare beneficiaries with HF are substantial and are compounded by a high rate of readmission. Keywords: heart failure, Medicare, health economics, hospitalization, costs

  7. Correlation between metal-ceramic bond strength and coefficient of linear thermal expansion difference

    Directory of Open Access Journals (Sweden)

    Stella Crosara Lopes

    2009-04-01

    Full Text Available The purpose of this study was to evaluate the metal-ceramic bond strength (MCBS of 6 metal-ceramic pairs (2 Ni-Cr alloys and 1 Pd-Ag alloy with 2 dental ceramics and correlate the MCBS values with the differences between the coefficients of linear thermal expansion (CTEs of the metals and ceramics. Verabond (VB Ni-Cr-Be alloy, Verabond II (VB2, Ni-Cr alloy, Pors-on 4 (P, Pd-Ag alloy, and IPS (I and Duceram (D ceramics were used for the MCBS test and dilatometric test. Forty-eight ceramic rings were built around metallic rods (3.0 mm in diameter and 70.0 mm in length made from the evaluated alloys. The rods were subsequently embedded in gypsum cast in order to perform a tensile load test, which enabled calculating the CMBS. Five specimens (2.0 mm in diameter and 12.0 mm in length of each material were made for the dilatometric test. The chromel-alumel thermocouple required for the test was welded into the metal test specimens and inserted into the ceramics. ANOVA and Tukey's test revealed significant differences (p=0.01 for the MCBS test results (MPa, with PI showing higher MCBS (67.72 than the other pairs, which did not present any significant differences. The CTE (10-6 oC-1 differences were: VBI (0.54, VBD (1.33, VB2I (-0.14, VB2D (0.63, PI (1.84 and PD (2.62. Pearson's correlation test (r=0.17 was performed to evaluate of correlation between MCBS and CTE differences. Within the limitations of this study and based on the obtained results, there was no correlation between MCBS and CTE differences for the evaluated metal-ceramic pairs.

  8. Correlation between metal-ceramic bond strength and coefficient of linear thermal expansion difference.

    Science.gov (United States)

    Lopes, Stella Crosara; Pagnano, Valéria Oliveira; Rollo, João Manuel Domingos de Almeida; Leal, Mônica Barbosa; Bezzon, Osvaldo Luiz

    2009-01-01

    The purpose of this study was to evaluate the metal-ceramic bond strength (MCBS) of 6 metal-ceramic pairs (2 Ni-Cr alloys and 1 Pd-Ag alloy with 2 dental ceramics) and correlate the MCBS values with the differences between the coefficients of linear thermal expansion (CTEs) of the metals and ceramics. Verabond (VB) Ni-Cr-Be alloy, Verabond II (VB2), Ni-Cr alloy, Pors-on 4 (P), Pd-Ag alloy, and IPS (I) and Duceram (D) ceramics were used for the MCBS test and dilatometric test. Forty-eight ceramic rings were built around metallic rods (3.0 mm in diameter and 70.0 mm in length) made from the evaluated alloys. The rods were subsequently embedded in gypsum cast in order to perform a tensile load test, which enabled calculating the CMBS. Five specimens (2.0 mm in diameter and 12.0 mm in length) of each material were made for the dilatometric test. The chromel-alumel thermocouple required for the test was welded into the metal test specimens and inserted into the ceramics. ANOVA and Tukey's test revealed significant differences (p=0.01) for the MCBS test results (MPa), with PI showing higher MCBS (67.72) than the other pairs, which did not present any significant differences. The CTE (10(-6) oC(-1)) differences were: VBI (0.54), VBD (1.33), VB2I (-0.14), VB2D (0.63), PI (1.84) and PD (2.62). Pearson's correlation test (r=0.17) was performed to evaluate of correlation between MCBS and CTE differences. Within the limitations of this study and based on the obtained results, there was no correlation between MCBS and CTE differences for the evaluated metal-ceramic pairs.

  9. Clinical, Ergonomic, and Economic Outcomes With Multichamber Bags Compared With (Hospital) Pharmacy Compounded Bags and Multibottle Systems: A Systematic Literature Review.

    Science.gov (United States)

    Alfonso, Jorge Emilio; Berlana, David; Ukleja, Andrew; Boullata, Joseph

    2017-09-01

    Multichamber bags (MCBs) may offer potential clinical, ergonomic, and economic advantages compared with (hospital) pharmacy compounded bags (COBs) and multibottle systems (MBSs). A systematic literature review was performed to identify and assess the available evidence regarding advantages of MCBs compared with COBs and MBSs. Medline, Embase, the Cochrane Databases, and EconLit were searched for articles reporting clinical, ergonomic, and economic outcomes for MCBs compared with COBs or MBSs. The search was limited to studies conducted in hospitalized patients >2 years of age that were published in English between January 1990 and November 2014. The Population Intervention Comparison Outcomes Study Design (PICOS) framework was used for the analysis. From 1307 unique citations, 74 potentially relevant publications were identified; review of references identified 2 additional publications. Among the 76 publications, 18 published studies met the inclusion criteria. Most were retrospective in design. Ten studies reported clinical outcomes, including 1 prospective randomized trial and multiple retrospective analyses that reported a lower risk of bloodstream infection for MCBs compared with other delivery systems. Sixteen studies reported ergonomic and/or economic outcomes; most reported a potential cost benefit for MCBs, with consistent reports of reduced time and labor compared with other systems. The largest cost benefit was observed in studies evaluating total hospitalization costs. The systematic literature review identified evidence of potential clinical, ergonomic, and economic benefits for MCBs compared with COBs and MBSs; however, methodological factors limited evidence quality. More prospective studies are required to corroborate existing evidence.

  10. Differences between paid and unpaid social services for beneficiaries

    NARCIS (Netherlands)

    Metz, Judith; Roza, Lonneke; Meijs, Lucas; van Baren, Eva; Hoogervorst, Niek

    2017-01-01

    In many Western welfare states, social work services that have traditionally been provided by paid employees are being replaced by family support, community support, informal networks and volunteering. For the field of social work, it is relevant to know what it matters to beneficiaries whether

  11. 42 CFR 412.507 - Limitation on charges to beneficiaries.

    Science.gov (United States)

    2010-10-01

    ... prospective payment system. If Medicare has paid the full LTC-DRG payment, that payment applies to the... SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.507 Limitation on charges to beneficiaries. (a) Prohibited...

  12. Wellbeing of Beneficiaries of the University Based Agricultural ...

    African Journals Online (AJOL)

    E M IGBOKWE

    The possibility of doing this won't be without the efforts of ... Nigeria in different higher institutions of learning have been adopted in different ... of UBAES and ADP are to engage in programmes that will see to the ... 6 months span) and weighted mean was used to rate beneficiaries access to these ... cars, farm size etc.

  13. Micronutrient deficiencies in food aid beneficiaries: A review of ...

    African Journals Online (AJOL)

    African Journal of Food, Agriculture, Nutrition and Development ... in food aid beneficiary populations and to guide the formulation of food aid products, this ... In some cases, food aid rations provide insufficient quantity and quality of ... studies found documenting the nutritional status of non-emergency food aid recipients.

  14. Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Higgins Angela Y

    2012-03-01

    Full Text Available Abstract Background The benefit of screening for decreasing the risk of death from colorectal cancer (CRC has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs vs. internal medicine (internists physicians. Methods Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey. The main outcome was the percentage of patients screened in 2007. We also examined the percentage of patients offered screening. Results Patients of FPs, compared to those of internists, were less likely to have received an FOBT kit or undergone home FOBT, even after accounting for patients' characteristics. Compared to internists, FPs' patients were more likely to have heard of colonoscopy, but were less likely to receive a screening colonoscopy recommendation (18% vs. 27%, or undergo a colonoscopy (43% vs. 46%, adjusted odds ratios [AOR], 95% confidence interval [CI]-- 0.65, 0.51-0.81 or any CRC screening (52% vs. 60%, AOR, CI--0.80, 0.68-0.94. Among subgroups examined, higher income beneficiaries receiving care from internists had the highest screening rate (68%, while disabled beneficiaries receiving care from FPs had the lowest screening rate (34%. Conclusion Patients cared for by FPs had a lower rate of screening compared to those cared for by internists, despite equal or higher levels of awareness; a difference that remained statistically significant after accounting for socioeconomic status and access to healthcare. Both groups of patients remained below the national goal of 70 percent.

  15. Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.

    Science.gov (United States)

    Sharma, Ravi; Lebrun-Harris, Lydie A; Ngo-Metzger, Quyen

    2014-01-01

    Determine the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). Data on elderly fee-for-service beneficiaries across 306 HRRs came from CMS' Geographic Variation in Medicare Spending and Utilization database (2010). We merged data on number of health center patients (HRSA's Uniform Data System) and number of low-income residents (American Community Survey). We estimated access to primary care in each HRR by "health center penetration" (health center patients as a proportion of low-income residents). We calculated total Medicare spending (adjusted for population size, local input prices, and health risk). We assessed clinical quality by preventable hospital admissions, hospital readmissions, and emergency department visits. We sorted HRRs by health center penetration rate and compared spending and quality measures between the high- and low-penetration deciles. We also employed linear regressions to estimate spending and quality measures as a function of health center penetration. The high-penetration decile had 9.7% lower Medicare spending ($926 per capita, p=0.01) than the low-penetration decile, and no different clinical quality outcomes. Compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings. Limited evidence suggests that these savings do not compromise clinical quality.

  16. Variations in Influenza and Pneumonia Immunizations for Medicare Beneficiaries Served by Rural Health Clinics.

    Science.gov (United States)

    Wan, Thomas T H; Lin, Yi-Ling; Ortiz, Judith

    2017-08-01

    The availability of a rural health clinic (RHC) database over the period of 6 years (2008-2013) offers a unique opportunity to examine the trends and patterns of disparities in immunization for influenza and pneumonia among Medicare beneficiaries in the southeastern states. The purpose of this exploratory study was twofold. First, it examined the rural trends and patterns of immunization rates before (2008-2009) and after (2010-2013) the Affordable Care Act (ACA) enactment by state and year. Second, it investigated how contextual, organizational, and aggregate patient characteristics may influence the variations in immunization for influenza and pneumonia of Medicare beneficiaries served by RHCs. Four data sources from federal agencies were merged to perform a longitudinal analysis of the influences of contextual, organizational, and aggregate patient characteristics on the disparities in immunization rates of rural Medicare beneficiaries for influenza and pneumonia. We included both time-varying and time-constant predictors in a multivariate analysis using Generalized Estimating Equation. This study revealed the increased immunization rates for both influenza and pneumonia over a period of 6 years. The ACA had a positive effect on increased immunization rates for pneumonia, but not for influenza, in rural Medicare beneficiaries in the eight states. The RHCs that served more dually-eligible patients had higher immunization rates. For influenza immunization, provider-based RHCs had a higher rate than the independent RHCs. For pneumonia immunization, no organizational variables were relevant in the explanation of the variability. The results also showed that no single dominant factor influenced health care disparities. This investigation suggested further improvements in preventive care are needed to target poor and isolated rural beneficiaries. Furthermore, the integration of immunization data from multiple sources is critically needed for understanding health

  17. 78 FR 59917 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary Sub...

    Science.gov (United States)

    2013-09-30

    ... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... 6002 of the Tax Relief and Health Care Act of 2006 (TRHCA 2006), Public Law 109-432, and section 1... apparel articles wholly assembled in one or more beneficiary sub-Saharan African countries from fabric...

  18. Choice of Personal Assistance Services Providers by Medicare Beneficiaries Using a Consumer-Directed Benefit: Rural-Urban Differences

    Science.gov (United States)

    Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Van Nostrand, Joan F.; Eggert, Gerald M.

    2010-01-01

    Purpose: To examine the impact of an experimental consumer-choice voucher benefit on the selection of independent and agency personal assistance services (PAS) providers among rural and urban Medicare beneficiaries with disabilities. Methods: The Medicare Primary and Consumer-Directed Care Demonstration enrolled 1,605 Medicare beneficiaries in 19…

  19. Changes in health care spending and quality for Medicare beneficiaries associated with a commercial ACO contract.

    Science.gov (United States)

    McWilliams, J Michael; Landon, Bruce E; Chernew, Michael E

    2013-08-28

    In a multipayer system, new payment incentives implemented by one insurer for an accountable care organization (ACO) may also affect spending and quality of care for another insurer's enrollees served by the ACO. Such spillover effects reflect the extent of organizational efforts to reform care delivery and can contribute to the net impact of ACOs. We examined whether the Blue Cross Blue Shield (BCBS) of Massachusetts' Alternative Quality Contract (AQC), an early commercial ACO initiative associated with reduced spending and improved quality for BCBS enrollees, was also associated with changes in spending and quality for Medicare beneficiaries, who were not covered by the AQC. Quasi-experimental comparisons from 2007-2010 of elderly fee-for-service Medicare beneficiaries in Massachusetts (1,761,325 person-years) served by 11 provider organizations entering the AQC in 2009 or 2010 (intervention group) vs beneficiaries served by other providers (control group). Using a difference-in-differences approach, we estimated changes in spending and quality for the intervention group in the first and second years of exposure to the AQC relative to concurrent changes for the control group. Regression and propensity score methods were used to adjust for differences in sociodemographic and clinical characteristics. The primary outcome was total quarterly medical spending per beneficiary. Secondary outcomes included spending by setting and type of service, 5 process measures of quality, potentially avoidable hospitalizations, and 30-day readmissions. Before entering the AQC, total quarterly spending per beneficiary for the intervention group was $150 (95% CI, $25-$274) higher than for the control group and increased at a similar rate. In year 2 of the intervention group's exposure to the AQC, this difference was reduced to $51 (95% CI, -$109 to $210; P = .53), constituting a significant differential change of -$99 (95% CI, -$183 to -$16; P = .02) or a 3.4% savings

  20. A comparative study of mid-day meal beneficiaries and private school attendees

    Directory of Open Access Journals (Sweden)

    Madhavi Bhargava

    2014-12-01

    Full Text Available Background: India is undergoing a rapid demographic transition accompanied by an epidemiologic and nutritional transition. The nutritional status of school-going children who form a major section of the population, can give an indication of the changing trends in nutritional profile of the population. According to Planning Commission report, 2010, Mid Day Meal (MDM Program has been successful in addressing classroom hunger and the objective of social equity in government school attendees. Aims & Objectives: To study the pattern of school lunch intake and nutritional status in private and government school-going children of district Dehradun. Material & Methods: This was an observational cross-sectional study in district Dehradun in government and private schools, with participants from class 1 to 12. A 24-hour dietary recall was done to measure caloric intake. Height and weight were measured using Microtoise (accuracy 0.1cm and digital weighing machine (Omron Model: HN286, accuracy 100 gm. Statistical analysis was done using SPSS, version 22. Nutritional status was classified using WHO cut-offs and analyzed using AnthroPlus Software. Student t-test was used to compare caloric intake of subgroups. Association between nutritional status and other variables was assessed using Chi-squared test. Results: Using WHO cut-offs, the proportion of thin children was 5.4% in private school and 21.5% in MDM beneficiaries of government schools. The proportion of children who were overweight was 27.7% in private schools and 3.6% in government schools (p<.0.05. The caloric content of school lunch was 271 Kcal in private school attendees and 375 Kcal in MDM beneficiaries. Proportion of children who skipped school lunch increased as they progressed in higher classes, and this proportion was greater in students of government schools beyond class VIII. Conclusion: The study highlights the need for more large scale nutritional surveys with school lunch in focus.

  1. 38 CFR 3.666 - Incarcerated beneficiaries and fugitive felons-pension.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Incarcerated beneficiaries and fugitive felons-pension. 3.666 Section 3.666 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  2. 38 CFR 3.714 - Improved pension elections-public assistance beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Improved pension elections-public assistance beneficiaries. 3.714 Section 3.714 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  3. 76 FR 59663 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary Sub...

    Science.gov (United States)

    2011-09-27

    ... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... Acceleration Act of 2004, Pub. L. 108-274; Division D, Title VI, section 6002 of the Tax Relief and Health Care... beneficiary sub-Saharan African countries. Section 112(b)(3) of TDA 2000 provides duty- and quota-free...

  4. The phenomenon of factoring, benefits for beneficiary and national economy

    Directory of Open Access Journals (Sweden)

    Kasavica Petar

    2015-01-01

    Full Text Available The essay encompasses three thematic units focused on the phenomenon of factoring and its benefits for beneficiaries and national economies. In the first part the essay analyses background, concept and participants, types of factoring products, and how factoring functions from the perspective of involved risks. In the second part the essay analyses benefits of factoring for beneficiaries, especially their financial performances and how factoring decreases collection risk and costs of working capital financing. In the third part the essay analyses benefits of factoring for national economies tackling its capabilities to support declining companies and how factoring upgrades macroeconomic figures and features of financial sector. This part explains the way how national economies are organized through international factoring based on two factor systems. The goal of the essay is to pinpoint micro benefits and their impact on macro environment, i.e. national economy.

  5. Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in “At-Risk” HMOs

    Science.gov (United States)

    Eggers, Paul W.; Prihoda, Ronald

    1982-01-01

    The Health Care Financing Administration (HCFA) has initiated several demonstration projects to encourage HMOs to participate in the Medicare program under a risk mechanism. These demonstrations are designed to test innovative marketing techniques, benefit packages, and reimbursement levels. HCFA's current method for prospective payments to HMOs is based on the Adjusted Average Per Capita Cost (AAPCC). An important issue in prospective reimbursement is the extent to which the AAPCC adequately reflects the risk factors which arise out of the selection process of Medicare beneficiaries into HMOs. This study examines the pre-enrollment reimbursement experience of Medicare beneficiaries who enrolled in the demonstration HMOs to determine whether or not a non-random selection process took place. The three demonstration HMOs included in the study are the Fallon Community Health Plan, the Greater Marshfield Community Health Plan, and the Kaiser-Permanente medical program of Portland, Oregon. The study includes 18,085 aged Medicare beneficiaries who had enrolled in the three plans as of April, 1981. We included comparison groups consisting of a 5 percent random sample of aged Medicare beneficiaries (N = 11,240) living in the same geographic areas as the control groups. The study compares the groups by total Medicare reimbursements for the years 1976 through 1979. Adjustments were made for AAPCC factor differences in the groups (age, sex, institutional status, and welfare status). In two of the HMO areas there was evidence of a selection process among the HMOs enrollees. Enrollees in the Fallon and Kaiser health plans were found to have had 20 percent lower Medicare reimbursements than their respective comparison groups in the four years prior to enrollment. This effect was strongest for inpatient services, but a significant difference also existed for use of physician and outpatient services. In the Marshfield HMO there was no statistically significant difference in pre

  6. Characteristics and healthcare utilisation patterns of high-cost beneficiaries in the Netherlands: a cross-sectional claims database study

    NARCIS (Netherlands)

    Wammes, J.J.G.; Tanke, M.A.C.; Jonkers, W.; Westert, G.P.; Wees, P.J. van der; Jeurissen, P.P.T.

    2017-01-01

    OBJECTIVE: To determine medical needs, demographic characteristics and healthcare utilisation patterns of the top 1% and top 2%-5% high-cost beneficiaries in the Netherlands. DESIGN: Cross-sectional study using 1 year claims data. We broke down high-cost beneficiaries by demographics, the most

  7. THE AUDIT OF FINANCIAL STATEMENTS PREPARED BY THE BENEFICIARIES OF EU GRANT

    Directory of Open Access Journals (Sweden)

    Danut Rada

    2013-12-01

    Full Text Available The patrimonial economic entities - public institutions or economic agents, beneficiaries of EU grants, are required to maintain separate accounts situations of the use of these financial resources and also to prepare financial statements in which to be reflected the fees occurred by implementing of projects. The audit of these financial statements is specific and is based on the provisions of international audit standards ISRS 4400 “international standard for related services” and ISAE 3000 “international standard for certification measures”. In some cases, considering the request of the audit beneficiary, can be applied the provisions of ISA 800, International Audit Standard “Special Considerations-Audit of financial statements prepared in accordance with special purpose frameworks”.

  8. 42 CFR 409.42 - Beneficiary qualifications for coverage of services.

    Science.gov (United States)

    2010-10-01

    ... HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital... home health services, a beneficiary must meet each of the following requirements: (a) Confined to the..., management and evaluation of a patient care plan is considered a reasonable and necessary skilled service...

  9. Parkinson’s Disease and Home Healthcare Use and Expenditures among Elderly Medicare Beneficiaries

    Directory of Open Access Journals (Sweden)

    Sandipan Bhattacharjee

    2015-01-01

    Full Text Available This study estimated excess home healthcare use and expenditures among elderly Medicare beneficiaries (age ≥ 65 years with Parkinson’s disease (PD compared to those without PD and analyzed the extent to which predisposing, enabling, need factors, personal health choice, and external environment contribute to the excess home healthcare use and expenditures among individuals with PD. A retrospective, observational, cohort study design using Medicare 5% sample claims for years 2006-2007 was used for this study. Logistic regressions and Ordinary Least Squares regressions were used to assess the association of PD with home health use and expenditures, respectively. Postregression nonlinear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. Elderly Medicare beneficiaries with PD had higher home health use and expenditures compared to those without PD. 27.5% and 18% of the gap in home health use and expenditures, respectively, were explained by differences in characteristics between the PD and no PD groups. A large portion of the differences in home healthcare use and expenditures remained unexplained.

  10. 26 CFR 1.1312-5 - Correlative deductions and inclusions for trusts or estates and legatees, beneficiaries, or heirs.

    Science.gov (United States)

    2010-04-01

    ..., heirs, or legatees; or (4) The exclusion of such amounts from the income of the beneficiaries, heirs, or... invalid the clause directing accumulation and determines that the income is required to be currently... beneficiary's tax for the year 1954, based on the exclusion from 1954 gross income of the capital gains...

  11. 28 CFR 104.52 - Distribution of award to decedent's beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... VICTIM COMPENSATION FUND OF 2001 Payment of Claims § 104.52 Distribution of award to decedent's beneficiaries. The Personal Representative shall distribute the award in a manner consistent with the law of the decedent's domicile or any applicable rulings made by a court of competent jurisdiction. The Personal...

  12. Study and Redefining Beneficiary Participation in Process Of House Design

    Directory of Open Access Journals (Sweden)

    Monshizadeh Morteza

    2016-01-01

    Full Text Available Since housing has a special place in human life and his physical, psychological and interactions, so in addition the unity of humans, multiplicity and diversity of them must be considered. This possible only by beneficiary participation in the design process, but because society has different economic and social texture and classes; and settling suit because of the time and place of special indexes are entitled, so prepare a comprehensive model includes the testimony and circumstances; identify factors influencing participation optimum need to selection population and certain species of private construction. Standard tool to study topic does not exist, so in order to produce tools using qualitative research methods; interpretation - historical correlation to extract components and variables and their effects on each other and enjoyed target table Content consisting of four domains of general knowledge - specialized knowledge of participation - participation mechanisms and factors influencing participation achieved. Extracted factors are: the initial formation of partnership - partnership executive process - the role of participant - optimal participation; by study and analyze the theoretical model. Due to history and social aspects; cultural participation in Shiraz; promote scientific and participatory approach designed to make operating housing; bed and new horizons of development of facilities and areas in the design of residential environment created and due consultation and decision making in addition to beneficiary participation to promote optimum utility of space; mutual flexibility and utilization of space; increase fixation and motivation will lead beneficiary reside” and the main question: “how is the model of scientific position optimal participation planning instrument in private housing in the city of Shiraz, in the process of design, implementation and use”.

  13. 20 CFR 411.566 - May an EN use outcome or milestone payments to make payments to the beneficiary?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false May an EN use outcome or milestone payments... an EN use outcome or milestone payments to make payments to the beneficiary? Yes, an EN may use milestone or outcome payments to make payments to a beneficiary. [73 FR 29350, May 20, 2008] ...

  14. Barriers to Employment Among Social Security Disability Insurance Beneficiaries in the Mental Health Treatment Study.

    Science.gov (United States)

    Milfort, Roline; Bond, Gary R; McGurk, Susan R; Drake, Robert E

    2015-12-01

    This study examined barriers to employment among Social Security Disability Insurance (SSDI) beneficiaries who received comprehensive vocational and mental health services but were not successful in returning to work. This study examined barriers to employment among 430 SSDI beneficiaries with mental disorders who received evidence-based vocational and mental health services for two years but worked less than one month or not at all. Comprehensive care teams, which included employment specialists, made consensus judgments for each participant, identifying the top three barriers to employment from a checklist of 14 common barriers. Teams most frequently identified three barriers to employment: poorly controlled symptoms of mental illness (55%), nonengagement in supported employment (44%), and poorly controlled general medical problems (33%). Other factors were identified much less frequently. Some SSDI beneficiaries, despite having access to comprehensive services, continued to experience psychiatric impairments, difficulty engaging in vocational services, and general medical problems that limited their success in employment.

  15. Body Pain Reporting in Tricare Eligible Beneficiaries with Orofacial Pain

    Science.gov (United States)

    2015-06-01

    provider performed a standard orofacial pain clinical examination. This included at a minimum a cranial nerve exam, shoulder and cervical range of...Attachment 2 Date The author hereby certifies that the use of any copyrighted material in the thesis manuscript entitled: Body pain reporting in...Tricare eligible beneficiaries with orofacial pain

  16. Chronic Disease Prevalence and Medicare Advantage Market Penetration: Findings From the Medical Expenditure Panel Survey.

    Science.gov (United States)

    Howard, Steven W; Bernell, Stephanie Lazarus; Casim, Faizan M; Wilmott, Jennifer; Pearson, Lindsey; Byler, Caitlin M; Zhang, Zidong

    2015-01-01

    By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary's portfolio of cardiometabolic diagnoses. This study uses 2004 to 2008 Medical Expenditure Panel Survey (MEPS) Household Component data to construct an aggregate index that captures multiple diagnoses in one outcome measure (Chronic Disease Severity Index [CDSI]). The MEPS data for 8089 Medicare beneficiaries are merged with MA market penetration data from Centers for Medicare and Medicaid Services (CMS). Ordinary least squares regressions are run with SAS 9.3 to model the effects of MA market penetration on CDSI. The results suggest that each percentage increase in MA market penetration is associated with a greater than 2-point decline in CDSI (lower burden of cardiometabolic chronic disease). Spill-over effects may be driving improvements in the cardiometabolic health of beneficiary populations in counties with elevated levels of MA market penetration.

  17. Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries.

    Science.gov (United States)

    Weeks, William B; Goertz, Christine M

    2016-05-01

    The purpose of this study was to determine whether the per-capita supply of doctors of chiropractic (DCs) or Medicare spending on chiropractic care was associated with opioid use among younger, disabled Medicare beneficiaries. Using 2011 data, at the hospital referral region level, we correlated the per-capita supply of DCs and spending on chiropractic manipulative therapy (CMT) with several measures of per-capita opioid use by younger, disabled Medicare beneficiaries. Per-capita supply of DCs and spending on CMT were strongly inversely correlated with the percentage of younger Medicare beneficiaries who had at least 1, as well as with 6 or more, opioid prescription fills. Neither measure was correlated with mean daily morphine equivalents per opioid user or per chronic opioid user. A higher per-capita supply of DCs and Medicare spending on CMT were inversely associated with younger, disabled Medicare beneficiaries obtaining an opioid prescription. However, neither measure was associated with opioid dosage among patients who obtained opioid prescriptions. Copyright © 2016. Published by Elsevier Inc.

  18. Favorable Risk Selection in Medicare Advantage: Trends in Mortality and Plan Exits Among Nursing Home Beneficiaries

    Science.gov (United States)

    Goldberg, Elizabeth M.; Trivedi, Amal N.; Mor, Vincent; Jung, Hye-Young; Rahman, Momotazur

    2016-01-01

    The 2003 Medicare Modernization Act (MMA) increased payments to Medicare Advantage plans and instituted a new risk-adjustment payment model to reduce plans' incentives to enroll healthier Medicare beneficiaries and avoid those with higher costs. Whether the MMA reduced risk selection remains debatable. This study uses mortality differences, nursing home utilization, and switch rates to assess whether the MMA successfully decreased risk selection from 2000 to 2012. We found no decrease in the mortality difference or adjusted difference in nursing home use between plan beneficiaries pre- and post the MMA. Among beneficiaries with nursing home use, disenrollment from Medicare Advantage plans declined from 20% to 12%, but it remained 6 times higher than the switch rate from traditional Medicare to Medicare Advantage. These findings suggest that the MMA was not associated with reductions in favorable risk selection, as measured by mortality, nursing home use, and switch rates. PMID:27516452

  19. Prevalence and Geographic Variations of Polypharmacy Among West Virginia Medicaid Beneficiaries.

    Science.gov (United States)

    Feng, Xue; Tan, Xi; Riley, Brittany; Zheng, Tianyu; Bias, Thomas K; Becker, James B; Sambamoorthi, Usha

    2017-11-01

    West Virginia (WV) residents are at high risk for polypharmacy given its considerable chronic disease burdens. To evaluate the prevalence, correlates, outcomes, and geographic variations of polypharmacy among WV Medicaid beneficiaries. In this cross-sectional study, we analyzed 2009-2010 WV Medicaid fee-for-service (FFS) claims data for adults aged 18-64 (N=37,570). We defined polypharmacy as simultaneous use of drugs from five or more different drug classes on a daily basis for at least 60 consecutive days in one year. Multilevel logistic regression was used to explore the individual- and county-level factors associated with polypharmacy. Its relationship with healthcare utilization was assessed using negative binomial regression and logistic regression. The univariate local indicators of spatial association method was applied to explore spatial patterns of polypharmacy in WV. The prevalence of polypharmacy among WV Medicaid beneficiaries was 44.6%. High-high clusters of polypharmacy were identified in southern WV, indicating counties with above-average prevalence surrounded by counties with above-average prevalence. Polypharmacy was associated with being older, female, eligible for Medicaid due to cash assistance or medical eligibility, having any chronic conditions or more chronic conditions, and living in a county with lower levels of education. Polypharmacy was associated with more hospitalizations, emergency department visits, and outpatient visits, as well as higher non-drug medical expenditures. Polypharmacy was prevalent among WV Medicaid beneficiaries and was associated with substantial healthcare utilization and expenditures. The clustering of high prevalence of polypharmacy in southern WV may suggest targeted strategies to reduce polypharmacy burden in these areas.

  20. 20 CFR 10.17 - Is a beneficiary who defrauds the Government in connection with a claim for benefits still...

    Science.gov (United States)

    2010-04-01

    ... connection with a claim for benefits, the beneficiary's entitlement to any further compensation benefits will... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Is a beneficiary who defrauds the Government in connection with a claim for benefits still entitled to those benefits? 10.17 Section 10.17...

  1. ESMO-Magnitude of Clinical Benefit Scale version 1.1

    NARCIS (Netherlands)

    Cherny, N. I.; Dafni, U.; Bogaerts, J.; Latino, N. J.; Pentheroudakis, G.; Douillard, J. -Y.; Tabernero, J.; Zielinski, C.; Piccart, M. J.; de Vries, E. G. E.

    2017-01-01

    Background: The ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) version 1.0 (v1.0) was published in May 2015 and was the first version of a validated and reproducible tool to assess the magnitude of clinical benefit from new cancer therapies. The ESMO-MCBS was designed to be a dynamic tool with

  2. Cross-Linguistic Variation in the Treatment of Beneficiaries and the Argument vs. Adjunct Distinction

    Directory of Open Access Journals (Sweden)

    Denis Creissels

    2014-01-01

    Full Text Available This paper compares the expression of beneficiaries with that of typical arguments and typical adjuncts in a sample of languages illustrating the variation in the extent to which NPs encoding beneficiaries show a syntactic behavior more or less similar to that of typical arguments or typical adjuncts. The observations support the position according to which semantic argumenthood as a comparative concept must be distinguished from its possible syntactic correlates, and must be defined as a scalar rather than categorical concept reflecting the interaction between the various factors that may contribute to defining the degree of involvement of participants in an event.

  3. Understanding the increase in the number of childbirth-related leave beneficiaries in Serbia

    Directory of Open Access Journals (Sweden)

    Stanić Katarina

    2017-01-01

    Full Text Available Over the past number of years, the public expenditures for childbirth-related leave benefits have more than doubled – in 2015 amounted to 0.7% GDP in relation to 0.3% GDP in 2002. This increase can mainly be attributed to the increased number of beneficiaries that grew consistently from 24 thousand in 2002 up to 40 thousand in 2015, despite the fact that the annual number of live births has been almost continually decreasing and the registered employment has dropped by almost 20 per cent in the observed period. One of the clear reasons explaining part of this increase is the extension of 3+ order of birth leaves in 2006, from one to two years, which can explain the increase of around 3.5 thousand of beneficiaries. Another reason is high number of beneficiaries using special child-care leave meant for parents with children with disabilities, but which, in reality, is very often used simply as the extension of parental leave. The average number of special child-care leave beneficiaries in the second half of 2015 amounted to 2.8 thousand. When these two effects are taken into account, we still notice significant increase of beneficiaries of around 10 thousand in the observed period. Fictitious employment during the pregnancy can explain this increase to some extent. Available data unambiguously show that a number of women formally employing during the second and third trimester of pregnancy has increased from 800 in 2002 to almost 3.5 thousand monthly average in the second half of 2015. There are two flaws of the childbirth-related leave programme in Serbia, which together lead to the constant increase of the number of beneficiaries. First is the lack of flexibility of the programme, both in terms of eligibility for acquiring the right as well as in terms of flexibility in use. Maternity/parental leave benefit may acquire only those in „standard employment” i.e. employed under employment contract (and entrepreneurs while other type of

  4. A Marketing Assessment of Beneficiaries at Kimbrough Army Community Hospital

    Science.gov (United States)

    1993-05-01

    environment, organizational goal formulation, strategy formulation, Marketing Assessment 10 organization and systems design ( Kotler , 1987). Second...environmental analysis itself is concerned with identifying marketing opportunities, threats, environmental trends and their implications ( Kotler , 1987...decision to develop beneficiary subgroups was based on the marketing principle of market segmentation which assumes that no one strategy will work for

  5. Knowledge, awareness, and utilization pattern of services under Janani Suraksha Yojana among beneficiaries in rural area of Himachal Pradesh

    Directory of Open Access Journals (Sweden)

    Prem Lal Chauhan

    2015-01-01

    Full Text Available Introduction: Safe motherhood is perceived as a human right, and the health sector is always encouraged to provide quality services to ensure the same. Government of India launched a scheme called Janani Suraksha Yojana (JSY on April 11, 2005, under the flagship of National Rural Health Mission to reduce maternal and neonatal mortality, by promoting institutional deliveries for which financial incentives are provided to mothers delivering in the health facilities. Objective: To study the knowledge, awareness, and utilization pattern of services under JSY among the beneficiaries in rural area of Shimla, Himachal Pradesh, India. Materials and Methods: This cross-sectional study was conducted among the 78 JSY beneficiaries residing in the rural field practice area of Indira Gandhi Medical College Shimla, Himachal Pradesh, India. These beneficiaries were interviewed with pretested, predesigned, semi-structured close ended questionnaire by house-to-house visits, after obtaining informed consent. Results: Majority of the JSY beneficiaries (50; 64% were in the age group of 20–25 years and 43 (55.1% of them heard about the JSY scheme before the present pregnancy. Anganwadi workers 78 (100% and female health workers (62; 79.5% were the main sources of information. More than half of the study participants (44; 56% had good knowledge about the scheme and 42 (53.85% registered their name in health institution during thefirst trimester of last pregnancy. Forty-four (56.4% beneficiaries had undergone three antenatal checkups and only 11 (14.1% of them received three postnatal (PN visits. All the beneficiaries received the JSY incentives 1-week the following delivery. Conclusions: Awareness regarding the JSY scheme, early antenatal registration, minimum three antenatal care visits, and three PN visits is still low among rural women which needs strengthening through intensification of IEC activities.

  6. 19 CFR 10.26 - Articles assembled or processed in a beneficiary country in whole of U.S. components or...

    Science.gov (United States)

    2010-04-01

    ..., material, ingredient, or article remained under the control of the customs authority of the non-beneficiary... 19 Customs Duties 1 2010-04-01 2010-04-01 false Articles assembled or processed in a beneficiary... textile components cut to shape in the United States. 10.26 Section 10.26 Customs Duties U.S. CUSTOMS AND...

  7. Medicare hospital spending per patient (Medicare Spending per Beneficiary) – Additional Decimal Places

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  8. Nonemergency medical transportation and health care visits among chronically ill urban and rural medicaid beneficiaries.

    Science.gov (United States)

    Thomas, Leela V; Wedel, Kenneth R

    2014-01-01

    Inaccessibility to health care services due to lack of transportation affects the most vulnerable segments of the society. The effect of Medicaid-provided nonemergency medical transportation (NEMT) in Oklahoma on health care visits for the management of chronic illnesses is examined. Analyses of claims data show that African Americans are the highest users of NEMT. Medicaid beneficiaries who use NEMT services are significantly more likely to make the recommended number of annual visits for the management of chronic conditions than those who do not use NEMT. Increased use of NEMT by making the services more accommodating and convenient for beneficiaries is proposed.

  9. The Expanded Public Works Programme: Perspectives of direct beneficiaries

    Directory of Open Access Journals (Sweden)

    Mondli S. Hlatshwayo

    2017-09-01

    Full Text Available Scholarship on the Expanded Public Works Programme (EPWP in South Africa tends to focus on quantitative evaluation to measure the progress made in the implementation of EPWP projects. The number of employment opportunities created by EPWP, demographic profiling, skills acquired by beneficiaries and training opportunities related to the Programme form the basis of typical statistical evaluations of it, but exclude comment by the workers who participate in its projects. Based on primary sources, including in-depth interviews, newspaper reports and internet sources, this article seeks to provide a qualitative review of the EPWP from the perspective of the beneficiaries of municipal EPWP projects. Various South African government sectors hire EPWP workers to provide local services such as cleaning and maintaining infrastructure, but the employment of these workers can still be regarded as precarious, in the sense that they have no job security, earn low wages and have no benefits such as medical aid or pension fund. The interviewees indicated that, although they appreciate the temporary employment opportunities provided by the EPWP, they also experience health and safety risks and lack the advantages of organised labour groupings. Their main disadvantage, however, is that they cannot access permanent employment, which offers better wages and concomitant benefits.

  10. 42 CFR 405.1205 - Notifying beneficiaries of hospital discharge appeal rights.

    Science.gov (United States)

    2010-10-01

    ...” is defined as any facility providing care at the inpatient hospital level, whether that care is short... basis, limited to specialty care or providing a broader spectrum of services. This definition includes... beneficiary refuses to sign the notice. The hospital may annotate its notice to indicate the refusal, and the...

  11. The Expanded Public Works Programme: Perspectives of direct beneficiaries

    OpenAIRE

    Mondli S. Hlatshwayo

    2017-01-01

    Scholarship on the Expanded Public Works Programme (EPWP) in South Africa tends to focus on quantitative evaluation to measure the progress made in the implementation of EPWP projects. The number of employment opportunities created by EPWP, demographic profiling, skills acquired by beneficiaries and training opportunities related to the Programme form the basis of typical statistical evaluations of it, but exclude comment by the workers who participate in its projects. Based on primary source...

  12. Innovative care models for high-cost Medicare beneficiaries: delivery system and payment reform to accelerate adoption.

    Science.gov (United States)

    Davis, Karen; Buttorff, Christine; Leff, Bruce; Samus, Quincy M; Szanton, Sarah; Wolff, Jennifer L; Bandeali, Farhan

    2015-05-01

    About a third of Medicare beneficiaries are covered by Medicare Advantage (MA) plans or accountable care organizations (ACOs). As a result of assuming financial risk for Medicare services and/or being eligible for shared savings, these organizations have an incentive to adopt models of delivering care that contribute to better care, improved health outcomes, and lower cost. This paper identifies innovative care models across the care continuum for high-cost Medicare beneficiaries that MA plans and ACOs could adopt to improve care while potentially achieving savings. It suggests policy changes that would accelerate testing and spread of promising care delivery model innovations. Targeted review of the literature to identify care delivery models focused on high-cost or high-risk Medicare beneficiaries. This paper presents select delivery models for high-risk Medicare beneficiaries across the care continuum that show promise of yielding better care at lower cost that could be considered for adoption by MA plans and ACOs. Common to these models are elements of the Wagner Chronic Care Model, including practice redesign to incorporate a team approach to care, the inclusion of nonmedical personnel, efforts to promote patient engagement, supporting provider education on innovations,and information systems allowing feedback of information to providers. The goal of these models is to slow the progression to long-term care, reduce health risks, and minimize adverse health impacts, all while achieving savings.These models attempt to maintain the ability of high-risk individuals to live in the home or a community-based setting, thereby avoiding costly institutional care. Identifying and implementing promising care delivery models will become increasingly important in launching successful population health initiatives. MA plans and ACOs stand to benefit financially from adopting care delivery models for high-risk Medicare beneficiaries that reduce hospitalization. Spreading

  13. Comparing Hospital Processes and Outcomes in California Medicare Beneficiaries: Simulation Prompts Reconsideration.

    Science.gov (United States)

    Escobar, Gabriel J; Baker, Jennifer M; Turk, Benjamin J; Draper, David; Liu, Vincent; Kipnis, Patricia

    2017-01-01

    This article is not a traditional research report. It describes how conducting a specific set of benchmarking analyses led us to broader reflections on hospital benchmarking. We reexamined an issue that has received far less attention from researchers than in the past: How variations in the hospital admission threshold might affect hospital rankings. Considering this threshold made us reconsider what benchmarking is and what future benchmarking studies might be like. Although we recognize that some of our assertions are speculative, they are based on our reading of the literature and previous and ongoing data analyses being conducted in our research unit. We describe the benchmarking analyses that led to these reflections. The Centers for Medicare and Medicaid Services' Hospital Compare Web site includes data on fee-for-service Medicare beneficiaries but does not control for severity of illness, which requires physiologic data now available in most electronic medical records.To address this limitation, we compared hospital processes and outcomes among Kaiser Permanente Northern California's (KPNC) Medicare Advantage beneficiaries and non-KPNC California Medicare beneficiaries between 2009 and 2010. We assigned a simulated severity of illness measure to each record and explored the effect of having the additional information on outcomes. We found that if the admission severity of illness in non-KPNC hospitals increased, KPNC hospitals' mortality performance would appear worse; conversely, if admission severity at non-KPNC hospitals' decreased, KPNC hospitals' performance would appear better. Future hospital benchmarking should consider the impact of variation in admission thresholds.

  14. Impact of HIV Infection on Medicare Beneficiaries with Lung Cancer

    International Nuclear Information System (INIS)

    Lee, J. Y.; Moore, P. C.; Lensing, S. Y.

    2012-01-01

    The incidence of lung cancer among individuals infected with the human immunodeficiency virus (HIV) is elevated compared to that among the general population. This study examines the prevalence of HIV and its impact on outcomes among Medicare beneficiaries who are 65 years of age or older and were diagnosed with non small cell lung cancer (NSCLC) between 1997 and 2008. Prevalence of HIV was estimated using the Poisson point estimate and its 95% confidence interval. Relative risks for potential risk factors were estimated using the log-binomial model. A total of 111,219 Medicare beneficiaries met the study criteria. The prevalence of HIV was 156.4 per 100,000 (95% CI: 140.8 to 173.8) and has increased with time. Stage at NSCLC diagnosis did not vary by HIV status. Mortality rates due to all causes were 44%, 76%, and 88% for patients with stage I/II, III, and IV NSCLC, respectively. Across stages of disease, there was no difference between those who were HIV-infected and those who were not with respect to overall mortality. HIV patients, however, were more likely to die of causes other than lung cancer than their immunocompetent counterparts.

  15. 78 FR 36035 - Proposed Information Collection Activity: [Beneficiary Travel Mileage Reimbursement Application...

    Science.gov (United States)

    2013-06-14

    ... provided for their convenience. This collection of information is necessary to enable the VHA to provide... online through FDMS. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor at (202) 461-5870 or Fax (202... use of other forms of information technology. Titles: Beneficiary Travel Mileage Reimbursement...

  16. The Final Beneficiaries are Actors Active Little and Influential in Decisions on Public Policy in Brazil

    Directory of Open Access Journals (Sweden)

    Diolina Rodrigues Santiago Silva

    2016-10-01

    Full Text Available Public policies are government programs that directly influence the citizens' lives. In the formulation and implementation of these policies, there is the presence of political and private actors. The final beneficiaries are between different types of private actors. Some laws require the government listen to society at the time of decision-making in public policy and in national conferences and public consultations. The final beneficiaries, actual users of these public policies have to reach some mechanisms of direct participation in the formulation of these policies, but the number of participants is smaller and doesn't influence in making government decisions.

  17. Potential Beneficiaries of the Obama Administration’s Executive Action Programs Deeply Embedded in US Society

    Directory of Open Access Journals (Sweden)

    Donald Kerwin

    2016-03-01

    Full Text Available The Obama administration has developed two broad programs to defer immigration enforcement actions against undocumented persons living in the United States: (1 Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA; and (2 Deferred Action for Childhood Arrivals (DACA. The DACA program, which began in August 2012, was expanded on November 20, 2014. DAPA and the DACA expansion (hereinafter referred to as “DACA-plus” are currently under review by the US Supreme Court and subject to an active injunction.This paper offers a statistical portrait of the intended direct beneficiaries of DAPA, DACA, and DACA-plus. It finds that potential DAPA, DACA, and DACA-plus recipients are deeply embedded in US society, with high employment rates, extensive US family ties, long tenure, and substantial rates of English-language proficiency. The paper also notes various groups that would benefit indirectly from the full implementation of DAPA and DACA or, conversely, would suffer from the removal of potential beneficiaries of these programs. For example, all those who would rely on the retirement programs of the US government will benefit from the high employment rates and relative youth of the DACA population, while many US citizens who rely on the income of a DAPA-eligible parent would fall into poverty or extreme poverty should that parent be removed from the United States.This paper offers an analysis of potential DAPA and DACA beneficiaries. In an earlier study, the authors made the case for immigration reform based on long-term trends related to the US undocumented population, including potential DAPA and DACA beneficiaries (Warren and Kerwin 2015. By contrast, this paper details the degree to which these populations have become embedded in US society. It also compares persons eligible for the original DACA program with those eligible for DACA-plus.As stated, the great majority of potential DAPA and DACA recipients enjoy strong family

  18. Knowledge of Precision Farming Beneficiaries

    Directory of Open Access Journals (Sweden)

    A.V. Greena

    2016-05-01

    Full Text Available Precision Farming is one of the many advanced farming practices that make production more efficient by better resource management and reducing wastage. TN-IAMWARM is a world bank funded project aims to improve the farm productivity and income through better water management. The present study was carried out in Kambainallur sub basin of Dharmapuri district with 120 TN-IAMWARM beneficiaries as respondents. The result indicated that more than three fourth (76.67 % of the respondents had high level of knowledge on precision farming technologies which was made possible by the implementation of TN-IAMWARM project. The study further revealed that educational status, occupational status and exposure to agricultural messages had a positive and significant contribution to the knowledge level of the respondents at 0.01 level of probability whereas experience in precision farming and social participation had a positive and significant contribution at 0.05 level of probability.

  19. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all outcome months? 411.555 Section 411.555 Employees... Payment Systems § 411.555 Can the EN keep the milestone and outcome payments even if the beneficiary does...

  20. States With Medically Needy Pathways: Differences in Long-Term and Temporary Medicaid Entry for Low-Income Medicare Beneficiaries.

    Science.gov (United States)

    Keohane, Laura M; Trivedi, Amal; Mor, Vincent

    2017-10-01

    Medically needy pathways may provide temporary catastrophic coverage for low-income Medicare beneficiaries who do not otherwise qualify for full Medicaid benefits. Between January 2009 and June 2010, states with medically needy pathways had a higher percentage of low-income beneficiaries join Medicaid than states without such programs (7.5% vs. 4.1%, p < .01). However, among new full Medicaid participants, living in a state with a medically needy pathway was associated with a 3.8 percentage point (adjusted 95% confidence interval [1.8, 5.8]) increase in the probability of switching to partial Medicaid and a 4.5 percentage point (adjusted 95% confidence interval [2.9, 6.2]) increase in the probability of exiting Medicaid within 12 months. The predicted risk of leaving Medicaid was greatest when new Medicaid participants used only hospital services, rather than nursing home services, in their first month of Medicaid benefits. Alternative strategies for protecting low-income Medicare beneficiaries' access to care could provide more stable coverage.

  1. Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders

    Directory of Open Access Journals (Sweden)

    Kit Sang Leung

    2015-01-01

    Conclusions: Substance use disorder is statistically associated with hospitalizations for most Ambulatory Care Sensitive Conditions but not with length of hospital stay for Ambulatory Care Sensitive Conditions, after adjusting for covariates. The significant associations between substance use disorder and Ambulatory Care Sensitive Condition admissions suggest unmet primary health care needs for substance use disorder beneficiaries and a need for integrated primary/behavioral healthcare.

  2. A multisite randomized controlled trial on time to self-support among sickness absence beneficiaries

    DEFF Research Database (Denmark)

    Nielsen, Maj Britt D.; Vinsløv Hansen, Jørgen; Aust, Birgit

    2015-01-01

    BACKGROUND: In 2010, the Danish Government launched the Danish national return-to-work (RTW) programme to reduce sickness absence and promote labour market attainment. Multidisciplinary teams delivered the RTW programme, which comprised a coordinated, tailored and multidisciplinary effort (CTM......) for sickness absence beneficiaries at high risk for exclusion from the labour market. The aim of this article was to evaluate the effectiveness of the RTW programme on self-support. METHODS: Beneficiaries from three municipalities (denoted M1, M2 and M3) participated in a randomized controlled trial. We.......54-0.95). In M1, we found no difference between the two groups (HR = 0.99, 95% CI: 0.84-1.17). CONCLUSION: The effect of the CTM programme on return to self-support differed substantially across the three participating municipalities. Thus, generalizing the study results to other Danish municipalities...

  3. 26 CFR 1.673(c)-1 - Reversionary interest after income beneficiary's death.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Reversionary interest after income beneficiary's death. 1.673(c)-1 Section 1.673(c)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Grantors and Others Treated As Substantial Owners § 1.673(c)-1 Reversionary interest after...

  4. Medication adherence and Medicare expenditure among beneficiaries with heart failure.

    Science.gov (United States)

    Lopert, Ruth; Shoemaker, J Samantha; Davidoff, Amy; Shaffer, Thomas; Abdulhalim, Abdulla M; Lloyd, Jennifer; Stuart, Bruce

    2012-09-01

    To (1) measure utilization of and adherence to heart failure medications and (2) assess whether better adherence is associated with lower Medicare spending. Pooled cross-sectional design using six 3-year cohorts of Medicare beneficiaries with congestive heart failure (CHF) from 1997 through 2005 (N = 2204). Adherence to treatment was measured using average daily pill counts. Bivariate and multivariate methods were used to examine the relationship between medication adherence and Medicare spending. Multivariate analyses included extensive variables to control for confounding, including healthy adherer bias. Approximately 58% of the cohort were taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), 72% a diuretic, 37% a beta-blocker, and 34% a cardiac glycoside. Unadjusted results showed that a 10% increase in average daily pill count for ACE inhibitors or ARBs, beta-blockers, diuretics, or cardiac glycosides was associated with reductions in Medicare spending of $508 (not significant [NS]), $608 (NS), $250 (NS), and $1244 (P <.05), respectively. Estimated adjusted marginal effects of a 10% increase in daily pill counts for beta-blockers and cardiac glycosides were reductions in cumulative 3-year Medicare spending of $510 to $561 and $750 to $923, respectively (P <.05). Higher levels of medication adherence among Medicare beneficiaries with CHF were associated with lower cumulative Medicare spending over 3 years, with savings generally exceeding the costs of the drugs in question.

  5. Ranking hospitals for outcomes in total hip replacement - administrative data with or without patient surveys? - Part 2: Patient survey and administrative data

    Directory of Open Access Journals (Sweden)

    Schäfer, Thomas

    2007-03-01

    Full Text Available Background: Many hospital rankings rely on the frequency of adverse outcomes and are based on administrative data. In the study presented here, we tried to find out, to what extent available administrative data of German Sickness Funds allow for an adequate hospital ranking and compared this with rankings based on additional information derived from a patient survey. Total hip replacement was chosen as an example procedure. In part II of the publication, we present the results of the approach based on administrative and patient-derived data. Methods: We used administrative data from a large health insurance (AOK-Lower Saxony of the year 2002 and from a patient survey. The study population comprised mainly beneficiaries, who received primary total hip replacement in the year 2002, were mailed a survey 6 month post-operatively and participated in the survey. Performance indicators used where “Revision”, “Complications” and “Change of functional impairment”. Hospitals were ranked if they performed at least 20 procedures on AOK-beneficiaries. Multivariate modelling (logistic regression and generalized linear models was used to estimate the performance indicators by case-mix variables (a.o. age, sex, co-morbidity, medical history and hospital characteristics (hospital size, surgical volume. The actual ranking was based on these multivariate models, excluding hospital variables and adding dummy-variables for each hospital. Hospitals were ranked by their case-mix adjusted odds ratio or Standardized Difference (SDR with respect to a pre-selected reference hospital. The resulting rankings were compared with each other and with regard to the impact of case-mix variables. Results: 4089 beneficiaries received primary total hip replacement in 2002. 3293 patients participated in the survey (80.5%. The ranking included 60 hospitals. The agreement of rankings based on different performance indicators in the same year was low to high (a correlation

  6. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    Science.gov (United States)

    2010-06-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act Medicare...

  7. Risk factors for dementia after critical illness in elderly medicare beneficiaries

    OpenAIRE

    Guerra, Carmen; Linde-Zwirble, Walter T; Wunsch, Hannah

    2012-01-01

    Introduction Hospitalization increases the risk of a subsequent diagnosis of dementia. We aimed to identify diagnoses or events during a hospitalization requiring critical care that are associated with a subsequent dementia diagnosis in the elderly. Methods A cohort study of a random 5% sample of Medicare beneficiaries who received intensive care in 2005 and survived to hospital discharge, with three years of follow-up (through 2008) was conducted using Medicare claims files. We defined demen...

  8. Report on the Biodigester User Survey 2008

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, U.W.; Jordan, A.

    2008-07-15

    Since April 2006, the Ministry of Agriculture, Forestry and Fisheries of the Kingdom of Cambodia (MAFF) and The Netherlands Development Organisation (SNV) are cooperating in the implementation of a National Biodigester Programme (NBP), the overall objective of which is 'the dissemination of domestic biodigesters as an indigenous, sustainable energy source through the development of a commercial, market oriented, biodigester sector in selected provinces of Cambodia'. In order to assess the socio-economic structure of beneficiary households, and reception, acceptance and impact of biodigesters, the Programme, which is currently operational in seven provinces, commissioned a Biodigester User Survey (BUS). The survey was carried out in March 2008 (including enumerator training, field testing and data entry), and data processing and reporting took place in April 2008.

  9. 78 FR 78342 - Extension of Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended...

    Science.gov (United States)

    2013-12-26

    ... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Autism Services Demonstration Project... (the Department) Enhanced Access to Autism Services Demonstration Project (Autism Demonstration) under the Extended Care Health Option (ECHO) for beneficiaries diagnosed with an Autism Spectrum Disorder...

  10. Affiliation of the beneficiaries of a deferred pension to the CERN Health Insurance Scheme

    CERN Multimedia

    2003-01-01

    Subsequent to the modifications to the Rules and Regulations of the Pension Fund allowing members of the personnel having five years of affiliation to the Fund to opt for a deferred retirement pension, the Organization wishes to recall the rules relating to the affiliation of those beneficiaries to the CERN Health Insurance Scheme (CHIS). In accordance with Articles III 2.02 and VIII 4.02 of the CHIS Rules, beneficiaries of a deferred retirement pension can only be Members of the CHIS as CERN pensioners if they applied to remain Members of the Scheme upon termination of their compulsory membership as a member of the personnel and if their membership has been uninterrupted up to the moment they become CERN pensioners. The applicable contribution for this intermediate period is indicated in Articles III 5.03 and X 1.02 of the CHIS Rules. The amount is revised annually, and is set at 936 CHF/ month for 2003. Human Resources Division Tel. 73635

  11. Offering lung cancer screening to high-risk medicare beneficiaries saves lives and is cost-effective: an actuarial analysis.

    Science.gov (United States)

    Pyenson, Bruce S; Henschke, Claudia I; Yankelevitz, David F; Yip, Rowena; Dec, Ellynne

    2014-08-01

    By a wide margin, lung cancer is the most significant cause of cancer death in the United States and worldwide. The incidence of lung cancer increases with age, and Medicare beneficiaries are often at increased risk. Because of its demonstrated effectiveness in reducing mortality, lung cancer screening with low-dose computed tomography (LDCT) imaging will be covered without cost-sharing starting January 1, 2015, by nongrandfathered commercial plans. Medicare is considering coverage for lung cancer screening. To estimate the cost and cost-effectiveness (ie, cost per life-year saved) of LDCT lung cancer screening of the Medicare population at high risk for lung cancer. Medicare costs, enrollment, and demographics were used for this study; they were derived from the 2012 Centers for Medicare & Medicaid Services (CMS) beneficiary files and were forecast to 2014 based on CMS and US Census Bureau projections. Standard life and health actuarial techniques were used to calculate the cost and cost-effectiveness of lung cancer screening. The cost, incidence rates, mortality rates, and other parameters chosen by the authors were taken from actual Medicare data, and the modeled screenings are consistent with Medicare processes and procedures. Approximately 4.9 million high-risk Medicare beneficiaries would meet criteria for lung cancer screening in 2014. Without screening, Medicare patients newly diagnosed with lung cancer have an average life expectancy of approximately 3 years. Based on our analysis, the average annual cost of LDCT lung cancer screening in Medicare is estimated to be $241 per person screened. LDCT screening for lung cancer in Medicare beneficiaries aged 55 to 80 years with a history of ≥30 pack-years of smoking and who had smoked within 15 years is low cost, at approximately $1 per member per month. This assumes that 50% of these patients were screened. Such screening is also highly cost-effective, at <$19,000 per life-year saved. If all eligible Medicare

  12. "I don't want to go back to the farm": A case study of Working for Water beneficiaries

    Directory of Open Access Journals (Sweden)

    Jan A. Hough

    2013-09-01

    Full Text Available In addition to clearing invasive alien plants, the Working for Water (WfW Programme, as a South African government public works programme, provides short-term employment and training to empower the poor in finding alternative employment within the labour market. Several studies indicate that its beneficiaries become financially dependent on WfW projects and tend to be reluctant to leave the programme. The sociological reasons for this reluctance, however, remain largely unstudied. We therefore address this gap by reporting on a case study of four WfW projects in the Western Cape Province. Face-to-face interviews with beneficiaries suggest that a number of push and pull factors contribute to their dependency on WfW. Chief among these factors is a fear among previous farmworkers of returning to farm work. It was found that the latter can be linked to a historical power-relations legacy between landowners and farmworkers, mainly created by institutional racism still prevailing on many Western Cape farms. These findings bear important implications for the implementation of a new draft WfW policy aimed at encouraging private landowners to employ WfW beneficiaries on their land as clearers of invasive alien plants.

  13. 75 FR 8927 - Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended Care Health...

    Science.gov (United States)

    2010-02-26

    ... DEPARTMENT OF DEFENSE Office of the Secretary Autism Services Demonstration Project for TRICARE... Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department implemented a...

  14. 76 FR 80903 - Extension of Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended...

    Science.gov (United States)

    2011-12-27

    ... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Autism Services Demonstration Project... Enhanced Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department...

  15. Out of Pocket expenditure among beneficiaries of Janani Shishu Suraksha Karyakaram

    Directory of Open Access Journals (Sweden)

    Jyoti Tyagi

    2016-12-01

    Full Text Available Background: About 67,000 women in India die every year (MoHFW, 2011, due to pregnancy related complications. Similarly, every year more than 13 lacs infants die, within 1 year of the birth and out of these approximately 9 lacs i.e. 2/3rd of the infant deaths take place within the first four weeks of life (1.Out of these, approximately 7 lacs i.e. 75% of the deaths take place within a week of the birth and a majority of these occur in the first two days after birth (1. In view of the difficulty being faced by the pregnant women and parents of sick new-born (MoHFW,2011, along with high out-of-pocket expenses incurred by them on delivery and treatment of sick new-born, Ministry of Health and Family Welfare has taken a major initiative, to provide completely free and cashless services to pregnant women including normal deliveries and caesarean operations and sick new born (up to 30 days after birth in Government health institutions in both rural & urban areas. Material & Methods: In this community based descriptive cross-sectional study, data was collected from 100 mothers, who had delivered in last one year at District Hospital Maternal Wing situated at Morar Block of Gwalior District M.P and MO, ANM’s, ASHA’s, using Semi structured close ended Interview schedule and an open ended questionnaire respectively. Data were compared by using SPSS (ver. 22.0 Result: Expenses were divided under two heads, medical and non-medical. 15% of the total beneficiaries incurred the medical expenses in the form of medicines, diagnostics etc. and almost 99% of all the respondents incurred the non-medical expenses in the form of transport, food etc. Conclusion: Based on the outcome of the study the overall impression was that 59% of the beneficiaries were not aware of the JSSK scheme. Only during pregnancies through the initiatives of the ASHAs the beneficiaries came to know about the free entitlements of the scheme. There was unavailability of ambulance when

  16. 26 CFR 1.679-2 - Trusts treated as having a U.S. beneficiary.

    Science.gov (United States)

    2010-04-01

    ... beneficiaries generally does not include heirs who will benefit from the trust under the laws of intestate... of the trust instrument do not allow the trust to be amended to benefit a U.S. person, but the law... law. A creates and funds FT for the benefit of C. The terms of FT (which, according to the trust...

  17. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies § 728.53 Department of Labor, Office of Workers... injury) incurred while engaged in: (i) Training. (ii) Flight instructions. (iii) Travel to or from... injury.) This category includes but is not limited to: (i) Civilian student employees in training at Navy...

  18. National Law Restrictions on Family Reunification Rights of International Protection Beneficiaries from a ECHR/EU Perspective

    DEFF Research Database (Denmark)

    Storgaard, Louise Halleskov

    n light of the refugee crisis, European countries are exploring new ways to restrict access of migrants to their territory. One such restriction relates to family reunification rights of international protection beneficiaries. Proposals in this area have already been adopted or are currently being...... considered in countries such as Norway, Denmark, Sweden, Austria and Germany most commonly in the form of waiting periods before applications for family reunification can be submitted and/or age requirements. The personal scope of these proposals differs. In some countries the restrictions apply/are intended...... to apply to international beneficiaries in general while they in other countries are applicable/envisaged applicable only to persons with subsidiary protection status or persons fleeing from generalised violence. The intention of the paper is to examine whether this legislative trend is in conformity...

  19. Oil royalties payment impact on socio-economic beneficiary countries development; O impacto do pagamento de royalties do petroleo no desenvolvimento socio-economico dos municipios beneficiarios

    Energy Technology Data Exchange (ETDEWEB)

    Lucchesi, Cesar Augusto M.; Anuatti Neto, Francisco [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Economia, Administracao e Contabilidade

    2004-07-01

    This research proposes to evaluate oil royalties payment impact on socio-economic beneficiary counties indicators. In the first step, it has been made royalties payments distribution among beneficiary counties (942), what showed a meaningful paid resources concentration between 1993 and 1999, when 20% of the beneficiaries apportioned of 98,5% from this period paid royalties. For these 188 greatest exaction counties the royalties impact analyses on County Human Development Index (IDH-M) evolution showed the received royalties amount positively influenced the 2000 IDH-M additional comparing to 1991. It indicates the petroleum industry contribution to municipal development of those counties which receive these resources. (author)

  20. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment for physician services...

  1. Possible causes of poverty within a group of land reform beneficiaries in the midlands of KwaZulu-Natal: Analysis and policy recommendations

    OpenAIRE

    Shinns, L.H.; Lyne, Michael C.

    2005-01-01

    This study investigates possible causes of poverty afflicting a community of land reform beneficiaries in the Midlands of KwaZulu-Natal. The 38 beneficiary households had previously been clustered into four groups displaying different symptoms of poverty. Linear Discriminant Analysis was used first to distinguish households that were relatively income and asset "rich" from those that were relatively income and asset "poor", and second to distinguish households that were relatively income poor...

  2. Early Hospital Readmission is a Predictor of One-Year Mortality in Community-Dwelling Older Medicare Beneficiaries

    NARCIS (Netherlands)

    Lum, H.D.; Studenski, S.A.; Degenholtz, H.B.; Hardy, S.E.

    2012-01-01

    BACKGROUND: Hospital readmission within thirty days is common among Medicare beneficiaries, but the relationship between rehospitalization and subsequent mortality in older adults is not known. OBJECTIVE: To compare one-year mortality rates among community-dwelling elderly hospitalized Medicare

  3. THE AUDIT OF FINANCIAL STATEMENTS PREPARED BY THE BENEFICIARIES OF EU GRANT

    OpenAIRE

    Danut Rada; Doina Rada

    2013-01-01

    The patrimonial economic entities - public institutions or economic agents, beneficiaries of EU grants, are required to maintain separate accounts situations of the use of these financial resources and also to prepare financial statements in which to be reflected the fees occurred by implementing of projects. The audit of these financial statements is specific and is based on the provisions of international audit standards ISRS 4400 “international standard for related services” and ISAE 3000 ...

  4. Purchased Behavioral Health Care Received by Military Health System Beneficiaries in Civilian Medical Facilities, 2000-2014.

    Science.gov (United States)

    Wooten, Nikki R; Brittingham, Jordan A; Pitner, Ronald O; Tavakoli, Abbas S; Jeffery, Diana D; Haddock, K Sue

    2018-02-06

    Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78

  5. Explaining the increased health care expenditures associated with gastroesophageal reflux disease among elderly Medicare beneficiaries with chronic obstructive pulmonary disease: a cost-decomposition analysis

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2014-04-01

    Full Text Available Mayank Ajmera,1 Amit D Raval,1 Chan Shen,2 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics and Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA Objective: To estimate excess health care expenditures associated with gastroesophageal reflux disease (GERD among elderly individuals with chronic obstructive pulmonary disease (COPD and examine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors to the excess expenditures, using the Blinder-Oaxaca linear decomposition technique. Methods: This study utilized a cross-sectional, retrospective study design, using data from multiple years (2006-2009 of the Medicare Current Beneficiary Survey linked with fee-for-service Medicare claims. Presence of COPD and GERD was identified using diagnoses codes. Health care expenditures consisted of inpatient, outpatient, prescription drugs, dental, medical provider, and other services. For the analysis, t-tests were used to examine unadjusted subgroup differences in average health care expenditures by the presence of GERD. Ordinary least squares regressions on log-transformed health care expenditures were conducted to estimate the excess health care expenditures associated with GERD. The Blinder-Oaxaca linear decomposition technique was used to determine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors, to excess health care expenditures associated with GERD. Results: Among elderly Medicare beneficiaries with COPD, 29.3% had co-occurring GERD. Elderly Medicare beneficiaries with COPD/GERD had 1.5 times higher ($36,793 vs $24,722 [P<0.001] expenditures than did those with COPD/no GERD. Ordinary

  6. Disease management for chronically ill beneficiaries in traditional Medicare.

    Science.gov (United States)

    Bott, David M; Kapp, Mary C; Johnson, Lorraine B; Magno, Linda M

    2009-01-01

    We summarize the Centers for Medicare and Medicaid Services' (CMS's) experience with disease management (DM) in fee-for-service Medicare. Since 1999, the CMS has conducted seven DM demonstrations involving some 300,000 beneficiaries in thirty-five programs. Programs include provider-based, third-party, and hybrid models. Reducing costs sufficient to cover program fees has proved particularly challenging. Final evaluations on twenty programs found three with evidence of quality improvement at or near budget-neutrality, net of fees. Interim monitoring covering at least twenty-one months on the remaining fifteen programs suggests that four are close to covering their fees. Characteristics of the traditional Medicare program present a challenge to these DM models.

  7. 26 CFR 1.167(h)-1 - Life tenants and beneficiaries of trusts and estates.

    Science.gov (United States)

    2010-04-01

    ... reserve) allocable to each. For example: (1) If under the trust instrument or local law the income of a... local law the income of a trust is to be distributed to a named beneficiary, but the trustee is directed... otherwise provided in this paragraph when the trust instrument or local law requires or permits the trustee...

  8. Habitat and Recreational Fishing Opportunity in Tampa Bay: Linking Ecological and Ecosystem Services to Human Beneficiaries

    Science.gov (United States)

    Estimating value of estuarine habitat to human beneficiaries requires that we understand how habitat alteration impacts function through both production and delivery of ecosystem goods and services (EGS). Here we expand on the habitat valuation technique of Bell (1997) with an es...

  9. 19 CFR 10.178 - Direct costs of processing operations performed in the beneficiary developing country.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Direct costs of processing operations performed in... processing operations performed in the beneficiary developing country. (a) Items included in the direct costs of processing operations. As used in § 10.176, the words “direct costs of processing operations...

  10. Enhancing and diluting the legal status of subsidiary protection beneficiaries under Union law

    DEFF Research Database (Denmark)

    Storgaard, Louise Halleskov

    2016-01-01

    Is it in accordance with the Qualification Directive (QD) to restrict the freedom of movement within the host country of beneficiaries of subsidiary protection (a form of protection parallel to refugee status) in receipt of social security benefits? This question was addressed by the CJEU in its...... and the substantive content of subsidiary protection while it, on the other hand, creates uncertainty about the applicable non-discrimination standard in such cases...

  11. [Dietary diversity in women who live in food insecurity settings in Mexico, beneficiaries of a food support program].

    Science.gov (United States)

    Morales Ruán, María Del Carmen; Valenzuela Bravo, Danae Gabriela; Jiménez Aguilar, Alejandra; Cuevas Nasu, Lucía; Méndez Gómez Humarán, Ignacio; Shamah Levy, Teresa

    2018-02-16

    food diversity is an approximation of diet quality. In Mexico, the Food Support Program (PAL, by its acronym in Spanish) grants support to families facing food poverty, in form of cash (PAL EFECTIVO) or through monetary transfers on a card intended exclusively for the purchase of food (PAL SIN-HAMBRE), seeking to improve their food diversity. to compare the dietary diversity in women beneficiaries of both schemes and their association with the level of food insecurity (FI) at household level. a cross-sectional study was carried out in a national random sample of 243 women beneficiaries from PAL EFECTIVO and 277 from PAL SIN-HAMBRE in 14 states. A multinomial logistic regression model was constructed to measure the association between the FI perception index and its relationship with the PAL and the dietary diversity index. the PAL SIN-HAMBRE scheme is associated with a lower probability of mild and severe FI with respect to the PAL EFECTIVO. The interaction between the type of scheme and the dietary diversity index showed that the PAL EFECTIVO had a lower probability of severe FI when the dietary diversity index was greater with respect to the PAL SIN-HAMBRE. the FI in the household and the low dietary diversity seem to be strongly associated in women of childbearing age and this relationship is higher in those beneficiaries of the PAL SIN-HAMBRE scheme.

  12. 42 CFR 411.12 - Charges imposed by an immediate relative or member of the beneficiary's household.

    Science.gov (United States)

    2010-10-01

    ...) Natural or adoptive parent, child, or sibling. (3) Stepparent, stepchild, stepbrother, or stepsister. (4... if the physician who ordered or supervised the services has an excluded relationship to the... provider or supplier if the owner has an excluded relationship to the beneficiary; and (ii) Charges imposed...

  13. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    Directory of Open Access Journals (Sweden)

    Kenneth J. Bagstad

    2014-06-01

    Full Text Available Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service, sinks (biophysical or anthropogenic features that deplete or alter service flows, users (user locations and level of demand, and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems' capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for

  14. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    Science.gov (United States)

    Bagstad, Kenneth J.; Villa, Ferdinando; Batker, David; Harrison-Cox, Jennifer; Voigt, Brian; Johnson, Gary W.

    2014-01-01

    Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service), sinks (biophysical or anthropogenic features that deplete or alter service flows), users (user locations and level of demand), and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems’ capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES) methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for economic

  15. 75 FR 60066 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary ATPDEA...

    Science.gov (United States)

    2010-09-29

    ... set of Harmonized System lines listed in the Annex to the World Trade Organization Agreement on... COMMITTEE FOR THE IMPLEMENTATION OF TEXTILE AGREEMENTS Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary ATPDEA Countries From Regional Country Fabric AGENCY...

  16. 78 FR 66972 - Submission for Review: Designation of Beneficiary: Civil Service Retirement System (CSRS), SF 2808

    Science.gov (United States)

    2013-11-07

    ... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Designation of Beneficiary: Civil Service Retirement System (CSRS), SF 2808 AGENCY: U.S. Office of Personnel Management. ACTION: 60-Day notice and... Retirement System, SF 2808. As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C...

  17. Low-Cost Generic Program Use by Medicare Beneficiaries: Implications for Medication Exposure Misclassification in Administrative Claims Data.

    Science.gov (United States)

    Pauly, Nathan J; Talbert, Jeffery C; Brown, Joshua

    2016-06-01

    Administrative claims data are used for a wide variety of research and quality assurance purposes; however, they are prone to medication exposure misclassification if medications are purchased without using an insurance benefit. Low-cost generic drug programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted, and the exposure may go unobserved in claims data. As heavy users of medications, Medicare beneficiaries have much to gain from the affordable medications offered through LCGPs. This use may put them at increased risk of exposure misclassification in claims data. Many high-risk medications (HRMs) and medications tracked for adherence and utilization quality metrics are available through LCGPs, and exposure misclassification of these medications may impact the quality assurance efforts reliant on administrative claims data. Presently, there is little information regarding the use of these programs among a geriatric population. To (a) quantify the prevalence of LCGP users in a nationally representative population of Medicare beneficiaries; (b) compare clinical and demographic characteristics of LCGP users and nonusers; (c) assess determinants of LCGP use and medications acquired through these programs; and (d) analyze patterns of LCGP use during the years 2007-2012. This study relied on data from the Medical Expenditure Panel Survey (MEPS) from 2007 to 2012. The first 3 objectives were completed with a cohort of individuals in the most recent MEPS panel, while the fourth objective was completed with a separate cohort composed of individuals who participated in MEPS from 2007 to 2012. Inclusion in either study cohort required that individuals were Medicare beneficiaries aged 65 years or greater, used at least 1 prescription drug during their 2-year panel period, and participated in all 5

  18. 19 CFR 10.196 - Cost or value of materials produced in a beneficiary country or countries.

    Science.gov (United States)

    2010-04-01

    ... country where it is tanned to create nonperishable “crust leather”. The tanned product is then imported... tanned to create nonperishable “crust leather”. The tanned skin is then imported directly into the U.S... composed is not wholly the growth, product, or manufacture of a beneficiary country and (2) the tanning...

  19. Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

    Science.gov (United States)

    Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…

  20. MCBS Sites of Biodiversity Significance

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data layer represents areas with varying levels of native biodiversity that may contain high quality native plant communities, rare plants, rare animals, and/or...

  1. Decomposing Racial/Ethnic Disparities in Influenza Vaccination among the Elderly

    Science.gov (United States)

    Yoo, Byung-Kwang; Hasebe, Takuya; Szilagyi, Peter G.

    2015-01-01

    While persistent racial/ethnic disparities in influenza vaccination have been reported among the elderly, characteristics contributing to disparities are poorly understood. This study aimed to assess characteristics associated with racial/ethnic disparities in influenza vaccination using a nonlinear Oaxaca-Blinder decomposition method. We performed cross-sectional multivariable logistic regression analyses for which the dependent variable was self-reported receipt of influenza vaccine during the 2010–2011 season among community dwelling non-Hispanic African-American (AA), non-Hispanic White (W), English-speaking Hispanic (EH) and Spanish-speaking Hispanic (SH) elderly, enrolled in the 2011 Medicare Current Beneficiary Survey (MCBS) (un-weighted/weighted N= 6,095/19.2million). Using the nonlinear Oaxaca-Blinder decomposition method, we assessed the relative contribution of seventeen covariates—including socio-demographic characteristics, health status, insurance, access, preference regarding healthcare, and geographic regions —to disparities in influenza vaccination. Unadjusted racial/ethnic disparities in influenza vaccination were 14.1 percentage points (pp) (W-AA disparity, p.8). The Oaxaca-Blinder decomposition method estimated that the unadjusted W-AA and W-SH disparities in vaccination could be reduced by only 45% even if AA and SH groups become equivalent to Whites in all covariates in multivariable regression models. The remaining 55% of disparities were attributed to (a) racial/ethnic differences in the estimated coefficients (e.g., odds ratios) in the regression models and (b) characteristics not included in the regression models. Our analysis found that only about 45% of racial/ethnic disparities in influenza vaccination among the elderly could be reduced by equalizing recognized characteristics among racial/ethnic groups. Future studies are needed to identify additional modifiable characteristics causing disparities in influenza vaccination. PMID

  2. Trends in Hospitalization Rates and Outcomes of Endocarditis among Medicare Beneficiaries

    Science.gov (United States)

    Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Desai, Mayur M.; Quagliarello, Vincent; Krumholz, Harlan M.

    2015-01-01

    Objectives To determine the hospitalization rates and outcomes of endocarditis among older adults. Background Endocarditis is the most serious cardiovascular infection and is especially common among older adults. Little is known about recent trends for endocarditis hospitalizations and outcomes. Methods Using Medicare inpatient Standard Analytic Files, we identified all Fee-For-Service beneficiaries aged ≥65 years with a principal or secondary diagnosis of endocarditis from 1999-2010. We used Medicare Denominator Files to report hospitalizations per 100,000 person-years. Rates of 30-day and 1-year mortality were calculated using Vital Status Files. We used mixed-effects models to calculate adjusted rates of hospitalization and mortality and to compare the results before and after 2007, when the American Heart Association revised recommendations for endocarditis prophylaxis. Results Overall, 262,658 beneficiaries were hospitalized with endocarditis. The adjusted hospitalization rate increased from 1999-2005, reaching 83.5 per 100,000 person-years in 2005, and declined during 2006-2007. After 2007, the decline continued, reaching 70.6 per 100,000 person-years in 2010. Adjusted 30-day and 1-year mortality rates ranged from 14.2% to 16.5% and from 32.6% to 36.2%, respectively. There were no consistent changes in adjusted rates of 30-day and 1-year mortality after 2007. Trends in rates of hospitalization and outcomes were consistent across demographic subgroups. Adjusted rates of hospitalization and mortality declined consistently in the subgroup with principal diagnosis of endocarditis. Conclusions Our study highlights the high burden of endocarditis among older adults. We did not observe an increase in adjusted rates of hospitalization or mortality associated with endocarditis after publication of the 2007 guidelines. PMID:23994421

  3. How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products.

    Science.gov (United States)

    Milcarz, Marek; Polańska, Kinga; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

    2017-09-07

    The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes ( p traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers ( p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe.

  4. Comparison of Clinical Features in a Population of Basic Military Trainees Versus the General Department of Defense Beneficiary Population Presenting With Influenza.

    Science.gov (United States)

    Scheuller, H Samuel; Park, Jisuk; Lott, Lisa; Tavish, Michele; Danaher, Patrick

    2017-09-01

    Upper respiratory tract infection (URI) is a well-documented cause of morbidity, extra expense, and lost training time among basic military trainees (BMTs). The goal of this study was to characterize the clinical presentation of influenza in the BMT population and to better understand how this presentation differs from that of the general Department of Defense (DoD) beneficiary population (non-BMTs). Clinical and demographic data were collected in a prospective study that enrolled DoD beneficiaries presenting to medical treatment facilities in San Antonio, Texas, with URI symptoms between January 2005 and March 2011. Vital signs and symptom duration were collected at the time of enrollment along with basic demographic information. Among 4,448 participants enrolled, 466 (10.5%) tested positive for influenza: 198 of 3,103 BMTs (6.4%) vs. 268 of 1,345 non-BMTs (20%) (p 0.5°F, p 0.5, 95% CI = 0.3-0.8, p 0.5, 95% CI = 0.3-0.8, p standard deviation = 1.4) symptoms, whereas non-BMTs presented with a mean of 6.9 (standard deviation = 1.3) symptoms (p < 0.01). The pretest probability of a BMT presenting with URI symptoms having influenza is significantly lower than that for the general DoD beneficiary population. BMTs with influenza presented sooner, with higher fever, and with fewer overall symptoms than the general DoD beneficiary population. These differences are likely attributable to early reporting and response bias and less likely attributed to age. Military efforts to identify BMTs with suspected influenza infection early and to refer them for treatment promptly are efficacious. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  5. Association Between Treatment by Locum Tenens Internal Medicine Physicians and 30-Day Mortality Among Hospitalized Medicare Beneficiaries.

    Science.gov (United States)

    Blumenthal, Daniel M; Olenski, Andrew R; Tsugawa, Yusuke; Jena, Anupam B

    2017-12-05

    Use of locum tenens physicians has increased in the United States, but information about their quality and costs of care is lacking. To evaluate quality and costs of care among hospitalized Medicare beneficiaries treated by locum tenens vs non-locum tenens physicians. A random sample of Medicare fee-for-service beneficiaries hospitalized during 2009-2014 was used to compare quality and costs of hospital care delivered by locum tenens and non-locum tenens internal medicine physicians. Treatment by locum tenens general internal medicine physicians. The primary outcome was 30-day mortality. Secondary outcomes included inpatient Medicare Part B spending, length of stay, and 30-day readmissions. Differences between locum tenens and non-locum tenens physicians were estimated using multivariable logistic regression models adjusted for beneficiary clinical and demographic characteristics and hospital fixed effects, which enabled comparisons of clinical outcomes between physicians practicing within the same hospital. In prespecified subgroup analyses, outcomes were reevaluated among hospitals with different levels of intensity of locum tenens physician use. Of 1 818 873 Medicare admissions treated by general internists, 38 475 (2.1%) received care from a locum tenens physician; 9.3% (4123/44 520) of general internists were temporarily covered by a locum tenens physician at some point. Differences in patient characteristics, demographics, comorbidities, and reason for admission between locum tenens and non-locum tenens physicians were not clinically relevant. Treatment by locum tenens physicians, compared with treatment by non-locum tenens physicians (n = 44 520 physicians), was not associated with a significant difference in 30-day mortality (8.83% vs 8.70%; adjusted difference, 0.14%; 95% CI, -0.18% to 0.45%). Patients treated by locum tenens physicians had significantly higher Part B spending ($1836 vs $1712; adjusted difference, $124; 95% CI, $93 to $154

  6. Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data

    Science.gov (United States)

    Guerino, Paul; Ewald, Erin; Laffan, Alison M.

    2017-01-01

    Abstract Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research. Methods: Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229). Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs. Conclusion: This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age. PMID:29125908

  7. Helping Hand: The Salin Kaalaman Tungo sa Kaunlaran Extension Program of Polytechnic University of the Philippines Among the Beneficiaries of the Pilot Centers in Sta. Mesa, Manila, Philippines

    Directory of Open Access Journals (Sweden)

    Junnette B. Hasco

    2016-11-01

    Full Text Available One of the four-fold functions of State Universities and Colleges in accordance by their mandates was to provide assistance to communities; this was achieved thru conducting different skills and development trainings in partnership with Local Government Units (LGU’s. This study was conducted to assess the current Extension program of the Polytechnic University of the Philippines (PUP. Some 74 beneficiaries from the 23 centers of Sta. Mesa, Manila were identified through the use of purposive sampling. The data gathering made use of aided surveys. Weighted Mean and Pearson Product Moment of Correlation was used to treat and process statistical data. Findings revealed that the Extension Services conducted by the PUP Salin Kaalaman Tungo sa Kaunlaran Extension Program (SALIN were highly effective regarding Information Dissemination, Staff and Officials, Trainings and Programs, Trainers and Speakers, Programs, Accommodation and Venue and the personal impact of the Extension Program to the Beneficiaries. Satisfaction rating on the extension program was also high. Further, this study found out that as respondents are satisfied with the implementation of SALIN, the greater the chance of positive assessment on the effectiveness of the project. The study also disclosed problems and recommendations identified by the respondents. In addressing the research gaps, this study further identified recommendations to enhance capabilities of program implementers such as better execution in the delivery of extension services, fund sourcing and forging linkages or networking.

  8. A Mirage or a Rural Life Line? Analysing the impact of Mahatma Gandhi Rural Employment Guarantee Act on Women Beneficiaries of Assam

    Directory of Open Access Journals (Sweden)

    Rituparna Bhattacharyya

    2013-05-01

    Full Text Available The National Rural Employment Guarantee Act (NREGA, launched in February 2006 was renamed in October 02, 2009 as the Mahatma Gandhi National Rural Employment Guarantee Act (henceforth, MGNREGA. It is an anti-poverty flagship programme of the Government of India. The key purpose of MGNREGA is to enhance wage employment in the rural areas by providing at least 100 days of guaranteed employment to every household in a financial year.  The MGNREGA implementation status report for the financial year 2012-2013 unfolds that the programme has already provided employment to 44.9 million households across 28 districts and five union territories. Hence, it is becoming increasingly difficult to ignore the impact of MGNREGA on women beneficiaries. A plethora of research argues that MGNREGA, which promotes inclusive growth, is a vehicle of change, a lifeline for rural women. So far, however, there has been very little discussion about the impact of MGNREGA on women beneficiaries of Assam. This research is an attempt to examine the participation of women in MGNREGA, Assam. It critically looks at the issues, problems and challenges confronted by the women while working at MGNREGA. Written from a feminist perspective on gender, poverty and women’s empowerment, the research seeks to address the problems of the women beneficiaries through their lived experiences. For this, we conducted in-depth interviews with the women beneficiaries in the months of August and September, 2009 in four remote areas namely, Burka, Chandrapur, Barbhang and Muguriya, the first two situated in Kamrup, while the third and the fourth in Barpeta districts of Assam, where the programme of MGNREGA is on-going. The findings of the research suggest measures so that the programme can be made more effective in the long run.

  9. Storage, preparation, and usage of fortified food aid among Guatemalan, Ugandan, and Malawian beneficiaries: a field study report.

    Science.gov (United States)

    Rowe, Jonathan P; Brodegard, William C; Pike, Oscar A; Steele, Frost M; Dunn, Michael L

    2008-09-01

    An important consideration in determining the ability of fortified food-aid commodities to meet the nutritional needs of beneficiaries is the manner in which commodities are utilized and prepared and the degree to which micronutrient losses occur during handling and cooking by the beneficiaries. A field study was conducted in Uganda, Malawi, and Guatemala to obtain data on storage, preparation, and usage of fortified blended foods provided by the US Agency for International Development. Interview and observational data on the use of corn-soy blend, cornmeal, soy-fortified cornmeal, soy-fortified bulgur, and fortified vegetable oil were collected from more than 100 households and two wet-feeding sites (where food is prepared and served by staff on-site) in 32 villages. Storage practices by beneficiaries appeared to be appropriate, and all commodities observed were free from off-flavors and odors. Cooking water was typically obtained from boreholes or open wells with a pH range of 4.7 to 7.7 Food preparation usually took place in covered areas with the use of an aluminum or clay pot over a wood-fueled fire. Thin or thick porridges were the most common dishes prepared from cereal-based products, with concentration ranges of 10% to 31% (wt/ wt) in water. Cooking times for porridges ranged from 5 to 53 minutes, with a mean of 26 minutes. Tortillas and beverages were other preparations commonly observed in Guatemala. Vegetable oil was typically used for pan frying. Cooking fuel could be saved and nutritional quality probably improved if relief agencies emphasized shorter cooking times. These data can be used to simulate preparation methods in the laboratory for assessment of the nutritional impact of cooking.

  10. Assessment of Intervention Being Provided at AWCs Related to Nutrition and Care during Pregnancy and Lactation in District Budgam of Kashmir Region J&K (Based on Beneficiary Responses)

    OpenAIRE

    Iffat Ghani; Rajini Dhingra

    2017-01-01

    This research was planned to study the intervention being provided by AWCs (Anganwadi Centers) to improve the knowledge level of women beneficiaries regarding health care and nutrition during pregnancy and lactation. Inthis context, four blocks were purposively selected from district Budgam of Kashmir region. From these four blocks 60 AWCs were randomly selected through lottery method with 15 AWCs from each block. A total number of 240 women beneficiaries were purposively selected from these ...

  11. Variation in Postsepsis Readmission Patterns: A Cohort Study of Veterans Affairs Beneficiaries

    Science.gov (United States)

    2017-01-01

    Rationale: Rehospitalization is common after sepsis, but little is known about the variation in readmission patterns across patient groups and care locations. Objectives: To examine the variation in postsepsis readmission rates and diagnoses by patient age, nursing facility use, admission year, and hospital among U.S. Veterans Affairs (VA) beneficiaries. Methods: Observational cohort study of VA beneficiaries who survived a sepsis hospitalization (2009–2011) at 114 VA hospitals, stratified by age (readmission after sepsis hospitalization and proportion of readmissions resulting from specific diagnoses, including the proportion of “potentially preventable” readmissions. Readmission diagnoses were similar from 2009 to 2011, with little variation in readmission rates across hospitals. The top six readmission diagnoses (heart failure, pneumonia, sepsis, urinary tract infection, acute renal failure, and chronic obstructive pulmonary disease) accounted for 30% of all readmissions. Although about one in five readmissions had a principal diagnosis for infection, 58% of all readmissions received early systemic antibiotics. Infection accounted for a greater proportion of readmissions among patients discharged to nursing facilities compared with patients discharged to home (25.0–27.1% vs. 16.8%) and among older vs. younger patients (22.2% vs. 15.8%). Potentially preventable readmissions accounted for a quarter of readmissions overall and were more common among older patients and patients discharged to nursing facilities. Conclusions: Hospital readmission rates after sepsis were similar by site and admission year. Heart failure, pneumonia, sepsis, and urinary tract infection were common readmission diagnoses across all patient groups. Readmission for infection and potentially preventable diagnoses were more common in older patients and patients discharged to nursing facilities. PMID:27854510

  12. Will the beneficiaries of the “Minha Casa, Minha Vida” program be satisfied? Empirical evidence in the state of Minas Gerais [doi: 10.21529/RECADM.2017008

    Directory of Open Access Journals (Sweden)

    Vinicius Souza Moreira

    2017-10-01

    Full Text Available The “Minha Casa, Minha Vida” Program (PMCMV is the main Brazilian government initiative to remedy the country's housing deficit, which, due to its reality, requires adequate management, avoiding detours that could make it unfeasible. In this sense, the objective was to evaluate the PMCMV results based on the perception of the beneficiary families. The theoretical framework was based on the concepts of evaluation of social programs and their application to the housing context. The investigation occurred in Minas Gerais, considering a sample of 110 families distributed in eight municipalities. We adopted three categories: housing unit, housing complex and environment. In relation to the housing unit, beneficiaries of horizontal housing were more satisfied; large families showed lower satisfaction and the second phase of the Program was better evaluated. On the housing set, beneficiaries of the vertical groups, with less members and of enterprises of the second phase were more satisfied. As for the environment, there was a decrease in satisfaction with infrastructure and access to the city as family size increased. From the contact with the beneficiaries was clear the social importance of the PMCMV and the modification promoted in their lives. It is considered necessary, based on the critical points raised, to continue making corrections in the Program so that the promoted improvements can solve the social inequalities.   Keywords Housing; Evaluation; Public policy; Satisfaction.

  13. Comparative Evaluation of Cash Benefit Scheme of Janani Suraksha Yojana for Beneficiary Mothers from Different Health Care Settings of Rewa District, Madhya Pradesh, India.

    Directory of Open Access Journals (Sweden)

    Trivedi R

    2014-05-01

    Full Text Available Introduction: For better outcomes in mother and child health, Government of India launched the National Rural Health Mission (NRHM in 2005 with a major objective of providing accessible, affordable and quality health care to the rural population; especially the vulnerable. Reduction in MMR to 100/100,000 is one of its goals and the Janani Suraksha Yojana (JSY is the key strategy of NRHM to achieve this reduction. The JSY, as a safe motherhood intervention and modified alternative of the National Maternity Benefit Scheme (NMBS, has been implemented in all states and Union territories with special focus on low performing states. The main objective and vision of JSY is to reduce maternal, neo-natal mortality and promote institutional delivery among the poor pregnant women of rural and urban areas. This scheme is 100% centrally sponsored and has an integrated delivery and post delivery care with the help of a key person i.e. ASHA (Accredited Social Health Activist, followed by cash monetary help to the women. Objectives: 1To evaluate cash benefit service provided under JSY at different health care settings. 2 To know the perception and elicit suggestions of beneficiaries on quality of cash benefit scheme of JSY. Methodology: This is a health care institute based observational cross sectional study including randomly selected 200 JSY beneficiary mothers from the different health care settings i.e., Primary Health Centres, Community Health Centres, District Hospital and Medical College Hospital of Rewa District of Madhya Pradesh state. Data was collected with the help of set pro forma and then analysed with Epi Info 2000. Chi square test was applied appropriately. Results: 60% and 80% beneficiaries from PHC and CHC received cash within 1 week after discharge whereas 100% beneficiaries of District Hospital and Medical College Hospital received cash at the time of discharge; the overall distribution of time of cash disbursement among beneficiaries of

  14. Clinical Analysis of Icotinib on Beneficiary of 
Advanced Non-small Cell Lung Cancer with EGFR Common Mutation

    Directory of Open Access Journals (Sweden)

    Xiaowen JIANG

    2016-04-01

    Full Text Available Background and objective Targeted therapy has become an indispensable therapy method in advanced non-small cell lung cancer (NSCLC treatment. Epithelial growth factor receptor (EGFR tyrosine kinase inhibitor (TKI can significantly prolong the survival of patients harboring EGFR gene mutation. Icotinb is China's first EGFR-TKI with independent intellectual property rights. The aim of this study is to investigate the clinical characteristics about the beneficiary of advanced NSCLC patients with EGFR Common mutation who were treated with Icotinib. Retrospectively collect the data about beneficiary [progression-free survival (PFS≥6 months] and analysis of the related risk factors for prognosis. Methods From September 1, 2011 to September 30, 2015, 231 cases of advanced NSCLC beneficiary with EGFR common mutation were enrolled for treatment with icotinib in Zhejiang Cancer Hospital. Results The one year benefit rate was 67.9% in the group treated with Icotinib as first line, and in the groupas second line or above was 53.6%, which is statisticallysignificant. The two years benefit rate was 18.7% and 9.3%, respectively. The median PFS of first line group and the second line or above was 16.7 and 12.4 months, respectively. The presence of brain metastasis (P=0.010, Prior chemotherapy (P=0.001, Eastern Cooperative Oncology Group (ECOG score (P=0.001 were the main factors influencing the prognosis. The most common adverse were skin rashes (51 cases, 22.1% and diarrhea (27 cases, 11.7%. Conclusion Icotinib offers long-term clinical benefit and good tolerance for advanced NSCLC harboring EGFR gene mutation. Its advantage groups in addition to the patients with brain metastases and better ECOG score, the curative effect of patients with the first-line treatment is superior to second or further line.

  15. [Clinical Analysis of Icotinib on Beneficiary of 
Advanced Non-small Cell Lung Cancer with EGFR Common Mutation].

    Science.gov (United States)

    Jiang, Xiaowen; Wang, Wenxian; Zhang, Yiping

    2016-04-20

    Targeted therapy has become an indispensable therapy method in advanced non-small cell lung cancer (NSCLC) treatment. Epithelial growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) can significantly prolong the survival of patients harboring EGFR gene mutation. Icotinb is China's first EGFR-TKI with independent intellectual property rights. The aim of this study is to investigate the clinical characteristics about the beneficiary of advanced NSCLC patients with EGFR Common mutation who were treated with Icotinib. Retrospectively collect the data about beneficiary [progression-free survival (PFS)≥6 months] and analysis of the related risk factors for prognosis. From September 1, 2011 to September 30, 2015, 231 cases of advanced NSCLC beneficiary with EGFR common mutation were enrolled for treatment with icotinib in Zhejiang Cancer Hospital. The one year benefit rate was 67.9% in the group treated with Icotinib as first line, and in the groupas second line or above was 53.6%, which is statisticallysignificant. The two years benefit rate was 18.7% and 9.3%, respectively. The median PFS of first line group and the second line or above was 16.7 and 12.4 months, respectively. The presence of brain metastasis (P=0.010), Prior chemotherapy (P=0.001), Eastern Cooperative Oncology Group (ECOG) score (P=0.001) were the main factors influencing the prognosis. The most common adverse were skin rashes (51 cases, 22.1%) and diarrhea (27 cases, 11.7%). Icotinib offers long-term clinical benefit and good tolerance for advanced NSCLC harboring EGFR gene mutation. Its advantage groups in addition to the patients with brain metastases and better ECOG score, the curative effect of patients with the first-line treatment is superior to second or further line. 
.

  16. Multicarrier Block-Spread CDMA for Broadband Cellular Downlink

    Directory of Open Access Journals (Sweden)

    Leus Geert

    2004-01-01

    Full Text Available Effective suppression of multiuser interference (MUI and mitigation of frequency-selective fading effects within the complexity constraints of the mobile constitute major challenges for broadband cellular downlink transceiver design. Existing wideband direct-sequence (DS code division multiple access (CDMA transceivers suppress MUI statistically by restoring the orthogonality among users at the receiver. However, they call for receive diversity and multichannel equalization to improve the fading effects caused by deep channel fades. Relying on redundant block spreading and linear precoding, we design a so-called multicarrier block-spread- (MCBS-CDMA transceiver that preserves the orthogonality among users and guarantees symbol detection, regardless of the underlying frequency-selective fading channels. These properties allow for deterministic MUI elimination through low-complexity block despreading and enable full diversity gains, irrespective of the system load. Different options to perform equalization and decoding, either jointly or separately, strike the trade-off between performance and complexity. To improve the performance over multi-input multi-output (MIMO multipath fading channels, our MCBS-CDMA transceiver combines well with space-time block-coding (STBC techniques, to exploit both multiantenna and multipath diversity gains, irrespective of the system load. Simulation results demonstrate the superior performance of MCBS-CDMA compared to competing alternatives.

  17. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010.

    Science.gov (United States)

    Kent, Shia T; Shimbo, Daichi; Huang, Lei; Diaz, Keith M; Kilgore, Meredith L; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    After the 2003 publication of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines, there was a 5-10% increase in patients initiating antihypertensive medication with a thiazide-type diuretic, but most patients still did not initiate treatment with this class. There are few contemporary published data on antihypertensive medication classes filled by patients initiating treatment. We used the 5% random Medicare sample to study the initiation of antihypertensive medication between 2007 and 2010. Initiation was defined by the first antihypertensive medication fill preceded by 365 days with no antihypertensive medication fills. We restricted our analysis to beneficiaries ≥ 65 years who had two or more outpatient visits with a hypertension diagnosis and full Medicare fee-for-service coverage for the 365 days prior to initiation of antihypertensive medication. Between 2007 and 2010, 32,142 beneficiaries in the 5% Medicare sample initiated antihypertensive medication. Initiation with a thiazide-type diuretic decreased from 19.2% in 2007 to 17.9% in 2010. No other changes in medication classes initiated occurred over this period. Among those initiating antihypertensive medication in 2010, 31.3% filled angiotensin-converting enzyme inhibitors (ACE-Is), 26.9% filled beta blockers, 17.2% filled calcium channel blockers, and 14.4% filled angiotensin receptor blockers (ARBs). Initiation with >1 antihypertensive medication class decreased from 25.6% in 2007 to 24.1% in 2010. Patients initiated >1 antihypertensive medication class most commonly with a thiazide-type diuretic and either an ACE-I or ARB. These results suggest that JNC 7 had a limited long-term impact on the choice of antihypertensive medication class and provide baseline data prior to the publication of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Panel Members Appointed to

  18. 20 CFR 30.17 - Is a beneficiary who defrauds the government in connection with a claim for EEOICPA benefits...

    Science.gov (United States)

    2010-04-01

    ... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions Rights and Penalties § 30... for benefits under the Act or any other federal or state workers' compensation law, the beneficiary... trial) any entitlement to any further benefits for any injury, illness or death covered by this part for...

  19. 26 CFR 1.642(h)-3 - Meaning of “beneficiaries succeeding to the property of the estate or trust”.

    Science.gov (United States)

    2010-04-01

    ... property of the estate or trustâ. 1.642(h)-3 Section 1.642(h)-3 Internal Revenue INTERNAL REVENUE SERVICE... § 1.642(h)-3 Meaning of “beneficiaries succeeding to the property of the estate or trust”. (a) The... excess of deductions over gross income for which a deduction is allowed, under section 642(h). (b) With...

  20. Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland

    Directory of Open Access Journals (Sweden)

    Dorota Kaleta

    2017-09-01

    Full Text Available Physical activity (PA has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA and commuting (CPA among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%, lack of time (28.1%, no willingness to exercise (25.4%. Close to 82% of the surveyed population did not practice commuting physical activity (CPA. The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11–1.65; p ≤ 0.05. Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs.

  1. Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland.

    Science.gov (United States)

    Kaleta, Dorota; Kalucka, Sylwia; Szatko, Franciszek; Makowiec-Dąbrowska, Teresa

    2017-09-26

    Physical activity (PA) has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA) and commuting (CPA) among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%), lack of time (28.1%), no willingness to exercise (25.4%). Close to 82% of the surveyed population did not practice commuting physical activity (CPA). The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11-1.65; p ≤ 0.05). Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs.

  2. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010.

    Directory of Open Access Journals (Sweden)

    Shia T Kent

    Full Text Available After the 2003 publication of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 guidelines, there was a 5-10% increase in patients initiating antihypertensive medication with a thiazide-type diuretic, but most patients still did not initiate treatment with this class. There are few contemporary published data on antihypertensive medication classes filled by patients initiating treatment.We used the 5% random Medicare sample to study the initiation of antihypertensive medication between 2007 and 2010. Initiation was defined by the first antihypertensive medication fill preceded by 365 days with no antihypertensive medication fills. We restricted our analysis to beneficiaries ≥ 65 years who had two or more outpatient visits with a hypertension diagnosis and full Medicare fee-for-service coverage for the 365 days prior to initiation of antihypertensive medication. Between 2007 and 2010, 32,142 beneficiaries in the 5% Medicare sample initiated antihypertensive medication. Initiation with a thiazide-type diuretic decreased from 19.2% in 2007 to 17.9% in 2010. No other changes in medication classes initiated occurred over this period. Among those initiating antihypertensive medication in 2010, 31.3% filled angiotensin-converting enzyme inhibitors (ACE-Is, 26.9% filled beta blockers, 17.2% filled calcium channel blockers, and 14.4% filled angiotensin receptor blockers (ARBs. Initiation with >1 antihypertensive medication class decreased from 25.6% in 2007 to 24.1% in 2010. Patients initiated >1 antihypertensive medication class most commonly with a thiazide-type diuretic and either an ACE-I or ARB.These results suggest that JNC 7 had a limited long-term impact on the choice of antihypertensive medication class and provide baseline data prior to the publication of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Panel

  3. 26 CFR 1.662(a)-1 - Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general. 1.662(a)-1 Section 1.662(a)-1 Internal Revenue INTERNAL... Trusts Which May Accumulate Income Or Which Distribute Corpus § 1.662(a)-1 Inclusion of amounts in gross...

  4. Cruise Tourism in Dominica: Benefits and Beneficiaries Bruno Marques, Romain Cruse

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    Bruno Marques

    2015-09-01

    Full Text Available The impressive growth of cruise tourism in Dominica, inside highly competitive area of the Caribbean basin, gives the island an astonishing flavor of success. By adopting a systemic approach the article demonstrates that three agents concentrate more than 70% of the financial impact of the cruise activity in Dominica: the local travel agencies, souvenir shops and the cruise lines. The low dispersion of the beneficiaries is concomitant with a spatial concentration and a minimal macroeconomic benefit. This case study, devoted to Dominica, suggests a highly concentrated model of cruise tourism in the Caribbean underpinned by organized tours as the main mode of experiencing the stopovers and a source of revenue for cruise lines, whose subcontractor: the local travel agencies are the primary distribution channel of cruise tourism revenue, high level of economic and spatial concentration generating low trickle down macroeconomic effect.

  5. Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries.

    Science.gov (United States)

    Zeng, Wu; Stason, William B; Fournier, Stephen; Razavi, Moaven; Ritter, Grant; Strickler, Gail K; Bhalotra, Sarita M; Shepard, Donald S

    2013-05-01

    This study reports outcomes of a Medicare-sponsored demonstration of two intensive lifestyle modification programs (LMPs) in patients with symptomatic coronary heart disease: the Cardiac Wellness Program of the Benson-Henry Mind Body Institute (MBMI) and the Dr Dean Ornish Program for Reversing Heart Disease® (Ornish). This multisite demonstration, conducted between 2000 and 2008, enrolled Medicare beneficiaries who had had an acute myocardial infarction or a cardiac procedure within the preceding 12 months or had stable angina pectoris. Health and economic outcomes are compared with matched controls who had received either traditional or no cardiac rehabilitation following similar cardiac events. Each program included a 1-year active intervention of exercise, diet, small-group support, and stress reduction. Medicare claims were used to examine 3-year outcomes. The analysis includes 461 elderly, fee-for-service, Medicare participants and 1,795 controls. Cardiac and non-cardiac hospitalization rates were lower in participants than controls in each program and were statistically significant in MBMI (P costs of $3,801 and $4,441 per participant for the MBMI and Ornish Programs, respectively, were offset by reduced health care costs yielding non-significant three-year net savings per participant of about $3,500 in MBMI and $1,000 in Ornish. A trend towards lower mortality compared with controls was observed in MBMI participants (P = .07). Intensive, year-long LMPs reduced hospitalization rates and suggest reduced Medicare costs in elderly beneficiaries with symptomatic coronary heart disease. Copyright © 2013 Mosby, Inc. All rights reserved.

  6. Utilization of Integrated Child Development Services (ICDS Scheme by child beneficiaries in Coastal Karnataka, India

    Directory of Open Access Journals (Sweden)

    Saranya Sivanesan

    2016-06-01

    Full Text Available Background: India’s main early childhood development intervention the ICDS Scheme has been sustained for 40 years and has been successful in some ways. However, nearly half of the children under six years are still under nourished. The program in reducing the proportion of undernourished children over the past decade has been modest and slower in India than what has been achieved in other countries with comparable socio-economic indicators. Aims & Objectives: 1. To study the utilization of services offered to children under ICDS, 2. To assess the perception about the services. Materials & Methods: A community based cross sectional study was done among mothers of 271 children in the age group three to six years registered in anganwadis. Results: Median duration of absenteeism to anganwadi was five months during the last six months enquired. About 95.9% of registered child beneficiaries utilized supplementary nutrition services and only 48.7% mothers of child beneficiaries were attending nutrition and health education sessions. Among mothers who were aware of growth monitoring, only 73.6% of their children’s weight was checked regularly.  About 60% of mothers were not happy with the quality of food served to their children in the anganwadi. Among children adherent to anganwadi, 72.5% children’s weight remained normal. Conclusion: Only 75% children were regularly attending. Median duration of adherence to anganwadi services was only 12 months and the most common reason for not adhering to the services is due to their simultaneous enrollment in other private nursery school.

  7. Patient Satisfaction, Empowerment, and Health and Disability Status Effects of a Disease Management-Health Promotion Nurse Intervention among Medicare Beneficiaries with Disabilities

    Science.gov (United States)

    Friedman, Bruce; Wamsley, Brenda R.; Liebel, Dianne V.; Saad, Zabedah B.; Eggert, Gerald M.

    2009-01-01

    Purpose: To report the impact on patient and informal caregiver satisfaction, patient empowerment, and health and disability status of a primary care-affiliated disease self-management-health promotion nurse intervention for Medicare beneficiaries with disabilities and recent significant health services use. Design and Methods: The Medicare…

  8. Discontinuity of Medicaid Coverage: Impact on Cost and Utilization Among Adult Medicaid Beneficiaries With Major Depression.

    Science.gov (United States)

    Ji, Xu; Wilk, Adam S; Druss, Benjamin G; Lally, Cathy; Cummings, Janet R

    2017-08-01

    Gaps in Medicaid coverage may disrupt access to and continuity of care. This can be detrimental for beneficiaries with chronic conditions, such as major depression, for whom disruptions in access to outpatient care may lead to increased use of acute care. However, little is known about how Medicaid coverage discontinuities impact acute care utilization among adults with depression. Examine the relationship between Medicaid discontinuities and service utilization among adults with major depression. A total of 139,164 adults (18-64) with major depression was identified using the 2003-2004 Medicaid Analytic eXtract Files. We used generalized linear and two-part models to examine the effect of Medicaid discontinuity on service utilization. To establish causality in this relationship, we used instrumental variables analysis, relying on exogenous variation in a state-level policy for identification. Emergency department (ED) visits, inpatient episodes, inpatient days, and Medicaid-reimbursed costs. Approximately 29.4% of beneficiaries experienced coverage disruptions. In instrumental variables models, those with coverage disruptions incurred an increase of $650 in acute care costs per-person per Medicaid-covered month compared with those with continuous coverage, evidenced by an increase in ED use (0.1 more ED visits per-person-month) and inpatient days (0.6 more days per-person-month). The increase in acute costs contributed to an overall increase in all-cause costs by $310 per-person-month (all P-valuesMedicaid coverage may help prevent acute episodes requiring high-cost interventions.

  9. Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

    Science.gov (United States)

    Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen

    2016-09-01

    At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The

  10. A randomized controlled trial of intensive care management for disabled Medicaid beneficiaries with high health care costs.

    Science.gov (United States)

    Bell, Janice F; Krupski, Antoinette; Joesch, Jutta M; West, Imara I; Atkins, David C; Court, Beverly; Mancuso, David; Roy-Byrne, Peter

    2015-06-01

    To evaluate outcomes of a registered nurse-led care management intervention for disabled Medicaid beneficiaries with high health care costs. Washington State Department of Social and Health Services Client Outcomes Database, 2008-2011. In a randomized controlled trial with intent-to-treat analysis, outcomes were compared for the intervention (n = 557) and control groups (n = 563). A quasi-experimental subanalysis compared outcomes for program participants (n = 251) and propensity score-matched controls (n = 251). Administrative data were linked to describe costs and use of health services, criminal activity, homelessness, and death. In the intent-to-treat analysis, the intervention group had higher odds of outpatient mental health service use and higher prescription drug costs than controls in the postperiod. In the subanalysis, participants had fewer unplanned hospital admissions and lower associated costs; higher prescription drug costs; higher odds of long-term care service use; higher drug/alcohol treatment costs; and lower odds of homelessness. We found no health care cost savings for disabled Medicaid beneficiaries randomized to intensive care management. Among participants, care management may have the potential to increase access to needed care, slow growth in the number and therefore cost of unplanned hospitalizations, and prevent homelessness. These findings apply to start-up care management programs targeted at high-cost, high-risk Medicaid populations. © Health Research and Educational Trust.

  11. Out-of-pocket medical expenses for inpatient care among beneficiaries of the National Health Insurance Program in the Philippines.

    Science.gov (United States)

    Tobe, Makoto; Stickley, Andrew; del Rosario, Rodolfo B; Shibuya, Kenji

    2013-08-01

    OBJECTIVE The National Health Insurance Program (NHIP) in the Philippines is a social health insurance system partially subsidized by tax-based financing which offers benefits on a fee-for-service basis up to a fixed ceiling. This paper quantifies the extent to which beneficiaries of the NHIP incur out-of-pocket expenses for inpatient care, and examines the characteristics of beneficiaries making these payments and the hospitals in which these payments are typically made. METHODS Probit and ordinary least squares regression analyses were carried out on 94 531 insurance claims from Benguet province and Baguio city during the period 2007 to 2009. RESULTS Eighty-six per cent of claims involved an out-of-pocket payment. The median figure for out-of-pocket payments was Philippine Pesos (PHP) 3016 (US$67), with this figure varying widely [inter-quartile range (IQR): PHP 9393 (US$209)]. Thirteen per cent of claims involved very large out-of-pocket payments exceeding PHP 19 213 (US$428)-the equivalent of 10% of the average annual household income in the region. Membership type, disease severity, age and residential location of the patient, length of hospitalization, and ownership and level of the hospital were all significantly associated with making out-of-pocket payments and/or the size of these payments. CONCLUSION Although the current NHIP reduces the size of out-of-pocket payments, NHIP beneficiaries are not completely free from the risk of large out-of-pocket payments (as the size of these payments varies widely and can be extremely large), despite NHIP's attempts to mitigate this by setting different benefit ceilings based on the level of the hospital and the severity of the disease. To reduce these large out-of-pocket payments and to increase financial risk protection further, it is essential to ensure more investment for health from social health insurance and/or tax-based government funding as well as shifting the provider payment mechanism from a fee

  12. The price sensitivity of Medicare beneficiaries: a regression discontinuity approach.

    Science.gov (United States)

    Buchmueller, Thomas C; Grazier, Kyle; Hirth, Richard A; Okeke, Edward N

    2013-01-01

    We use 4 years of data from the retiree health benefits program of the University of Michigan to estimate the effect of price on the health plan choices of Medicare beneficiaries. During the period of our analysis, changes in the University's premium contribution rules led to substantial price changes. A key feature of this 'natural experiment' is that individuals who had retired before a certain date were exempted from having to pay any premium contributions. This 'grandfathering' creates quasi-experimental variation that is ideal for estimating the effect of price. Using regression discontinuity methods, we compare the plan choices of individuals who retired just after the grandfathering cutoff date and were therefore exposed to significant price changes to the choices of a 'control group' of individuals who retired just before that date and therefore did not experience the price changes. The results indicate a statistically significant effect of price, with a $10 increase in monthly premium contributions leading to a 2 to 3 percentage point decrease in a plan's market share. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Variación del estado nutricional durante el tratamiento antituberculoso en beneficiarios del programa PANTBC Change in nutritional status over the course of antituberculosis treatment in current and past beneficiaries of the program PANTBC

    Directory of Open Access Journals (Sweden)

    Juan Pablo Aparco

    2012-09-01

    Full Text Available Objetivos. Analizar la variación nutricional de los beneficiarios actuales y pasados del Programa de Alimentación y Nutrición al Paciente Ambulatorio con Tuberculosis y Familia (PANTBC. Materiales y métodos. Se realizó un análi-sis secundario a partir de la valoración antropométrica por medio del índice de masa corporal (IMC en beneficiarios actuales y pasados del programa PANTBC. Las mediciones se realizaron al inicio, segundo y quinto o sexto mes y se comparó la distribución del estado nutricional al inicio respecto al final (prueba de McNemar-Bowker. Resultados. Se incluyó información de 409 beneficiarios actuales y 110 beneficiarios pasados. Tanto en beneficiarios actuales como pasados se observó disminución progresiva de la condición de bajo peso (IMCObjectives. Analyze the nutritional changes among current and old beneficiaries of the Food and Nutrition Program for Outpatients with Tuberculosis and their Family (PANTBC, Spanish acronym. Materials and methods. A secondary analysis was conducted based on the anthropometric measurements with the body mass index (BMI in current and old beneficiaries of the PANTBC program. The measurements were taken at the baseline, second and fifth or sixth month, and the distribution of the nutritional status was analyzed at baseline as compared to the endpoint (McNemar-Bowker test. Results. Information about 409 current beneficiaries and 110 old beneficiaries were included. A progressive decline in low weight as well as an increase in overweight were observed in both current and old beneficiaries (IMC<18.5. The results of the third measurement showed that 57.7% of current beneficiaries who started with low weight ended up with normal weight, while 20.7% of those who started with normal weight ended up with overweight. The analysis of the nutritional status at baseline compared to the endpoint showed changes in distribution (p<0.05. Conclusions. Across the PANTBC program, there is a variation

  14. Assessing Measurement Error in Medicare Coverage From the National Health Interview Survey

    Science.gov (United States)

    Gindi, Renee; Cohen, Robin A.

    2012-01-01

    Objectives Using linked administrative data, to validate Medicare coverage estimates among adults aged 65 or older from the National Health Interview Survey (NHIS), and to assess the impact of a recently added Medicare probe question on the validity of these estimates. Data sources Linked 2005 NHIS and Master Beneficiary Record and Payment History Update System files from the Social Security Administration (SSA). Study design We compared Medicare coverage reported on NHIS with “benchmark” benefit records from SSA. Principal findings With the addition of the probe question, more reports of coverage were captured, and the agreement between the NHIS-reported coverage and SSA records increased from 88% to 95%. Few additional overreports were observed. Conclusions Increased accuracy of the Medicare coverage status of NHIS participants was achieved with the Medicare probe question. Though some misclassification remains, data users interested in Medicare coverage as an outcome or correlate can use this survey measure with confidence. PMID:24800138

  15. Customers, clients or co-designers

    DEFF Research Database (Denmark)

    Plant, Peter

    2007-01-01

    The primary beneficiaries of career guidance are the direct users. At which level should they be involved? This article points to levels of involvement that go beyond satisfaction surveys and into democratisation.......The primary beneficiaries of career guidance are the direct users. At which level should they be involved? This article points to levels of involvement that go beyond satisfaction surveys and into democratisation....

  16. 38 CFR 3.1000 - Entitlement under 38 U.S.C. 5121 to benefits due and unpaid upon death of a beneficiary.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Entitlement under 38 U.S.C. 5121 to benefits due and unpaid upon death of a beneficiary. 3.1000 Section 3.1000 Pensions... Dependency and Indemnity Compensation Accrued § 3.1000 Entitlement under 38 U.S.C. 5121 to benefits due and...

  17. Certain aspects of the accounting of the bank guarantee at the principal and the beneficiary

    Directory of Open Access Journals (Sweden)

    L. A. Zimakova

    2016-01-01

    Full Text Available For any kind of business such category as risks is peculiar. The research of this category was conducted by scientists from the different sides, certain approaches of protection against risks were developed and instruments of decrease in financial risks are offered. The bank guarantee is one of the most demanded instruments of additional financial protection today. Its active using of the commercial organizations courses questions of the organization of the detailed accounting of guarantees at the principal and the beneficiary. A little concerning the historical aspect of the bank guarantee, authors provided the overview of the determinations of "bank guarantee" characterizing it as the banking service providing distribution of responsibility between the guarantor and the principal under certain conditions. Having considered the essence of the legal nature and features of the bank guarantee recommendations about the organization of the disaggregated financial accounting on off-balance accounts were developed. In particular, need of allocation of a currency type as the directions of conducting the analytics providing correctness of reflection of cost criterion is proved. For the purpose of control of timeliness of carrying out calculations it is recommended to allocate guarantees: coincident and in coincident with primary obligation; short-term and long-term. From the point of view of nature of guarantees payment guarantees and guarantees of obligation fulfilment were allocated. These recommendations concern the beneficiary, and lack of accounting entries at a principal generates need of creation of additional registers and analytical reports which forms were offered by authors. The provided recommendations will allow obtaining transparent information on bank guarantees for the purpose of its full disclosure in the financial reporting.

  18. Epidemiology and Self-Treatment of Travelers’ Diarrhea in a Large, Prospective Cohort of Department of Defense Beneficiaries

    Science.gov (United States)

    Lalani, Tahaniyat; Maguire, Jason D.; Grant, Edward M.; Fraser, Jamie; Ganesan, Anuradha; Johnson, Mark D.; Deiss, Robert G.; Riddle, Mark S.; Burgess, Timothy; Tribble, David R.

    2014-01-01

    Background Infectious diarrhea is a common problem among travelers. Expert guidelines recommend the prompt use of antibiotics for self-treatment of moderate or severe traveler’s diarrhea (TD). There is limited data on whether travelers follow these self-treatment guidelines. We evaluated the risk factors associated with TD, use of TD self-treatment, and risk of irritable bowel syndrome (IBS) during travel. Methods Department of Defense beneficiaries traveling outside the US for ≤ 6.5 months were enrolled in a prospective cohort study. Participants received pre- and post-travel surveys, and could opt into a travel illness diary and follow-up surveys for symptoms of IBS. Standard definitions were used to assess for TD and IBS. Sub-optimal self-treatment was defined as use of antibiotics (with or without antidiarrheal agents) for mild TD, or use of antidiarrheals alone or no self-treatment in cases of moderate or severe TD. Results Twenty-four percent of participants (270/1120) met criteria for TD. The highest incidence was recorded in Africa (8.6 cases/100 person-weeks, 95% CI: 6.7–10.5). Two hundred and twelve TD cases provided information regarding severity and self-treatment: 89 (42%) had mild TD and 123 (58%) had moderate or severe TD. Moderate or severe TD was independently associated with suboptimal self-treatment (OR 10.4 [95% CI: 4.92–22.0]). Time to last unformed stool did not differ between optimal and suboptimal self-treatment. IBS occurred in 4.5% (7/154) of TD cases and 3.1% (16/516) of patients without TD (p=0.39). Among TD cases, a lower incidence of IBS was noted in participants who took antibiotics (4.8% (5/105) vs. 2.2% (1/46)), but the difference did not reach statistical significance (p=0.60). Conclusions Our results suggest the underutilization of antibiotics in travelers with moderate or severe TD. Further studies are needed to systematically evaluate pre-travel instruction and traveler adherence to self-treatment guidelines, and the

  19. Do beneficiaries' views matter in healthcare purchasing decisions? Experiences from the Nigerian tax-funded health system and the formal sector social health insurance program of the National Health Insurance Scheme.

    Science.gov (United States)

    Ibe, Ogochukwu; Honda, Ayako; Etiaba, Enyi; Ezumah, Nkoli; Hanson, Kara; Onwujekwe, Obinna

    2017-12-28

    Purchasing is a health financing function that involves the transfer of pooled resources to providers on behalf of a covered population. Little attention has been paid to the extent to which the views of that population  are reflected in purchasing decisions. This article explores how purchasers in two financing mechanisms: the Formal Sector Social Health Insurance Programme (FSSHIP) operating under the Nigerian National Health Insurance Scheme (NHIS), and the tax-funded health system perform their roles in light of their responsibilities to the populations. A case study approach was adopted in which each financing mechanism is a case. Sixteen (16) in-depth interviews with purchasers and eight (8) focus group discussions with beneficiaries were held. Agency and organizational behavioural theories were used to characterise the purchaser-citizen relationships. A deductive framework approach was used to assess whether actions identified in a model of 'ideal' strategic purchasing actions were undertaken in each case. For both cases, mechanisms exist to reflect people's health needs in purchasing decisions, including quantitative and qualitative needs assessment, mechanisms to raise awareness of benefit entitlements and allow choice. However, purchasers do not use the mechanisms to effectively engage with and hold themselves accountable to the people. In the tax-funded system, weak information systems and unclear communication channels between the purchaser and citizens constrain assessment of needs; while timeliness of health information and poor engagement practices of Health Maintenance Organisations (HMOs) are the main constraints in FSSHIP. Inadequate information sharing in both mechanisms limits beneficiaries' awareness of entitlements. Although beneficiaries of FSSHIP can choose providers, lack of information on the quality of services offered by providers constrains rational decision-making and the inability to change HMOs reduces HMO responsiveness to

  20. The Medicare Health Outcomes Survey program: Overview, context, and near-term prospects

    Directory of Open Access Journals (Sweden)

    Miller Nancy A

    2004-07-01

    Full Text Available Abstract In 1996, the Centers for Medicare & Medicaid Services (CMS initiated the development of the Medicare Health Outcomes Survey (HOS. It is the first national survey to measure the quality of life and functional health status of Medicare beneficiaries enrolled in managed care. The program seeks to gather valid and reliable health status data in Medicare managed care for use in quality improvement activities, public reporting, plan accountability and improving health outcomes based on competition. The context that led to the development of the HOS was formed by the convergence of the following factors: 1 a recognized need to monitor the performance of managed care plans, 2 technical expertise and advancement in the areas of quality measurement and health outcomes assessment, 3 the existence of a tested functional health status assessment tool (SF-36®1, which was valid for an elderly population, 4 CMS leadership, and 5 political interest in quality improvement. Since 1998, there have been six baseline surveys and four follow up surveys. CMS, working with its partners, performs the following tasks as part of the HOS program: 1 Supports the technical/scientific development of the HOS measure, 2 Certifies survey vendors, 3 Collects Health Plan Employer Data and Information Set(HEDIS®2 HOS data, 4 Cleans, scores, and disseminates annual rounds of HOS data, public use files and reports to CMS, Quality Improvement Organizations (QIOs, Medicare+Choice Organizations (M+COs, and other stakeholders, 5 Trains M+COs and QIOs in the use of functional status measures and best practices for improving care, 6 Provides technical assistance to CMS, QIOs, M+COs and other data users, and 7 Conducts analyses using HOS data to support CMS and HHS priorities. CMS has recently sponsored an evaluation of the HOS program, which will provide the information necessary to enhance the future administration of the program. Information collected to date reveals that the

  1. Chronic Disease Prevalence and Medicare Advantage Market Penetration

    OpenAIRE

    Steven W. Howard; Stephanie Lazarus Bernell; Faizan M. Casim; Jennifer Wilmott; Lindsey Pearson; Caitlin M. Byler; Zidong Zhang

    2015-01-01

    By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary?s portfolio of cardiometabolic diagnoses. This study uses 2004 to 2008 Medical Expenditure Panel Survey (MEPS) Household Component data to construct an aggregate inde...

  2. 75 FR 34740 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Science.gov (United States)

    2010-06-18

    ... satisfaction of the customer service that the DMOA provides to Medicare beneficiaries and their representatives... alternative approach to payment under traditional Medicare. The episode of care is defined as the bundle of... Collection: Beneficiary Customer Service Feedback Survey; Use: The Centers for Medicare & Medicaid Services...

  3. The Effect of Clinical Care Location on Clinical Outcomes After Peripheral Vascular Intervention in Medicare Beneficiaries.

    Science.gov (United States)

    Turley, Ryan S; Mi, Xiaojuan; Qualls, Laura G; Vemulapalli, Sreekanth; Peterson, Eric D; Patel, Manesh R; Curtis, Lesley H; Jones, W Schuyler

    2017-06-12

    Modifications in reimbursement rates by Medicare in 2008 have led to peripheral vascular interventions (PVI) being performed more commonly in outpatient and office-based clinics. The objective of this study was to determine the effects of this shift in clinical care setting on clinical outcomes after PVI. Modifications in reimbursement have led to peripheral vascular intervention (PVI) being more commonly performed in outpatient hospital settings and office-based clinics. Using a 100% national sample of Medicare beneficiaries from 2010 to 2012, we examined 30-day and 1-year rates of all-cause mortality, major lower extremity amputation, repeat revascularization, and all-cause hospitalization by clinical care location of index PVI. A total of 218,858 Medicare beneficiaries underwent an index PVI between 2010 and 2012. Index PVIs performed in inpatient settings were associated with higher 1-year rates of all-cause mortality (23.6% vs. 10.4% and 11.7%; p index revascularization and geographic region on the occurrence of all-cause hospitalization, repeat revascularization, and lower extremity amputation. Index PVI performed in office-based settings was associated with a higher hazard of repeat revascularization when compared with other settings. Differences in clinical outcomes across treatment settings and geographic regions suggest that inconsistent application of PVI may exist and highlights the need for studies to determine optimal delivery of PVI in clinical practice. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  4. Long-term declines in ADLs, IADLs, and mobility among older Medicare beneficiaries

    Directory of Open Access Journals (Sweden)

    Wolinsky Fredric D

    2011-08-01

    Full Text Available Abstract Background Most prior studies have focused on short-term (≤ 2 years functional declines. But those studies cannot address aging effects inasmuch as all participants have aged the same amount. Therefore, the authors studied the extent of long-term functional decline in older Medicare beneficiaries who were followed for varying time lengths, and the authors also identified the risk factors associated with those declines. Methods The analytic sample included 5,871 self- or proxy-respondents who had complete baseline and follow-up survey data that could be linked to their Medicare claims for 1993-2007. Functional status was assessed using activities of daily living (ADLs, instrumental ADLs (IADLs, and mobility limitations, with declines defined as the development of two of more new difficulties. Multiple logistic regression analysis was used to focus on the associations involving respondent status, health lifestyle, continuity of care, managed care status, health shocks, and terminal drop. Results The average amount of time between the first and final interviews was 8.0 years. Declines were observed for 36.6% on ADL abilities, 32.3% on IADL abilities, and 30.9% on mobility abilities. Functional decline was more likely to occur when proxy-reports were used, and the effects of baseline function on decline were reduced when proxy-reports were used. Engaging in vigorous physical activity consistently and substantially protected against functional decline, whereas obesity, cigarette smoking, and alcohol consumption were only associated with mobility declines. Post-baseline hospitalizations were the most robust predictors of functional decline, exhibiting a dose-response effect such that the greater the average annual number of hospital episodes, the greater the likelihood of functional status decline. Participants whose final interview preceded their death by one year or less had substantially greater odds of functional status decline

  5. Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013.

    Science.gov (United States)

    Gupt, Anadi; Kaur, Prabhdeep; Kamraj, P; Murthy, B N

    2016-01-01

    Health insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY), should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE) for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL) families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013. We conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains. Overall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%). The median overall OOPE was $39 (Rs 2567) in the non-beneficiaries group as compared to $11 (Rs 713) in the beneficiaries group (p<0.01). Median expenditure on in house and out house drugs and consumables was $23 (Rs 1500) in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01). Non-beneficiary status was significantly associated [OR: 2.4 (1.3-4.3)] with OOPE above median independently and also after adjusting for various covariates. RSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility.

  6. Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013.

    Directory of Open Access Journals (Sweden)

    Anadi Gupt

    Full Text Available Health insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY, should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013.We conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains.Overall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%. The median overall OOPE was $39 (Rs 2567 in the non-beneficiaries group as compared to $11 (Rs 713 in the beneficiaries group (p<0.01. Median expenditure on in house and out house drugs and consumables was $23 (Rs 1500 in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01. Non-beneficiary status was significantly associated [OR: 2.4 (1.3-4.3] with OOPE above median independently and also after adjusting for various covariates.RSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility.

  7. Work participation and health-related characteristics of sickness absence beneficiaries with multiple somatic symptoms

    DEFF Research Database (Denmark)

    Momsen, A H; Nielsen, Claus Vinther; Nielsen, M B D

    2016-01-01

    unemployed was higher for this group than for those with a low score. Adjusting for general health reduced the association between symptoms and unemployment, whereas problems with social relations only affected it marginally. Conclusions: Sick-listed individuals reporting high levels of symptoms were more......Objectives: The primary aim was to study whether high levels of multiple symptoms influenced sick-listed individuals' employment status or desire to return to work (RTW) and whether this was associated with social relations at work. Study design: A cross-sectional study nested in a clinical trial......-listing, and use of health care were register-data. Multivariate logistic regression analyses with adjustments were performed. Results: Beneficiaries with high SCL-SOM score (n = 218, 33%) reported poorer health, job satisfaction, a lower desire to RTW and more problems with supervisors. The risk of being...

  8. Health care utilization and expenditures among Medicaid beneficiaries with neuropathic pain following spinal cord injury

    Directory of Open Access Journals (Sweden)

    Margolis JM

    2014-07-01

    Full Text Available Jay M Margolis,1 Paul Juneau,1 Alesia Sadosky,2 Joseph C Cappelleri,3 Thomas N Bryce,4 Edward C Nieshoff5 1Truven Health Analytics, Bethesda, MD, USA; 2Pfizer Inc., New York, NY, USA; 3Pfizer Inc., Groton, CT, USA; 4Department of Rehabilitation Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA; 5Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, MI, USA Background: The study aimed to evaluate health care resource utilization (HRU and costs for neuropathic pain (NeP secondary to spinal cord injury (SCI among Medicaid beneficiaries. Methods: The retrospective longitudinal cohort study used Medicaid beneficiary claims with SCI and evidence of NeP (SCI-NeP cohort matched with a cohort without NeP (SCI-only cohort. Patients had continuous Medicaid eligibility 6 months pre- and 12 months postindex, defined by either a diagnosis of central NeP (ICD-9-CM code 338.0x or a pharmacy claim for an NeP-related antiepileptic or antidepressant drug within 12 months following first SCI diagnosis. Demographics, clinical characteristics, HRU, and expenditures were compared between cohorts. Results: Propensity score-matched cohorts each consisted of 546 patients. Postindex percentages of patients with physician office visits, emergency department visits, SCI- and pain-related procedures, and outpatient prescription utilization were all significantly higher for SCI-NeP (P<0.001. Using regression models to account for covariates, adjusted mean expenditures were US$47,518 for SCI-NeP and US$30,150 for SCI only, yielding incremental costs of US$17,369 (95% confidence interval US$9,753 to US$26,555 for SCI-NeP. Factors significantly associated with increased cost included SCI type, trauma-related SCI, and comorbidity burden. Conclusion: Significantly higher HRU and total costs were incurred by Medicaid patients with NeP secondary to SCI compared with matched SCI-only patients. Keywords: spinal

  9. When is a lie acceptable? Work and private life lying acceptance depends on its beneficiary.

    Science.gov (United States)

    Cantarero, Katarzyna; Szarota, Piotr; Stamkou, Eftychia; Navas, Marisol; Dominguez Espinosa, Alejandra Del Carmen

    2018-01-01

    In this article we show that when analyzing attitude towards lying in a cross-cultural setting, both the beneficiary of the lie (self vs other) and the context (private life vs. professional domain) should be considered. In a study conducted in Estonia, Ireland, Mexico, The Netherlands, Poland, Spain, and Sweden (N = 1345), in which participants evaluated stories presenting various types of lies, we found usefulness of relying on the dimensions. Results showed that in the joint sample the most acceptable were other-oriented lies concerning private life, then other-oriented lies in the professional domain, followed by egoistic lies in the professional domain; and the least acceptance was shown for egoistic lies regarding one's private life. We found a negative correlation between acceptance of a behavior and the evaluation of its deceitfulness.

  10. Bridging the Gap: Collaboration between a School of Pharmacy, Public Health, and Governmental Organizations to provide Clinical and Economic Services to Medicare Beneficiaries

    Directory of Open Access Journals (Sweden)

    Rajul Patel

    2018-01-01

    Full Text Available Objective: Promoting healthy communities through the provision of accessible quality healthcare services is a common mission shared by schools of pharmacy, public health departments, and governmental agencies. The following study seeks to identify and detail the benefits of collaboration between these different groups. Methods: In total, 112 mobile clinics targeting Medicare beneficiaries were held in 20 cities across Northern/Central California from 2007 to 2016. Under the supervision of licensed pharmacists, trained student pharmacists provided vaccinations, health screenings, Medicare Part D plan optimization services, and Medication Therapy Management (MTM to patients at each clinic site. Clinic support was extended by public health departments, governmental agency partners, and a health professional program. Results: Since clinic inception, 8,996 patients were provided services. In total, 19,441 health screenings and 3,643 vaccinations were collectively provided to clinic patients. We assisted 5,549 beneficiaries with their Part D benefit, resulting in an estimated aggregate out-of-pocket drug cost savings of $5.7 million. Comprehensive MTM services were provided to 4,717 patients during which 8,184 medication-related problem (MRP were identified. In 15.3% of patients, the MRP was determined severe enough to warrant prescriber follow-up. In total, 42.9% of clinic patients were from racial/ethnic minority groups and 25.5% had incomes ≤150% of the Federal Poverty Level. Conclusion: Collaboration between a school of pharmacy, public health departments, and governmental organizations can effectively serve Medicare beneficiary populations and result in: 1 lower out-of-pocket drug costs, 2 minimization of medication-related problems, 3 increased vaccination uptake, and 4 increased utilization of health screenings. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate

  11. A Survey of the Perception of the Services of Micro Finance Institutions by the Female Service Users in Benin City, South-South, Nigeria

    Directory of Open Access Journals (Sweden)

    Ernest Osas Ugiagbe

    2014-04-01

    Full Text Available The study examines the perceptions of the services of the micro finance Institutions by the women service users, and how the services of micro Institutions affect businesses of the beneficiaries of the micro credit loans. The research design for the study was the survey method. The instruments of data collection were structured questionnaires and in-depth interview. A total of 450 questionnaires were administered to the female participants, and senior management personnel of the micro credit institutions were interviewed. The cluster and simple random sampling were used to select the participants for the study. The leaders of registered unions were the informants.  The result reveals that the poor services and attitude of officials of micro finance institutions and other problems like the regressive tax regimes, harsh economic climate and patriarchy are negatively affecting the business ventures of the loan beneficiaries and by implication the goals of poverty reduction via micro credit scheme . The women beneficiaries are groaning under the burden of loan repayment and meeting other obligations as mothers and wives. This study is applicable in the context of social policy development at this time when social services delivery is not only poor but at dismal level. The need for gender sensitive and social development becomes imperative. It is critical to social work practice in the context of advocacy, empowerment programs, facilitating and initiating service delivery and Community organizing by social workers that will enhance the war against Poverty and other social impediments against women empowerment in Nigeria.  Normal 0 false false false EN-GB X-NONE X-NONE

  12. Reductions in mortality among Medicare beneficiaries following the implementation of Medicare Part D.

    Science.gov (United States)

    Semilla, April P; Chen, Fang; Dall, Timothy M

    2015-07-01

    Medicare Part D is a prescription drug program that provides seniors and disabled individuals enrolled in Medicare with outpatient drug coverage benefits. Part D has been shown to increase access to medicines and improve medication adherence; however, the effect of Part D on health outcomes has not yet been extensively studied. In this study, we used a published and validated Markov-based microsimulation model to quantify the relationships among medication use, disease incidence and severity, and mortality. Based on the simulation results, we estimate that since the implementation of Part D in 2006, nearly 200,000 Medicare beneficiaries have lived at least 1 year longer. Reductions in mortality have occurred because of fewer deaths associated with medication-sensitive conditions such as diabetes, congestive heart failure, stroke, and myocardial infarction. Improved access to medication through Medicare Part D helps patients improve blood pressure, cholesterol, and blood glucose levels, which in turn can prevent or delay the onset of disease and the incidence of adverse health events, thus reducing mortality.

  13. Oral health service utilization by elderly beneficiaries of the Mexican Institute of Social Security in México city

    Directory of Open Access Journals (Sweden)

    Solórzano-Santos Fortino

    2007-12-01

    Full Text Available Abstract Background The aging population poses a challenge to Mexican health services. The aim of this study is to describe recent oral health services utilization and its association with socio-demographic characteristics and co-morbidity in Mexican Social Security beneficiaries 60 years and older. Methods A sample of 700 individuals aged 60+ years was randomly chosen from the databases of the Mexican Institute of Social Security (IMSS. These participants resided in the southwest of Mexico City and made up the final sample of a cohort study for identifying risk factors for root caries in elderly patients. Sociodemographic variables, presence of cognitive decline, depression, morbidity, medication consumption, and utilization of as well as reasons for seeking oral health services within the past 12 months were collected through a questionnaire. Clinical oral assessments were carried out to determine coronal and root caries experience. Results The sample consisted of 698 individuals aged 71.6 years on average, of whom 68.3% were women. 374 participants (53.6% had made use of oral health services within the past 12 months. 81% of those who used oral health services sought private medical care, 12.8% sought social security services, and 6.2% public health services. 99.7% had experienced coronal caries and 44.0% root caries. Female sex (OR = 2.0, 6 years' schooling or less (OR = 1.4, and caries experience in more than 22 teeth (OR = 0.6 are factors associated with the utilization of these services. Conclusion About half the elderly beneficiaries of social security have made use of oral health services within the past 12 months, and many of them have to use private services. Being a woman, having little schooling, and low caries experience are factors associated with the use of these services.

  14. Factors affecting perception of beneficiaries of National Programme on Improved Cookstoves regarding cost-benefit of adoption of Mamta Stove

    Energy Technology Data Exchange (ETDEWEB)

    George, R.; Yadla, V.L. [M.S. Univ. of Baroda, Vadodara (India). Home Management Dept.

    1995-10-01

    Perceived levels of cost-benefit of adoption of Mamta Stove (MS) was investigated on a sample of 390 beneficiaries of National Programme on Improved Cookstoves (NPIC) drawn through multistage random sampling technique from 3 villages in Gujarat State, viz., Kanjari, Vadadla, and Sindhrot. A standardized cost-benefit scale that exhibited a reliability coefficient of 0.92 was used in the study. The main cooks revealed a mean age of 36 years. Regarding perception on available sources of cooking fuel and accessibility to those, a wide disparity was observed, not only with reference to commercial sources and fuel forms but also with reference to free fuels gathered from forest land and waste land. MSs were installed in rural kitchens with the active involvement of about 50% of the main cooks. Majority of the cooks in Sindhrot village attended user education camps. The mean perceived cost-benefit ratio (PCBR) was computed to be 0.14. However, PCBR of the cooks from Sindhrot village was 0.51 while those of Vadadla and Kanjari were 0.09 and {minus}0.19 respectively. The correlation coefficient computed between PCBR and selected variables revealed that there existed a significant positive correlation between PCBR of the cook and their participation in NPIC and quality of installation of MS. The observation of the highest PCBR in Sindhrot village, a model smokeless village developed by TBU Baroda, could be attributed to the implementation of NPIC in a systematic manner adopting participatory model. The paper discusses at length the implications of the study and outlines the strategies for achieving widespread adoption of MS by beneficiaries of NPIC.

  15. Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries

    Directory of Open Access Journals (Sweden)

    Scott C. Brown

    2018-03-01

    Full Text Available Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18% and depression (by 28% for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.

  16. Does the Medicare Part D Decision-Making Experience Differ by Rural/Urban Location?

    Science.gov (United States)

    Henning-Smith, Carrie; Casey, Michelle; Moscovice, Ira

    2017-01-01

    Although much has been written about Medicare Part D enrollment, much less is known about beneficiaries' personal experiences with choosing a Part D plan, especially among rural residents. This study sought to address this gap by examining geographic differences in Part D enrollees' perceptions of the plan decision-making process, including their confidence in their choice, their knowledge about the program, and their satisfaction with available information. We used data from the 2012 Medicare Current Beneficiary Survey and included adults ages 65 and older who were enrolled in Part D at the time of the survey (n = 3,706). We used ordered logistic regression to model 4 outcomes based on beneficiaries' perceptions of the Part D decision-making and enrollment process, first accounting only for differences by rurality, then adjusting for sociodemographic, health, and coverage characteristics. Overall, half of all beneficiaries were not very confident in their Part D knowledge. Rural beneficiaries had lower odds of being confident in the plan they chose and in being satisfied with the amount of information available to them during the decision-making process. After adjusting for all covariates, micropolitan residents continued to have lower odds of being confident in the plan that they chose. Policy-makers should pay particular attention to making information about Part D easily accessible for all beneficiaries and to addressing unique barriers that rural residents have in accessing information while making decisions, such as reduced Internet availability. Furthermore, confidence in the decision-making process may be improved by simplifying the Part D program. © 2016 National Rural Health Association.

  17. The National Heart Failure Project: a health care financing administration initiative to improve the care of Medicare beneficiaries with heart failure.

    Science.gov (United States)

    Masoudi, F A; Ordin, D L; Delaney, R J; Krumholz, H M; Havranek, E P

    2000-01-01

    This is the second in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The first article outlined the history of HCFA quality-improvement projects and current initiatives to improve care in six priority areas: heart failure, acute myocardial infarction, stroke, pneumonia, diabetes, and breast cancer. This article details the objectives and design of the Medicare National Heart Failure Quality Improvement Project (NHF), which has as its goal the improvement of inpatient heart failure care. (c)2000 by CHF, Inc.

  18. The South African traditional health practitioner as a beneficiary of and provider to medical funds and schemes through the traditional health practitioners Act (Act No 22, 2007: A present-day perspective

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2017-01-01

    Full Text Available Background Payments to traditional health practitioners for services rendered from medical funds and schemes, as envisaged by the Traditional Health Practitioners Act (Act No 22, 2007, is controversial and a point of contention. Such policy was followed before in South Africa in the 1990s when some funds and schemes offered limited alternative healthcare benefits for members consulting traditional healers. Aims The study aimed to offer a contemporary view of the South African traditional health practitioner as a provider to and beneficiary of the medical funds and schemes through the Traditional Health Practitioners Act (No 22, 2007. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the South African traditional health practitioner as a provider to and beneficiary of the medical schemes and funds through the Traditional Health Practitioners Act (No 22, 2007. The findings are offered in narrative form. Results It seems as if the South African authorities completely misunderstand the future implications of the Traditional Health Practitioners Act (No 22, 2007 on healthcare. This is specifically true when it comes to the right to claim from medical funds and schemes for services rendered by traditional health practitioners and the possible extra costs for these medical schemes and funds. Conclusion The implications of Section 42(2 of the Traditional Health Practitioners Act (No 22, 2007 which aims to set up a claiming process for traditional health practitioners, seems to be very problematic. The fact that Act No 22 (2007 has not been enacted properly nine years after its promulgation has put a halt on the professionalization of traditional healers until 2015. This also affected their status as a beneficiary of and service provider to the

  19. How well does a single question about health predict the financial health of Medicare managed care plans?

    Science.gov (United States)

    Bierman, A S; Bubolz, T A; Fisher, E S; Wasson, J H

    1999-01-01

    Responses to simple questions that predict subsequent health care utilization are of interest to both capitated health plans and the payer. To determine how responses to a single question about general health status predict subsequent health care expenditures. Participants in the 1992 Medicare Current Beneficiary Survey were asked the following question: "In general, compared to other people your age, would you say your health is: excellent, very good, good, fair or poor?" To obtain each participant's total Medicare expenditures and number of hospitalizations in the ensuing year, we linked the responses to this question with data from the 1993 Medicare Continuous History Survey. Nationally representative sample of 8775 noninstitutionalized Medicare beneficiaries 65 years of age and older. Annual age- and sex-adjusted Medicare expenditures and hospitalization rates. Eighteen percent of the beneficiaries rated their health as excellent, 56% rated it as very good or good, 17% rated it as fair, and 7% rated it as poor. Medicare expenditures had a marked inverse relation to self-assessed health ratings. In the year after assessment, age- and sex-adjusted annual expenditures varied fivefold, from $8743 for beneficiaries rating their health as poor to $1656 for beneficiaries rating their health as excellent. Hospitalization rates followed the same pattern: Respondents who rated their health as poor had 675 hospitalizations per 1000 beneficiaries per year compared with 136 per 1000 for those rating their health as excellent. The response to a single question about general health status strongly predicts subsequent health care utilization. Self-reports of fair or poor health identify a group of high-risk patients who may benefit from targeted interventions. Because the current Medicare capitation formula does not account for health status, health plans can maximize profits by disproportionately enrolling beneficiaries who judge their health to be good. However, they are at

  20. A prospective cohort study of long-term cognitive changes in older Medicare beneficiaries.

    Science.gov (United States)

    Wolinsky, Fredric D; Bentler, Suzanne E; Hockenberry, Jason; Jones, Michael P; Weigel, Paula A; Kaskie, Brian; Wallace, Robert B

    2011-09-20

    Promoting cognitive health and preventing its decline are longstanding public health goals, but long-term changes in cognitive function are not well-documented. Therefore, we first examined long-term changes in cognitive function among older Medicare beneficiaries in the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD), and then we identified the risk factors associated with those changes in cognitive function. We conducted a secondary analysis of a prospective, population-based cohort using baseline (1993-1994) interview data linked to 1993-2007 Medicare claims to examine cognitive function at the final follow-up interview which occurred between 1995-1996 and 2006-2007. Besides traditional risk factors (i.e., aging, age, race, and education) and adjustment for baseline cognitive function, we considered the reason for censoring (entrance into managed care or death), and post-baseline continuity of care and major health shocks (hospital episodes). Residual change score multiple linear regression analysis was used to predict cognitive function at the final follow-up using data from telephone interviews among 3,021 to 4,251 (sample size varied by cognitive outcome) baseline community-dwelling self-respondents that were ≥ 70 years old, not in managed Medicare, and had at least one follow-up interview as self-respondents. Cognitive function was assessed using the 7-item Telephone Interview for Cognitive Status (TICS-7; general mental status), and the 10-item immediate and delayed (episodic memory) word recall tests. Mean changes in the number of correct responses on the TICS-7, and 10-item immediate and delayed word recall tests were -0.33, -0.75, and -0.78, with 43.6%, 54.9%, and 52.3% declining and 25.4%, 20.8%, and 22.9% unchanged. The main and most consistent risks for declining cognitive function were the baseline values of cognitive function (reflecting substantial regression to the mean), aging (a strong linear pattern of increased decline

  1. La empleabilidad y los beneficiarios del Seguro de Capacitación y Empleo en Mar del Plata Employability and beneficiaries of the Training and Employment Insurance in Mar del Plata

    Directory of Open Access Journals (Sweden)

    Ana Julia Atucha

    2011-12-01

    Full Text Available El objetivo de este documento es analizar si la participación de los beneficiarios del Partido de General Pueyrredon en el Seguro de Capacitación y Empleo implicó mejoras en su empleabilidad. En particular, se examinan las relaciones entre formación y empleo de este colectivo, como aproximación a la medición del impacto de esta política de mercado de trabajo en Mar del Plata. La información utilizada se basa en la "Encuesta de Informalidad y Beneficiarios de Programas Sociales" en el aglomerado, llevada a cabo en octubre de 2009 por el Grupo Estudios del Trabajo de la Facultad de Ciencias Económicas y Sociales de la Universidad Nacional de Mar del Plata, en el marco de un proyecto en convenio con la OIT. Esta fuente primaria fue complementada por entrevistas telefónicas a destinatarios seleccionados. El acercamiento se efectuó a través de una exploración de las trayectorias formativas seguidas por los destinatarios, de la valoración que ha tenido la capacitación respecto a la mejora sobre su empleabilidad y de la tarea de vinculación entre demandantes y oferentes que realiza la Oficina de Empleo. Entre los principales resultados se detectaron gran proporción de beneficiarios sin una trayectoria formativa que los califique sobre un oficio, percepciones negativas respecto a su empleabilidad y situaciones de inactividad. El documento deja planteada la necesidad de optimizar las tareas de orientación y vinculación al mercado de trabajo para mejorar la situación del grupo bajo análisis.This paper is aimed to analyze whether the participation of beneficiaries in the Training and Employment Insurance improved their employability. In particular, the relationship between training and employment of this group, as an approach to measuring the effect of this labor market policy in Mar del Plata, will be examined. The information come from the "Survey of Informality and Beneficiaries of Social Programs" collected in Mar del Plata

  2. Rates, Amounts, and Determinants of Ambulatory Blood Pressure Monitoring Claim Reimbursements Among Medicare Beneficiaries

    Science.gov (United States)

    Kent, Shia T.; Shimbo, Daichi; Huang, Lei; Diaz, Keith M.; Viera, Anthony J.; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    Ambulatory blood pressure monitoring (ABPM) can be used to identify white coat hypertension and guide hypertensive treatment. We determined the percentage of ABPM claims submitted between 2007–2010 that were reimbursed. Among 1,970 Medicare beneficiaries with submitted claims, ABPM was reimbursed for 93.8% of claims that had an ICD-9 diagnosis code of 796.2 (“elevated blood pressure reading without diagnosis of hypertension”) versus 28.5% of claims without this code. Among claims without an ICD-9 diagnosis code of 796.2 listed, those for the component (e.g., recording, scanning analysis, physician review, reporting) versus full ABPM procedures and performed by institutional versus non-institutional providers were each more than two times as likely to be successfully reimbursed. Of the claims reimbursed, the median payment was $52.01 (25–75th percentiles: $32.95–$64.98). In conclusion, educating providers on the ABPM claims reimbursement process and evaluation of Medicare reimbursement may increase the appropriate use of ABPM and improve patient care. PMID:25492833

  3. OAPS’ ACTIVITY IN THE LABOUR MARKET IN THE CONTEXT OF SURVEY RESEARCH

    Directory of Open Access Journals (Sweden)

    Władysława Łuczka-Bakuła

    2013-12-01

    Full Text Available A great deal of attention has been paid in recent years not merely to young people’s activity in the labour market, but also to the vocational involvement of elderly people. The traditional attitude towards the contemporary labour market results from the social and economic transformation, but also demographic changes and, the process of population ageing. It is thus a vital issue. A growing number of elderly people contributes to the increase in the number of beneficiaries, which is reflected in lower labour force participation and, consequently, may lead to a deterioration of production capacity of economy. On the one hand, higher pensions may be viewed as higher incomes of pensioners, but on the other hand, they constitute an extra burden for public expenses. Conversely, lower pensions may not merely result in increased activity in the labour market and higher incomes, but also be linked with an increase in social welfare expenditure. The article discusses the results of survey research conducted between 2009 and 2010 in a group of pensioners. The research shows that over a half of the surveyed OAPs were active in the labour market and their activity was mainly induced by their financial situation. 

  4. Impact of Bolsa Família Program on the nutritional status of children and adolescents from two Brazilian regions

    Directory of Open Access Journals (Sweden)

    Naiara SPERANDIO

    Full Text Available ABSTRACT Objective: To assess and compare the impact of the Bolsa Família Program (Family Allowance on the nutritional status of children and adolescents from the Brazilian Northeastern and Southeastern regions. Methods: The study used data from a database derived from a subsample of the Family Budget Survey conducted from 2008 to 2009. The ratios of underweight, stunted, and overweight children were calculated. Impact measurement analysis was preceded by propensity score matching, which matches beneficiary and non-beneficiary families in relation to a set of socioeconomic features. The nearest-neighbor matching algorithm estimated the program impact. Results: The ratio of underweight children and adolescents was, on average, 1.1% smaller in the beneficiary families than in the non-beneficiary families in the Northeastern region. As for the Southeastern region, the ratio of overweight children and adolescents was, on average, 4.2% smaller in the beneficiary families. The program did not affect stunting in either region. Conclusion: The results showed the positive impact and good focus of the program. Thus, once linked to structural actions, the program may help to improve the nutritional status and quality of life of its beneficiaries.

  5. Transurethral resection of the prostate among Medicare beneficiaries in the United States: time trends and outcomes. Prostate Patient Outcomes Research Team (PORT).

    Science.gov (United States)

    Lu-Yao, G L; Barry, M J; Chang, C H; Wasson, J H; Wennberg, J E

    1994-11-01

    The purpose of this study was to examine the epidemiology of transurethral resection of the prostate (TURP) and associated risks among Medicare beneficiaries during the period of 1984 to 1990. Medicare hospital claims for a 20% national sample of Medicare beneficiaries were used to identify TURPs performed during the study period. All reported rates were adjusted to the composition of the 1990 Medicare population. Risks of mortality and reoperation were evaluated using life-table methods. The age-adjusted rate of TURP reached a peak in 1987 and declined thereafter. Similar trends were observed for all age groups. In 1990, the rates of TURP (including all indications) were approximately 25, 19, and 13 per 1000 for men over the age of 75, 70 to 74, and 65 to 69, respectively. The 30-day mortality following TURP for the treatment of benign prostatic hyperplasia (BPH) decreased from 1.20% in 1984 to 0.77% in 1990 (linear trend, p = 0.0001). The cumulative incidence of a second TURP among men with BPH has likewise decreased steadily over time; in this study, the average was 7.2% over 7 years (5.5% when the indication for the second TURP was restricted to BPH only). The rate of TURP has been declining since 1987, conceivably due to increasing availability of alternative treatments or changes in treatment preferences of patients and physicians. Over the same period, the outcomes following TURPs have improved, perhaps due to improved surgical care and changes in patient selection.

  6. Do Experiences with Medicare Managed Care Vary According to the Proportion of Same-Race/Ethnicity/Language Individuals Enrolled in One's Contract?

    Science.gov (United States)

    Price, Rebecca Anhang; Haviland, Amelia M; Hambarsoomian, Katrin; Dembosky, Jacob W; Gaillot, Sarah; Weech-Maldonado, Robert; Williams, Malcolm V; Elliott, Marc N

    2015-01-01

    Objective To examine whether care experiences and immunization for racial/ethnic/language minority Medicare beneficiaries vary with the proportion of same-group beneficiaries in Medicare Advantage (MA) contracts. Data Sources/Study Setting Exactly 492,495 Medicare beneficiaries responding to the 2008–2009 MA Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey. Data Collection/Extraction Methods Mixed-effect regression models predicted eight CAHPS patient experience measures from self-reported race/ethnicity/language preference at individual and contract levels, beneficiary-level case-mix adjustors, along with contract and geographic random effects. Principal Findings As a contract's proportion of a given minority group increased, overall and non-Hispanic, white patient experiences were poorer on average; for the minority group in question, however, high-minority plans may score as well as low-minority plans. Spanish-preferring Hispanic beneficiaries also experience smaller disparities relative to non-Hispanic whites in plans with higher Spanish-preferring proportions. Conclusions The tendency for high-minority contracts to provide less positive patient experiences for others in the contract, but similar or even more positive patient experiences for concentrated minority group beneficiaries, may reflect cultural competency, particularly language services, that partially or fully counterbalance the poorer overall quality of these contracts. For some beneficiaries, experiences may be just as positive in some high-minority plans with low overall scores as in plans with higher overall scores. PMID:25752334

  7. ALL MEMBERS AND BENEFICIARIES OF THE PENSION FUND ARE INVITED TO ATTEND THE ANNUAL GENERAL ASSEMBLY

    CERN Multimedia

    2000-01-01

    Annual General Assembly to be held in the CERN Auditorium on Wednesday 4 October 2000 at 14.30 hrs The Agenda comprises: 1. Opening Remarks: - P. Levaux 2. The Swiss provident system: - C. Cuénoud recent trends 3. Annual Report 1999: - C. Cuénoud Presentation and results Copies of the Report are available from divisional secretariats. 4. Pension Fund’s investment policy and performance: - G. Maurin 5. Questions from members and beneficiaries Persons wishing to ask questions are encouraged to submit them, where possible, in writing in advance, addressed to Mr C. Cuénoud, Administrator of the Fund. 5. Conclusions P. Levaux As usual, participants are invited to drinks after the assembly. NB The minutes of the 1999 General Assembly are available from the Administration of the Fund (tel.(+4122)767 9194; e-mail Graziella.Praire@cern.ch) SOME ASPECTS OF THE FUND’S ACTIVITIES IN 1999 The Governing Board (at 31 December 1999) Members Appointed by C. Bovet (Alternate: E. Chiaveri...

  8. Geographic variation in fee-for-service medicare beneficiaries' medical costs is largely explained by disease burden.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Romano, Patrick S

    2013-10-01

    Control for area differences in population health (casemix adjustment) is necessary to measure geographic variations in medical spending. Studies use various casemix adjustment methods, resulting in very different geographic variation estimates. We study casemix adjustment methodological issues and evaluate alternative approaches using claims from 1.6 million Medicare beneficiaries in 60 representative communities. Two key casemix adjustment methods-controlling for patient conditions obtained from diagnoses on claims and expenditures of those at the end of life-were evaluated. We failed to find evidence of bias in the former approach attributable to area differences in physician diagnostic patterns, as others have found, and found that the assumption underpinning the latter approach-that persons close to death are equally sick across areas-cannot be supported. Diagnosis-based approaches are more appropriate when current rather than prior year diagnoses are used. Population health likely explains more than 75% to 85% of cost variations across fixed sets of areas.

  9. Stability of return to work after a coordinated and tailored intervention for sickness absence compensation beneficiaries with mental health problems

    DEFF Research Database (Denmark)

    Martin, Marie H. T.; D. Nielsen, Maj Britt; Pedersen, Jacob

    2015-01-01

    PURPOSE: Mental health problems (MHPs) are increasingly common as reasons for long-term sickness absence. However, the knowledge of how to promote a stable return to work (RTW) after sickness absence due to MHPs is limited. The purpose of this study was to assess the effects of a multidisciplinary...... showed no benefits in terms of improved stability of RTW, reduced sickness absence or improved labour market status after 2 years when compared to conventional case management. IMPLICATIONS FOR REHABILITATION: Evidence for effective return-to-work (RTW) interventions for people with mental health...... compared to conventional case management of sickness absence beneficiaries in Denmark. A stronger focus on cooperation with social insurance officers and employers may produce better results....

  10. Military veterans and Social Security.

    Science.gov (United States)

    Olsen, Anya

    There are 9.4 million military veterans receiving Social Security benefits, which means that almost one out of every four adult Social Security beneficiaries has served in the United States military. In addition, veterans and their families make up almost 40 percent of the adult Social Security beneficiary population. Policymakers are particularly interested in military veterans and their families and have provided them with benefits through several government programs, including Social Security credits, home loan guarantees, and compensation and pension payments through the Department of Veterans Affairs. It is therefore important to understand the economic and demographic characteristics of this population. Information in this article is based on data from the March 2004 Current Population Survey, a large, nationally representative survey of U.S. households. Veterans are overwhelmingly male compared with all adult Social Security beneficiaries who are more evenly split between males and females. Military veterans receiving Social Security are more likely to be married and to have finished high school compared with all adult Social Security beneficiaries, and they are less likely to be poor or near poor than the overall beneficiary population. Fourteen percent of veterans receiving Social Security benefits have income below 150 percent of poverty, while 25 percent of all adult Social Security beneficiaries are below this level. The higher economic status among veterans is also reflected in the relatively high Social Security benefits they receive. The number of military veterans receiving Social Security benefits will remain high over the next few decades, while their make-up and characteristics will change. In particular, the number of Vietnam War veterans who receive Social Security will increase in the coming decades, while the number of veterans from World War II and the Korean War will decline.

  11. Methodological Issues in Using Multiple Years of the MCBS

    Data.gov (United States)

    U.S. Department of Health & Human Services — In the systematic review, we identified 22 pooled, 17 repeated cross-sectional, and 17 longitudinal studies. Less than half of these studies explicitly described the...

  12. Application of Micro-segmentation Algorithms to the Healthcare Market:A Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Sukumar, Sreenivas R [ORNL; Aline, Frank [ORNL

    2013-01-01

    We draw inspiration from the recent success of loyalty programs and targeted personalized market campaigns of retail companies such as Kroger, Netflix, etc. to understand beneficiary behaviors in the healthcare system. Our posit is that we can emulate the financial success the companies have achieved by better understanding and predicting customer behaviors and translating such success to healthcare operations. Towards that goal, we survey current practices in market micro-segmentation research and analyze health insurance claims data using those algorithms. We present results and insights from micro-segmentation of the beneficiaries using different techniques and discuss how the interpretation can assist with matching the cost-effective insurance payment models to the beneficiary micro-segments.

  13. AVANCEMOS: Efectos sobre el abandono educativo en el hogar de personas beneficiarias

    OpenAIRE

    Muñoz-Alvarado, José Alfonso

    2016-01-01

    The following paper shows the difference between the variables that explain school dropout in households in which at least one person is an AVANCEMOS beneficiary and in households where no member is. Furthermore, it seeks to demonstrate whether there is any effect on the program AVANCEMOS on siblings of a beneficiary in their decision to leave the educational system. Using The National Household Survey 2013 from INEC and through descriptive statistics and logistic models, we obtain results in...

  14. Cash grants in humanitarian assistance: a nongovernmental organization experience in Aceh, Indonesia, following the 2004 Indian Ocean Tsunami.

    Science.gov (United States)

    Doocy, Shannon; Johnson, Diane; Robinson, Courtland

    2008-06-01

    Historically, cash interventions, as opposed to material or in-kind aid, have been relatively uncommon in the humanitarian response to emergencies. The widespread implementation of cash-based programs following the 2004 Indian Ocean tsunami provided an opportunity to examine cash distributions following disasters. The Mercy Corps cash grant program in Aceh, Indonesia, was a short-term intervention intended to assist in recompensing losses from the December 2004 tsunami. An evaluation of the Mercy Corps cash grant program was conducted for the 12-month period following the tsunami using program monitoring data and a systematic survey of cash grant beneficiaries. in 2005, the cash grant program disbursed more than US$3.3 million to more than 53,000 beneficiaries; the average cash grant award was US$6390, which was shared by an average of 108 beneficiaries. In a beneficiary survey, more than 95% of respondents reported the grant allocation processes were fair and transparent and that grant funds were received. The Mercy Corps experience with cash programs suggests that cash interventions in the emergency context, when properly administered, can have an immediate impact and serve as an efficient mechanism for providing assistance. Organizations involved in humanitarian relief, particularly donors and nongovernmental organizations, should consider incorporating cash-based interventions as an element of their response in future emergencies.

  15. Ranking hospitals for outcomes in total hip replacement - administrative data with or without additional patient surveys? - Part 1: Administrative data

    Directory of Open Access Journals (Sweden)

    Dörning, Hans

    2007-03-01

    Full Text Available Background: Many hospital rankings rely on the frequency of adverse outcomes and are based on administrative data. In the study presented here, we tried to find out, to what extent available administrative data of German Sickness Funds allow for an adequate hospital ranking and compared this with rankings based on additional information derived from a patient survey. Total hip replacement was chosen as an example procedure. In part I of the publication, we present the results of the approach based on administrative data. Methods: We used administrative data from the AOK-Lower Saxony of the years 2000, 2001 and 2002. The study population comprised all beneficiaries, who received total hip replacement in the years 2000 or 2001. Performance indicators used where “critical incident (Mortality or revision” and “number of revisions” within the first year. Hospitals were ranked if they performed at least 20 procedures on AOK-beneficiaries in each of the two years. Multivariate modelling (logistic and poisson regression was used to estimate the performance indicators by case-mix variables (age, sex, co-diagnoses and hospital characteristics (hospital size, surgical volume. The actual ranking was based on these multivariate models, excluding hospital variables and adding dummy-variables for each hospital. Hospitals were ranked by their case-mix adjusted odds ratio or SMR respectively with respect to a pre-selected reference hospital. The resulting rankings were compared with each other, with regard to temporal stability, and the impact of case-mix variables.Results: About 4500 beneficiaries received total hip replacement in each year (n2000: 4482; n2001: 4579. The ranking included 65 hospitals. Comparing the years 2000 and 2001, the temporal stability of the rankings based on a single performance indicator was low (Spearman rang correlation coefficients 0.158 and 0.191. The agreement of rankings based on different performance indicators in the

  16. Cost-Related Medication Nonadherence and Cost-Saving Behaviors Among Patients With Glaucoma Before and After the Implementation of Medicare Part D.

    Science.gov (United States)

    Blumberg, Dana M; Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; De Moraes, C Gustavo

    2015-09-01

    Understanding factors that lead to nonadherence to glaucoma treatment is important to diminish glaucoma-related disability. To determine whether the implementation of the Medicare Part D prescription drug benefit affected rates of cost-related nonadherence and cost-reduction strategies in Medicare beneficiaries with and without glaucoma and to evaluate associated risk factors for such nonadherence. Serial cross-sectional study using 2004 to 2009 Medicare Current Beneficiary Survey data linked with Medicare claims. Coding to extract data started in January 2014 and analyses were performed between September and November of 2014. Participants were all Medicare beneficiaries, including those with a glaucoma-related diagnosis in the year prior to the collection of the survey data, those with a nonglaucomatous ophthalmic diagnosis in the year prior to the collection of the survey data, and those without a recent eye care professional claim. Effect of the implementation of the Medicare Part D drug benefit. The change in cost-related nonadherence and the change in cost-reduction strategies. Between 2004 and 2009, the number of Medicare beneficiaries with glaucoma who reported taking smaller doses and skipping doses owing to cost dropped from 9.4% and 8.2% to 2.7% (P cost did not improve in the same period (3.4% in 2004 and 2.1% in 2009; P = .12). After Part D, patients with glaucoma had a decrease in several cost-reduction strategies, namely price shopping (26.2%-15.2%; P cost-related nonadherence measures were female sex, younger age, lower income (implementation of Part D, there was a decrease in the rate that beneficiaries with glaucoma reported engaging in cost-saving measures. Although there was a decline in the rate of several cost-related nonadherence behaviors, patients reporting failure to fill prescriptions owing to cost remained stable. This suggests that efforts to improve cost-related nonadherence should focus both on financial hardship and medical

  17. [Population-based study of child developmental screening in Mexican PROSPERA beneficiaries younger than 5 years old].

    Science.gov (United States)

    Rizzoli-Córdoba, Antonio; Martell-Valdez, Liliana; Delgado-Ginebra, Ismael; Villasís-Keever, Miguel Ángel; Reyes-Morales, Hortensia; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Vargas-López, Guillermo; Muñoz-Hernández, Onofre

    Evaluación del Desarrollo Infantil or Child Development Evaluation (CDE) test, a screening tool designed and validated in Mexico, classifies child development as normal (green) or abnormal (developmental lag or yellow and risk of delay or red). Population-based results of child development level with this tool are not known. The objective of this work was to evaluate the developmental level of children aged 1-59 months living in poverty (PROSPERA program beneficiaries) through application of the CDE test. CDE tests were applied by specifically trained and standardized personnel to children rural areas; fine motor skills, language and knowledge were more affected in males. The proportion of children with abnormal results is similar to other population-based studies. The highest rate in older children reinforces the need for an early-based intervention. The different pattern of areas affected between urban and rural areas suggests the need for a differentiated intervention. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  18. Inflammatory bowel disease and risk of Parkinson's disease in Medicare beneficiaries.

    Science.gov (United States)

    Camacho-Soto, Alejandra; Gross, Anat; Searles Nielsen, Susan; Dey, Neelendu; Racette, Brad A

    2018-05-01

    Gastrointestinal (GI) dysfunction precedes the motor symptoms of Parkinson's disease (PD) by several years. PD patients have abnormal aggregation of intestinal α-synuclein, the accumulation of which may be promoted by inflammation. The relationship between intestinal α-synuclein aggregates and central nervous system neuropathology is unknown. Recently, we observed a possible inverse association between inflammatory bowel disease (IBD) and PD as part of a predictive model of PD. Therefore, the objective of this study was to examine the relationship between PD risk and IBD and IBD-associated conditions and treatment. Using a case-control design, we identified 89,790 newly diagnosed PD cases and 118,095 population-based controls >65 years of age using comprehensive Medicare data from 2004-2009 including detailed claims data. We classified IBD using International Classification of Diseases version 9 (ICD-9) diagnosis codes. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the association between PD and IBD. Covariates included age, sex, race/ethnicity, smoking, Elixhauser comorbidities, and health care use. PD was inversely associated with IBD overall (OR = 0.85, 95% CI 0.80-0.91) and with both Crohn's disease (OR = 0.83, 95% CI 0.74-0.93) and ulcerative colitis (OR = 0.88, 95% CI 0.82-0.96). Among beneficiaries with ≥2 ICD-9 codes for IBD, there was an inverse dose-response association between number of IBD ICD-9 codes, as a potential proxy for IBD severity, and PD (p-for-trend = 0.006). IBD is associated with a lower risk of developing PD. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Publications | Page 502 | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Chadian relations on trade, investment and development aid, identifying principal beneficiaries and ... Survey of levels of support or opposition to the FCTC by important constituencies in Malaysia (restricted access).

  20. Vaccine financing and billing in practices serving adult patients: A follow-up survey.

    Science.gov (United States)

    Lindley, Megan C; Hurley, Laura P; Beaty, Brenda L; Allison, Mandy A; Crane, Lori A; Brtnikova, Michaela; Snow, Megan; Bridges, Carolyn B; Kempe, Allison

    2018-02-14

    Financial concerns are often cited by physicians as a barrier to administering routinely recommended vaccines to adults. The purpose of this study was to assess perceived payments and profit from administering recommended adult vaccines and vaccine purchasing practices among general internal medicine (GIM) and family medicine (FM) practices in the United States. We conducted an interviewer-administered survey from January-June 2014 of practices stratified by specialty (FM or GIM), affiliation (standalone or ≥ 2 practice sites), and level of financial decision-making (independent or larger system level) in FM and GIM practices that responded to a previous survey on adult vaccine financing and provided contact information for follow-up. Practice personnel identified as knowledgeable about vaccine financing and billing responded to questions about payments relative to vaccine purchase price and payment for vaccine administration, perceived profit on vaccination, claim denial, and utilization of various purchasing strategies for private vaccine stocks. Survey items on payment and perceived profit were assessed for various public and private payer types. Descriptive statistics were calculated and responses compared by physician specialty, practice affiliation, and level of financial decision-making. Of 242 practices approached, 43% (n = 104) completed the survey. Reported payment levels and perceived profit varied by payer type. Only for preferred provider organizations did a plurality of respondents report profiting on adult vaccination services. Over half of respondents reported losing money vaccinating adult Medicaid beneficiaries. One-quarter to one-third of respondents reported not knowing about Medicare Part D payment levels for vaccine purchase and vaccine administration, respectively. Few respondents reported negotiating with manufacturers or insurance plans on vaccine purchase prices or payments for vaccination. Practices vaccinating adults may

  1. Armenia - Water to Market Credit

    Data.gov (United States)

    Millennium Challenge Corporation — The analysis of WtM credit used baseline and final follow-up Farming Practices Survey (FPS) data to summarize beneficiary and loan characteristics, as well as to...

  2. The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: Evidence from the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Lipton, Brandy J; Decker, Sandra L

    2016-02-01

    Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time. This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies. Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points. Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Breast reconstruction after mastectomy among Department of Defense beneficiaries by race.

    Science.gov (United States)

    Enewold, Lindsey R; McGlynn, Katherine A; Zahm, Shelia H; Poudrier, Jill; Anderson, William F; Shriver, Craig D; Zhu, Kangmin

    2014-10-01

    Postmastectomy breast reconstruction increased approximately 20% between 1998 and 2008 in the United States and has been found to improve body image, self-esteem, and quality of life. These procedures, however, tend to be less common among minority women, which may be due to variations in health care access. The Department of Defense provides equal health care access, thereby affording an exceptional environment in which to assess whether racial variations persist when access to care is equal. Linked Department of Defense cancer registry and medical claims data were used. The receipt of reconstruction was compared between white women (n = 2974) and black women (n = 708) who underwent mastectomies to treat incident histologically confirmed breast cancer diagnosed from 1998 through 2007. During the study period, postmastectomy reconstruction increased among both black (27.3% to 40.0%) and white (21.8% to 40.6%) female patients with breast cancer. Receipt of reconstruction did not vary significantly by race (odds ratio, 0.93; 95% confidence interval, 0.76-1.15). Reconstruction decreased significantly with increasing age, tumor stage, and receipt of radiotherapy and was significantly more common in more recent years and among active service women, TRICARE Prime (health maintenance organization) beneficiaries, and women whose sponsor was an officer. The receipt of breast reconstruction did not vary by race within this equal-access health system, indicating that the racial disparities reported in previous studies may have been due in part to variations in access to health care. Additional research to determine why a large percentage of patients with breast cancer do not undergo reconstruction might be beneficial, particularly because these procedures have been associated with noncosmetic benefits. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  4. Relation between BMI and diabetes mellitus and its complications among US older adults.

    Science.gov (United States)

    Gray, Natallia; Picone, Gabriel; Sloan, Frank; Yashkin, Arseniy

    2015-01-01

    This study examined relations between elevated body mass index (BMI) and time to diagnosis with type 2 diabetes mellitus and its complications among older adults in the United States. Data came from the Medicare Current Beneficiary Survey, 1991-2010. A Cox proportional hazard model was used to assess relations between excess BMI at the first Medicare Current Beneficiary Survey interview and time to diabetes mellitus diagnosis, complications, and insulin dependence among Medicare beneficiaries, older than 65 years of age with no prior diabetes mellitus diagnosis, and who were not enrolled in Medicare Advantage (N = 14,657). Among individuals diagnosed as having diabetes mellitus, elevated BMIs were associated with a progressively higher risk of complications from diabetes mellitus. For women with a BMI ≥40, the risk of insulin dependence (hazard ratio [HR] 3.57; 95% confidence interval [CI] 2.36-5.39) was twice that for women with 25 ≤ BMI diabetes mellitus. For men, the increased risk of these complications occurred at higher BMI levels than in women. Ocular complications occurred at higher BMI levels than other complication types in both men and women.

  5. Patient-reported denials, appeals, and complaints: associations with overall plan ratings.

    Science.gov (United States)

    Quigley, Denise D; Haviland, Amelia M; Dembosky, Jacob W; Klein, David J; Elliott, Marc N

    2018-03-01

    To assess whether Medicare patients' reports of denied care, appeals/complaints, and satisfactory resolution were associated with ratings of their health plan or care. Retrospective analysis of 2010 Medicare Advantage Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data. Multivariate linear regression of data from 154,766 respondents (61.1% response rate) tested the association of beneficiary ratings of plan and care with beneficiary reports of denied care, appeals, complaints, and complaint resolution, adjusting for beneficiary demographics. Beneficiaries who reported being denied needed care rated their plans and care significantly less positively, by 17.2 points (on a 100-point scale) and 9.1 points, respectively. Filing an appeal was not statistically significantly associated with further lower ratings. Beneficiaries who filed a complaint that was satisfactorily resolved gave slightly lower ratings of plans (-3.4 points) and care (-2.5 points) than those not filing a complaint (P plans. Our results suggest that beneficiaries may attribute the actions that lead to complaints or denials to plans more than to the care they received. Successful complaint resolution and utilization management review might eliminate most deficits associated with complaints and denied care, consistent with the service recovery paradox. High rates of complaints and denied care might identify areas that need improved utilization management review, customer service, and quality improvement. Among those reporting being denied care, filing an appeal was not associated with lower patient ratings of plan or care.

  6. A Survey on Visual Programming Languages in Internet of Things

    Directory of Open Access Journals (Sweden)

    Partha Pratim Ray

    2017-01-01

    Full Text Available Visual programming has transformed the art of programming in recent years. Several organizations are in race to develop novel ideas to run visual programming in multiple domains with Internet of Things. IoT, being the most emerging area of computing, needs substantial contribution from the visual programming paradigm for its technological propagation. This paper surveys visual programming languages being served for application development, especially in Internet of Things field. 13 such languages are visited from several popular research-electronic databases (e.g., IEEE Xplore, Science Direct, Springer Link, Google Scholar, Web of Science, and Postscapes and compared under four key attributes such as programming environment, license, project repository, and platform supports. Grouped into two segments, open source and proprietary platform, these visual languages pertain few crucial challenges that have been elaborated in this literature. The main goal of this paper is to present existing VPLs per their parametric proforma to enable naïve developers and researchers in the field of IoT to choose appropriate variant of VPL for particular type of application. It is also worth validating the usability and adaptability of VPLs that is essential for selection of beneficiary in terms of IoT.

  7. Changes in Initial Treatment for Prostate Cancer Among Medicare Beneficiaries, 1999–2007

    International Nuclear Information System (INIS)

    Dinan, Michaela A.; Robinson, Timothy J.; Zagar, Timothy M.; Scales, Charles D.; Curtis, Lesley H.; Reed, Shelby D.; Lee, W. Robert; Schulman, Kevin A.

    2012-01-01

    Purpose: In the absence of evidence from large clinical trials, optimal therapy for localized prostate cancer remains unclear; however, treatment patterns continue to change. We examined changes in the management of patients with prostate cancer in the Medicare population. Methods and Materials: We conducted a retrospective claims-based analysis of the use of radiation therapy, surgery, and androgen deprivation therapy in the 12 months after diagnosis of prostate cancer in a nationally representative 5% sample of Medicare claims. Patients were Medicare beneficiaries 67 years or older with incident prostate cancer diagnosed between 1999 and 2007. Results: There were 20,918 incident cases of prostate cancer between 1999 and 2007. The proportion of patients receiving androgen deprivation therapy decreased from 55% to 36%, and the proportion of patients receiving no active therapy increased from 16% to 23%. Intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the most common method of radiation therapy, accounting for 77% of external beam radiotherapy by 2007. Minimally invasive radical prostatectomy began to replace open surgical approaches, being used in 49% of radical prostatectomies by 2007. Conclusions: Between 2002 and 2007, the use of androgen deprivation therapy decreased, open surgical approaches were largely replaced by minimally invasive radical prostatectomy, and intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the predominant method of radiation therapy in the Medicare population. The aging of the population and the increasing use of newer, higher-cost technologies in the treatment of patients with prostate cancer may have important implications for nationwide health care costs.

  8. Reliability of a patient survey assessing cost-related changes in health care use among high deductible health plan enrollees

    Directory of Open Access Journals (Sweden)

    Galbraith Alison A

    2011-05-01

    Full Text Available Abstract Background Recent increases in patient cost-sharing for health care have lent increasing importance to monitoring cost-related changes in health care use. Despite the widespread use of survey questions to measure changes in health care use and related behaviors, scant data exists on the reliability of such questions. Methods We administered a cross-sectional survey to a stratified random sample of families in a New England health plan's high deductible health plan (HDHP with ≥ $500 in annualized out-of-pocket expenditures. Enrollees were asked about their knowledge of their plan, information seeking, behavior change associated with having a deductible, experience of delay in care due in part to cost, and hypothetical delay in care due in part to cost. Initial respondents were mailed a follow-up survey within two weeks of each family returning the original survey. We computed several agreement statistics to measure the test-retest reliability for select questions. We also conducted continuity adjusted chi-square, and McNemar tests in both the original and follow-up samples to measure the degree to which our results could be reproduced. Analyses were stratified by self-reported income. Results The test-retest reliability was moderate for the majority of questions (0.41 - 0.60 and the level of test-retest reliability did not differ substantially across each of the broader domains of questions. The observed proportions of respondents with delayed or foregone pediatric, adult, or any family care were similar when comparing the original and follow-up surveys. In the original survey, respondents in the lower-income group were more likely to delay or forego pediatric care, adult care, or any family care. All of the tests comparing income groups in the follow-up survey produced the same result as in the original survey. Conclusions In this population of HDHP beneficiaries, we found that survey questions concerning plan knowledge, information

  9. ESTIMATING MORAL DEVELOPMENT IN A SAMPLE OF ALTERNATIVE FORMULAS OF PRISON SENTENCED BENEFICIARIES FROM WEST VENEZUELA

    Directory of Open Access Journals (Sweden)

    CARLOS ENRIQUE ZERPA

    2006-05-01

    Full Text Available The level of moral development in a sampled of convicts from West Venezuela is presented. The studywas carried out by means of Defining Issues Test (DIT evaluation. The sample includes 50 persons between19 and 55 years old (M = 34,33 y DT = 8,76, out of them 39 were males (average age 33,74,DT=8,24 an 11 were females (average age 35,91, DT=10,67. All of them were beneficiaries of alternativesformulas of their respective sentences such as social work, parole or conditional suspension ofsentences and following the corresponding process or rehabilitation out of prisons. This sample registereda moral principles index of 19,67 and a non-relevant answers index of 12,07 as well as fourthmoral developmental stage of 41,3 which are unusually high. The results suggest that there is not astatistically significant difference in the pattern of moral development depending on sex, age, or institutionfor sentenced fulfillment. However, the unusual high pattern of answers and the inverse correspondence between the duration of sentences and the resulting level of moral principles suggest that thesample behaves in a way, which is different from what is expected in no-out-law samples. Findings andimplications are discused.

  10. Stability of return to work after a coordinated and tailored intervention for sickness absence compensation beneficiaries with mental health problems: results of a two-year follow-up study.

    Science.gov (United States)

    Martin, Marie H T; Nielsen, Maj Britt D; Pedersen, Jacob; Rugulies, Reiner

    2015-01-01

    Mental health problems (MHPs) are increasingly common as reasons for long-term sickness absence. However, the knowledge of how to promote a stable return to work (RTW) after sickness absence due to MHPs is limited. The purpose of this study was to assess the effects of a multidisciplinary, coordinated and tailored RTW-intervention in terms of stability of RTW, cumulative sickness absence and labour market status after 2 years among sickness absence compensation beneficiaries with MHPs. In a quasi-randomised, controlled trial, we followed recipients of the intervention (n = 88) and of conventional case management (n = 80) for 2 years to compare their risk of recurrent sickness absence and unemployment after RTW, their cumulative sickness absence and their labour market status after 2 years. We found no statistically significant intervention effect in terms of the risk of recurrent sickness absence or unemployment. Intervention recipients had more cumulated sickness absence in year one (mean difference = 58 days; p sickness absence or improved labour market status after 2 years when compared to conventional case management. Evidence for effective return-to-work (RTW) interventions for people with mental health problems is limited, as most research to date has been done in the context of musculoskeletal disorders. A complex, multidisciplinary intervention, detached from the workplace, does not appear to improve the stability of RTW and may actually lead to more sickness absence days and less self-support when compared to conventional case management of sickness absence beneficiaries in Denmark. A stronger focus on cooperation with social insurance officers and employers may produce better results.

  11. A Survey of the Non-clinical Benefits of EBVM

    Directory of Open Access Journals (Sweden)

    Sarah Hauser

    2017-08-01

    Full Text Available Objective: This study aims to add non-clinical benefits to the virtues for adopting Evidence-based Veterinary Medicine (EBVM. The objective is to quantify the commercial benefits of EBVM through an online survey of veterinary professionals, giving clear indications of the key areas of non-clinical benefits of EBVM. Further, the study aims to outline barriers to the wider implementation of EBVM and find preferred ways of overcoming those barriers.Background: A PICO-based literature review (Hauser and Jackson, 2016 found that while there are some papers suggesting a link between the practice of EBVM and better non-clinical benefits such as client satisfaction, a single study, focusing on the non-clinical benefits of EBVM, had yet to be conducted. This study builds on the findings of an exploratory study (Jackson and Hauser, 2017 outlining key areas of non-clinical benefits of EBVM: increased client satisfaction and retention, improved reputation, confidence, as well as employee engagement.Evidentiary value: This online survey of veterinary professionals (n=407 provides evidence for practitioners, universities and other veterinary staff regarding the non-clinical benefits of EBVM, the barriers to a wider adoption of the practice and ways of overcoming those barriers.Methods: The online survey of veterinary professionals was conducted during September – October 2016 and contained 23 questions. Survey participation was voluntary and the data used for analysis were de-identified.Results: The survey responses of 407 veterinary professionals provide quantitative evidence of how EBVM is put into practice, how EBVM is perceived to impact client behaviour and employee engagement, what the barriers are to practising EBVM and how these could be overcome. Key findings are that veterinary professionals are more likely to practise EBVM if they have been taught how to do so at vet school. EBVM is a way to provide value to and build trust with clients. Survey

  12. Neighborhood Environment and Disparities in Health Care Access Among Urban Medicare Beneficiaries With Diabetes: A Retrospective Cohort Study.

    Science.gov (United States)

    Ryvicker, Miriam; Sridharan, Sridevi

    2018-01-01

    Older adults' health is sensitive to variations in neighborhood environment, yet few studies have examined how neighborhood factors influence their health care access. This study examined whether neighborhood environmental factors help to explain racial and socioeconomic disparities in health care access and outcomes among urban older adults with diabetes. Data from 123 233 diabetic Medicare beneficiaries aged 65 years and older in New York City were geocoded to measures of neighborhood walkability, public transit access, and primary care supply. In 2008, 6.4% had no office-based "evaluation and management" (E&M) visits. Multilevel logistic regression indicated that this group had greater odds of preventable hospitalization in 2009 (odds ratio = 1.31; 95% confidence interval: 1.22-1.40). Nonwhites and low-income individuals had greater odds of a lapse in E&M visits and of preventable hospitalization. Neighborhood factors did not help to explain these disparities. Further research is needed on the mechanisms underlying these disparities and older adults' ability to navigate health care. Even in an insured population living in a provider-dense city, targeted interventions may be needed to overcome barriers to chronic illness care for older adults in the community.

  13. Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support.

    Science.gov (United States)

    Calabrese, Sarah K; Underhill, Kristen; Earnshaw, Valerie A; Hansen, Nathan B; Kershaw, Trace S; Magnus, Manya; Krakower, Douglas S; Mayer, Kenneth H; Betancourt, Joseph R; Dovidio, John F

    2016-07-01

    Strategic framing of public messages about HIV pre-exposure prophylaxis (PrEP) may influence public support for policies and programs affecting access. This survey study examined how public attitudes toward PrEP differed based on the social group PrEP was described as benefiting ("beneficiary") and the moderating effect of prejudice. Members of the general public (n = 154) recruited online were randomly assigned to three beneficiary conditions: general population, gay men, or Black gay men. All participants received identical PrEP background information before completing measures of PrEP attitudes (specifying beneficiary), racism, and heterosexism. Despite anticipating greater PrEP adherence among gay men and Black gay men and perceiving PrEP as especially beneficial to the latter, participants expressed lower support for policies/programs making PrEP affordable for these groups vs. the general population. This disparity in support was stronger among participants reporting greater prejudice. Inclusive framing of PrEP in public discourse may prevent prejudice from undermining implementation efforts.

  14. 75 FR 54150 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Science.gov (United States)

    2010-09-03

    ... used to measure overall satisfaction of the customer service that the DMOA provides to Medicare... care as an alternative approach to payment under traditional Medicare. The episode of care is defined...; Title of Information Collection: Beneficiary Customer Service Feedback Survey; Use: The Centers for...

  15. Rising Prices of Targeted Oral Anticancer Medications and Associated Financial Burden on Medicare Beneficiaries.

    Science.gov (United States)

    Shih, Ya-Chen Tina; Xu, Ying; Liu, Lei; Smieliauskas, Fabrice

    2017-08-01

    Purpose The high cost of oncology drugs threatens the affordability of cancer care. Previous research identified drivers of price growth of targeted oral anticancer medications (TOAMs) in private insurance plans and projected the impact of closing the coverage gap in Medicare Part D in 2020. This study examined trends in TOAM prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. Methods Using SEER linked to Medicare Part D, 2007 to 2012, we identified patients who take TOAMs via National Drug Codes in Part D claims. We calculated total drug costs (prices) and OOP payments per patient per month and compared their rates of inflation with general health care prices. Results The study cohort included 42,111 patients who received TOAMs between 2007 and 2012. Although the general prescription drug consumer price index grew at 3% per year over 2007 to 2012, mean TOAM prices increased by nearly 12% per year, reaching $7,719 per patient per month in 2012. Prices increased over time for newly and previously launched TOAMs. Mean patient OOP payments dropped by 4% per year over the study period, with a 40% drop among patients with a high financial burden in 2011, when the coverage gap began to close. Conclusion Rising TOAM prices threaten the financial relief patients have begun to experience under closure of the coverage gap in Medicare Part D. Policymakers should explore methods of harnessing the surge of novel TOAMs to increase price competition for Medicare beneficiaries.

  16. Clinical and epidemiologic characteristics of an outbreak of novel H1N1 (swine origin) influenza A virus among United States military beneficiaries.

    Science.gov (United States)

    Crum-Cianflone, Nancy F; Blair, Patrick J; Faix, Dennis; Arnold, John; Echols, Sara; Sherman, Sterling S; Tueller, John E; Warkentien, Tyler; Sanguineti, Gabriela; Bavaro, Mary; Hale, Braden R

    2009-12-15

    A novel swine-origin influenza A (H1N1) virus was identified in March 2009 and subsequently caused worldwide outbreaks. The San Diego region was an early focal point of the emerging pandemic. We describe the clinical and epidemiologic characteristics of this novel strain in a military population to assist in future outbreak prevention and control efforts. We performed an epidemiologic evaluation of novel H1N1 virus infections diagnosed in San Diego County among 96,258 local US military beneficiaries. The structured military medical system afforded the ability to obtain precise epidemiologic information on the impact on H1N1 virus infection in a population. The novel H1N1 virus was confirmed using real-time reverse transcriptase polymerase chain reaction (rRT-PCR). From 21 April through 8 May 2009, 761 patients presented with influenza-like illness and underwent rRT-PCR testing. Of these patients, 97 had confirmed novel H1N1 virus infection, with an incidence rate of 101 cases per 100,000 persons. The median age of H1N1 patients with H1N1 virus infection was 21 years (interquartile range, 15-25 years). Fever was a universal symptom in patients with H1N1 virus infection; other symptoms included cough (present in 96% of patients), myalgia or arthralgia (57%), and sore throat (51%). Sixty-eight (70%) of our patients had an identifiable epidemiologic link to another confirmed patient. The largest cluster of cases of H1N1 virus infection occurred on a Navy ship and involved 32 (8%) of 402 crew members; the secondary attack rate was 6%-14%. The rapid influenza testing that was used during this outbreak had a sensitivity of 51% and specificity of 98%, compared with rRT-PCR. Only 1 patient was hospitalized, and there were no deaths. A novel H1N1 influenza A virus caused a significant outbreak among military beneficiaries in San Diego County, including a significant cluster of cases onboard a Navy ship. The outbreak described here primarily affected adolescents and young

  17. Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey.

    Science.gov (United States)

    Kang, Yu; Meng, Hongdao; Miller, Nancy A

    2011-12-01

    To evaluate the impact of rural geographic location on nursing home quality of care in the United States. The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used multilevel regression models to predict risk-adjusted rates of hospitalization, influenza and pneumococcal vaccination, and moderate to severe pain while controlling for resident and facility characteristics. Adjusting for covariates, residents in rural facilities were more likely to experience hospitalization (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.16-1.94) and moderate to severe pain (OR = 1.68, 95% CI = 1.35-2.09). Significant facility-level predictors of higher quality included higher percentage of Medicaid beneficiaries, accreditation status, and special care programs. Medicare payment findings were mixed. Significant resident-level predictors included dementia diagnosis and being a "long-stay" resident. Rural residents were more likely to reside in facilities without accreditations or special care programs, factors that increased their odds of receiving poorer quality of care. Policy efforts to enhance Medicare payment approaches as well as increase rural facilities' accreditation status and provision of special care programs will likely reduce quality of care disparities in facilities.

  18. Patient Perceptions of Electronic Health Records

    Science.gov (United States)

    Lulejian, Armine

    2011-01-01

    Research objective. Electronic Health Records (EHR) are expected to transform the way medicine is delivered with patients/consumers being the intended beneficiaries. However, little is known regarding patient knowledge and attitudes about EHRs. This study examined patient perceptions about EHR. Study design. Surveys were administered following…

  19. 15 CFR 806.11 - Estates, trusts, and intermediaries.

    Science.gov (United States)

    2010-01-01

    ... affiliate. (3) If a particular foreign direct investment in the United States is held, exercised... (Continued) BUREAU OF ECONOMIC ANALYSIS, DEPARTMENT OF COMMERCE DIRECT INVESTMENT SURVEYS § 806.11 Estates... direct investment, and the estate, not the beneficiary, is considered to be the owner. (b) A trust...

  20. Impact of the Bolsa Família program on food availability of low-income Brazilian families: a quasi experimental study.

    Science.gov (United States)

    Martins, Ana Paula Bortoletto; Monteiro, Carlos Augusto

    2016-08-19

    The Bolsa Família Program was created in Brazil in 2003, by the joint of different social programs aimed at poor or very poor families with focus on income transfer to promote immediate poverty relief, conditionalities and complementary programs. Given the contributions of conditional cash transfer programs to poverty alleviation and their potential effects on nutrition and health, the objective of this study was to assess the impact of the Bolsa Família Program on food purchases of low-income households in Brazil. Representative data from the Household Budget Survey conducted in 2008-2009 were studied, with probabilistic sample of 55,970 households. 11,282 households were eligible for this study and 48.5 % were beneficiaries of the BFP. Food availability indicators were compared among paired blocks of households (n = 100), beneficiaries or non-beneficiaries of the Bolsa Família Program, with monthly per capita income up to R$ 210.00. Blocks of households were created based on the propensity score of each household to have beneficiaries and were homogeneous regarding potential confounding variables. The food availability indicators were weekly per capita expenditure and daily energy consumption, both calculated considering all food items and four food groups based on the extent and purpose of the industrial food processing. The comparisons between the beneficiaries and non-beneficiaries blocks of households were conducted through paired 't' tests. Compared to non-beneficiaries, the beneficiaries households had 6 % higher food expenditure (p = 0.015) and 9.4 % higher total energy availability (p = 0.010). It was found a 7.3 % higher expenditure on in natura or minimally processed foods and 10.4 % higher expenditure on culinary ingredients among the Bolsa Família Program families. No statistically significant differences were found regarding the expenditure and the availability of processed and ultra-processed food and drink products. In the in

  1. Posthospitalization home health care use and changes in functional status in a Medicare population.

    Science.gov (United States)

    Hadley, J; Rabin, D; Epstein, A; Stein, S; Rimes, C

    2000-05-01

    The objective of this work was to estimate the effect of Medicare beneficiaries' use of home health care (HHC) for 6 months after hospital discharge on the change in functional status over a 1-year period beginning before hospitalization. Data came from the Medicare Current Beneficiary Survey, which is a nationally representative sample of Medicare beneficiaries, in-person interview data, and Medicare claims for 1991 through 1994 for 2,127 nondisabled, community-dwelling, elderly Medicare beneficiaries who were hospitalized within 6 months of their annual in-person interviews. Econometric estimation with the instrumental variable method was used to correct for observational data bias, ie, the nonrandom allocation of discharged beneficiaries to the use of posthospitalization HHC. The analysis estimates a first-stage model of HHC use from which an instrumental variable estimate is constructed to estimate the effect on change in functional status. The instrumental variable estimates suggest that HHC users experienced greater improvements in functional status than nonusers as measured by the change in a continuous scale based on the number and mix of activities of daily living and instrumental activities of daily living before and after hospitalization. The estimated improvement in functional status could be as large as 13% for a 10% increase in HHC use. In contrast, estimation with the observational data on HHC use implies that HHC users had poorer health outcomes. Adjusting for potential observational data bias is critical to obtaining estimates of the relationship between the use of posthospitalization HHC and the change in health before and after hospitalization. After adjustment, the results suggest that efforts to constrain Medicare's spending for HHC, as required by the Balanced Budget Act of 1997, may lead to poorer health outcomes for some beneficiaries.

  2. Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.

    Science.gov (United States)

    van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W

    2015-02-01

    To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008-June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition. Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008. Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices. This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care. © Health Research and Educational Trust.

  3. Indian social safety net programs as platforms for introducing wheat flour fortification: a case study of Gujarat, India.

    Science.gov (United States)

    Fiedler, John L; Babu, Sunil; Smitz, Marc-Francois; Lividini, Keith; Bermudez, Odilia

    2012-03-01

    Micronutrient deficiencies exact an enormous health burden on India. The release of the National Family Health Survey results--showing the relatively wealthy state of Gujarat having deficiency levels exceeding national averages--prompted Gujarat officials to introduce fortified wheat flour in their social safety net programs (SSNPs). To provide a case study of the introduction of fortified wheat flour in Gujarat's Public Distribution System (PDS), Integrated Child Development Scheme (ICDS), and Mid-Day Meal (MDM) Programme to assess the coverage, costs, impact, and cost-effectiveness of the initiative. India's 2004/05 National Sample Survey data were used to identify beneficiaries of each of Gujarat's three SSNPs and to estimate usual intake levels of vitamin A, iron, and zinc. Comparing age- and sex-specific usual intakes to Estimated Average Requirements, the proportion of the population with inadequate intakes was estimated. Postfortification intake levels and reductions in inadequate intake were estimated. The incremental cost of fortifying wheat flour and the cost-effectiveness of each program were estimated. When each program was assessed independently, the proportion of the population with inadequate vitamin A intakes was reduced by 34% and 74% among MDM and ICDS beneficiaries, respectively. Both programs effectively eliminated inadequate intakes of both iron and zinc. Among PDS beneficiaries, the proportion with inadequate iron intakes was reduced by 94%. CONCLUSIONS. Gujarat's substitution of fortified wheat flour for wheat grain is dramatically increasing the intake of micronutrients among its SSNP beneficiaries. The incremental cost of introducing fortification in each of the programs is low, and, according to World Health Organization criteria, each program is "highly cost-effective." The introduction of similar reforms throughout India would largely eliminate the inadequate iron intake among persons participating in any of the three SSNPs and would

  4. Medicare: Reviews of Quality of Care at Participating Hospitals. Report to the Administrator, Health Care Financing Administration.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Div. of Human Resources.

    This report concerns the Health Care Financing Administration's (HCFA) contracting with Utilization and Quality Control Peer Review Organizations (PROs) as a means of monitoring the medical necessity and quality of in-hospital care provided to Medicare beneficiaries. Findings from a HCFA survey of PROs in California, Florida, and Georgia are used…

  5. Comparison of postarthroplasty functional outcomes in skilled nursing facilities among Medicare and Managed Care beneficiaries

    Directory of Open Access Journals (Sweden)

    Brandon A. Haghverdian, BSc

    2017-12-01

    Full Text Available Background: After home health care, the skilled nursing facility (SNF is the most commonly used postacute care modality, among Medicare beneficiaries, after total joint arthroplasty. Prior studies demonstrated that a loss in postsurgical ambulatory gains is incurred in the interval between hospital discharge and arrival at the SNF. The aim of this present study is to determine the consequences of that loss in function, as well as compare SNF-related outcomes in patients with Medicare vs Managed Care (MC insurance. Methods: We conducted a retrospective analysis of 80 patients (54 Medicare and 26 MC who attended an SNF after hospitalization for total joint arthroplasty. Outcomes from physical therapy records were abstracted from each patient's SNF file. Results: There was an approximately 40% drop-off in gait achievements between hospital discharge and SNF admission. This decline in ambulation was significantly greater in Medicare patients (Medicare: 94.6 ± 123.2 ft, MC: 40.0 ± 48.9 ft, P = .034. Larger reductions in gait achievements between hospital discharge and SNF admission were significantly correlated with longer SNF lengths of stay and poorer gait achievements by SNF discharge. Patients with MC insurance made significant improvements in gait training at the SNF beyond that which was acquired at the hospital, whereas Medicare patients did not (PMedicare = .28, PMC = .003. Conclusions: Large losses in motor function between hospital discharge and SNF admission were associated with poor functional outcomes and longer stays at the SNF. These effects were more pronounced in Medicare patients than those with MC insurance. Keywords: Total joint arthroplasty, Skilled nursing facility, Medicare, Managed Care, Physical therapy

  6. Chronic Disease Prevalence and Medicare Advantage Market Penetration

    Science.gov (United States)

    Bernell, Stephanie Lazarus; Casim, Faizan M.; Wilmott, Jennifer; Pearson, Lindsey; Byler, Caitlin M.; Zhang, Zidong

    2015-01-01

    By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary’s portfolio of cardiometabolic diagnoses. This study uses 2004 to 2008 Medical Expenditure Panel Survey (MEPS) Household Component data to construct an aggregate index that captures multiple diagnoses in one outcome measure (Chronic Disease Severity Index [CDSI]). The MEPS data for 8089 Medicare beneficiaries are merged with MA market penetration data from Centers for Medicare and Medicaid Services (CMS). Ordinary least squares regressions are run with SAS 9.3 to model the effects of MA market penetration on CDSI. The results suggest that each percentage increase in MA market penetration is associated with a greater than 2-point decline in CDSI (lower burden of cardiometabolic chronic disease). Spill-over effects may be driving improvements in the cardiometabolic health of beneficiary populations in counties with elevated levels of MA market penetration. PMID:28462266

  7. Pengaruh Layanan Bimbingan Kelompok Terhadap Kebiasaan Merokok pada Penerima Manfaat di Balai Rehabilitasi Mandiri Semarang

    Directory of Open Access Journals (Sweden)

    Gilang Ditya Setiaji

    2014-10-01

    Full Text Available Tujuan penelitian ini adalah untuk mengetahui pengaruh bimbingan kelompok terhadap kebiasaan merokok. penelitian ini bersifat kuantitaif, responden penelitian adalah penerima manfaat Balai Rehabilitai Mandiri Semarang, teknik pengumpulan data berupa angket dan dokumentasi. Teknik analisis data menggunakan uji wilcoxon. Hasil penelitian menunjukkan Berdasarkan  hasil penelitian, kondisi kebiasaan merokok yang dimiliki oleh penerima manfaat sebelum memperoleh layanan bimbingan kelompok dan setelah memperoleh layanan bimbingan kelompok  memiliki perbedaan. Kesimpulan dari penelitian ini adalah ada pengaruh pemberian layanan  bimbingan kelompok terhadap kebiasaan merokok pada penerima manfaat. The purpose of this study was to determine the effect of group counseling on smoking habits. This research is quantitative, survey respondents are beneficiaries Rehabilitai Hall Independent Semarang, data collection techniques such as questionnaires and documentation. Analysis using Wilcoxon test. The results showed Based on this research, the habit of smoking conditions held by beneficiaries prior to obtaining services group counseling and guidance services after obtaining group differences. The conclusion of this study is that there is the effect of group counseling services to the habit of smoking to the beneficiaries.

  8. Surveying Future Surveys

    Science.gov (United States)

    Carlstrom, John E.

    2016-06-01

    The now standard model of cosmology has been tested and refined by the analysis of increasingly sensitive, large astronomical surveys, especially with statistically significant millimeter-wave surveys of the cosmic microwave background and optical surveys of the distribution of galaxies. This talk will offer a glimpse of the future, which promises an acceleration of this trend with cosmological information coming from new surveys across the electromagnetic spectrum as well as particles and even gravitational waves.

  9. Specialist participation in healthcare delivery transformation: influence of patient self-referral.

    Science.gov (United States)

    Aliu, Oluseyi; Sun, Gordon; Burke, James; Chung, Kevin C; Davis, Matthew M

    2014-01-01

    Improving coordination of care and containing healthcare costs are prominent goals of healthcare reform. Specialist involvement in healthcare delivery transformation efforts like Accountable Care Organizations (ACOs) is necessary to achieve these goals. However, patients’ self-referrals to specialists may undermine care coordination and incur unnecessary costs if patients frequently receive care from specialists not engaged in such healthcare delivery transformation efforts. Additionally, frequent self-referrals may also diminish the incentive for specialist participation in reform endeavors like ACOs to get access to a referral base. To examine recent national trends in self-referred new visits to specialists. A descriptive cross-sectional study of new ambulatory visits to specialists from 2000 to 2009 using data from the National Ambulatory Medical Care Survey. We calculated nationally representative estimates of the proportion of new specialist visits through self-referrals among Medicare and private insurance beneficiaries. We also estimated the nationally representative absolute number of self-referred new specialist visits among both groups of beneficiaries. Among Medicare and private insurance beneficiaries, self-referred visits declined from 32.2% (95% confidence interval [CI], 24.0%-40.4%) to 19.6% (95% CI, 13.9%-23.3%) and from 32.4% (95% CI, 27.9%-36.8%) to 24.1% (95% CI,18.8%-29.4%), respectively. Hence, at least 1 in 5 and 1 in 4 new visits to specialists among Medicare and private insurance beneficiaries, respectively, are self-referred. The current considerable rate of self-referred new specialist visits among both Medicare and private insurance beneficiaries may have adverse implications for organizations attempting to transform healthcare delivery with improved care coordination.

  10. Total Survey Error for Longitudinal Surveys

    NARCIS (Netherlands)

    Lynn, Peter; Lugtig, P.J.

    2016-01-01

    This article describes the application of the total survey error paradigm to longitudinal surveys. Several aspects of survey error, and of the interactions between different types of error, are distinct in the longitudinal survey context. Furthermore, error trade-off decisions in survey design and

  11. Cost-effectiveness of community vegetable gardens for people living with HIV in Zimbabwe.

    Science.gov (United States)

    Puett, Chloe; Salpéteur, Cécile; Lacroix, Elisabeth; Zimunya, Simbarashe Dennis; Israël, Anne-Dominique; Aït-Aïssa, Myriam

    2014-01-01

    There is little evidence to date of the potential impact of vegetable gardens on people living with HIV (PLHIV), who often suffer from social and economic losses due to the disease. From 2008 through 2011, Action Contre la Faim France (ACF) implemented a project in Chipinge District, eastern Zimbabwe, providing low-input vegetable gardens (LIGs) to households of PLHIV. Program partners included Médecins du Monde, which provided medical support, and Zimbabwe's Agricultural Extension Service, which supported vegetable cultivation. A survey conducted at the end of the program found LIG participants to have higher Food Consumption Scores (FCS) and Household Dietary Diversity Scores (HDDS) relative to comparator households of PLHIV receiving other support programs. This study assessed the incremental cost-effectiveness of LIGs to improve FCS and HDDS of PLHIV compared to other support programs. This analysis used an activity-based cost model, and combined ACF accounting data with estimates of partner and beneficiary costs derived using an ingredients approach to build an estimate of total program resource use. A societal perspective was adopted to encompass costs to beneficiary households, including their opportunity costs and an estimate of their income earned from vegetable sales. Qualitative methods were used to assess program benefits to beneficiary households. Effectiveness data was taken from a previously-conducted survey. Providing LIGs to PLHIV cost an additional 8,299 EUR per household with adequate FCS and 12,456 EUR per household with HDDS in the upper tertile, relative to comparator households of PLHIV receiving other support programs. Beneficiaries cited multiple tangible and intangible benefits from LIGs, and over 80% of gardens observed were still functioning more than one year after the program had finished. Cost outcomes were 20-30 times Zimbabwe's per capita GDP, and unlikely to be affordable within government services. This analysis concludes that

  12. Web-based Surveys: Changing the Survey Process

    OpenAIRE

    Gunn, Holly

    2002-01-01

    Web-based surveys are having a profound influence on the survey process. Unlike other types of surveys, Web page design skills and computer programming expertise play a significant role in the design of Web-based surveys. Survey respondents face new and different challenges in completing a Web-based survey. This paper examines the different types of Web-based surveys, the advantages and challenges of using Web-based surveys, the design of Web-based surveys, and the issues of validity, error, ...

  13. The impact of medical insurance for the poor in Georgia: a regression discontinuity approach.

    Science.gov (United States)

    Bauhoff, Sebastian; Hotchkiss, David R; Smith, Owen

    2011-11-01

    Improving access to health care and financial protection of the poor is a key concern for policymakers in low- and middle-income countries, but there have been few rigorous program evaluations. The Medical Insurance Program for the Poor in the republic of Georgia provides a free and extensive benefit package and operates through a publicly funded voucher program, enabling beneficiaries to choose their own private insurance company. Eligibility is determined by a proxy means test administered to applicant households. The objective of this study is to evaluate the program's impact on key outcomes including utilization, financial risk protection, and health behavior and management. A dedicated survey of approximately 3500 households around the thresholds was designed to minimize unobserved heterogeneity by sampling clusters with both beneficiary and non-beneficiary households. The research design exploits the sharp discontinuities at two regional eligibility thresholds to estimate local average treatment effects. Results suggest that the program did not affect utilization of health services but decreased mean out-of-pocket expenditures for some groups and reduced the risk of high inpatient expenditures. There are no systematic impacts on health behavior, management of chronic illnesses, and patient satisfaction. Copyright © 2010 John Wiley & Sons, Ltd.

  14. Chronic Disease Prevalence and Medicare Advantage Market Penetration

    Directory of Open Access Journals (Sweden)

    Steven W. Howard

    2015-10-01

    Full Text Available By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary’s portfolio of cardiometabolic diagnoses. This study uses 2004 to 2008 Medical Expenditure Panel Survey (MEPS Household Component data to construct an aggregate index that captures multiple diagnoses in one outcome measure (Chronic Disease Severity Index [CDSI]. The MEPS data for 8089 Medicare beneficiaries are merged with MA market penetration data from Centers for Medicare and Medicaid Services (CMS. Ordinary least squares regressions are run with SAS 9.3 to model the effects of MA market penetration on CDSI. The results suggest that each percentage increase in MA market penetration is associated with a greater than 2-point decline in CDSI (lower burden of cardiometabolic chronic disease. Spill-over effects may be driving improvements in the cardiometabolic health of beneficiary populations in counties with elevated levels of MA market penetration.

  15. Comparison of short-term response to two spinal manipulation techniques for patients with low back pain in a military beneficiary population.

    Science.gov (United States)

    Sutlive, Thomas G; Mabry, Lance M; Easterling, Emmanuel J; Durbin, Jose D; Hanson, Stephen L; Wainner, Robert S; Childs, John D

    2009-07-01

    To determine whether military health care beneficiaries with low back pain (LBP) who are likely to respond successfully to spinal manipulation experience a difference in short-term clinical outcomes based on the manipulation technique that is used. Sixty patients with LBP identified as likely responders to manipulation underwent a standardized clinical examination and were randomized to receive a lumbopelvic (LP) or lumbar neutral gap (NG) manipulation technique. Outcome measures were a numeric pain rating scale and the modified Oswestry Disability Questionnaire. Both the LP and NG groups experienced statistically significant reductions in pain and disability at 48 hours postmanipulation. The improvements seen in each group were small because of the short follow-up. There were no statistically significant or clinically meaningful differences in pain or disability between the two groups. The two manipulation techniques used in this study were equally effective at reducing pain and disability when compared at 48 hours posttreatment. Clinicians may employ either technique for the treatment of LBP and can expect similar outcomes in those who satisfy the clinical prediction rule (CPR). Further research is required to determine whether differences exist at longer-term follow-up periods, after multiple treatment sessions, or in different clinical populations.

  16. What are the economic and social effects from the electric power beneficiary price of the largest consumers

    International Nuclear Information System (INIS)

    Bogov, Dimitar

    2003-01-01

    In the last few years the two largest consumers of electricity 'Feni' and 'Jugohrom', were sold to the foreign strategic investor. The key issue in the negotiations with the investor was the price of electricity for these companies. The final outcome is known, they got beneficiary price. Now two questions emerge: (1) what is the exact size of the under pricing? (2) what are the economic and social effects of their activity and whether the social gain for the country is higher than the loss for the country from the under pricing of electricity. The paper is trying to give an answer on the second question. Therewith, the analyze is focused on two issues: (1) how much is the contribution of these two companies on production, export and economic growth of the Republic of Macedonia; (2) what is their impact on the living standard and social costs. Macedonian industry has very unfavorable structure with only a few export products. Restructuring of industry and widening of the array of products is a slow process. Until new products and new industries are developed, the only generator of larger export and higher economic growth is the increase of the export of existing products. 'Feni industry' and 'Silmak' are some of rare Macedonian companies that have foreign strategic investor who provide stable and unlimited market (having in mind that Macedonian production is relatively small compared to the world demand for nickel and ferro silicium). Thus, the growth of export of metals produced by 'Feni industry' and 'Silmak' could be the principal generators of the growth of Macedonian economy in the period of restructuring of the industry and development of new competitive products. (Original)

  17. Stated preferences for tropical wildlife conservation amongst distant beneficiaries

    DEFF Research Database (Denmark)

    Morse-Jones, Sian; Bateman, Ian J.; Kontoleon, Andreas

    2012-01-01

    Despite heightened awareness of the need to find additional resources for tropical biodiversity conservation, and recognition that the benefits to populations in developed countries may be significant, very few empirical studies have been conducted to estimate these values. In this article, we...... report the results of a choice experiment survey that investigated the preferences of UK residents for the conservation of threatened wildlife in the Eastern Arc Mountains in Tanzania, part of the Eastern Afromontane “biodiversity hotspot”. We examine the sensitivity of values to species types......, the number of species, the number of conservation sites and, more unusually, to potential substitutes/complements. Critically we find some evidence of coherency in preferences. Respondents are willing to pay significant, positive amounts to conserve charismatic and/or endemic species and are scope sensitive...

  18. Medicare capitation model, functional status, and multiple comorbidities: model accuracy

    Science.gov (United States)

    Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena

    2012-01-01

    Objective This study examined financial implications of CMS-Hierarchical Condition Categories (HCC) risk-adjustment model on Medicare payments for individuals with comorbid chronic conditions. Study Design The study used 1992-2000 data from the Medicare Current Beneficiary Survey and corresponding Medicare claims. The pairs of comorbidities were formed based on the prior evidence about possible synergy between these conditions and activities of daily living (ADL) deficiencies and included heart disease and cancer, lung disease and cancer, stroke and hypertension, stroke and arthritis, congestive heart failure (CHF) and osteoporosis, diabetes and coronary artery disease, CHF and dementia. Methods For each beneficiary, we calculated the actual Medicare cost ratio as the ratio of the individual’s annualized costs to the mean annual Medicare cost of all people in the study. The actual Medicare cost ratios, by ADLs, were compared to the HCC ratios under the CMS-HCC payment model. Using multivariate regression models, we tested whether having the identified pairs of comorbidities affects the accuracy of CMS-HCC model predictions. Results The CMS-HCC model underpredicted Medicare capitation payments for patients with hypertension, lung disease, congestive heart failure and dementia. The difference between the actual costs and predicted payments was partially explained by beneficiary functional status and less than optimal adjustment for these chronic conditions. Conclusions Information about beneficiary functional status should be incorporated in reimbursement models since underpaying providers for caring for population with multiple comorbidities may provide severe disincentives for managed care plans to enroll such individuals and to appropriately manage their complex and costly conditions. PMID:18837646

  19. Who should carry the cost of ecosystem service provision? A pan-European citizens’ view

    DEFF Research Database (Denmark)

    Prokofieva, Irina; Mavsar, Robert; Bartczak, Anna

    2014-01-01

    accepted concept in theory, the legitimacy of which nevertheless has not yet been challenged in practice. In our study, we conducted an extensive survey in five European countries – Finland, Denmark, Poland, Italy and Spain – with the aim to explore citizens’ opinions of who should carry the costs...... of ecosystem services provision. The ecosystem services in question were biodiversity, recreation, carbon sequestration, water quality, and scenic beauty. Our results show that the majority of respondents in all studied countries generally think that the costs of enhanced provision of ecosystem services shall......The underlying notion of payments for environmental services is that beneficiaries of environmental services (directly or indirectly) financially support their provision by covering at least part of the costs landowners incur to generate them. This so-called “beneficiary-pay principle” is a widely...

  20. No association between Centers for Medicare and Medicaid services payments and volume of Medicare beneficiaries or per-capita health care costs for each state.

    Science.gov (United States)

    Harewood, Gavin C; Alsaffar, Omar

    2015-03-01

    The Centers for Medicare and Medicaid Services recently published data on Medicare payments to physicians for 2012. We investigated regional variations in payments to gastroenterologists and evaluated whether payments correlated with the number of Medicare patients in each state. We found that the mean payment per gastroenterologist in each state ranged from $35,293 in Minnesota to $175,028 in Mississippi. Adjusted per-physician payments ranged from $11 per patient in Hawaii to $62 per patient in Washington, DC. There was no correlation between the mean per-physician payment and the mean number of Medicare patients per physician (r = 0.09), there also was no correlation between the mean per-physician payment and the overall mean per-capita health care costs for each state (r = -0.22). There was a 5.6-fold difference between the states with the lowest and highest adjusted Medicare payments to gastroenterologists. Therefore, the Centers for Medicare and Medicaid Services payments do not appear to be associated with the volume of Medicare beneficiaries or overall per-capita health care costs for each state. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  1. Influenza vaccination coverage estimates in the fee-for service Medicare beneficiary population 2006 - 2016: Using population-based administrative data to support a geographic based near real-time tool.

    Science.gov (United States)

    Shen, Angela K; Warnock, Rob; Brereton, Stephaeno; McKean, Stephen; Wernecke, Michael; Chu, Steve; Kelman, Jeffrey A

    2018-04-11

    Older adults are at great risk of developing serious complications from seasonal influenza. We explore vaccination coverage estimates in the Medicare population through the use of administrative claims data and describe a tool designed to help shape outreach efforts and inform strategies to help raise influenza vaccination rates. This interactive mapping tool uses claims data to compare vaccination levels between geographic (i.e., state, county, zip code) and demographic (i.e., race, age) groups at different points in a season. Trends can also be compared across seasons. Utilization of this tool can assist key actors interested in prevention - medical groups, health plans, hospitals, and state and local public health authorities - in supporting strategies for reaching pools of unvaccinated beneficiaries where general national population estimates of coverage are less informative. Implementing evidence-based tools can be used to address persistent racial and ethnic disparities and prevent a substantial number of influenza cases and hospitalizations.

  2. Web-Based Surveys: Not Your Basic Survey Anymore

    Science.gov (United States)

    Bertot, John Carlo

    2009-01-01

    Web-based surveys are not new to the library environment. Although such surveys began as extensions of print surveys, the Web-based environment offers a number of approaches to conducting a survey that the print environment cannot duplicate easily. Since 1994, the author and others have conducted national surveys of public library Internet…

  3. Using Self-reports or Claims to Assess Disease Prevalence: It's Complicated.

    Science.gov (United States)

    St Clair, Patricia; Gaudette, Étienne; Zhao, Henu; Tysinger, Bryan; Seyedin, Roxanna; Goldman, Dana P

    2017-08-01

    Two common ways of measuring disease prevalence include: (1) using self-reported disease diagnosis from survey responses; and (2) using disease-specific diagnosis codes found in administrative data. Because they do not suffer from self-report biases, claims are often assumed to be more objective. However, it is not clear that claims always produce better prevalence estimates. Conduct an assessment of discrepancies between self-report and claims-based measures for 2 diseases in the US elderly to investigate definition, selection, and measurement error issues which may help explain divergence between claims and self-report estimates of prevalence. Self-reported data from 3 sources are included: the Health and Retirement Study, the Medicare Current Beneficiary Survey, and the National Health and Nutrition Examination Survey. Claims-based disease measurements are provided from Medicare claims linked to Health and Retirement Study and Medicare Current Beneficiary Survey participants, comprehensive claims data from a 20% random sample of Medicare enrollees, and private health insurance claims from Humana Inc. Prevalence of diagnosed disease in the US elderly are computed and compared across sources. Two medical conditions are considered: diabetes and heart attack. Comparisons of diagnosed diabetes and heart attack prevalence show similar trends by source, but claims differ from self-reports with regard to levels. Selection into insurance plans, disease definitions, and the reference period used by algorithms are identified as sources contributing to differences. Claims and self-reports both have strengths and weaknesses, which researchers need to consider when interpreting estimates of prevalence from these 2 sources.

  4. Alumni Perspectives Survey, 2010. Survey Report

    Science.gov (United States)

    Sheikh, Sabeen

    2010-01-01

    During the months of April and September of 2009, the Graduate Management Admission Council[R] (GMAC[R]) conducted the Alumni Perspectives Survey, a longitudinal study of prior respondents to the Global Management Education Graduate Survey of management students nearing graduation. A total of 3,708 alumni responded to the April 2009 survey,…

  5. Multiple Surveys of Students and Survey Fatigue

    Science.gov (United States)

    Porter, Stephen R.; Whitcomb, Michael E.; Weitzer, William H.

    2004-01-01

    This chapter reviews the literature on survey fatigue and summarizes a research project that indicates that administering multiple surveys in one academic year can significantly suppress response rates in later surveys. (Contains 4 tables.)

  6. Using Electronic Surveys: Advice from Survey Professionals.

    Directory of Open Access Journals (Sweden)

    David M. Shannon

    2002-01-01

    Full Text Available The study reports the perceptions and recommendations of sixty-two experienced survey..researchers from the American Educational Research Association regarding the use of..electronic surveys. The most positive aspects cited for the use of electronic surveys were..reduction of costs (i.e., postage, phone charges, the use of electronic mail for pre-notification or..follow-up purposes, and the compatibility of data with existing software programs. These..professionals expressed limitations in using electronic surveys pertaining to the limited..sampling frame as well as issues of confidentiality, privacy, and the credibility of the sample...They advised that electronic surveys designed with the varied technological background and..capabilities of the respondent in mind, follow sound principles of survey construction, and be..administered to pre-notified, targeted populations with published email addresses.

  7. Economic Impact of e-Velanmai Model of Extension Service

    Directory of Open Access Journals (Sweden)

    Duraisamy Prabha

    2016-07-01

    Full Text Available A study was carried out to assess the impact of e-Velanmai project, which is an ICT (Information and Communication Technology enabled extension service implemented by Tamil Nadu Agricultural University, in three districts viz., Coimbatore, Tirupur and Villupuram of Tamil Nadu state, with 180 farmer respondents (90 e-Velanmai beneficiaries and 90 non-beneficiaries. Partial budgeting analysis revealed that the beneficiary respondentswith respect to yield, it is noticed that the yield value of beneficiaries was higher than that of the non-beneficiaries. As a result the net-gain for the beneficiaries was Rs. 28,481 per acre. With respect to the constraints faced by beneficiaries, an overwhelming percentage (94.40 % of the beneficiary respondents had expressed that they faced no constraints, while a small percentage (5.50 % indicated that there is no direct contact with TNAU Scientists’, and no follow-up visit by Field Coordinators after giving advice (1.10 %.

  8. [Food assistance programs in Mexico, coverage and targeting].

    Science.gov (United States)

    Morales-Ruán, Ma del Carmen; Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Cuevas-Nasu, Lucía; Romero-Martínez, Martín; Villalpando, Salvador; Rivera-Dommarco, Juan Ángel

    2013-01-01

    To describe the distribution of social food assistance programs in Mexico. Information about 36 150 households from the National Health and Nutrition Survey (ENSANUT 2012) was included. The distribution of the social assistance food programs by characteristics as rural/urban locality, country region, ethnicity, socioeconomic level and nutritional status was observed. At the national level, food assistance programs with the greater coverage are Oportunidades (reaching 18.8% of the population), Liconsa (milk distribution, 9.7%) and School Breakfasts (12.2%). The program that assists in the best way the target population is Oportunidades, where 75% of its beneficiaries belong to the "low" and "lower" socioeconomic levels, in contrast to Liconsa and School Breakfasts programs, where only 42% and 55% of the beneficiaries are in such levels, respectively. Current focus and application of the food assistance programs must be adjusted under the perspective of wellness, health and nutrition of the children population.

  9. Are trends in billing for high-intensity emergency care explained by changes in services provided in the emergency department? An observational study among US Medicare beneficiaries

    Science.gov (United States)

    Burke, Laura G; Wild, Robert C; Orav, E John; Hsia, Renee Y

    2018-01-01

    Objective There has been concern that an increase in billing for high-intensity emergency care is due to changes in coding practices facilitated by electronic health records. We sought to characterise the trends in billing for high-intensity emergency care among Medicare beneficiaries and to examine the degree to which trends in high-intensity billing are explained by changes in patient characteristics and services provided in the emergency department (ED). Design, setting and participants Observational study using traditional Medicare claims to identify ED visits at non-federal acute care hospitals for elderly beneficiaries in 2006, 2009 and 2012. Outcomes measures Billing intensity was defined by emergency physician evaluation and management (E&M) codes. We tested for overall trends in high-intensity billing (E&M codes 99285, 99291 and 99292) and in services provided over time using linear regression models, adjusting for patient characteristics. Additionally, we tested for time trends in rates of admission to the hospital and to the intensive care unit (ICU). Next, we classified outpatient visits into 39 diagnosis categories and analysed the change in proportion of high-intensity visits versus the change in number of services. Finally, we quantified the extent to which trends in high-intensity billing are explained by changes in patient demographics and services provided in the ED using multivariable modelling. Results High-intensity visits grew from 45.8% of 671 103 visits in 2006 to 57.8% of 629 010 visits in 2012 (2.0% absolute increase per year; 95% CI 1.97% to 2.03%) as did the mean number of services provided for admitted (1.28 to 1.41; +0.02 increase in procedures per year; 95% CI 0.018 to 0.021) and discharged ED patients (7.1 to 8.6; +0.25 increase in services per year; 95% CI 0.245 to 0.255). There was a reduction in hospital admission rate from 40.1% to 35.9% (−0.68% per year; 95% CI −0.71% to −0.65%; Pbilled as high intensity

  10. 30-day mortality and readmission after hemorrhagic stroke among Medicare beneficiaries in Joint Commission primary stroke center-certified and noncertified hospitals.

    Science.gov (United States)

    Lichtman, Judith H; Jones, Sara B; Leifheit-Limson, Erica C; Wang, Yun; Goldstein, Larry B

    2011-12-01

    Ischemic stroke patients treated at Joint Commission Primary Stroke Center (JC-PSC)-certified hospitals have better outcomes. Data reflecting the impact of JC-PSC status on outcomes after hemorrhagic stroke are limited. We determined whether 30-day mortality and readmission rates after hemorrhagic stroke differed for patients treated at JC-PSC-certified versus noncertified hospitals. The study included all fee-for-service Medicare beneficiaries aged 65 years or older with a primary discharge diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) in 2006. Covariate-adjusted logistic and Cox proportional hazards regression assessed the effect of care at a JC-PSC-certified hospital on 30-day mortality and readmission. There were 2305 SAH and 8708 ICH discharges from JC-PSC-certified hospitals and 3892 SAH and 22 564 ICH discharges from noncertified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% versus 33.2%, Pmortality (SAH: 35.1% versus 44.0%, Pmortality was 34% lower (odds ratio, 0.66; 95% confidence interval, 0.58-0.76) after SAH and 14% lower (odds ratio, 0.86; 95% confidence interval, 0.80-0.92) after ICH for patients discharged from JC-PSC-certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status. Patients treated at JC-PSC-certified hospitals had lower risk-adjusted mortality rates for both SAH and ICH but similar 30-day readmission rates as compared with noncertified hospitals.

  11. Survey on the Assessment of the Current Actual Expenses Incurred by Students on the Meals and Accommodation within and around the Campuses: The Case of Tanzania Higher Education Students' Loans Beneficiaries

    Science.gov (United States)

    Nyahende, Veronica R.; Bangu, Asangye N.; Chakaza, Benedicto C.

    2015-01-01

    This Survey analyses the current actual expenses incurred by students on the meals and accommodation within and around the campuses. The study was geared towards achieving the following objectives: (i) to examine the current cost incurred by a students for meals In Campus, (ii) to examine the current cost incurred by a students for accommodation…

  12. Is expanding Medicare coverage cost-effective?

    Directory of Open Access Journals (Sweden)

    Muennig Peter

    2005-03-01

    Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

  13. Influence of sustained deworming pressure on the anthelmintic resistance status in strongyles of sheep under field conditions.

    Science.gov (United States)

    Vijayasarathi, M K; Sreekumar, C; Venkataramanan, R; Raman, M

    2016-10-01

    Anthelmintic resistance (AR) status in Madras Red sheep from selected field flocks of a government funded scheme, covered by regular, sustained anthelmintic treatment for more than 10 years was determined. Parameters such as fecal egg count reduction test (FECRT), larval paralysis assay (LPA), and allele-specific-PCR (AS-PCR) were used to test the efficacy of fenbendazole, tetramisole, and ivermectin at recommended doses, in two seasons. Sheep belonging to non-beneficiary farmers were used as controls. Mean FECRT values of beneficiary group during winter and summer seasons were 77.77 and 76.04, 93.65 and 92.12, and 95.37 and 98.06 %, respectively, for fenbendazole, tetramisole, and ivermectin. In the non-beneficiary groups, the corresponding values were 74.82 and 81.09 %, 96.05 and 97.40 %, and 97.26 and 98.23 %, respectively. The results revealed resistance to fenbendazole, suspect resistance to tetramisole and susceptibility to ivermectin in beneficiary flock. In non-beneficiary flock, while resistance was noticed against fenbendazole, both tetramisole and ivermectin were effective. FECR values were found to be significantly different between beneficiary and non-beneficiary groups against tetramisole. The results of LPA confirmed this finding, as 50 % of the Haemonchus contortus larvae were paralyzed at the concentration of 0.0156 μg/ml in the beneficiary group, while those of non-beneficiary groups required lower concentrations of 0.0078 μg/ml. AS-PCR revealed the predominance of heterozygous susceptible population of H. contortus in the beneficiary group. In this study, resistance to fenbendazole was confirmed in both the beneficiary and non-beneficiary groups and this could be attributed to frequent use of benzimidazoles as seen from the deworming records. Emergence of tetramisole resistance was detected in the beneficiary group, where the drug was used continuously for 4 years. Ivermectin was found to be effective in all the flocks. It is

  14. 20 CFR 404.2040 - Use of benefit payments.

    Science.gov (United States)

    2010-04-01

    ..., if a beneficiary is a member of an Aid to Families With Dependent Children (AFDC) assistance unit, we... beneficiary's brother, who is the payee, learns the beneficiary needs new shoes and does not have any funds to... a pair of shoes for $29. He also takes the beneficiary to see a movie which costs $3. When they...

  15. Understanding Trends in Medicare Spending, 2007-2014.

    Science.gov (United States)

    Keohane, Laura M; Gambrel, Robert J; Freed, Salama S; Stevenson, David; Buntin, Melinda B

    2018-03-06

    To analyze the sources of per-beneficiary Medicare spending growth between 2007 and 2014, including the role of demographic characteristics, attributes of Medicare coverage, and chronic conditions. Individual-level Medicare spending and enrollment data. Using an Oaxaca-Blinder decomposition model, we analyzed whether changes in price-standardized, per-beneficiary Medicare Part A and B spending reflected changes in the composition of the Medicare population or changes in relative spending levels per person. We identified a 5 percent sample of fee-for-service Medicare beneficiaries age 65 and above from years 2007 to 2014. Mean payment-adjusted Medicare per-beneficiary spending decreased by $180 between the 2007-2010 and 2011-2014 time periods. This decline was almost entirely attributable to lower spending levels for beneficiaries. Notably, declines in marginal spending levels for beneficiaries with chronic conditions were associated with a $175 reduction in per-beneficiary spending. The decline was partially offset by the increasing prevalence of certain chronic diseases. Still, we are unable to attribute a large share of the decline in spending levels to observable beneficiary characteristics or chronic conditions. Declines in spending levels for Medicare beneficiaries with chronic conditions suggest that changing patterns of care use may be moderating spending growth. © Health Research and Educational Trust.

  16. The Effect of Payments for Ecosystem Services Programs on the Relationship of Livelihood Capital and Livelihood Strategy among Rural Communities in Northwestern China

    Directory of Open Access Journals (Sweden)

    Fei Wang

    2015-07-01

    Full Text Available The security and quality of livelihoods for peasant households is the core issue for rural areas in China. A stable livelihood contributes to the harmonious development of related polices, poverty eradication and sustainable use of resources. In Qinghe County, located in the extremely arid zone of Northwest China, 238 validated surveys were conducted. The analysis focuses on the importance of livelihood capitals for the selection of on- or off-farm livelihood strategies among beneficiaries of different kinds of ecological compensation packages. The goal is to see if different groups of beneficiaries are better able to pursue off-farm livelihoods activity, which reduces pressure on the resource base, and whether specific capitals are especially effective in helping households pursue off-farm livelihoods, which benefits their well-being. The findings show that proportionally more herdsmen (who participated in a pastureland rehabilitation program were able to pursue off-farm livelihoods than farmers (who participated in the cultivated land reforestation program, and especially agro-pastoralists (who participated in both programs. Further, models of livelihood strategy show that human and financial capitals facilitate off-farm livelihoods, while productive capital tends to lead to on-farm livelihoods. These findings indicate that there is no single determinant of livelihood strategy, and future policies must consciously differentiate among beneficiaries to reach the desired result.

  17. Older people going online: its value and before-after evaluation of volunteer support.

    Science.gov (United States)

    Jones, Ray B; Ashurst, Emily J; Atkey, Jo; Duffy, Barbara

    2015-05-18

    Although Internet usage can benefit older people by reducing social isolation, increasing access to services, and improving health and well-being, only a minority are online. Barriers to Internet uptake include attitude and a lack of knowledge and help. We have evaluated volunteer support in helping older people go online. Knowing what value the Internet has been to older people who have just gone online should guide how it is "sold" to those remaining offline. Objectives of this study are (1) to assess the feasibility of recruiting volunteers aged 50 years and older and supporting them in helping people (ie, beneficiaries) aged 65 years and older go online, (2) to assess the impact of beneficiaries using the Internet on contacts with others, loneliness, and mental health, and (3) to assess the perceived value to beneficiaries of going online. Beneficiaries received help in using the Internet from 32 volunteers in one of two ways: (1) one-on-one in their own homes, receiving an average of 12 hours of help over eight visits, or (2) in small group sessions, receiving 12 hours of help over six visits. We assessed, at registration and follow-up, the number of contacts with others, using Lubben's 6-item Lubben Social Network Scale (LBNS-6), loneliness, using De Jong Gierveld's 6-item De Jong Gierveld loneliness scale (DJG-6), and mental well-being, using Tennant's Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). We also assessed how beneficiaries valued going online using a Social Return on Investment (SROI) approach by postal survey. A total of 144 beneficiaries were recruited with the aim of helping them go online via one-on-one (n=58) or small group (n=86) sessions. Data through to follow-up were available on 76.4% (110/144) of participants. From baseline to follow-up, the number of contacts with others was significantly increased-LBNS-6, mean 13.7 to mean 17.6-loneliness scores were reduced-DJG-6, mean 2.38 to mean 1.80-and mental well-being improved

  18. Annual Omnibus Survey: A survey of life in Qatar 2014

    OpenAIRE

    Diop, Abdoulaye; Gengler, Justin John; Khan, Mohammad N.; Traugott, Michael; Elawad, Elmogiera Fadlallh; Al Ansari, Majed; Le, Kien T.; El-Maghraby, Engi; Elkassem, Rima Charbaji; Qutteina, Yara; Al Khulaifi, Buthaina; Nasrallah, Catherine; Al Subaey, Mohammed; Mustafa, Semsia Al-Ali; Alqassass, Haneen

    2015-01-01

    This Executive Summary presents the highlights of the 2014 Omnibus survey, the fourth in a series of Omnibus surveys since 2010. The surveys were carried out by the Social and Economic Survey Research Institute (SESRI) of Qatar University. Each Omnibus survey interviews a large and representative sample of Qatari citizens, resident expatriates and laborers. In these surveys, we asked a number of questions covering several topics of importance to Qatari society, including their ...

  19. Spironolactone use and higher hospital readmission for Medicare beneficiaries with heart failure, left ventricular ejection fraction 73 m(2.).

    Science.gov (United States)

    Inampudi, Chakradhari; Parvataneni, Sridivya; Morgan, Charity J; Deedwania, Prakash; Fonarow, Gregg C; Sanders, Paul W; Prabhu, Sumanth D; Butler, Javed; Forman, Daniel E; Aronow, Wilbert S; Allman, Richard M; Ahmed, Ali

    2014-07-01

    Although randomized controlled trials have demonstrated benefits of aldosterone antagonists for patients with heart failure and reduced ejection fraction (HFrEF), they excluded patients with serum creatinine >2.5 mg/dl, and their use is contraindicated in those with advanced chronic kidney disease (CKD). In the present analysis, we examined the association of spironolactone use with readmission in hospitalized Medicare beneficiaries with HFrEF and advanced CKD. Of the 1,140 patients with HFrEF (EF 73 m(2)), 207 received discharge prescriptions for spironolactone. Using propensity scores (PSs) for the receipt of discharge prescriptions for spironolactone, we estimated PS-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for spironolactone-associated outcomes. Patients (mean age 76 years, 49% women, 25% African-American) had mean EF 28%, mean eGFR 31 ml/min/1.73 m(2), and mean potassium 4.5 mEq/L. Spironolactone use had significant PS-adjusted association with higher risk of 30-day (HR 1.41, 95% CI 1.04 to 1.90) and 1-year (HR 1.36, 95% CI 1.13 to 1.63) all-cause readmissions. The risk of 1-year all-cause readmission was higher among 106 patients with eGFR 73 m(2) (HR 4.75, 95% CI 1.84 to 12.28) than among those with eGFR 15 to 45 ml/min/1.73 m(2) (HR 1.34, 95% CI 1.11 to 1.61, p for interaction 0.003). Spironolactone use had no association with HF readmission and all-cause mortality. In conclusion, among hospitalized patients with HFrEF and advanced CKD, spironolactone use was associated with higher all-cause readmission but had no association with all-cause mortality or HF readmission. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Variables Associated With Inpatient and Outpatient Resource Utilization Among Medicare Beneficiaries With Nonalcoholic Fatty Liver Disease With or Without Cirrhosis.

    Science.gov (United States)

    Sayiner, Mehmet; Otgonsuren, Munkhzul; Cable, Rebecca; Younossi, Issah; Afendy, Mariam; Golabi, Pegah; Henry, Linda; Younossi, Zobair M

    2017-03-01

    Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide with tremendous clinical burden. The economic burden of NAFLD is not well studied. To assess the economic burden of NAFLD. Medicare beneficiaries (January 1, 2010 to December 31, 2010) with NAFLD diagnosis by International Classification of Diseases, Ninth Revision codes in the absence of other liver diseases were selected. Inpatient and outpatient resource utilization parameters were total charges and total provider payments. NAFLD patients with compensated cirrhosis (CC) were compared with decompensated cirrhosis (DC). A total of 976 inpatients and 4742 outpatients with NAFLD were included-87% were white, 36% male, 30% had cardiovascular disease (CVD) or metabolic syndrome conditions, and 12% had cirrhosis. For inpatients, median total hospital charge was $36,289. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($61,151 vs. $33,863 and $18,804 vs. $10,146, P<0.001). Compared with CC, NAFLD patients with DC had higher charges and payments (P<0.02). For outpatients, median total charge was $9,011. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($12,049 vs. $8,830 and $2,586 vs. $1,734, P<0.001). Compared with CC, DC patients had higher total charges ($15,187 vs. $10,379, P=0.04). In multivariate analysis, variables associated with increased inpatient resource utilization were inpatient mortality, DC, and CVD; for outpatients, having CVD, obesity, and hypertension (all P<0.001). NAFLD is associated with significant economic burden to Medicare. Presence of cirrhosis and CVD are associated with increased resource utilization.

  1. ATTITUDES TOWARDS TUITION FEES PAYMENT IN TERTIARY EDUCATION: A SURVEY OF SUNYANI POLYTECHNIC MARKETING STUDENTS IN SUNYANI GHANA

    Directory of Open Access Journals (Sweden)

    Samuel Asuamah Yeboah

    2012-01-01

    Full Text Available The paper aims at contributing to knowledge in the area of educational finance by assessing student’s attitude towards tuition fees payment. The research is based on quantitative research design and a survey of the marketing students in Sunyani polytechnic that were selected using convenience sample method for a sample of 149. Data were analysed using percentages and one-ANOVA using the SPSS. The findings indicate that student’s knowledge on tuition fees and user fees are low. Respondents did not know that they do not pay tuition fees which are constitutional provision. Respondents consider it appropriate to contribute to the financing of their education but are not will to pay tuition. Parents of students should fund the education of their wards. Students face inadequate funding in their education and that result in worrying which affect their concentration while studying. Respondents are not willing to pay tuition fees and also the current user fees are high. Sources of funding students education are remittance from parents/friends/relative and scholarship. Those who are beneficiaries of the loan spend the amount mostly on course of study and on living expenses. This study should be replicated in other departments in the school and in other tertiary school to assess if these findings will be replicated. Since parents are the major financiers of education future study should target them to assess their attitude towards tuition fee payment.

  2. What Are Probability Surveys used by the National Aquatic Resource Surveys?

    Science.gov (United States)

    The National Aquatic Resource Surveys (NARS) use probability-survey designs to assess the condition of the nation’s waters. In probability surveys (also known as sample-surveys or statistical surveys), sampling sites are selected randomly.

  3. Survey research.

    Science.gov (United States)

    Alderman, Amy K; Salem, Barbara

    2010-10-01

    Survey research is a unique methodology that can provide insight into individuals' perspectives and experiences and can be collected on a large population-based sample. Specifically, in plastic surgery, survey research can provide patients and providers with accurate and reproducible information to assist with medical decision-making. When using survey methods in research, researchers should develop a conceptual model that explains the relationships of the independent and dependent variables. The items of the survey are of primary importance. Collected data are only useful if they accurately measure the concepts of interest. In addition, administration of the survey must follow basic principles to ensure an adequate response rate and representation of the intended target sample. In this article, the authors review some general concepts important for successful survey research and discuss the many advantages this methodology has for obtaining limitless amounts of valuable information.

  4. Knowledge and exercise of human rights, and barriers and facilitators to claiming rights: a cross-sectional study of female sex workers and high-risk men who have sex with men in Andhra Pradesh, India

    OpenAIRE

    Ganju, Deepika; Patel, Sangram Kishor; Prabhakar, Parimi; Adhikary, Rajatashurva

    2016-01-01

    Background HIV prevention interventions recognize the need to protect the rights of key populations and support them to claim their rights as a vulnerability reduction strategy. This study explores knowledge of human rights, and barriers and facilitators to claiming rights, among female sex workers (FSWs) and high-risk men who have sex with men (HR-MSM) who are beneficiaries of a community mobilization intervention in Andhra Pradesh, India. Methods Data are drawn from a cross-sectional survey...

  5. 77 FR 49721 - International Services Surveys and Direct Investment Surveys Reporting

    Science.gov (United States)

    2012-08-17

    .... See, e.g., Direct Investment Surveys: BE-12, Benchmark Survey of Foreign Direct Investment in the...] RIN 0691-AA81 International Services Surveys and Direct Investment Surveys Reporting AGENCY: Bureau of... BEA will follow to collect data on international trade in services and direct investment surveys. The...

  6. The survey of the Omagari fault using electric survey

    International Nuclear Information System (INIS)

    Matsuo, Koichi; Kishimoto, Munemaru; Negi, Tateyuki; Teshima, Minoru

    2005-08-01

    The present document is to report the results of geophysical survey by electric survey around a site proposed for the Horonobe Underground Research Program at Horonobe-cho, Hokkaido by the Japan Nuclear Cycle Development Institute. Electric survey using dipole-dipole array was carried out at 2,061 points using 101 electrodes over 1 km survey line in the area of Hokushin in Horonobe-cho near presumed Omagari-fault. Two dimensional resistivity inversion analysis was carried out and the resistivity structure from the surface to 250 m below sea level became clear. The resistivity structure was studied by comparing structure presumed from existing geological and geophysical informations. Resistivity distribution near surface was about 100 ohm-m and it became from 10 to 2 ohm-m as the depth increasing. Resistivity near presumed Omagari-fault was relatively lower than around that fault. Resistivity distribution was good agreement with two dimensional resistivity structure perfumed by AMT survey (2003) and existing electrical resistivity log data. Resistivity distribution of shallow zone at survey area was clear because the density of survey points were very high. (author)

  7. [Differences in factors associated with health checkup participation between persons with differing income levels. A cross-sectional analysis using residential taxation as a measure of household income].

    Science.gov (United States)

    Tsukishima, Eri; Takahashi, Kyoko; Yano, Koichi; Mori, Mitsuru

    2012-11-01

    Health insurers in Japan are required to provide health checkups specifically designed to detect signs of metabolic syndrome. Since National Health Insurance organizations have been increasing their numbers of low-income beneficiaries, this observational study was carried out to investigate the differences between persons with differing household income levels based on the factors associated with their participation in health checkups. The data source for this study was a database of scored answers in collected, unsigned questionnaires provided by the National Health Insurance of Sapporo City. The survey was conducted in 2009, approaching 3000 beneficiaries aged 40-74 years and sampling 4 groups divided by household income and participation in the 2008 health checkup. The survey included questions about demographics, awareness of the details of the health checkup, and knowledge of lifestyle-related diseases. Valid answers from 1656 respondents were analyzed using multiple logistic regression analysis. After analyzing the level of awareness of health checkup details among subjects and its association with checkup participation, knowledge of the locations where the checkups were held showed the highest adjusted odds ratios. Multivariate logistic regression analysis showed that the following factors were associated with participation in checkups in both lower- and higher-income groups: previous and regular participation in health checkups, willingness to attend the next checkup, and status of family or friends regarding checkup participation. In addition, that a substantial out-of-pocket cost for the checkup was not levied had a significant relationship with checkup attendance in lower-income beneficiaries, while personal obligation to undergo regular health checkups regardless of the busyness of their schedules was found to have a significant relationship in higher-income beneficiaries. In addition, logistic models that excluded factors of previous and future health

  8. 76 FR 38449 - Agency Information Collection Activities; Proposed Request and Comment Request

    Science.gov (United States)

    2011-06-30

    ... Information (BEVE)--20 CFR 401.40-- 0960-0595 The electronic proof of income (POI) verification Internet service, BEVE, provides Supplemental Security Income (SSI) recipients, Social Security beneficiaries, and Medicare beneficiaries the convenience of requesting a POI statement through the Internet. Beneficiaries...

  9. Comparison of Satellite Surveying to Traditional Surveying Methods for the Resources Industry

    Science.gov (United States)

    Osborne, B. P.; Osborne, V. J.; Kruger, M. L.

    Modern ground-based survey methods involve detailed survey, which provides three-space co-ordinates for surveyed points, to a high level of accuracy. The instruments are operated by surveyors, who process the raw results to create survey location maps for the subject of the survey. Such surveys are conducted for a location or region and referenced to the earth global co- ordinate system with global positioning system (GPS) positioning. Due to this referencing the survey is only as accurate as the GPS reference system. Satellite survey remote sensing utilise satellite imagery which have been processed using commercial geographic information system software. Three-space co-ordinate maps are generated, with an accuracy determined by the datum position accuracy and optical resolution of the satellite platform.This paper presents a case study, which compares topographic surveying undertaken by traditional survey methods with satellite surveying, for the same location. The purpose of this study is to assess the viability of satellite remote sensing for surveying in the resources industry. The case study involves a topographic survey of a dune field for a prospective mining project area in Pakistan. This site has been surveyed using modern surveying techniques and the results are compared to a satellite survey performed on the same area.Analysis of the results from traditional survey and from the satellite survey involved a comparison of the derived spatial co- ordinates from each method. In addition, comparisons have been made of costs and turnaround time for both methods.The results of this application of remote sensing is of particular interest for survey in areas with remote and extreme environments, weather extremes, political unrest, poor travel links, which are commonly associated with mining projects. Such areas frequently suffer language barriers, poor onsite technical support and resources.

  10. A Subaru galaxy redshift survey: WFMOS survey

    International Nuclear Information System (INIS)

    Takada, M

    2008-01-01

    A planned galaxy redshift survey with the Subaru 8.2m telescope, the WFMOS survey, offers a unique opportunity for probing detailed properties of large-scale structure formation in the expanding universe by measuring clustering strength of galaxy distribution as a function of distance scale and redshift. In particular, the precise measurement of the galaxy power spectrum, combined with the cosmic microwave background experiments, allows us to obtain stringent constraints on or even determine absolute mass scales of the Big-Bang relic neutrinos as the neutrinos imprint characteristic scale- and redshift-dependent modifications onto the galaxy power spectrum shape. Here we describe the basic concept of how the galaxy clustering measurement can be used to explore the neutrino masses, with particular emphasis on advantages of the WFMOS survey over the existing low-redshift surveys such as SDSS

  11. Clinicians' awareness of the Affordable Care Act mandate to provide comprehensive tobacco cessation treatment for pregnant women covered by Medicaid

    Directory of Open Access Journals (Sweden)

    Van T. Tong

    2015-01-01

    Full Text Available The Affordable Care Act (ACA requires states to provide tobacco-cessation services without cost-sharing for pregnant traditional Medicaid-beneficiaries effective October 2010. It is unknown the extent to which obstetricians–gynecologists are aware of the Medicaid tobacco-cessation benefit. We sought to examine the awareness of the Medicaid tobacco-cessation benefit in a national sample of obstetricians–gynecologists and assessed whether reimbursement would influence their tobacco cessation practice. In 2012, a survey was administered to a national stratified-random sample of obstetricians–gynecologists (n = 252 regarding awareness of the Medicaid tobacco-cessation benefit. Results were stratified by the percentage of pregnant Medicaid patients. Chi-squared tests (p < 0.05 were used to assess significant associations. Analyses were conducted in 2014. Eighty-three percent of respondents were unaware of the benefit. Lack of awareness increased as the percentage of pregnant Medicaid patients in their practices decreased (range = 71.9%–96.8%; P = 0.02. One-third (36.1% of respondents serving pregnant Medicaid patients reported that reimbursement would influence them to increase their cessation services. Four out of five obstetricians–gynecologists surveyed in 2012 were unaware of the ACA provision that required states to provide tobacco cessation coverage for pregnant traditional Medicaid beneficiaries as of October 2010. Broad promotion of the Medicaid tobacco-cessation benefit could reduce treatment barriers.

  12. CONTRIBUTIONS OF MICROFINANCE INSTITUTIONS TO ECONOMIC EFFICIENCY OF CASSAVA FARMERS IN ABIA STATE, NIGERIA

    Directory of Open Access Journals (Sweden)

    Kingsley Chukwuemeka OBIKE

    2014-10-01

    Full Text Available The study examined contributions of microfinance institutions to economic efficiency of cassava farmers in Abia state, Nigeria. A multistage random sampling technique was adopted in collecting cross sectional data on a sample size of 240 respondents (120 MFI beneficiaries and 120 non beneficiaries. Primary Data was collected by administering questionnaire on cassava farmers. The result showed that economic efficiency of MFI beneficiaries was influenced by wage rate, price of fertilizer and adjusted Y (output, while wage rate, price of fertilizer and price of cassava cutting s are variables that influenced economic efficiency of non beneficiaries. The t – test analysis confirmed that MFI beneficiaries had higher economic efficiency advantage compared with non beneficiaries. It is recommended that government agricultural policy should take positive steps to reduce interest rate to encourage MFI efforts in providing the necessary platform to encourage higher efficiency in cassava production in Abia state, Nigeria.

  13. Engineering surveying

    CERN Document Server

    Schofield, W

    2001-01-01

    The aim of Engineering Surveying has always been to impart and develop a clear understanding of the basic topics of the subject. The author has fully revised the book to make it the most up-to-date and relevant textbook available on the subject.The book also contains the latest information on trigonometric levelling, total stations and one-person measuring systems. A new chapter on satellites ensures a firm grasp of this vitally important topic.The text covers engineering surveying modules for civil engineering students on degree courses and forms a reference for the engineering surveying module in land surveying courses. It will also prove to be a valuable reference for practitioners.* Simple clear introduction to surveying for engineers* Explains key techniques and methods* Details reading systems and satellite position fixing

  14. 30-Day Mortality and Readmission after Hemorrhagic Stroke among Medicare Beneficiaries in Joint Commission Primary Stroke Center Certified and Non-Certified Hospitals

    Science.gov (United States)

    Lichtman, Judith H.; Jones, Sara B.; Leifheit-Limson, Erica C.; Wang, Yun; Goldstein, Larry B.

    2012-01-01

    Background and Purpose Ischemic stroke patients treated at Joint Commission Primary Stroke Center (JC-PSC) certified hospitals have better outcomes. Data reflecting the impact of JC-PSC status on outcomes after hemorrhagic stroke are limited. We determined whether 30-day mortality and readmission rates after hemorrhagic stroke differed for patients treated at JC-PSC certified versus non-certified hospitals. Methods The study included all fee-for-service Medicare beneficiaries ≥65 years old with a primary discharge diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) in 2006. Covariate-adjusted logistic and Cox proportional hazards regression assessed the effect of care at a JC-PSC certified hospital on 30-day mortality and readmission. Results There were 2,305 SAH and 8,708 ICH discharges from JC-PSC certified hospitals and 3,892 SAH and 22,564 ICH discharges from non-certified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% vs. 33.2%, pmortality (SAH: 35.1% vs. 44.0%, pmortality was 34% lower (OR 0.66, 95% CI 0.58–0.76) after SAH and 14% lower (OR 0.86, 95% CI 0.80–0.92) after ICH for patients discharged from JC-PSC certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status. Conclusions Patients treated at JC-PSC certified hospitals had lower risk-adjusted mortality rates for both SAH and ICH but similar 30-day readmission rates as compared with non-certified hospitals. PMID:22033986

  15. Multiagency radiation survey and site investigation manual (MARSSIM): Survey design

    International Nuclear Information System (INIS)

    Abelquist, E.W.; Berger, J.D.

    1996-01-01

    This paper describes the MultiAgency Radiation Survey and Site Investigation Manual (MARSSIM) strategy for designing a final status survey. The purpose of the final status survey is to demonstrate that release criteria established by the regulatory agency have been met. Survey design begins with identification of the contaminants and determination of whether the radionuclides of concern exist in background. The decommissioned site is segregated into Class 1, Class 2, and Class 3 areas, based on contamination potential, and each area is further divided into survey units. Appropriate reference areas for indoor and outdoor background measurements are selected. Survey instrumentation and techniques are selected in order to assure that the instrumentation is capable of detecting the contamination at the derived concentration guideline level (DCGL). Survey reference systems are established and the number of survey data points is determined-with the required number of data points distributed on a triangular grid Pattern. Two suitistical tests are used to evaluate data from final status surveys. For contaminants that are b, present in background, the Wilcoxon Rank Sum test is used; for contaminants that are not present in background, the Wilcoxon Signed Rank (or Sign) test is used. The number of data points needed to satisfy these nonparametric tests is based on the contaminant DCGL value, the expected Standard deviation of the contaminant in background and in the survey unit, and the acceptable probability of making Type I and Type II decision errors. The MARSSIM also requires a reasonable level of assurance that any small areas of elevated residual radioactivity that could be significant relative to regulatory limits are not missed during the final status survey. Measurements and sampling on a specified grid size are used to obtain an adequate assurance level that small locations of elevated radioactivity will Still satisfy DCGLs-applicable to small areas

  16. Impacto das remessas familiares e do programa Prospera em jovens de nível médio superior em Choix, Sinaloa, México

    OpenAIRE

    Pintor Sandoval, Renato; Peraza Noriega, Brianda Elena; Heredia Trasviña, Karen Olivia

    2017-01-01

    Objective: to establish the impact of family remittances from the United States and the "Prospera" welfare program for the high school student population in a community with high social exclusion and poverty in Sinaloa.Methodology: first, the population, economic and work activities in the community of Choix, Sinaloa were described. Then, the discussion on remittances and the beneficiary families of the Prospera program were characterized; finally, a survey was designed and applied to 114 hig...

  17. 77 FR 772 - International Services Surveys and Direct Investment Surveys Reporting

    Science.gov (United States)

    2012-01-06

    ... and publish in the Federal Register notices of future surveys of foreign and direct investment in the....: 111012619-1619-01] RIN 0691-AA81 International Services Surveys and Direct Investment Surveys Reporting... international trade in services and direct investment surveys provided for by the International Investment and...

  18. Download this PDF file

    African Journals Online (AJOL)

    sys01

    primary school education while 24.0% had secondary school education. About 21.3% of the beneficiaries had no formal education while. 36.0% and 14.67% of the non- beneficiaries possessed primary and secondary school education, respectively. This implies there was higher literacy level among the beneficiaries.

  19. A randomized, placebo controlled pilot trial of botulinum toxin for paratonic rigidity in people with advanced cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Galit Kleiner-Fisman

    Full Text Available Evaluate safety and efficacy of Incobotulinumtoxin A in elderly patients with dementia and paratonia.University-affiliated hospital, spasticity management Clinic.Ten subjects were enrolled.1 severe cognitive impairment 2 diagnosis of Alzheimer's disease, vascular dementia, or frontotemporal dementia, and 3 score >3 on the paratonic assessment instrument, with posture in an arm(s interfering with provision of care.1 alternate etiologies for increased tone and 2 injection with botulinum toxin within the 6 months preceding the study.Single center, randomized, double blind, placebo-controlled, crossover trial with two treatment cycles of 16 weeks. Assessments occurred at 2, 6, 12 and16 weeks following injections. Subjects received up to 300 U of Incobotulinumtoxin A in arm(s.Primary outcome measure was the modified caregiver burden scale (mCBS; exploratory secondary outcome measures were also performed. Analysis of variance and mixed modeling techniques were used to evaluate treatment effects.Incobotulinumtoxin A treatment produced significant improvement in mCBS total score -1.11 (-2.04 to -0.18 (Treatment effect and 95% CI, dressing sub-score -0.36 (-0.59 to 0.12, and cleaning under the left and right armpits sub-score -0.5 (-0.96 to -0.04, -0.41 (-0.79 to -0.04 respectively. PROM in the left and right elbow increased by 27.67 degrees (13.32-42.02 and 22.07 degrees (9.76-34.39 respectively. PROM in the left and right shoulder increased by 11.92 degrees (5.46-18.38 and 8.58 degrees (3.73-13.43 respectively. No significant treatment effect was found for GAS, VAS and PAINAD scales or change in time to perform care. No adverse drug reactions occurred.Administration of Incobotulinumtoxin A in elderly people with advanced dementia and paratonia may be an efficacious and safe treatment to increase range of motion and reduce functional burden. Further studies are needed to confirm results.ClinicalTrials.Gov NCT02212119.

  20. Aerial radiation surveys

    International Nuclear Information System (INIS)

    Jobst, J.

    1980-01-01

    A recent aerial radiation survey of the surroundings of the Vitro mill in Salt Lake City shows that uranium mill tailings have been removed to many locations outside their original boundary. To date, 52 remote sites have been discovered within a 100 square kilometer aerial survey perimeter surrounding the mill; 9 of these were discovered with the recent aerial survey map. Five additional sites, also discovered by aerial survey, contained uranium ore, milling equipment, or radioactive slag. Because of the success of this survey, plans are being made to extend the aerial survey program to other parts of the Salt Lake valley where diversions of Vitro tailings are also known to exist

  1. 26 CFR 1.641(b)-3 - Termination of estates and trusts.

    Science.gov (United States)

    2010-04-01

    ... or contingent liabilities and expenses (not including a claim by a beneficiary in the capacity of... the payment of unascertained or contingent liabilities and expenses (not including a claim by a beneficiary in the capacity of beneficiary). Notwithstanding the above, if the estate has joined in making a...

  2. 42 CFR 415.120 - Conditions for payment: Radiology services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conditions for payment: Radiology services. 415.120... Services to Beneficiaries in Providers § 415.120 Conditions for payment: Radiology services. (a) Services to beneficiaries. The carrier pays for radiology services furnished by a physician to a beneficiary...

  3. 77 FR 2724 - CVS Caremark Corporation; Analysis of Proposed Consent Order To Aid Public Comment

    Science.gov (United States)

    2012-01-19

    ... ``donut hole,'' at which point the beneficiary pays the full cost of the drugs. The Commission's complaint... estimates of the prices that beneficiaries would pay for those drugs at CVS and Walgreens. Rather, the... discrepancy, many RxAmerica beneficiaries using CVS Pharmacy and Walgreens stores ran through their benefits...

  4. Geological survey by high resolution electrical survey on granite areas

    International Nuclear Information System (INIS)

    Sugimoto, Yoshihiro; Yamada, Naoyuki

    2002-03-01

    As an Integral part of the geological survey in 'The study of the regions ground water flow system' that we are carrying out with Tono Geoscience Center, we proved the relation between the uncontinuation structure such as lineament in the base rock and resistivity structure (resistivity distribution), for the purpose of that confirms the efficacy of the high resolution electrical survey as geological survey, we carried out high resolution electrical survey on granite area. We obtained the following result, by the comparison of resistivity distribution with established geological survey, lineament analysis and investigative drilling. 1. The resistivity structure of this survey area is almost able to classify it into the following four range. 1) the low resistivity range of 50-800 Ωm, 2) The resistivity range like the middle of 200-2000 Ωm, 3) The high resistivity range of 2000 Ωm over, 4) The low resistivity range of depth of the survey line 400-550 section. 2. The low resistivity range of 4) that correspond with the established geological data is not admitted. 3. It was confirmed that resistivity structure almost correspond to geological structure by the comparison with the established data. 4. The small-scale low resistivity area is admitted in the point equivalent to the lineament position of established. 5. We carried out it with the simulation method about the low resistivity range of 4). As a result, it understood that it has the possibility that the narrow ratio low resistivity area is shown as the wide ratio resistivity range in the analysis section. In the survey in this time, it is conceivable that the resistivity distribution with the possibility of the unhomogeneous and uncontinuation structure of the base rock is being shown conspicuously, the efficacy of the high resolution resistivity survey as geological survey on granite was shown. (author)

  5. Impact of the 2013 National Rollout of CMS Competitive Bidding Program: The Disruption Continues.

    Science.gov (United States)

    Puckrein, Gary A; Hirsch, Irl B; Parkin, Christopher G; Taylor, Bruce T; Xu, Liou; Marrero, David G

    2018-05-01

    Use of glucose monitoring is essential to the safety of individuals with insulin-treated diabetes. In 2011, the Centers for Medicare & Medicaid Services (CMS) implemented the Medicare Competitive Bidding Program (CBP) in nine test markets. This resulted in a substantial disruption of beneficiary access to self-monitoring of blood glucose (SMBG) supplies and significant increases in the percentage of beneficiaries with either reduced or no acquisition of supplies. These reductions were significantly associated with increased mortality, hospitalizations, and costs. The CBP was implemented nationally in July 2013. We evaluated the impact of this rollout to determine if the adverse outcomes seen in 2011 persisted. This longitudinal study followed 529,627 insulin-treated beneficiaries from 2009 through 2013 to assess changes in beneficiary acquisition of testing supplies in the initial nine test markets (TEST, n = 43,939) and beneficiaries not affected by the 2011 rollout (NONTEST, n = 485,688). All Medicare beneficiary records for analysis were obtained from CMS. The percentages of beneficiaries with partial/no SMBG acquisition were significantly higher in both the TEST (37.4%) and NONTEST (37.6%) groups after the first 6 months of the national CBP rollout, showing increases of 48.1% and 60.0%, respectively (both P < 0.0001). The percentage of beneficiaries with no record for SMBG acquisition increased from 54.1% in January 2013 to 62.5% by December 2013. Disruption of beneficiary access to their prescribed SMBG supplies has persisted and worsened. Diabetes testing supplies should be excluded from the CBP until transparent, science-based methodologies for safety monitoring are adopted and implemented. © 2017 by the American Diabetes Association.

  6. Lesotho - Enterprise Survey

    Data.gov (United States)

    Millennium Challenge Corporation — The 2011 MCA-Lesotho baseline enterprise survey is a national survey of enterprises. The main objective of the survey was to assess the current status of businesses...

  7. 12 CFR 330.10 - Revocable trust accounts.

    Science.gov (United States)

    2010-01-01

    ... respect to which the owner evidences an intention that upon his or her death the funds shall belong to one...) Required intention and naming of beneficiaries. (1) The required intention in paragraph (a) of this section... insured depository institution. (c) Definition of beneficiary. For purposes of this section, a beneficiary...

  8. 20 CFR 416.621 - What is our order of preference in selecting a representative payee for you?

    Science.gov (United States)

    2010-04-01

    ... family member. (c) For beneficiaries under age 18, our preference is— (1) A natural or adoptive parent who has custody of the beneficiary, or a guardian; (2) A natural or adoptive parent who does not have... strong concern for the beneficiary's well being; (3) A natural or adoptive parent who does not have...

  9. The environmental survey manual

    International Nuclear Information System (INIS)

    1987-08-01

    The purpose of this manual is to provide guidance to the Survey and Sampling and Analysis teams that conduct the one-time Environmental Survey of the major US Department of Energy (DOE) operating facilities. This manual includes a discussion of DOE's policy on environmental issues, a review of statutory guidance as it applies to the Survey, the procedures and protocols to be used by the Survey teams, criteria for the use of the Survey teams in evaluating existing environmental data for the Survey effort, generic technical checklists used in every Survey, health and safety guidelines for the personnel conducting the Survey, including the identification of potential hazards, prescribed protective equipment, and emergency procedures, the required formats for the Survey reports, guidance on identifying environmental problems that need immediate attention by the Operations Office responsible for the particular facility, and procedures and protocols for the conduct of sampling and analysis

  10. PES Impact and Leakages over Several Cohorts: The Case of PSA-H in Yucatan, Mexico

    OpenAIRE

    LE VELLY , Gwenole; Sauquet , Alexandre; CORTINA-VILLAR , Sergio

    2015-01-01

    We assess the impact of a payment for environmental services scheme implemented in Mexico, the PSA-H, over the 2005-2012 period. By studying several cohorts of program beneficiaries we are able to shed lights on the permanence of the program's impact. Based on the exploitation of 2.5 to 20m resolution SPOT images and ejido-surveys carried out in 76 ejidos located in the Cono Sur of Yucatan, we find that the program's effects are cancelled after communities choose to withdraw from the program,...

  11. Encouraging Medicare Advantage Enrollees to Switch to Higher Quality Plans: Assessing the Effectiveness of a “Nudge” Letter

    Directory of Open Access Journals (Sweden)

    Benjamin L. Howell PhD

    2017-04-01

    Full Text Available There are considerable quality differences across private Medicare Advantage insurance plans, so it is important that beneficiaries make informed choices. During open enrollment for the 2013 coverage year, the Centers for Medicare & Medicaid Services sent letters to beneficiaries enrolled in low-quality Medicare Advantage plans (i.e., plans rated less than 3 stars for at least 3 consecutive years by Medicare explaining the stars and encouraging them to reexamine their choices. To understand the effectiveness of these low-cost, behavioral “nudge” letters, we used a beneficiary-level national retrospective cohort and performed multivariate regression analysis of plan selection during the 2013 open enrollment period among those enrolled in plans rated less than 3 stars. Our analysis controls for beneficiary demographic characteristics, health and health care spending risks, the availability of alternative higher rated plan options in their local market, and historical disenrollment rates from the plans. We compared the behaviors of those beneficiaries who received the nudge letters with those who enrolled in similar poorly rated plans but did not receive such letters. We found that beneficiaries who received the nudge letter were almost twice as likely (28.0% [95% confidence interval = 27.7%, 28.2%] vs. 15.3% [95% confidence interval = 15.1%, 15.5%] to switch to a higher rated plan compared with those who did not receive the letter. White beneficiaries, healthier beneficiaries, and those residing in areas with more high-performing plan choices were more likely to switch plans in response to the nudge. Our findings highlight both the importance and efficacy of providing timely and actionable information to beneficiaries about quality in the insurance marketplace to facilitate informed and value-based coverage decisions.

  12. 20 CFR 404.2021 - What is our order of preference in selecting a representative payee for you?

    Science.gov (United States)

    2010-04-01

    ... appropriate; or (5) A family member. (c) For beneficiaries under age 18, our preference is— (1) A natural or adoptive parent who has custody of the beneficiary, or a guardian; (2) A natural or adoptive parent who... demonstrating strong concern for the beneficiary's well being; (3) A natural or adoptive parent who does not...

  13. "Suntelligence" Survey

    Science.gov (United States)

    ... to the American Academy of Dermatology's "Suntelligence" sun-smart survey. Please answer the following questions to measure ... be able to view a ranking of major cities suntelligence based on residents' responses to this survey. ...

  14. Follow-up skeletal surveys for nonaccidental trauma: can a more limited survey be performed?

    Energy Technology Data Exchange (ETDEWEB)

    Harlan, Susan R. [University of Utah School of Medicine, Department of Radiology, Salt Lake City, UT (United States); Nixon, G.W.; Prince, Jeffrey S. [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States); Campbell, Kristine A.; Hansen, Karen [University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, UT (United States)

    2009-09-15

    Studies have demonstrated the value of the follow-up skeletal survey in identifying additional fractures, clarifying indeterminate findings, and improving dating of skeletal injuries in victims of physical abuse. To determine whether a more limited follow-up survey could yield the same radiologic data as a full follow-up survey. The study cohort comprised 101 children who had follow-up surveys that met our inclusion criteria. Consensus readings of both original and follow-up surveys were performed by two pediatric radiologists. These results were compared to determine additional findings from the follow-up surveys. Limited skeletal survey protocols were evaluated to determine whether they would detect the same fractures seen with a complete osseous survey. In the 101 children 244 fractures were identified on the initial osseous survey. Follow-up surveys demonstrated new information in 38 children (37.6%). A 15-view limited follow-up survey identified all additional information seen on the complete follow-up survey. Our data demonstrate that a 15-view limited follow-up skeletal survey could be performed without missing clinically significant new fractures and still allow proper identification of confirmed fractures or normal findings. A limited survey would decrease radiation dose in children. (orig.)

  15. Follow-up skeletal surveys for nonaccidental trauma: can a more limited survey be performed?

    International Nuclear Information System (INIS)

    Harlan, Susan R.; Nixon, G.W.; Prince, Jeffrey S.; Campbell, Kristine A.; Hansen, Karen

    2009-01-01

    Studies have demonstrated the value of the follow-up skeletal survey in identifying additional fractures, clarifying indeterminate findings, and improving dating of skeletal injuries in victims of physical abuse. To determine whether a more limited follow-up survey could yield the same radiologic data as a full follow-up survey. The study cohort comprised 101 children who had follow-up surveys that met our inclusion criteria. Consensus readings of both original and follow-up surveys were performed by two pediatric radiologists. These results were compared to determine additional findings from the follow-up surveys. Limited skeletal survey protocols were evaluated to determine whether they would detect the same fractures seen with a complete osseous survey. In the 101 children 244 fractures were identified on the initial osseous survey. Follow-up surveys demonstrated new information in 38 children (37.6%). A 15-view limited follow-up survey identified all additional information seen on the complete follow-up survey. Our data demonstrate that a 15-view limited follow-up skeletal survey could be performed without missing clinically significant new fractures and still allow proper identification of confirmed fractures or normal findings. A limited survey would decrease radiation dose in children. (orig.)

  16. Web survey methodology

    CERN Document Server

    Callegaro, Mario; Vehovar, Asja

    2015-01-01

    Web Survey Methodology guides the reader through the past fifteen years of research in web survey methodology. It both provides practical guidance on the latest techniques for collecting valid and reliable data and offers a comprehensive overview of research issues. Core topics from preparation to questionnaire design, recruitment testing to analysis and survey software are all covered in a systematic and insightful way. The reader will be exposed to key concepts and key findings in the literature, covering measurement, non-response, adjustments, paradata, and cost issues. The book also discusses the hottest research topics in survey research today, such as internet panels, virtual interviewing, mobile surveys and the integration with passive measurements, e-social sciences, mixed modes and business intelligence. The book is intended for students, practitioners, and researchers in fields such as survey and market research, psychological research, official statistics and customer satisfaction research.

  17. Access Point Backhaul Resource Aggregation as a Many-to-One Matching Game in Wireless Local Area Networks

    Directory of Open Access Journals (Sweden)

    Kawther Hassine

    2017-01-01

    Full Text Available This paper studies backhaul bandwidth aggregation in the context of a wireless local area network composed of two different types of access points: those with spare backhaul capacity (which we term providers and those in shortage of it (beneficiaries; the aim is to transfer excess capacity from providers to beneficiaries. We model the system as a matching game with many-to-one setting wherein several providers can be matched to one beneficiary and adopt the so-called deferred acceptance algorithm to reach an optimal and stable solution. We consider two flavors, when the beneficiaries are limited in their resource demands and when they are not, and two scenarios, when resources are abundant and when they are scarce. Our results show that the many-to-one setting outperforms the one-to-one case in terms of overall throughput gain, resource usage, and individual beneficiaries satisfaction by up to 50%, whether resources are scarce or abundant. As of the limited versus nonlimited case, the former ensures more fair sharing of spectral resources and higher satisfaction percentage between beneficiaries.

  18. The Aalborg Survey / Part 1 - Web Based Survey

    DEFF Research Database (Denmark)

    Harder, Henrik; Christensen, Cecilie Breinholm

    Background and purpose The Aalborg Survey consists of four independent parts: a web, GPS and an interview based survey and a literature study, which together form a consistent investigation and research into use of urban space, and specifically into young people’s use of urban space: what young......) and the research focus within the cluster of Mobility and Tracking Technologies (MoTT), AAU. Summary / Part 1 Web Base Survey The 1st part of the research project Diverse Urban Spaces (DUS) has been carried out during the period from December 1st 2007 to February 1st 2008 as a Web Based Survey of the 27.040 gross...... [statistikbanken.dk, a] young people aged 14-23 living in Aalborg Municipality in 2008. The web based questionnaire has been distributed among the group of young people studying at upper secondary schools in Aalborg, i.e. 7.680 young people [statistikbanken.dk, b]. The resulting data from those respondents who...

  19. The Aalborg Survey / Part 3 - Interview Based Survey

    DEFF Research Database (Denmark)

    Harder, Henrik; Christensen, Cecilie Breinholm; Jensen, Maria Vestergaard

    Background and purpose The Aalborg Survey consists of four independent parts: a web, GPS and an interview based survey and a literature study, which together form a consistent investigation and research into use of urban space, and specifically into young people’s use of urban space: what young...... people do in urban spaces, where they are in the urban spaces and when the young people are in the urban spaces. The answers to these questions form the framework and enable further academic discussions and conclusions in relation to the overall research project Diverse Urban Spaces (DUS). The primary......) and the research focus within the cluster of Mobility and Tracking Technologies (MoTT), AAU. Summary / Part 3 - Interview Based Survey The 3rd part of the DUS research project has been carried out during the fall of 2009 and the summer and fall of 2010 as an interview based survey of 18 selected participants (nine...

  20. Developing the online survey.

    Science.gov (United States)

    Gordon, Jeffry S; McNew, Ryan

    2008-12-01

    Institutions of higher education are now using Internet-based technology tools to conduct surveys for data collection. Research shows that the type and quality of responses one receives with online surveys are comparable with what one receives in paper-based surveys. Data collection can take place on Web-based surveys, e-mail-based surveys, and personal digital assistants/Smartphone devices. Web surveys can be subscription templates, software packages installed on one's own server, or created from scratch using Web programming development tools. All of these approaches have their advantages and disadvantages. The survey owner must make informed decisions as to the right technology to implement. The correct choice can save hours of work in sorting, organizing, and analyzing data.

  1. Out-of-pocket expenditures for childbirth in the context of the Janani Suraksha Yojana (JSY) cash transfer program to promote facility births: who pays and how much? Studies from Madhya Pradesh, India.

    Science.gov (United States)

    Sidney, Kristi; Salazar, Mariano; Marrone, Gaetano; Diwan, Vishal; DeCosta, Ayesha; Lindholm, Lars

    2016-05-03

    High out-of-pocket expenditures (OOPE) make delivery care difficult to access for a large proportion of India's population. Given that home deliveries increase the risk of maternal mortality, in 2005 the Indian Government implemented the Janani Suraksha Yojana (JSY) program to incentivize poor women to deliver in public health facilities by providing a cash transfer upon discharge. We study the OOPE among JSY beneficiaries and women who deliver at home, and predictors of OOPE in two districts of Madhya Pradesh. September 2013 to April 2015 a cross-sectional community-based survey was performed. All recently delivered women were interviewed to elicit delivery costs, socio-demographic characteristics and delivery related information. Most women (n = 1995, 84 %) delivered in JSY public health facility, the remaining 16 % (n = 386) delivered at home. Women who delivered under JSY program had a higher median, IQR OOPE ($8, 3-18) compared to home ($6, 2-13). Among JSY beneficiaries, poorest women had twice net gain ($20) versus wealthiest ($10) post cash transfer. Informal payments (64 %) and food/baby items (77 %) were the two most common sources of OOPE. OOPE made among JSY beneficiaries was pro-poor: poorer women made proportionally less expenditures compared to wealthier women. In an adjusted model, delivering in a JSY public facility increased odds of incurring expenditures (OR: 1.58, 95 % CI: 1.11-2.25) but at the same time to a 16 % (95 % CI: 0.73-0.96) decrease in the amount paid compared to home deliveries. OOPE is prevalent among JSY beneficiaries as well in home deliveries. In JSY, OOPE varies by income quintile: wealthier quintiles pay more OOPE. However the cash incentive is adequate enough to provide a net gain for all quintiles. OOPE was largely due to indirect costs and not direct medical payments. The program seems to be effective in providing financial protection for the most vulnerable groups.

  2. Health care utilization among Medicare-Medicaid dual eligibles: a count data analysis

    Directory of Open Access Journals (Sweden)

    Shin Jaeun

    2006-04-01

    Full Text Available Abstract Background Medicare-Medicaid dual eligibles are the beneficiaries of both Medicare and Medicaid. Dual eligibles satisfy the eligibility conditions for Medicare benefit. Dual eligibles also qualify for Medicaid because they are aged, blind, or disabled and meet the income and asset requirements for receiving Supplement Security Income (SSI assistance. The objective of this study is to explore the relationship between dual eligibility and health care utilization among Medicare beneficiaries. Methods The household component of the nationally representative Medical Expenditure Panel Survey (MEPS 1996–2000 is used for the analysis. Total 8,262 Medicare beneficiaries are selected from the MEPS data. The Medicare beneficiary sample includes individuals who are covered by Medicare and do not have private health insurance during a given year. Zero-inflated negative binomial (ZINB regression model is used to analyse the count data regarding health care utilization: office-based physician visits, hospital inpatient nights, agency-sponsored home health provider days, and total dental visits. Results Dual eligibility is positively correlated with the likelihood of using hospital inpatient care and agency-sponsored home health services and the frequency of agency-sponsored home health days. Frequency of dental visits is inversely associated with dual eligibility. With respect to racial differences, dually eligible Afro-Americans use more office-based physician and dental services than white duals. Asian duals use more home health services than white duals at the 5% statistical significance level. The dual eligibility programs seem particularly beneficial to Afro-American duals. Conclusion Dual eligibility has varied impact on health care utilization across service types. More utilization of home healthcare among dual eligibles appears to be the result of delayed realization of their unmet healthcare needs under the traditional Medicare-only program

  3. How to communicate climate change 'impact and solutions' to vulnerable population of Indian Sundarbans? From theory to practice.

    Science.gov (United States)

    Chowdhury, Abhiroop; Maiti, Subodh Kumar; Bhattacharyya, Santanu

    2016-01-01

    Global consciousness on climate change problems and adaptation revolves around the disparity of information sharing and communication gap between theoretical scientific knowledge at academic end and practical implications of these at the vulnerable populations' end. Coastal communities facing socio-economic stress, like densely populated Sundarbans, are the most affected part of the world, exposed to climate change problems and uncertainties. This article explores the successes of a socio-environmental project implemented at Indian Sundarbans targeted towards economic improvement and aims at communicating environmental conservation through organized community participation. Participatory rural appraisal (PRA) and the wealth rank tool (WRT) were used to form a "group based organization" with 2100 vulnerable families to give them knowledge about capacity building, disaster management, resource conservation and sustainable agriculture practices. Training was conducted with the selected group members on resource conservation, institution building, alternative income generation activities (AIGA) like, Poultry, Small business, Tricycle van, Organic farming and disaster management in a participatory mode. The climate change 'problems-solutions' were communicated to this socio-economically marginalized and ostracized community through participatory educational theater (PET). WRT revealed that 45 % of the population was under economic stress. Out of 2100 beneficiaries', 1015 beneficiaries' started organic farming, 133 beneficiaries' adopted poultry instead of resource exploitive livelihood and 71 beneficiaries' engaged themselves with small business, which was the success stories of this project. To mitigate disaster, 10-committees were formed and the endemic knowledge about climate change was recorded by participatory method validated through survey by structured questionnaire. As a part of this project 87 ha of naked deforested mudflat was reclaimed with endangered

  4. Surveying ethnic minorities

    NARCIS (Netherlands)

    Joost Kappelhof

    2015-01-01

    Obtaining accurate survey data on ethnic minorities is not easy. Ethnic minorities are usually underrepresented in surveys, and it is moreover not certain that those who do take part in surveys are representative of the group the researcher is interested in. For example, is it only people with

  5. Evaluation of Medicare Health Support chronic disease pilot program.

    Science.gov (United States)

    Cromwell, Jerry; McCall, Nancy; Burton, Joe

    2008-01-01

    The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries. In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings. Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

  6. APPLICATION OF THE GAP TECHNIQUE IN MEASURING SERVICE QUALITY IN EGYPTIAN FEDERATION KARATE

    Directory of Open Access Journals (Sweden)

    Khalil Samira

    2010-08-01

    Full Text Available This study aims to measure the gap between the administration and the beneficiaries of the quality of the service in the federation and sport regions of Karate. The sample of this study was chosen randomly between the members of the board of directors of the Federation and regions, the coaches , referees and players registered in theEgyptian Federation of Karate whose numbers are (149. The sample of the study was classified into two beneficiary classes. The first beneficiary class is coaches and referees whose number are (70 persons and their administration is the members of the board of directors of the Federation and its regions whose number are (14persons. The second class is the players whose number are (65 players and their administration is the members ofthe board of directors of the Federation and its regions the referees and coaches' number are (84 persons. This study used a questionnaire (SERVQUAL to measure the quality of the service. Results pointed to a negative gap between the expectations of the beneficiaries of the excellent service level and the perceptions of the administrations of these expectations.These results refer to the weakness of administration ability in the Egyptian Federation of Karate to know the needs and desires of beneficiaries from (coaches-referees- players of the quality level in the service provided to them. The existence of a relative gap between the perceptions of the beneficiaries of the service actually provided and the administration of the qualities of the service actually provided, therefore itrefers to the decline the motive level of the administration of Egyptian Federation of Karate to provide the service to the beneficiaries in a form that conforms with what the administration already decided for the specifications. The existence of a negative gap between the expectations of the beneficiaries of the level of theexcellent service and its perception of the actual performance of this service refers to

  7. Conducting online surveys

    NARCIS (Netherlands)

    Selm, M. van; Jankowski, N.W.

    2006-01-01

    The World Wide Web (WWW) is increasingly being used as a tool and platform for survey research. Two types of electronic or online surveys available for data collection are the email and Web based survey, and they constitute the focus of this paper. We address a multitude of issues researchers should

  8. AFFORDABILITY OF LOW INCOME HOUSING IN PUMWANI, NAIROBI, KENYA

    Directory of Open Access Journals (Sweden)

    Crispino C. Ochieng

    2007-07-01

    Full Text Available Since 1987, in Kenya, through the National Housing Corporation (NHC, an arm of the central government that delivers affordable houses, the local government embarked on the redevelopment of Pumwani the oldest surviving affordable low income housing in Nairobi. Pumwani was started in 1923 and it targeted early African immigrants to Nairobi. Currently, the old Pumwani is home to some of the city’s poorest dwellers majorities who depend on the informal sector for an income. Redevelopment was targeted at housing all the genuine dwellers. Instead delivery ended up with house types that were at first rejected by the beneficiaries. Although the new housing was slightly of an improved physical and spatial quality it was unaffordable. Beneficiaries were required to pay an average monthly rent of US$157 for up to eighteen years towards purchase of the new house. In the beginning, some of them had declined to take position of the newly built houses. To raise the basic rent majorities of those who have since moved in have opted to rent out some of the space. To date there is still standoff with some of the houses still unoccupied. Except during the period of social survey when the beneficiaries were brought in to supply the necessary information, the entire construction process was undertaken by NHC under a turnkey project. Among other factors the construction process was at fault for it raised the costs. Also, some of the basic housing needs were not effectively looked into. There was a housing mismatch.

  9. Evaluation of functioning of ICDS project areas under Indore and Ujjain divisions of the state of Madhya Pradesh

    Directory of Open Access Journals (Sweden)

    Sanjay Dixit

    2010-07-01

    Full Text Available Background: Integrated Child Development Services (ICDS is recognized worldwide as one of the most efficient community based programmes promoting early childhood care. Regular evaluations of the programme have been conducted to make it more effective and adequate for the beneficiaries. Objectives: To evaluate the functioning of the Anganwadi Centers under different project areas of Indore and Ujjain Divisions. Methods: Under the present evaluation system one ICDS project and five Anganwadi Centers under the project area (AWCs were visited on a monthly basis and services provided reviewed. Findings reported are from nine project areas under Indore and Ujjain Divisions in the state of Madhya Pradesh from October 2008 – June 2009. Results: A total of 45 centers were evaluated. 29 centers were operating from rented buildings and storage facilities were lacking at 19 of the centers. Though the quality of food was acceptable to the beneficiaries shortage of food was a problem at the centers. Absence of Pre-School Education (PSE and Nutrition and Health Education (NHED Kits compromised PSE and NHED activities at the centers. Unavailability of medicine kits, lack of regular visits by the ANMs to the centers and absence of routine health check up of beneficiaries were other problems encountered under the project areas surveyed. Availability of a doctor under each project area was stated as a major need by the workers. Conclusion: Coordinated steps catering to different services provided at the centers are needed to optimize the functioning of the ICDS scheme.

  10. Public perceptions and acceptance of induced earthquakes related to energy development

    International Nuclear Information System (INIS)

    McComas, Katherine A.; Lu, Hang; Keranen, Katie M.; Furtney, Maria A.; Song, Hwansuck

    2016-01-01

    Growing awareness of the potential for some energy-related activities to induce earthquakes has created a need to understand how the public evaluates the risks of induced earthquakes versus the benefits of energy development. To address this need, this study presents a web survey that used a between-subjects factorial experimental design to explore the views of 325 U.S. adults, who were asked about their experiences with earthquakes; risk perceptions related to different causes of earthquakes (e.g., natural versus induced); and acceptability of earthquakes depending on the benefits, beneficiaries, and decision making process. The results found that participants had more negative feelings toward induced versus naturally occurring earthquakes. Although they judged no earthquake as “acceptable,” participants rated induced earthquakes significantly less acceptable than naturally occurring ones. Attributing the benefits to the provision of renewable energy or climate change mitigation did not increase induced earthquake acceptability, and no particular beneficiary made earthquakes more acceptable, although private companies as beneficiaries made earthquakes less acceptable. Finally, induced earthquake acceptability was significantly higher when people believed that people like them had a voice in the decision to implement the technology that caused the earthquake, underscoring the importance of public engagement in the development of energy technologies. - Highlights: • Human induced earthquakes were perceived as more negative than natural earthquakes. • Attributing benefits to renewable energy did not increase earthquake acceptability. • Acceptability was highest after a procedurally fair decision making process. • Acceptability was lowest following an expert-driven decision.

  11. The relationship between perceived discrimination and patient experiences with health care.

    Science.gov (United States)

    Weech-Maldonado, Robert; Hall, Allyson; Bryant, Thomas; Jenkins, Kevin A; Elliott, Marc N

    2012-09-01

    Prior studies have shown that racial/ethnic minorities have lower Consumer Assessments of Healthcare Providers and Systems (CAHPS) scores. Perceived discrimination may mediate the relationship between race/ethnicity and patient experiences with care. To examine the relationship between perceived discrimination based on race/ethnicity and Medicaid insurance and CAHPS reports and ratings of care. The study analyzed 2007 survey data from 1509 Florida Medicaid beneficiaries. CAHPS reports (getting needed care, timeliness of care, communication with doctor, and health plan customer service) and ratings (personal doctor, specialist care, overall health care, and health plan) of care were the primary outcome variables. Patient perceptions of discrimination based on their race/ethnicity and having Medicaid insurance were the primary independent variables. Regression analysis modeled the effect of perceptions of discrimination on CAHPS reports and ratings controlling for age, sex, education, self-rated health status, race/ethnicity, survey language, and fee-for-service enrollment. SEs were corrected for correlation within plans. Medicaid beneficiaries reporting discrimination based on race/ethnicity had lower CAHPS scores, ranging from 15 points lower (on a 0-100 scale) for getting needed care to 6 points lower for specialist rating, compared with those who never experienced discrimination. Similar results were obtained for perceived discrimination based on Medicaid insurance. Perceptions of discrimination based on race/ethnicity and Medicaid insurance are prevalent and are associated with substantially lower CAHPS reports and ratings of care. Practices must develop and implement strategies to reduce perceived discrimination among patients.

  12. Comparison of Long-term Care in Nursing Homes Versus Home Health: Costs and Outcomes in Alabama.

    Science.gov (United States)

    Blackburn, Justin; Locher, Julie L; Kilgore, Meredith L

    2016-04-01

    To compare acute care outcomes and costs among nursing home residents with community-dwelling home health recipients. A matched retrospective cohort study of Alabamians aged more than or equal to 65 years admitted to a nursing home or home health between March 31, 2007 and December 31, 2008 (N = 1,291 pairs). Medicare claims were compared up to one year after admission into either setting. Death, emergency department and inpatient visits, inpatient length of stay, and acute care costs were compared using t tests. Medicaid long-term care costs were compared for a subset of matched beneficiaries. After one year, 77.7% of home health beneficiaries were alive compared with 76.2% of nursing home beneficiaries (p Home health beneficiaries averaged 0.2 hospital visits and 0.1 emergency department visits more than nursing home beneficiaries, differences that were statistically significant. Overall acute care costs were not statistically different; home health beneficiaries' costs averaged $31,423, nursing home beneficiaries' $32,239 (p = .5032). Among 426 dual-eligible pairs, Medicaid long-term care costs averaged $4,582 greater for nursing home residents (p nursing home or home health care. Additional research controlling for exogenous factors relating to long-term care decisions is needed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Surveying Humaness

    DEFF Research Database (Denmark)

    Markussen, Randi; Gad, Christopher

    carried out in a Danish county in order to improve treatment of people who have suffered from long-term illnesses. The surveys concern not only feed back on how people experience their present and past interaction with the social services and health care system; they also ask people to indicate the state......Christopher Gad. Ph.d. Dept. of Information and Media Studies Randi Markussen. Associate Professor, Dept. of Information and Media Studies. rmark@imv.au.dk   Abstract:   Surveying humanness -politics of care improvement   For various reasons we both were subjected to a specific survey procedure...... and development of a large collection of biological and psychological symptoms and psycho-social problems. However, the surveys say nothing about how the information will be of use to the people who answer the procedure or how this scientific intervention will be put to use more specifically within the public...

  14. Indexing contamination surveys

    International Nuclear Information System (INIS)

    Brown, R.L.

    1998-01-01

    The responsibility for safely managing the Tank Farms at Hanford belongs to Lockheed Martin Hanford Corporation which is part of the six company Project Hanford Management Team led by Fluor Daniel Hanford, Inc.. These Tank Farm Facilities contain numerous outdoor contamination areas which are surveyed at a periodicity consistent with the potential radiological conditions, occupancy, and risk of changes in radiological conditions. This document describes the survey documentation and data tracking method devised to track the results of contamination surveys this process is referred to as indexing. The indexing process takes a representative data set as an indicator for the contamination status of the facility. The data are further manipulated into a single value that can be tracked and trended using standard statistical methodology. To report meaningful data, the routine contamination surveys must be performed in a manner that allows the survey method and the data collection process to be recreated. Three key criteria are necessary to accomplish this goal: Accurate maps, consistent documentation, and consistent consolidation of data meeting these criteria provides data of sufficient quality to be tracked. Tracking of survey data is accomplished by converting the individual survey results into a weighted value, corrected for the actual number of survey points. This information can be compared over time using standard statistical analysis to identify trends. At the Tank Farms, the need to track and trend the facility's radiological status presents unique challenges. Many of these Tank Farm facilities date back to the second world war. The Tank Farm Facilities are exposed to weather extremes, plant and animal intrusion, as well as all of the normal challenges associated with handling radiological waste streams. Routine radiological surveys did not provide a radiological status adequate for continuing comparisons

  15. Surveys & Programs

    Science.gov (United States)

    Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My residential construction. Business Dynamics Statistics (BDS) Provides measures of openings and closings, job

  16. The sloan digital sky survey-II supernova survey

    DEFF Research Database (Denmark)

    Frieman, Joshua A.; Bassett, Bruce; Becker, Andrew

    2008-01-01

    The Sloan Digital Sky Survey-II (SDSS-II) has embarked on a multi-year project to identify and measure light curves for intermediate-redshift (0.05 < z < 0.35) Type Ia supernovae (SNe Ia) using repeated five-band (ugriz) imaging over an area of 300 sq. deg. The survey region is a stripe 2.5° wide...

  17. Physics Survey Overview

    International Nuclear Information System (INIS)

    2002-01-01

    An overview of a series of assignments of the branches of physics carried out by the Board on Physics and Astronomy of the National Research Council. It identifies further theories in physics and makes recommendations on preventive priorities. The Board on Physics and Astronomy (BPA) has conducted a new decadal survey of physics entitled ''Physics in a New Era''. The survey includes assessments of the main branches of physics as well as certain selected emerging areas. The various elements of the survey were prepared by separately-appointed National Research Council (NRC) committees. The BPA formed the Physics Survey Overview Committee (PSOVC) to complete the survey by preparing an overview of the field of physics to summarize and synthesize the results of the various assessments and to address cross-cutting issues that concern physics as a whole

  18. Musculoskeletal impairment survey in Rwanda: Design of survey tool, survey methodology, and results of the pilot study (a cross sectional survey

    Directory of Open Access Journals (Sweden)

    Simms Victoria

    2007-03-01

    Full Text Available Abstract Background Musculoskeletal impairment (MSI is an important cause of morbidity and mortality worldwide, especially in developing countries. Prevalence studies for MSI in the developing world have used varying methodologies and are seldom directly comparable. This study aimed to develop a new tool to screen for and diagnose MSI and to pilot test the methodology for a national survey in Rwanda. Methods A 7 question screening tool to identify cases of MSI was developed through literature review and discussions with healthcare professionals. To validate the tool, trained rehabilitation technicians screened 93 previously identified gold standard 'cases' and 86 'non cases'. Sensitivity, specificity and positive predictive value were calculated. A standardised examination protocol was developed to determine the aetiology and diagnosis of MSI for those who fail the screening test. For the national survey in Rwanda, multistage cluster random sampling, with probability proportional to size procedures will be used for selection of a cross-sectional, nationally representative sample of the population. Households to be surveyed will be chosen through compact segment sampling and all individuals within chosen households will be screened. A pilot survey of 680 individuals was conducted using the protocol. Results: The screening tool demonstrated 99% sensitivity and 97% specificity for MSI, and a positive predictive value of 98%. During the pilot study 468 out of 680 eligible subjects (69% were screened. 45 diagnoses were identified in 38 persons who were cases of MSI. The subjects were grouped into categories based on diagnostic subgroups of congenital (1, traumatic (17, infective (2 neurological (6 and other acquired(19. They were also separated into mild (42.1%, moderate (42.1% and severe (15.8% cases, using an operational definition derived from the World Health Organisation's International Classification of Functioning, Disability and Health

  19. The Kilo-Degree Survey

    NARCIS (Netherlands)

    de Jong, J. T. A.; Kuijken, K.; Applegate, D.; Begeman, K.; Belikov, A.; Blake, C.; Bout, J.; Boxhoorn, D.; Buddelmeijer, H.; Buddendiek, A.; Cacciato, M.; Capaccioli, M.; Choi, A.; Cordes, O.; Covone, G.; Dall'Ora, M.; Edge, A.; Erben, T.; Franse, J.; Getman, F.; Grado, A.; Harnois-Deraps, J.; Helmich, E.; Herbonnet, R.; Heymans, C.; Hildebrandt, H.; Hoekstra, H.; Huang, Z.; Irisarri, N.; Joachimi, B.; Köhlinger, F.; Kitching, T.; La Barbera, F.; Lacerda, P.; McFarland, J.; Miller, L.; Nakajima, R.; Napolitano, N. R.; Paolillo, M.; Peacock, J.; Pila-Diez, B.; Puddu, E.; Radovich, M.; Rifatto, A.; Schneider, P.; Schrabback, T.; Sifon, C.; Sikkema, G.; Simon, P.; Sutherland, W.; Tudorica, A.; Valentijn, E.; van der Burg, R.; van Uitert, E.; van Waerbeke, L.; Velander, M.; Kleijn, G. V.; Viola, M.; Vriend, W.-J.

    2013-01-01

    The Kilo-Degree Survey (KiDS), a 1500-square-degree optical imaging survey with the recently commissioned OmegaCAM wide-field imager on the VLT Survey Telescope (VST), is described. KiDS will image two fields in u-,g-,r- and i-bands and, together with the VIKING survey, produce nine-band (u- to

  20. Changes in Case-Mix and Health Outcomes of Medicare Fee-for-Service Beneficiaries and Managed Care Enrollees During the Years 1992-2011.

    Science.gov (United States)

    Koroukian, Siran M; Basu, Jayasree; Schiltz, Nicholas K; Navale, Suparna; Bakaki, Paul M; Warner, David F; Dor, Avi; Given, Charles W; Stange, Kurt C

    2018-01-01

    Recent studies suggest that managed care enrollees (MCEs) and fee-for-service beneficiaries (FFSBs) have become similar in case-mix over time; but comparisons of health outcomes have yielded mixed results. To examine changes in differentials between MCEs and FFSBs both in case-mix and health outcomes over time. Temporal study of the linked Health and Retirement Study (HRS) and Medicare data, comparing case-mix and health outcomes between MCEs and FFSBs across 3 time periods: 1992-1998, 1999-2004, and 2005-2011. We used multivariable analysis, stratified by, and pooled across the study periods. The unit of analysis was the person-wave (n=167,204). HRS participants who were also enrolled in Medicare. Outcome measures included self-reported fair/poor health, 2-year self-rated worse health, and 2-year mortality. Our main covariate was a composite measure of multimorbidity (MM), MM0-MM3, defined as the co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes. The case-mix differential between MCEs and FFSBs persisted over time. Results from multivariable models on the pooled data and incorporating interaction terms between managed care status and study period indicated that MCEs and FFSBs were as likely to die within 2 years from the HRS interview (P=0.073). This likelihood remained unchanged across the study periods. However, MCEs were more likely than FFSBs to report fair/poor health in the third study period (change in probability for the interaction term: 0.024, P=0.008), but less likely to rate their health worse in the last 2 years, albeit at borderline significance (change in probability: -0.021, P=0.059). Despite the persistence of selection bias, the differential in self-reported fair/poor status between MCEs and FFSBs seems to be closing over time.

  1. The Hyper Suprime-Cam SSP Survey: Overview and survey design

    Science.gov (United States)

    Aihara, Hiroaki; Arimoto, Nobuo; Armstrong, Robert; Arnouts, Stéphane; Bahcall, Neta A.; Bickerton, Steven; Bosch, James; Bundy, Kevin; Capak, Peter L.; Chan, James H. H.; Chiba, Masashi; Coupon, Jean; Egami, Eiichi; Enoki, Motohiro; Finet, Francois; Fujimori, Hiroki; Fujimoto, Seiji; Furusawa, Hisanori; Furusawa, Junko; Goto, Tomotsugu; Goulding, Andy; Greco, Johnny P.; Greene, Jenny E.; Gunn, James E.; Hamana, Takashi; Harikane, Yuichi; Hashimoto, Yasuhiro; Hattori, Takashi; Hayashi, Masao; Hayashi, Yusuke; Hełminiak, Krzysztof G.; Higuchi, Ryo; Hikage, Chiaki; Ho, Paul T. P.; Hsieh, Bau-Ching; Huang, Kuiyun; Huang, Song; Ikeda, Hiroyuki; Imanishi, Masatoshi; Inoue, Akio K.; Iwasawa, Kazushi; Iwata, Ikuru; Jaelani, Anton T.; Jian, Hung-Yu; Kamata, Yukiko; Karoji, Hiroshi; Kashikawa, Nobunari; Katayama, Nobuhiko; Kawanomoto, Satoshi; Kayo, Issha; Koda, Jin; Koike, Michitaro; Kojima, Takashi; Komiyama, Yutaka; Konno, Akira; Koshida, Shintaro; Koyama, Yusei; Kusakabe, Haruka; Leauthaud, Alexie; Lee, Chien-Hsiu; Lin, Lihwai; Lin, Yen-Ting; Lupton, Robert H.; Mandelbaum, Rachel; Matsuoka, Yoshiki; Medezinski, Elinor; Mineo, Sogo; Miyama, Shoken; Miyatake, Hironao; Miyazaki, Satoshi; Momose, Rieko; More, Anupreeta; More, Surhud; Moritani, Yuki; Moriya, Takashi J.; Morokuma, Tomoki; Mukae, Shiro; Murata, Ryoma; Murayama, Hitoshi; Nagao, Tohru; Nakata, Fumiaki; Niida, Mana; Niikura, Hiroko; Nishizawa, Atsushi J.; Obuchi, Yoshiyuki; Oguri, Masamune; Oishi, Yukie; Okabe, Nobuhiro; Okamoto, Sakurako; Okura, Yuki; Ono, Yoshiaki; Onodera, Masato; Onoue, Masafusa; Osato, Ken; Ouchi, Masami; Price, Paul A.; Pyo, Tae-Soo; Sako, Masao; Sawicki, Marcin; Shibuya, Takatoshi; Shimasaku, Kazuhiro; Shimono, Atsushi; Shirasaki, Masato; Silverman, John D.; Simet, Melanie; Speagle, Joshua; Spergel, David N.; Strauss, Michael A.; Sugahara, Yuma; Sugiyama, Naoshi; Suto, Yasushi; Suyu, Sherry H.; Suzuki, Nao; Tait, Philip J.; Takada, Masahiro; Takata, Tadafumi; Tamura, Naoyuki; Tanaka, Manobu M.; Tanaka, Masaomi; Tanaka, Masayuki; Tanaka, Yoko; Terai, Tsuyoshi; Terashima, Yuichi; Toba, Yoshiki; Tominaga, Nozomu; Toshikawa, Jun; Turner, Edwin L.; Uchida, Tomohisa; Uchiyama, Hisakazu; Umetsu, Keiichi; Uraguchi, Fumihiro; Urata, Yuji; Usuda, Tomonori; Utsumi, Yousuke; Wang, Shiang-Yu; Wang, Wei-Hao; Wong, Kenneth C.; Yabe, Kiyoto; Yamada, Yoshihiko; Yamanoi, Hitomi; Yasuda, Naoki; Yeh, Sherry; Yonehara, Atsunori; Yuma, Suraphong

    2018-01-01

    Hyper Suprime-Cam (HSC) is a wide-field imaging camera on the prime focus of the 8.2-m Subaru telescope on the summit of Mauna Kea in Hawaii. A team of scientists from Japan, Taiwan, and Princeton University is using HSC to carry out a 300-night multi-band imaging survey of the high-latitude sky. The survey includes three layers: the Wide layer will cover 1400 deg2 in five broad bands (grizy), with a 5 σ point-source depth of r ≈ 26. The Deep layer covers a total of 26 deg2 in four fields, going roughly a magnitude fainter, while the UltraDeep layer goes almost a magnitude fainter still in two pointings of HSC (a total of 3.5 deg2). Here we describe the instrument, the science goals of the survey, and the survey strategy and data processing. This paper serves as an introduction to a special issue of the Publications of the Astronomical Society of Japan, which includes a large number of technical and scientific papers describing results from the early phases of this survey.

  2. Aerial radiation survey

    International Nuclear Information System (INIS)

    Pradeep Kumar, K.S.

    1998-01-01

    Aerial gamma spectrometry surveys are the most effective, comprehensive and preferred tool to delimit the large area surface contamination in a radiological emergency either due to a nuclear accident or following a nuclear strike. The airborne survey apart from providing rapid and economical evaluation of ground contamination over large areas due to larger ground clearance and higher speed, is the only technique to overcome difficulties posed by ground surveys of inaccessible region. The aerial survey technique can also be used for searching of lost radioactive sources, tracking of radioactive plume and generation of background data on the Emergency Planning Zone (EPZ) of nuclear installations

  3. Predicting survey responses: how and why semantics shape survey statistics on organizational behaviour.

    Directory of Open Access Journals (Sweden)

    Jan Ketil Arnulf

    Full Text Available Some disciplines in the social sciences rely heavily on collecting survey responses to detect empirical relationships among variables. We explored whether these relationships were a priori predictable from the semantic properties of the survey items, using language processing algorithms which are now available as new research methods. Language processing algorithms were used to calculate the semantic similarity among all items in state-of-the-art surveys from Organisational Behaviour research. These surveys covered areas such as transformational leadership, work motivation and work outcomes. This information was used to explain and predict the response patterns from real subjects. Semantic algorithms explained 60-86% of the variance in the response patterns and allowed remarkably precise prediction of survey responses from humans, except in a personality test. Even the relationships between independent and their purported dependent variables were accurately predicted. This raises concern about the empirical nature of data collected through some surveys if results are already given a priori through the way subjects are being asked. Survey response patterns seem heavily determined by semantics. Language algorithms may suggest these prior to administering a survey. This study suggests that semantic algorithms are becoming new tools for the social sciences, opening perspectives on survey responses that prevalent psychometric theory cannot explain.

  4. Arecibo pulsar survey using ALFA. III. Precursor survey and population synthesis

    Energy Technology Data Exchange (ETDEWEB)

    Swiggum, J. K.; Lorimer, D. R.; McLaughlin, M. A.; Bates, S. D.; Senty, T. R. [Department of Physics and Astronomy, West Virginia University, Morgantown, WV 26506 (United States); Champion, D. J.; Lazarus, P. [Max-Planck-Institut für Radioastronomie, D-53121 Bonn (Germany); Ransom, S. M. [NRAO, Charlottesville, VA 22903 (United States); Brazier, A.; Chatterjee, S.; Cordes, J. M. [Astronomy Department, Cornell University, Ithaca, NY 14853 (United States); Hessels, J. W. T. [ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA, Dwingeloo (Netherlands); Nice, D. J. [Department of Physics, Lafayette College, Easton, PA 18042 (United States); Ellis, J.; Allen, B. [Physics Department, University of Wisconsin-Milwaukee, Milwaukee WI 53211 (United States); Bhat, N. D. R. [Center for Astrophysics and Supercomputing, Swinburne University, Hawthorn, Victoria 3122 (Australia); Bogdanov, S.; Camilo, F. [Columbia Astrophysics Laboratory, Columbia University, New York, NY 10027 (United States); Crawford, F. [Department of Physics and Astronomy, Franklin and Marshall College, Lancaster, PA 17604-3003 (United States); Deneva, J. S. [Arecibo Observatory, HC3 Box 53995, Arecibo, PR 00612 (United States); and others

    2014-06-01

    The Pulsar Arecibo L-band Feed Array (PALFA) Survey uses the ALFA 7-beam receiver to search both inner and outer Galactic sectors visible from Arecibo (32° ≲ ℓ ≲ 77° and 168° ≲ ℓ ≲ 214°) close to the Galactic plane (|b| ≲ 5°) for pulsars. The PALFA survey is sensitive to sources fainter and more distant than have previously been seen because of Arecibo's unrivaled sensitivity. In this paper we detail a precursor survey of this region with PALFA, which observed a subset of the full region (slightly more restrictive in ℓ and |b| ≲ 1°) and detected 45 pulsars. Detections included 1 known millisecond pulsar and 11 previously unknown, long-period pulsars. In the surveyed part of the sky that overlaps with the Parkes Multibeam Pulsar Survey (36° ≲ ℓ ≲ 50°), PALFA is probing deeper than the Parkes survey, with four discoveries in this region. For both Galactic millisecond and normal pulsar populations, we compare the survey's detections with simulations to model these populations and, in particular, to estimate the number of observable pulsars in the Galaxy. We place 95% confidence intervals of 82,000 to 143,000 on the number of detectable normal pulsars and 9000 to 100,000 on the number of detectable millisecond pulsars in the Galactic disk. These are consistent with previous estimates. Given the most likely population size in each case (107,000 and 15,000 for normal and millisecond pulsars, respectively), we extend survey detection simulations to predict that, when complete, the full PALFA survey should have detected 1000{sub −230}{sup +330} normal pulsars and 30{sub −20}{sup +200} millisecond pulsars. Identical estimation techniques predict that 490{sub −115}{sup +160} normal pulsars and 12{sub −5}{sup +70} millisecond pulsars would be detected by the beginning of 2014; at the time, the PALFA survey had detected 283 normal pulsars and 31 millisecond pulsars, respectively. We attribute the deficiency in normal pulsar

  5. Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012.

    Science.gov (United States)

    Murugiah, Karthik; Wang, Yun; Desai, Nihar R; Spatz, Erica S; Nuti, Sudhakar V; Dreyer, Rachel P; Krumholz, Harlan M

    2016-03-01

    The aim of this study was to assess trends in hospitalizations and outcomes for Takotsubo cardiomyopathy (TTC). There is a paucity of nationally representative data on trends in short- and long-term outcomes for patients with TTC. The authors examined hospitalization rates; in-hospital, 30-day, and 1-year mortality; and all-cause 30-day readmission for Medicare fee-for-service beneficiaries with principal and secondary diagnoses of TTC from 2007 to 2012. Hospitalizations for principal or secondary diagnosis of TTC increased from 5.7 per 100,000 person-years in 2007 to 17.4 in 2012 (p for trend < 0.001). Patients were predominantly women and of white race. For principal TTC, in-hospital, 30-day, and 1-year mortality was 1.3% (95% confidence interval [CI]: 1.1% to 1.6%), 2.5% (95% CI: 2.2% to 2.8%), and 6.9% (95% CI: 6.4% to 7.5%), and the 30-day readmission rate was 11.6% (95% CI: 10.9% to 12.3%). For secondary TTC, in-hospital, 30-day, and 1-year mortality was 3% (95% CI: 2.7% to 3.3%), 4.7% (95% CI: 4.4% to 5.1%), and 11.4% (95% CI: 10.8% to 11.9%), and the 30-day readmission rate was 15.8% (95% CI: 15.1% to 16.4%). Over time, there was no change in mortality or readmission rate for both cohorts. Patients ≥85 years of age had higher in-hospital, 30-day, and 1-year mortality and 30-day readmission rates. Among patients with principal TTC, male and nonwhite patients had higher 1-year mortality than their counterparts, whereas in those with secondary TTC, mortality was worse at all 3 time points. Nonwhite patients had higher 30-day readmission rates for both cohorts. Hospitalization rates for TTC are increasing, but short- and long-term outcomes have not changed. At 1 year, 14 in 15 patients with principal TTC and 8 in 9 with secondary TTC are alive. Older, male, and nonwhite patients have worse outcomes. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. Rural-Urban Differences in Alzheimer's Disease and Related Disorders Diagnostic Prevalence in Kentucky and West Virginia.

    Science.gov (United States)

    Abner, Erin L; Jicha, Gregory A; Christian, W Jay; Schreurs, Bernard G

    2016-06-01

    Older adults living in rural areas may face barriers to obtaining a diagnosis of Alzheimer's disease and related disorders (ADRD). We sought to examine rural-urban differences in prevalence of ADRD among Medicare beneficiaries in Kentucky and West Virginia, 2 contiguous, geographically similar states with large rural areas and aged populations. We used Centers for Medicare and Medicaid Services Public Use Files data from 2007 to 2013 to assess prevalence of ADRD at the county level among all Medicare beneficiaries in each state. Rural-Urban Continuum Codes were used to classify counties as rural or urban. We used Poisson regression to estimate unadjusted and adjusted prevalence ratios. Primary analyses focused on 2013 data and were repeated for 2007 to 2012. This study was completely ecologic. After adjusting for state, average beneficiary age, percent of female beneficiaries, percent of beneficiaries eligible for Medicaid in each county, Central Appalachian county, percent of age-eligible residents enrolled in Medicare, and percent of residents under age 65 enrolled in Medicare in our adjusted models, we found that 2013 ADRD diagnostic prevalence was 11% lower in rural counties (95% CI: 9%-13%). Medicare beneficiaries in rural counties in Kentucky and West Virginia may be underdiagnosed with respect to ADRD. However, due to the ecologic design, and evidence of a younger, more heavily male beneficiary population in some rural areas, further studies using individual-level data are needed to confirm the results. © 2015 National Rural Health Association.

  7. Incidence of Norovirus-Associated Medical Encounters among Active Duty United States Military Personnel and Their Dependents.

    Directory of Open Access Journals (Sweden)

    Brian Rha

    Full Text Available Norovirus is a leading cause of gastroenteritis episodes and outbreaks in US military deployments, but estimates of endemic disease burden among military personnel in garrison are lacking.Diagnostic codes from gastroenteritis-associated medical encounters of active duty military personnel and their beneficiaries from July 1998-June 2011 were obtained from the Armed Forces Health Surveillance Center. Using time-series regression models, cause-unspecified encounters were modeled as a function of encounters for specific enteropathogens. Model residuals (representing unexplained encounters were used to estimate norovirus-attributable medical encounters. Incidence rates were calculated using population data for both active duty and beneficiary populations.The estimated annual mean rate of norovirus-associated medically-attended visits among active duty personnel and their beneficiaries was 292 (95% CI: 258 to 326 and 93 (95% CI: 80 to 105 encounters per 10,000 persons, respectively. Rates were highest among beneficiaries <5 years of age with a median annual rate of 435 (range: 318 to 646 encounters per 10,000 children. Norovirus was estimated to cause 31% and 27% of all-cause gastroenteritis encounters in the active duty and beneficiary populations, respectively, with over 60% occurring between November and April. There was no evidence of any lag effect where norovirus disease occurred in one population before the other, or in one beneficiary age group before the others.Norovirus is a major cause of medically-attended gastroenteritis among non-deployed US military active duty members as well as in their beneficiaries.

  8. Pilot pulsar surveys with LOFAR

    NARCIS (Netherlands)

    Coenen, T.

    2013-01-01

    We are performing two complementary pilot pulsar surveys as part of LOFAR commissioning. The LOFAR Pilot Pulsar Survey (LPPS) is a shallow all-sky survey using an incoherent combination of LOFAR stations. The LOFAR Tied-Array Survey (LOTAS) is a deeper pilot survey using 19 simultaneous tied-array

  9. 2015 Community Survey Data

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — These are the answers to the 2015 Community Survey.A comprehensive summary of the survey results can be found here.The survey asked town members to address their...

  10. Issues in environmental survey design

    International Nuclear Information System (INIS)

    Iachan, R.

    1989-01-01

    Several environmental survey design issues are discussed and illustrated with surveys designed by Research Triangle Institute statisticians. Issues related to sampling and nonsampling errors are illustrated for indoor air quality surveys, radon surveys, pesticide surveys, and occupational and personal exposure surveys. Sample design issues include the use of auxiliary information (e.g. for stratification), and sampling in time. We also discuss the reduction and estimation of nonsampling errors, including nonresponse and measurement bias

  11. Does good medication adherence really save payers money?

    Science.gov (United States)

    Stuart, Bruce C; Dai, Mingliang; Xu, Jing; Loh, Feng-Hua E; S Dougherty, Julia

    2015-06-01

    Despite a growing consensus that better adherence with evidence-based medications can save payers money, assertions of cost offsets may be incomplete if they fail to consider additional drug costs and/or are biased by healthy adherer behaviors unobserved in typical medical claims-based analyses. The objective of this study was to determine whether controlling for healthy adherer bias (HAB) materially affected estimated medical cost offsets and additional drug spending associated with higher adherence. A total of 1273 Medicare beneficiaries with diabetes enrolled in Part D plans between 2006 and 2009. Using survey and claims data from the Medicare Current Beneficiary Survey, we measured medical and drug costs associated with good and poor adherence (proportion of days covered ≥ 80% and <80%, respectively) to oral antidiabetic drugs, ACE inhibitors/ARBs, and statins over 2 years. To test for HAB, we estimated pairs of regression models, one set containing variables typically controlled for in conventional claims analysis and a second set with survey-based variables selected to capture HAB effects. We found consistent evidence that controlling for HAB reduces estimated savings in medical costs from better adherence, and likewise, reduces estimates of additional adherence-related drug spending. For ACE inhibitors/ARBs we estimate that controlling for HAB reduced adherence-related medical cost offsets from $6389 to $4920 per person (P<0.05). Estimates of additional adherence-related drug costs were 26% and 14% lower in HAB-controlled models (P < 0.05). These results buttress the economic case for action by health care payers to improve medication adherence among insured persons with chronic disease. However, given the limitations of our research design, further research on larger samples with other disease states is clearly warranted.

  12. Redshift Survey Strategies

    Science.gov (United States)

    Jones, A. W.; Bland-Hawthorn, J.; Kaiser, N.

    1994-12-01

    In the first half of 1995, the Anglo-Australian Observatory is due to commission a wide field (2.1(deg) ), 400-fiber, double spectrograph system (2dF) at the f/3.3 prime focus of the AAT 3.9m bi-national facility. The instrument should be able to measure ~ 4000 galaxy redshifts (assuming a magnitude limit of b_J ~\\ 20) in a single dark night and is therefore ideally suited to studies of large-scale structure. We have carried out simple 3D numerical simulations to judge the relative merits of sparse surveys and contiguous surveys. We generate a survey volume and fill it randomly with particles according to a selection function which mimics a magnitude-limited survey at b_J = 19.7. Each of the particles is perturbed by a gaussian random field according to the dimensionless power spectrum k(3) P(k) / 2pi (2) determined by Feldman, Kaiser & Peacock (1994) from the IRAS QDOT survey. We introduce some redshift-space distortion as described by Kaiser (1987), a `thermal' component measured from pairwise velocities (Davis & Peebles 1983), and `fingers of god' due to rich clusters at random density enhancements. Our particular concern is to understand how the window function W(2(k)) of the survey geometry compromises the accuracy of statistical measures [e.g., P(k), xi (r), xi (r_sigma ,r_pi )] commonly used in the study of large-scale structure. We also examine the reliability of various tools (e.g. genus) for describing the topological structure within a contiguous region of the survey.

  13. Regulatory and licensee surveys

    International Nuclear Information System (INIS)

    2009-01-01

    Prior to the workshop two CSNI/WGHOF surveys were distributed. One survey was directed at regulatory bodies and the other was directed at plant licensees. The surveys were: 1 - Regulatory Expectations of Licensees' Arrangements to Ensure Suitable Organisational Structure, Resources and Competencies to Manage Safety (sent to WGHOF regulatory members). The survey requested that the respondents provide a brief overview of the situation related to plant organisations in their country, their regulatory expectations and their formal requirements. The survey addressed three subjects: the demonstration and documentation of organisational structures, resources and competencies, organisational changes, issues for improvement (for both current and new plants). Responses were received from eleven regulatory bodies. 2 - Approaches to Justify Organisational Suitability (sent to selected licensees). The purpose of the survey to was to gain an understanding of how licensees ensure organisational suitability, resources and competencies. This information was used to assist in the development of the issues and subjects that were addressed at the group discussion sessions. Responses were received from over fifteen licensees from nine countries. The survey requested that the licensees provide information on how they ensure effective organisational structures at their plants. The survey grouped the questions into the following four categories: organisational safety functions, resource and competence, decision-making and communication, good examples and improvement needs. The findings from these surveys were used in conjunction with other factors to identify the key issues for the workshop discussion sessions. The responses from these two surveys are discussed briefly in Sections 4 and 5 of this report. More extensive reviews of the regulatory and licensee responses are provided in Appendix 1

  14. The Southern H ii Region Discovery Survey (SHRDS): Pilot Survey

    Energy Technology Data Exchange (ETDEWEB)

    Brown, C.; Dickey, John M. [School of Physical Sciences, Private Bag 37, University of Tasmania, Hobart, TAS, 7001 (Australia); Jordan, C. [International Centre for Radio Astronomy Research, Curtin University, Perth, WA, 6845 (Australia); Anderson, L. D.; Armentrout, W. P. [Department of Physics and Astronomy, West Virginia University, P.O. Box 6315, Morgantown, WV 26506 (United States); Balser, Dana S.; Wenger, Trey V. [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22904 (United States); Bania, T. M. [Institute for Astrophysical Research, Department of Astronomy, Boston University, 725 Commonwealth Avenue, Boston, MA 02215 (United States); Dawson, J. R. [Department of Physics and Astronomy and MQ Research Centre in Astronomy, Astrophysics and Astrophotonics, Macquarie University, NSW, 2109 (Australia); Mc Clure-Griffiths, N. M. [Research School of Astronomy and Astrophysics, The Australian National University, Canberra ACT 2611 (Australia)

    2017-07-01

    The Southern H ii Region Discovery Survey is a survey of the third and fourth quadrants of the Galactic plane that will detect radio recombination line (RRL) and continuum emission at cm-wavelengths from several hundred H ii region candidates using the Australia Telescope Compact Array. The targets for this survey come from the WISE Catalog of Galactic H ii Regions and were identified based on mid-infrared and radio continuum emission. In this pilot project, two different configurations of the Compact Array Broad Band receiver and spectrometer system were used for short test observations. The pilot surveys detected RRL emission from 36 of 53 H ii region candidates, as well as seven known H ii regions that were included for calibration. These 36 recombination line detections confirm that the candidates are true H ii regions and allow us to estimate their distances.

  15. The Southern H ii Region Discovery Survey (SHRDS): Pilot Survey

    International Nuclear Information System (INIS)

    Brown, C.; Dickey, John M.; Jordan, C.; Anderson, L. D.; Armentrout, W. P.; Balser, Dana S.; Wenger, Trey V.; Bania, T. M.; Dawson, J. R.; Mc Clure-Griffiths, N. M.

    2017-01-01

    The Southern H ii Region Discovery Survey is a survey of the third and fourth quadrants of the Galactic plane that will detect radio recombination line (RRL) and continuum emission at cm-wavelengths from several hundred H ii region candidates using the Australia Telescope Compact Array. The targets for this survey come from the WISE Catalog of Galactic H ii Regions and were identified based on mid-infrared and radio continuum emission. In this pilot project, two different configurations of the Compact Array Broad Band receiver and spectrometer system were used for short test observations. The pilot surveys detected RRL emission from 36 of 53 H ii region candidates, as well as seven known H ii regions that were included for calibration. These 36 recombination line detections confirm that the candidates are true H ii regions and allow us to estimate their distances.

  16. Strategic survey framework for the Northwest Forest Plan survey and manage program.

    Science.gov (United States)

    Randy Molina; Dan McKenzie; Robin Lesher; Jan Ford; Jim Alegria; Richard Cutler

    2003-01-01

    This document outlines an iterative process for assessing the information needs for all Northwest Forest Plan (NWFP) survey and manage species, designing and implementing strategic surveys (including field surveys and other information-gathering processes), and analyzing that information for use in the NWFP annual species review and adaptive-management processes. The...

  17. Underutilization of high-intensity statin therapy after hospitalization for coronary heart disease.

    Science.gov (United States)

    Rosenson, Robert S; Kent, Shia T; Brown, Todd M; Farkouh, Michael E; Levitan, Emily B; Yun, Huifeng; Sharma, Pradeep; Safford, Monika M; Kilgore, Meredith; Muntner, Paul; Bittner, Vera

    2015-01-27

    National guidelines recommend use of high-intensity statins after hospitalization for coronary heart disease (CHD) events. This study sought to estimate the proportion of Medicare beneficiaries filling prescriptions for high-intensity statins after hospital discharge for a CHD event and to analyze whether statin intensity before hospitalization is associated with statin intensity after discharge. We conducted a retrospective cohort study using a 5% random sample of Medicare beneficiaries between 65 and 74 years old. Beneficiaries were included in the analysis if they filled a statin prescription after a CHD event (myocardial infarction or coronary revascularization) in 2007, 2008, or 2009. High-intensity statins included atorvastatin 40 to 80 mg, rosuvastatin 20 to 40 mg, and simvastatin 80 mg. Among 8,762 Medicare beneficiaries filling a statin prescription after a CHD event, 27% of first post-discharge fills were for a high-intensity statin. The percent filling a high-intensity statin post-discharge was 23.1%, 9.4%, and 80.7%, for beneficiaries not taking statins pre-hospitalization, taking low/moderate-intensity statins, and taking high-intensity statins before their CHD event, respectively. Compared with beneficiaries not on statin therapy pre-hospitalization, multivariable adjusted risk ratios for filling a high-intensity statin were 4.01 (3.58-4.49) and 0.45 (0.40-0.52) for participants taking high-intensity and low/moderate-intensity statins before their CHD event, respectively. Only 11.5% of beneficiaries whose first post-discharge statin fill was for a low/moderate-intensity statin filled a high-intensity statin within 365 days of discharge. The majority of Medicare beneficiaries do not fill high-intensity statins after hospitalization for CHD. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. An assessment of incentive versus survey length trade-offs in a Web survey of radiologists.

    Science.gov (United States)

    Ziegenfuss, Jeanette Y; Niederhauser, Blake D; Kallmes, David; Beebe, Timothy J

    2013-03-20

    It is generally understood that shorter Web surveys and use of incentives result in higher response rates in Web surveys directed to health care providers. Less is known about potential respondent preference for reduced burden as compared to increased reward. To help elicit preference for minimized burden compared to reward for completion of a survey, we observed physician preferences for shorter Web surveys compared to incentives as well as incentive preference (small guaranteed incentive compared to larger lottery incentive) accompanying an electronic request to complete a survey. This was an observational study that accompanied a large Web survey study of radiology staff, fellows, and residents at select academic medical centers in the United States. With the request to complete the survey, potential respondents were offered three options: (1) a 10-minute Web survey with the chance to win an iPad, (2) a 10-minute Web survey with a guaranteed nominal incentive ($5 amazon.com gift card), or (3) a shorter (5-7 minute) Web survey with no incentive. A total of 254 individuals responded to the Web survey request. Overwhelmingly, individuals chose a longer survey accompanied by an incentive compared to a shorter survey with no incentive (85% compared to 15%, P<.001). Of those opting for an incentive, a small, but not significant majority chose the chance to win an iPad over a guaranteed $5 gift card (56% compared to 44%). When given the choice, radiologists preferred a reward (either guaranteed or based on a lottery) to a less burdensome survey, indicating that researchers should focus more attention at increasing perceived benefits of completing a Web survey compared to decreasing perceived burden.

  19. Environmental Survey preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    1988-04-01

    This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Sandia National Laboratories conducted August 17 through September 4, 1987. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with Sandia National Laboratories-Albuquerque (SNLA). The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at SNLA, and interviews with site personnel. 85 refs., 49 figs., 48 tabs.

  20. Primer on Health Surveys

    Directory of Open Access Journals (Sweden)

    David L Nordstrom

    2012-06-01

    Full Text Available The aim of this paper is to introduce novice researchers to surveys as a method of data collection. It starts with the definition of a survey, its major purposes and types as well as changes in the goals surveys have helped to achieve over time. Advantages and disadvantages of surveys over population censuses and medical examinations are discussed. Approaches to questionnaire construction are introduced along with properties that questionnaires are evaluated for. Modes of administration, sample size issues, and data analysis approaches are also introduced. The primer is illustrated with examples of surveys conducted in different countries with various public health purposes.

  1. Infrared Sky Surveys

    Science.gov (United States)

    Price, Stephan D.

    2009-02-01

    A retrospective is given on infrared sky surveys from Thomas Edison’s proposal in the late 1870s to IRAS, the first sensitive mid- to far-infrared all-sky survey, and the mid-1990s experiments that filled in the IRAS deficiencies. The emerging technology for space-based surveys is highlighted, as is the prominent role the US Defense Department, particularly the Air Force, played in developing and applying detector and cryogenic sensor advances to early mid-infrared probe-rocket and satellite-based surveys. This technology was transitioned to the infrared astronomical community in relatively short order and was essential to the success of IRAS, COBE and ISO. Mention is made of several of the little known early observational programs that were superseded by more successful efforts.

  2. Using Linked Survey Paradata to Improve Sampling Strategies in the Medical Expenditure Panel Survey

    Directory of Open Access Journals (Sweden)

    Mirel Lisa B.

    2017-06-01

    Full Text Available Using paradata from a prior survey that is linked to a new survey can help a survey organization develop more effective sampling strategies. One example of this type of linkage or subsampling is between the National Health Interview Survey (NHIS and the Medical Expenditure Panel Survey (MEPS. MEPS is a nationally representative sample of the U.S. civilian, noninstitutionalized population based on a complex multi-stage sample design. Each year a new sample is drawn as a subsample of households from the prior year’s NHIS. The main objective of this article is to examine how paradata from a prior survey can be used in developing a sampling scheme in a subsequent survey. A framework for optimal allocation of the sample in substrata formed for this purpose is presented and evaluated for the relative effectiveness of alternative substratification schemes. The framework is applied, using real MEPS data, to illustrate how utilizing paradata from the linked survey offers the possibility of making improvements to the sampling scheme for the subsequent survey. The improvements aim to reduce the data collection costs while maintaining or increasing effective responding sample sizes and response rates for a harder to reach population.

  3. Primer on Health Surveys

    OpenAIRE

    David L Nordstrom; David L Nordstrom

    2012-01-01

    The aim of this paper is to introduce novice researchers to surveys as a method of data collection. It starts with the definition of a survey, its major purposes and types as well as changes in the goals surveys have helped to achieve over time. Advantages and disadvantages of surveys over population censuses and medical examinations are discussed. Approaches to questionnaire construction are introduced along with properties that questionnaires are evaluated for. Modes of administration, sam...

  4. The Role of Medicare's Inpatient Cost-Sharing in Medicaid Entry.

    Science.gov (United States)

    Keohane, Laura M; Trivedi, Amal N; Mor, Vincent

    2018-04-01

    To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge. In a regression discontinuity analysis, we take advantage of this Medicare benefit feature to test whether beneficiaries with greater cost-sharing have higher rates of Medicaid enrollment. We identified 221,248 Medicare beneficiaries with an initial hospital stay and a readmission 53-59 days later (no deductible) or 60-66 days later (charged a deductible). Among beneficiaries in low-socioeconomic areas with two hospitalizations, those readmitted 60-66 days after discharge were 21 percent more likely to join Medicaid compared with those readmitted 53-59 days following their initial hospitalization (absolute difference in adjusted risk of Medicaid entry: 3.7 percent vs. 3.1 percent, p = .01). Increasing Medicare cost-sharing requirements may promote Medicaid enrollment among low-income beneficiaries. Potential savings from an increased cost-sharing in the Medicare program may be offset by increased Medicaid participation. © Health Research and Educational Trust.

  5. The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul

    Directory of Open Access Journals (Sweden)

    Jungah Kim

    2018-04-01

    Full Text Available The Medical Aid program is government’s medical benefit program to secure the minimum livelihood and medical services for low-income Korean households. In Seoul, the number of Medical Aid beneficiaries has grown, driving an increases in the length of stay (LOS and healthcare cost. Until now, studies have focused on quantity indicators, such as LOS, but only a few studies have been conducted on the service quality. We investigated both LOS and the preventable hospitalization (PH rate as proxy indicators for the quantity and quality of services provided to Medical Aid beneficiaries in Seoul. To understand the program’s impact, we extracted appropriate data of Medical Aid beneficiaries and data of the lower 20% of National Health Insurance (NHI enrollees, performed Propensity Score Matching (PSM, and controlled the variables related to disease severity. The differences between Medical Aid beneficiaries and NHI enrollees were estimated using multilevel analysis. The LOS of Medical Aid beneficiaries was longer, and the preventable hospitalization (PH rate was higher than that of NHI enrollees. It implies that these beneficiaries did not receive timely and adequate healthcare services, despite their high rate of service utilization. Thus, indicators such as patient’s visits and screening related to PHs should be included in management policies to improve primary care.

  6. Racial and ethnic disparities in depression care in community-dwelling elderly in the United States.

    Science.gov (United States)

    Akincigil, Ayse; Olfson, Mark; Siegel, Michele; Zurlo, Karen A; Walkup, James T; Crystal, Stephen

    2012-02-01

    We investigated racial/ethnic disparities in the diagnosis and treatment of depression among community-dwelling elderly. We performed a secondary analysis of Medicare Current Beneficiary Survey data (n = 33,708) for 2001 through 2005. We estimated logistic regression models to assess the association of race/ethnicity with the probability of being diagnosed and treated for depression with either antidepressant medication or psychotherapy. Depression diagnosis rates were 6.4% for non-Hispanic Whites, 4.2% for African Americans, 7.2% for Hispanics, and 3.8% for others. After we adjusted for a range of covariates including a 2-item depression screener, we found that African Americans were significantly less likely to receive a depression diagnosis from a health care provider (adjusted odds ratio [AOR] = 0.53; 95% confidence interval [CI] = 0.41, 0.69) than were non-Hispanic Whites; those diagnosed were less likely to be treated for depression (AOR = 0.45; 95% CI = 0.30, 0.66). Among elderly Medicare beneficiaries, significant racial/ethnic differences exist in the diagnosis and treatment of depression. Vigorous clinical and public health initiatives are needed to address this persisting disparity in care.

  7. Semi-customizing patient surveys

    DEFF Research Database (Denmark)

    Riiskjær, Erik; Ammentorp, Jette; Nielsen, Jørn Flohr

    2011-01-01

    Objective. The study investigated the needs and consequences of semi-customizing patient satisfaction surveys to low organizational levels and explored whether patient satisfaction was correlated with local organizational conditions. Design. From 1999 to 2006, the County of Aarhus carried out 398....... Establishing a link between patient satisfaction and organizational variables broadens the quality development focus to include more than simply analysis of specific questions. Semi-customizing patient surveys are recommended....... surveys during four rounds in eight hospitals. To explain differences between the wards, data on the 40 wards with the best and the 40 wards with the worst evaluations (identified by patient surveys) were compared with the data from job satisfaction surveys and management information systems. Setting...

  8. Satisfaction with the humanitarian response to the 2010 Pakistan floods: a call for increased accountability to beneficiaries.

    Science.gov (United States)

    Kirsch, Thomas; Siddiqui, Muhammad Ahmed; Perrin, Paul Clayton; Robinson, W Courtland; Sauer, Lauren M; Doocy, Shannon

    2013-07-01

    Ascertain recipients' level of satisfaction with humanitarian response efforts. A multi-stage, 80×20 cluster sample randomized survey (1800 households) with probability proportional to size of households affected by the 2010 Indus river floods in Pakistan. The floods affected over 18 million households and led to more than 8 billion USD in response dollars. Less than 20% of respondents reported being satisfied with response, though a small increase in satisfaction levels was observed over the three time periods of interest. Within the first month, receipt of hygiene items, food and household items was most strongly predictive of overall satisfaction. At 6 months, positive receipt of medicines was also highly predictive of satisfaction. The proportion of households reporting unmet needs remained elevated throughout the 6-month period following the floods and varied from 50% to 80%. Needs were best met between 1 and 3 months postflood, when response was at its peak. Unmet needs were the greatest at 6 months, when response was being phased down. Access-limiting issues were rarely captured during routine monitoring and evaluation efforts and seem to be a significant predictor in dissatisfaction with relief efforts, at least in the case of Pakistan, another argument in favor of independent, population-based surveys of this kind. There is also need to better identify and serve those not residing in camps. Direct surveys of the affected population can be used operationally to assess ongoing needs, more appropriately redirect humanitarian resources, and ultimately, judge the overall quality of a humanitarian response.

  9. Plenary III–04: Responses to Drug Costs: Year Three of the Medicare Part D Program

    OpenAIRE

    Fung, Vicki; Reed, Mary; Hsu, John

    2010-01-01

    Background/Aims: Many Medicare Part D beneficiaries face substantial prescription drug cost-sharing. In the first year of the program, many beneficiaries reported substantial drug use changes in response to the coverage gap. In response, an increasing number of plans offer generic drug coverage during the gap. We compared responses to Part D costs among beneficiaries with generic-only gap coverage and full gap coverage in 2008, the third year of the Part D program.

  10. Specialty Drug Spending Trends Among Medicare And Medicare Advantage Enrollees, 2007–11

    OpenAIRE

    Trish, Erin; Joyce, Geoffrey; Goldman, Dana P.

    2014-01-01

    Specialty pharmaceuticals include most injectable and biologic agents used to treat complex conditions such as rheumatoid arthritis, multiple sclerosis, and cancer. We analyzed trends in specialty drug spending among Medicare beneficiaries ages sixty-five and older using 2007–11 pharmacy claims data from a 20 percent sample of Medicare beneficiaries. Annual specialty drug spending per beneficiary who used specialty drugs increased considerably during the study period, from $2,641 to $8,976. H...

  11. Aerogeophysical survey in Olkiluoto 2009

    International Nuclear Information System (INIS)

    Kurimo, M.

    2009-08-01

    This report describes the survey operation, survey and processing methods and the deliverables of an aerogeophysical survey in Olkiluoto area in May 2009. The survey was conducted by Geological Survey of Finland (GTK). The survey aircraft was a twin-engine Twin Otter operated by Finnish Aviation Academy (SIO) and owned by Natural Environment Research Council / British Geological Survey (NERC / BGS), with whom GTK has established a joint venture called Joint Airborne-geoscience Capability (JAC). The survey was conducted in May 2009 between May 5th and May 18th. The survey consists of ten separate survey flights and two magnetic calibration flights. The survey was based in Pori airport. Survey line spacing was 50 meters and nominal survey altitude was 30 meters. Measurements were completed in May 2009, and data processing and reporting was done in June 2009. Two cesium magnetometers installed onboard the aircraft (at the left wingtip and in a nose cone) were measuring the magnetic total field intensity during the survey flights. An automatic compensation unit corrected the aircraft attitude errors in the magnetic data in real time. The four-frequency electromagnetic (EM) unit included four transmitter coils with amplifiers in right wingtip and four receiver coils in left wingtip. Frequencies were 900 Hz, 3 kHz, 14 kHz and 24.5 kHz. The gamma spectrometer with two crystal packages (total volume 42 litres) measured the 256 channel energy spectra. In addition, auxiliary parameters such as flight altitude and aircraft attitude were also recorded simultaneously. Reference ground base station was used for recording the temporal variations in the magnetic field and also reference data for post-positioning of coordinate information. In the post-processing phase, heading correction, base station correction and microlevelling procedures were applied to the magnetic data. The EM data and radiometric data were corrected with calibration coefficients and levelled. The data was

  12. GPS satellite surveying

    CERN Document Server

    Leick, Alfred; Tatarnikov, Dmitry

    2015-01-01

    THE MOST COMPREHENSIVE, UP-TO-DATE GUIDE ON GPS TECHNOLOGY FOR SURVEYING Three previous editions have established GPS Satellite Surveying as the definitive industry reference. Now fully updated and expanded to reflect the newest developments in the field, this Fourth Edition features cutting-edge information on GNSS antennas, precise point positioning, real-time relative positioning, lattice reduction, and much more. Expert authors examine additional tools and applications, offering complete coverage of geodetic surveying using satellite technologies. The past decade has seen a major evolut

  13. Innovative vaccine delivery strategies in response to a cholera outbreak in the challenging context of Lake Chilwa. A rapid qualitative assessment.

    Science.gov (United States)

    Heyerdahl, Leonard W; Ngwira, Bagrey; Demolis, Rachel; Nyirenda, Gabriel; Mwesawina, Maurice; Rafael, Florentina; Cavailler, Philippe; Bernard Le Gargasson, Jean; Mengel, Martin A; Gessner, Bradford D; Guillermet, Elise

    2017-11-07

    A reactive campaign using two doses of Shanchol Oral Cholera Vaccine (OCV) was implemented in 2016 in the Lake Chilwa Region (Malawi) targeting fish dependent communities. Three strategies for the second vaccine dose delivery (including delivery by a community leader and self-administration) were used to facilitate vaccine access. This assessment collected vaccine perceptions and opinions about the OCV campaign of 313 study participants, including: fishermen, fish traders, farmers, community leaders, and one health and one NGO officer. Socio-demographic surveys were conducted, In Depth Interviews and Focus Group Discussions were conducted before and during the campaign. Some fishermen perceived the traditional delivery strategy as reliable but less practical. Delivery by traditional leaders was acceptable for some participants while others worried about traditional leaders not being trained to deliver vaccines or beneficiaries taking doses on their own. A slight majority of beneficiaries considered the self-administration strategy practical while some beneficiaries worried about storing vials outside of the cold chain or losing vials. During the campaign, a majority of participants preferred receiving oral vaccines instead of injections given ease of intake and lack of pain. OCV was perceived as efficacious and safe. However, a lack of information on how sero-protection may be delayed and the degree of sero-protection led to loss of trust in vaccine potency among some participants who witnessed cholera cases among vaccinated individuals. OCV campaign implementation requires accompanying communication on protective levels, less than 100% vaccine efficacy, delays in onset of sero-protection, and out of cold chain storage. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. 78 FR 50057 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Science.gov (United States)

    2013-08-16

    ... beneficiaries and their caregivers to more thoroughly understand patients' experiences with their PCMHs and how... ``what, how, and why'' questions about beneficiaries' experiences with care and access to and...

  15. 78 FR 25089 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Science.gov (United States)

    2013-04-29

    ... beneficiaries and their caregivers to more thoroughly understand patients' experiences with their PCMHs and how... ``what, how, and why'' questions about beneficiaries' experiences with care and access to and...

  16. Sea Scallop Survey

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The standardized NEFSC Sea Scallop Survey began in 1980 and has covered an area from Cape Hatteras to Georges Bank. The survey aims to determine the distribution and...

  17. GIS Readiness Survey 2014

    DEFF Research Database (Denmark)

    Schrøder, Lise; Hvingel, Line Træholt; Hansen, Henning Sten

    2014-01-01

    The GIS Readiness Survey 2014 is a follow-up to the corresponding survey that was carried out among public institutions in Denmark in 2009. The present survey thus provides an updated image of status and challenges in relation to the use of spatial information, the construction of the com- mon...

  18. Who benefits from free institutional delivery? evidence from a cross sectional survey of North Central and Southwestern Nigeria.

    Science.gov (United States)

    Ajayi, Anthony I; Akpan, Wilson

    2017-09-02

    The reasons for low utilisation of maternal health services in settings where the user-fee removal policy has been implemented continue to generate scholarly debates. Evidence of whether user-fee removal benefits the poor women in underserved settings is scanty and inconsistent. This article examines use of maternal health care services in the context of free maternal healthcare and profiles the beneficiaries of user-fee removal. The study adopted a descriptive design. A three-stage cluster sampling method was used to select a representative sample of 1227 women who gave birth between 2011 and 2015. Questionnaires were administered using a face-to-face interview approach and data generated were analysed using descriptive and inferential statistics. The analysis shows that the use of maternal healthcare services has improved considerably in North Central and Southwestern Nigeria. While socioeconomic and geographical inequality in the use of maternal healthcare services appear to be disappearing in Southwestern Nigeria, it appears to be widening in North Central Nigeria. The findings indicate that 33.6% of women reported to have benefitted from the free child-delivery programme; however, substantial variation exists across the two regions. The proportion of beneficiaries of user-fee removal policy was highest in urban areas (35.9%), among women belonging to the middle income category (38.3%), among women who gave birth in primary health centres (63.1%) and among women who resided in communities where there was availability of health facilities (37.2%). The study concludes that low coverage of the free maternal health programme, especially among women of low socioeconomic status residing in underserved settings is among the reasons for persistent poor maternal health outcomes in the context of free maternal healthcare. A model towards improving maternal health in underserved settings, especially in North Central Nigeria, would entail provisioning of health facilities

  19. Chronic Condition Data Warehouse

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Chronic Condition Data Warehouse (CCW) provides researchers with Medicare and Medicaid beneficiary, claims, and assessment data linked by beneficiary across...

  20. 31 CFR 346.2 - Registration.

    Science.gov (United States)

    2010-07-01

    ..., DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING UNITED STATES INDIVIDUAL... ownership or beneficiary form. A bond registered in the beneficiary form will be inscribed substantially as...

  1. Geothermal survey handbook

    Energy Technology Data Exchange (ETDEWEB)

    1974-01-01

    The objective of this handbook is to publicize widely the nature of geothermal surveys. It covers geothermal survey planning and measurement as well as measurement of thermal conductivity. Methods for the detection of eruptive areas, the measurement of radiative heat using snowfall, the measurement of surface temperature using infrared radiation and the measurement of thermal flow are described. The book also contains information on physical detection of geothermal reservoirs, the measurement of spring wells, thermographic measurement of surface heat, irregular layer surveying, air thermographics and aerial photography. Isotope measurement techniques are included.

  2. GDOT employee survey.

    Science.gov (United States)

    2017-07-04

    The research team worked in collaboration with GDOT to conduct the 2016 GDOT Employee Survey. This research study aimed to increase the response rate and the usefulness of the feedback from the GDOT employee survey to support organizational decisions...

  3. Preventive Care Quality of Medicare Accountable Care Organizations: Associations of Organizational Characteristics With Performance.

    Science.gov (United States)

    Albright, Benjamin B; Lewis, Valerie A; Ross, Joseph S; Colla, Carrie H

    2016-03-01

    Accountable Care Organizations (ACOs) are a delivery and payment model aiming to coordinate care, control costs, and improve quality. Medicare ACOs are responsible for 8 measures of preventive care quality. To create composite measures of preventive care quality and examine associations of ACO characteristics with performance. This is a cross-sectional study of Medicare Shared Savings Program and Pioneer participants. We linked quality performance to descriptive data from the National Survey of ACOs. We created composite measures using exploratory factor analysis, and used regression to assess associations with organizational characteristics. Of 252 eligible ACOs, 246 reported on preventive care quality, 177 of which completed the survey (response rate=72%). In their first year, ACOs lagged behind PPO performance on the majority of comparable measures. We identified 2 underlying factors among 8 measures and created composites for each: disease prevention, driven by vaccines and cancer screenings, and wellness screening, driven by annual health screenings. Participation in the Advanced Payment Model, having fewer specialists, and having more Medicare ACO beneficiaries per primary care provider were associated with significantly better performance on both composites. Better performance on disease prevention was also associated with inclusion of a hospital, greater electronic health record capabilities, a larger primary care workforce, and fewer minority beneficiaries. ACO preventive care quality performance is related to provider composition and benefitted by upfront investment. Vaccine and cancer screening quality performance is more dependent on organizational structure and characteristics than performance on annual wellness screenings, likely due to greater complexity in eligibility determination and service administration.

  4. Do patient surveys work? The influence of a national survey programme on local quality-improvement initiatives.

    Science.gov (United States)

    Reeves, R; Seccombe, I

    2008-12-01

    To assess current attitudes towards the national patient survey programme in England, establish the extent to which survey results are used and identify barriers and incentives for using them. Qualitative interviews with hospital staff responsible for implementing the patient surveys (survey leads). National Health Service (NHS) hospital organisations (trusts) in England. Twenty-four patient survey leads for NHS trusts. Perceptions of the patient surveys were mainly positive and were reported to be improving. Interviewees welcomed the surveys' regular repetition and thought the questionnaires, survey methods and reporting of results, particularly inter-organisational benchmark charts, were of a good standard. The survey results were widely used in action planning and were thought to support organisational patient-centredness. There was variation in the extent to which trusts disseminated survey findings to patients, the public, staff and their board members. The most common barrier to using results was difficulty engaging clinicians because survey findings were not sufficiently specific to specialties, departments or wards. Limited statistical expertise and concerns that the surveys only covered a short time frame also contributed to some scepticism. Other perceived barriers included a lack of knowledge of effective interventions, and limited time and resources. Actual and potential incentives for using survey findings included giving the results higher weightings in the performance management system, financial targets, Payment by Results (PbR), Patient Choice, a patient-centred culture, leadership by senior members of the organisation, and boosting staff morale by disseminating positive survey findings. The national patient surveys are viewed positively, their repetition being an important factor in their success. The results could be used more effectively if they were more specific to smaller units.

  5. Psychiatric inpatient expenditures and public health insurance programmes: analysis of a national database covering the entire South Korean population

    Directory of Open Access Journals (Sweden)

    Chung Woojin

    2010-09-01

    Full Text Available Abstract Background Medical spending on psychiatric hospitalization has been reported to impose a tremendous socio-economic burden on many developed countries with public health insurance programmes. However, there has been no in-depth study of the factors affecting psychiatric inpatient medical expenditures and differentiated these factors across different types of public health insurance programmes. In view of this, this study attempted to explore factors affecting medical expenditures for psychiatric inpatients between two public health insurance programmes covering the entire South Korean population: National Health Insurance (NHI and National Medical Care Aid (AID. Methods This retrospective, cross-sectional study used a nationwide, population-based reimbursement claims dataset consisting of 1,131,346 claims of all 160,465 citizens institutionalized due to psychiatric diagnosis between January 2005 and June 2006 in South Korea. To adjust for possible correlation of patients characteristics within the same medical institution and a non-linearity structure, a Box-Cox transformed, multilevel regression analysis was performed. Results Compared with inpatients 19 years old or younger, the medical expenditures of inpatients between 50 and 64 years old were 10% higher among NHI beneficiaries but 40% higher among AID beneficiaries. Males showed higher medical expenditures than did females. Expenditures on inpatients with schizophrenia as compared to expenditures on those with neurotic disorders were 120% higher among NHI beneficiaries but 83% higher among AID beneficiaries. Expenditures on inpatients of psychiatric hospitals were greater on average than expenditures on inpatients of general hospitals. Among AID beneficiaries, institutions owned by private groups treated inpatients with 32% higher costs than did government institutions. Among NHI beneficiaries, inpatients medical expenditures were positively associated with the proportion of

  6. Cold in-place recycling characterization framework for single or multiple component binder systems

    Science.gov (United States)

    Cox, Benjamin C.

    Cold in-place recycling (CIR) is a pavement rehabilitation technique which has gained momentum in recent years. This momentum is due partly to its economic and sustainability characteristics, which has led to CIR market expansion. When pavement network deterioration is considered alongside increasing material costs, it is not beyond reason to expect demands on CIR to continue to increase. Historically, single component binder (SCB) systems, those with one stabilization binder (or two if the secondary binder dosage is 1% or less), have dominated the CIR market and could be considered the general state of practice. Common stabilization binders are either bituminous or cementitious. Two example SCB systems would be: 1) 3% portland cement, or 2) 3% asphalt emulsion with 1% hydrated lime. While traditional SCB systems have demonstrated positive economic and sustainability impacts, this dissertation focuses on multiple component binder (MCB) systems (bituminous and cementitious combined) which exhibit the potential to provide better overall economics and performance. Use of MCBs has the potential to alleviate SCB issues to some extent (e.g. cracking with cementitious SCBs, rutting with bituminous SCBs). Furthermore, to fairly represent both binders in an MCB system a universal design method which can accommodate multiple binder types is needed. The main objectives of this dissertation are to develop a universal CIR design framework and, using this framework, characterize multiple SCB and MCB systems. Approximately 1500 CIR specimens were tested herein along with approximately 300 asphalt concrete specimens which serve as a reference data set for CIR characterization. A case study of a high-traffic Mississippi CIR project which included cement SCB and emulsion SCB sections is also presented to support laboratory efforts. Individual components needed to comprise a universal design framework, such as curing protocols, were developed. SCB and MCB characterization indicated

  7. The VLA Sky Survey

    Science.gov (United States)

    Lacy, Mark; VLASS Survey Team, VLASS Survey Science Group

    2018-01-01

    The VLA Sky Survey (VLASS), which began in September 2017, is a seven year project to image the entire sky north of Declination -40 degrees in three epochs. The survey is being carried out in I,Q and U polarization at a frequency of 2-4GHz, and a resolution of 2.5 arcseconds, with each epoch being separated by 32 months. Raw data from the survey, along with basic "quicklook" images are made freely available shortly after observation. Within a few months, NRAO will begin making available further basic data products, including refined images and source lists. In this talk I shall describe the science goals and methodology of the survey, the current survey status, and some early results, along with plans for collaborations with external groups to produce enhanced, high level data products.

  8. Conducting Surveys and Data Collection: From Traditional to Mobile and SMS-based Surveys

    Directory of Open Access Journals (Sweden)

    Iftikhar Alam

    2014-08-01

    Full Text Available Fresh, bias-free and valid data collected using different survey modes is considered an essential requirement for smooth functioning and evolution of an organization. Surveys play a major role in making in-time correct decisions and generating reports. The aim of this study is to compare and investigate state-of-the-art in different survey modes including print, email, online, mobile and SMS-based surveys. Results indicated that existing methods are neither complete nor sufficient to fulfil the overall requirements of an organization which primarily rely on surveys. Also, it shows that SMS is a dominant method for data collection due to its pervasiveness. However, existing SMS-based data collection has limitations like limited number of characters per SMS, single question per SMS and lake of multimedia support. Recent trends in data collection emphasis on data collection applications for smart phones. However, in developing countries low-end mobile devices are still extensively used which makes the data collection difficult from man in the street. The paper conclude that existing survey modes and methods should be improved to get maximum responses quickly in low cost manner. The study has contributed to the area of surveying and data collection by analysing different factors such as cost, time and response rate. The results of this study can help practitioners in creating a more successful surveying method for data collection that can be effectively used for low budget projects in developed as well as developing countries.

  9. Medicare Hospice Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — More Medicare beneficiaries are taking advantage of the quality and compassionate care provided through the hospice benefit. As greater numbers of beneficiaries have...

  10. School Leavers' Survey Report 2007

    OpenAIRE

    Byrne, Delma; McCoy, Selina; Watson, Dorothy

    2008-01-01

    Since the late 1970s the Economic and Social Research Institute has conduced research on recent school leavers in the Republic of Ireland on behalf of various government departments. The School Leavers’ Survey has been in existence since it first surveyed young people who left the second-level education system in the academic year 1978/1979. Since its inception, 24 surveys in all have been carried out either on a yearly or bi-yearly basis, until the most recent survey which survey...

  11. Quarry Haul Road Ecological Survey

    International Nuclear Information System (INIS)

    1992-09-01

    This biological survey was performed to document the summer flora and fauna found along the haul road constructed as part of the remedial action for the quarry bulk waste. State and Federal species listed as threatened or endangered were noted if encountered while surveying. Sampling locations were equally spaced along the quarry haul road, and a survey for vegetation and birds conducted at each location. Bird observations were conducted as breeding bird surveys once in June of 1991, and again in June of 1992. Each year's survey includes two observations in the early morning and one late in the evening. Vegetation surveys were conducted in 1991 using quadrants and transects. mammal, reptile, and amphibian sightings were noted as encountered

  12. 45 CFR 1050.3 - What conditions apply to the Charitable Choice provisions of the CSBG Act?

    Science.gov (United States)

    2010-10-01

    ... HUMAN SERVICES CHARITABLE CHOICE UNDER THE COMMUNITY SERVICES BLOCK GRANT ACT PROGRAMS § 1050.3 What..., discriminate against a program beneficiary or prospective program beneficiary on the basis of religion or a...

  13. Explaining discrepancies in reproductive health indicators from population-based surveys and exit surveys: a case from Rwanda.

    Science.gov (United States)

    Meekers, D; Ogada, E A

    2001-06-01

    Reproductive health programmes often need exit surveys and population-based surveys for monitoring and evaluation. This study investigates why such studies produce discrepant estimates of condom use, sexual behaviour and condom brand knowledge, and discusses the implications for future use of exit surveys for programme monitoring. Logistic regression is used to explain differences between a household survey of 1295 persons and an exit survey among a random sample of 2550 consumers at retail outlets in RWANDA: Discrepancies in ever use of condoms and risky sexual behaviours are due to differences in socioeconomic status of the two samples. After controls, exit surveys at most outlet types have the same results as the household survey. Only exit surveys at bars, nightclubs and hotels yield significantly different estimates. However, the above-average knowledge of Prudence Plus condoms in the exit interviews is not attributable to socioeconomic or demographic variables, most likely because respondents have seen the product at the outlets. Information about condom use and sexual behaviour obtained from exit surveys appears as accurate as that obtained through household surveys. Nevertheless, exit surveys must be used cautiously. Because exit surveys may include wealthier and better-educated respondents, they are not representative of the general population. The composition of exit survey samples should be validated through existing household surveys. Comparisons across survey types are generally unadvisable, unless they control for sample differences. When generalizing to the population at large is not needed (e.g. for studies aimed at identifying the characteristics and behaviour of users of particular products or services), exit surveys can provide an appropriate alternative to household surveys.

  14. Aerial radiological surveys of Steed Pond, Savannah River Site: Dates of surveys, 1984--1989

    International Nuclear Information System (INIS)

    Fritzsche, A.E.; Jobst, J.E.

    1993-09-01

    From June 1984 to August 1985, three aerial radiological surveys were conducted over Steed Pond at the Savannah River Site in South Carolina. In addition, Steed Pond was included in larger-area surveys of the Savannah River Site in subsequent years. The surveys were conducted by the Remote Sensing Laboratory of EG ampersand G Energy Measurements, Inc., Las Vegas, Nevada, for the US Department of Energy. Airborne measurements were obtained for both natural and man-made gamma radiation over Steed Pond and surrounding areas. The first survey was conducted when the pond was filled to normal capacity for the time of the year. On September 1, 1984, the Steed Pond dam spillway failed causing the pond to drain. The four subsequent surveys were conducted with the pond drained. The second survey and the third were conducted to study silt deposits exposed by the drop in water level after the spillway's opening. Steed Pond data from the February 1987 and April 1989 Savannah River Site surveys have been included to bring this study up to date

  15. Our Surveys & Programs

    Science.gov (United States)

    Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My Classification Codes (i.e., NAICS) Economic Census Economic Indicators Economic Studies Industry Statistics

  16. Satellite Sounder Observations of Contrasting Tropospheric Moisture Transport Regimes: Saharan Air Layers, Hadley Cells, and Atmospheric Rivers

    Energy Technology Data Exchange (ETDEWEB)

    Nalli, Nicholas R.; Barnet, Christopher D.; Reale, Tony; Liu, Quanhua; Morris, Vernon R.; Spackman, J. Ryan; Joseph, Everette; Tan, Changyi; Sun, Bomin; Tilley, Frank; Leung, L. Ruby; Wolfe, Daniel

    2016-12-01

    This paper examines the performance of satellite sounder atmospheric vertical moisture proles (AVMP) under tropospheric conditions encompassing moisture contrasts driven by convection and advection transport mechanisms, specifically Atlantic Ocean Saharan air layers (SALs) and Pacific Ocean moisture conveyer belts (MCBs) commonly referred to as atmospheric rivers (ARs), both of these being mesoscale to synoptic meteorological phenomena within the vicinity of subtropical Hadley subsidence zones. Operational AVMP environmental data records retrieved from the Suomi National Polar-orbiting Partnership (SNPP) NOAA-Unique Combined Atmospheric Processing System (NUCAPS) are collocated with dedicated radiosonde observations (RAOBs) obtained from ocean-based intensive field campaigns; these RAOBs provide uniquely independent correlative truth data not assimilated into numerical weather prediction models for satellite sounder validation over open ocean. Using these marine-based data, we empirically assess the performance of the operational NUCAPS AVMP product for detecting and resolving these tropospheric moisture features over otherwise RAOB-sparse regions.

  17. Can conditional cash transfer programs generate equality of opportunity in highly unequal societies? Evidence from Brazil

    Directory of Open Access Journals (Sweden)

    Simone Bohn

    2014-09-01

    Full Text Available This article examines whether the state, through conditional cash transfer programs (CCT, can reduce the poverty and extremely poverty in societies marred by high levels of income concentration. We focus on one of the most unequal countries in the globe, Brazil, and analyze the extent to which this country's CCT program - Bolsa Família (BF, Family Grant program - is able to improve the life chances of extremely poor beneficiaries, through the three major goals of PBF: First, to immediately end hunger; second, to create basic social rights related to healthcare and education; finally, considering also complementary policies, to integrate adults into the job market. The analysis relies on a quantitative survey with 4,000 beneficiaries and a qualitative survey comprised of in-depth interviews with 38 program's participants from all the regions of the country in 2008, it means that this study is about the five first years of the PBF. In order to answer the research questions, we ran four probit analyses related: a the determinants of the realization of prenatal care; b the determinants of food security among BF beneficiaries, c the determinants that adult BF recipients will return to school, d the determinants that a BF beneficiary will obtain a job. Important results from the study are: First, those who before their participation on PBF were at the margins have now been able to access healthcare services on a more regular basis. Thus, the women at the margins who were systematically excluded - black women, poorly educated and from the North - now, after their participation in the CCT program, have more access to prenatal care and can now count with more availability of public healthcare network. Second, before entering the Bolsa Família program, 50.3% of the participants faced severe food insecurity. This number went down to 36.8% in very five years. Men are more likely than women; non-blacks more likely than blacks; and South and Centre

  18. 75 FR 35289 - International Services Surveys: BE-180, Benchmark Survey of Financial Services Transactions...

    Science.gov (United States)

    2010-06-22

    ...-AA73 International Services Surveys: BE-180, Benchmark Survey of Financial Services Transactions Between U.S. Financial Services Providers and Foreign Persons AGENCY: Bureau of Economic Analysis... Survey of Financial Services Transactions between U.S. Financial Services Providers and Foreign Persons...

  19. Residential Energy Consumption Survey: Quality Profile

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    The Residential Energy Consumption Survey (RECS) is a periodic national survey that provides timely information about energy consumption and expenditures of U.S. households and about energy-related characteristics of housing units. The survey was first conducted in 1978 as the National Interim Energy Consumption Survey (NIECS), and the 1979 survey was called the Household Screener Survey. From 1980 through 1982 RECS was conducted annually. The next RECS was fielded in 1984, and since then, the survey has been undertaken at 3-year intervals. The most recent RECS was conducted in 1993.

  20. 75 FR 10704 - International Services Surveys: BE-180, Benchmark Survey of Financial Services Transactions...

    Science.gov (United States)

    2010-03-09

    ...] RIN 0691-AA73 International Services Surveys: BE-180, Benchmark Survey of Financial Services Transactions Between U.S. Financial Services Providers and Foreign Persons AGENCY: Bureau of Economic Analysis... BE-180, Benchmark Survey of Financial Services Transactions between U.S. Financial Services Providers...

  1. Determinants of success in Shared Savings Programs: An analysis of ACO and market characteristics.

    Science.gov (United States)

    Ouayogodé, Mariétou H; Colla, Carrie H; Lewis, Valerie A

    2017-03-01

    Medicare's Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs. We examined the association between ACO financial performance and ACO provider composition, leadership structure, beneficiary characteristics, risk bearing experience, quality and process improvement capabilities, physician performance management, market competition, CMS-assigned financial benchmark, and ACO contract start date. We examined two outcomes from Medicare ACOs' first performance year: savings per Medicare beneficiary and earning shared savings payments (a dichotomous variable). When modeling the ACO ability to save and earn shared savings payments, we estimated positive regression coefficients for a greater proportion of primary care providers in the ACO, more practicing physicians on the governing board, physician leadership, active engagement in reducing hospital re-admissions, a greater proportion of disabled Medicare beneficiaries assigned to the ACO, financial incentives offered to physicians, a larger financial benchmark, and greater ACO market penetration. No characteristic of organizational structure was significantly associated with both outcomes of savings per beneficiary and likelihood of achieving shared savings. ACO prior experience with risk-bearing contracts was positively correlated with savings and significantly increased the likelihood of receiving shared savings payments. In the first year, performance is quite heterogeneous, yet organizational structure does not

  2. The Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+Choice Plans

    Science.gov (United States)

    Buntin, Melinda Beeuwkes; Garber, Alan M; McClellan, Mark; Newhouse, Joseph P

    2004-01-01

    Objective To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life—a group that accounts for more than one-quarter of Medicare's annual expenditures. Data Source Medicare administrative claims for 1994 and 1995. Study Design We calculated the payment a plan would have received under three risk-adjustment systems for each beneficiary in our 1995 sample based on his or her age, gender, county of residence, original reason for Medicare entitlement, and principal inpatient diagnoses received during any hospital stays in 1994. We compared these amounts to the actual costs incurred by those beneficiaries. We then looked for clinical categories that were predictive of costs, including costs in a beneficiary's last year of life, not accounted for by the risk adjusters. Data Extraction Methods The analyses were conducted using claims for a 5 percent random sample of Medicare beneficiaries who died in 1995 and a matched group of survivors. Principal Findings Medicare is currently implementing the Principal Inpatient Diagnostic Cost Groups (PIP-DCG) risk adjustment payment system to address the problem of risk selection in the Medicare+Choice program. We quantify the strong financial disincentives to enroll terminally ill beneficiaries that plans still have under this risk adjustment system. We also show that up to one-third of the selection observed between Medicare HMOs and the traditional fee-for-service system could be due to differential enrollment of decedents. A risk adjustment system that incorporated more of the available diagnostic information would attenuate this disincentive; however, plans could still use clinical information (not included in the risk adjustment scheme) to identify beneficiaries whose expected costs exceed expected payments. Conclusions More disaggregated prospective

  3. Survey of photovoltaic systems

    Energy Technology Data Exchange (ETDEWEB)

    1979-08-01

    In developing this survey of photovoltaic systems, the University of Alabama in Huntsville assembled a task team to perform an extensive telephone survey of all known photovoltaic manufacturers. Three US companies accounted for 77% of the total domestic sales in 1978. They are Solarex Corporation, Solar Power Croporation, and ARCO Solar, Inc. This survey of solar photovoltaic (P/V) manufacturers and suppliers consists of three parts: a catalog of suppliers arranged alphabetically, data sheets on specific products, and typical operating, installation, or maintenance instructions and procedures. This report does not recommend or endorse any company product or information presented within as the results of this survey.

  4. Basic Stand Alone Medicare Prescription Drug Events PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This is a Public Use File for Prescription Drug Events drawn from the 2008 Beneficiary Summary File of Medicare beneficiaries enrolled during the calendar year 2008,...

  5. Aeromagnetic survey in Eurajoensalmi, Olkiluoto 2008

    International Nuclear Information System (INIS)

    Levaeniemi, H.

    2008-08-01

    This report describes the survey operation, survey and processing methods and the deliverables of an aerogeophysical survey in Olkiluoto area in April 2008. The survey was conducted by Geological Survey of Finland (GTK). The survey aircraft was a twin-engine Twin Otter operated by Finnish Aviation Academy (SIO) and owned by Natural Environment Research Council / British Geological Survey (NERC / BGS), with whom GTK has established a joint venture called Joint Airborne-geoscience Capability (JAC). The survey was conducted in April 2008 during six days. The survey consists of six separate survey flights, one of which was a magnetic calibration flight. The survey was based in Pori airport. Survey line spacing was 50 meters and nominal survey altitude was 30 meters. Measurements were completed in April 2008, and data processing and reporting was done in June 2008. Two cesium magnetometers installed onboard the aircraft (at the left wingtip and in a nose cone) were measuring the magnetic total field intensity during the survey flights. An automatic compensation unit corrected the aircraft attitude errors in the magnetic data in real time. In addition to magnetic measurement, auxiliary parameters such as flight altitude and aircraft attitude were also recorded simultaneously. Reference ground base station was used for recording the temporal variations in the magnetic field and also reference data for post-positioning of coordinate information. In the post-processing phase, heading correction, base station correction and microlevelling procedures were applied to the magnetic data. The data was exported to numeric XYZ files and interpolated into grid data file. A noteworthy local detail present in the survey and in the processing was the massive power line. For safety reasons, flight altitude had to be increased and survey lines had to be cut short in the vicinity of the powerline. However, due to reasonable planning of the survey area boundaries, this caused no great

  6. PEP surveying procedures and equipment

    International Nuclear Information System (INIS)

    Linker, F.

    1982-06-01

    The PEP Survey and Alignment System, which employs both laser-based and optical survey methods, is described. The laser is operated in conjunction with the Tektronix 4051 computer and surveying instruments such as ARM and SAM, system which is designed to automate data input, reduction, and production of alignment instructions. The laser system is used when surveying ring quadrupoles, main bend magnets, sextupoles, and is optional when surveying RF cavities and insertion quadrupoles. Optical methods usually require that data be manually entered into the computer for alignment, but in some cases, an element can be aligned using nominal values of fiducial locations without use of the computer. Optical surveying is used in the alignment of NIT and SIT, low field bend magnets, wigglers, RF cavities, and insertion quadrupoles

  7. Telephony user survey

    CERN Multimedia

    IT Department

    2016-01-01

    Let us know your needs to better plan the transition to a new CERN telephony system.   CERN is planning to upgrade its telephony network and replace the system with a new and modern VoIP infrastructure. We strive to make this transition as beneficial and smooth as possible for you. Please let us know more about your current working environment, expectations and suggestions by responding to this survey: https://cern.ch/tel-survey. The more answers we get, the better the new system will serve everyone in the future. The survey will take you about five minutes to complete; we are counting on your feedback!

  8. AERIAL RADIOLOGICAL SURVEYS

    International Nuclear Information System (INIS)

    Proctor, A.E.

    1997-01-01

    Measuring terrestrial gamma radiation from airborne platforms has proved to be a useful method for characterizing radiation levels over large areas. Over 300 aerial radiological surveys have been carried out over the past 25 years including U.S. Department of Energy (DOE) sites, commercial nuclear power plants, Formerly Utilized Sites Remedial Action Program/Uranium Mine Tailing Remedial Action Program (FUSRAP/UMTRAP) sites, nuclear weapons test sites, contaminated industrial areas, and nuclear accident sites. This paper describes the aerial measurement technology currently in use by the Remote Sensing Laboratory (RSL) for routine environmental surveys and emergency response activities. Equipment, data-collection and -analysis methods, and examples of survey results are described

  9. 2012 Mask Industry Survey

    Science.gov (United States)

    Malloy, Matt; Litt, Lloyd C.

    2012-11-01

    A survey supported by SEMATECH and administered by David Powell Consulting was sent to semiconductor industry leaders to gather information about the mask industry as an objective assessment of its overall condition. The survey was designed with the input of semiconductor company mask technologists and merchant mask suppliers. 2012 marks the 11th consecutive year for the mask industry survey. This year's survey and reporting structure are similar to those of the previous years with minor modifications based on feedback from past years and the need to collect additional data on key topics. Categories include general mask information, mask processing, data and write time, yield and yield loss, delivery times, and maintenance and returns. Within each category are multiple questions that result in a detailed profile of both the business and technical status of the mask industry. Results, initial observations, and key comparisons between the 2011 and 2012 survey responses are shown here, including multiple indications of a shift towards the manufacturing of higher end photomasks.

  10. Engineering surveying

    CERN Document Server

    Schofield, W

    2007-01-01

    Engineering surveying involves determining the position of natural and man-made features on or beneath the Earth's surface and utilizing these features in the planning, design and construction of works. It is a critical part of any engineering project. Without an accurate understanding of the size, shape and nature of the site the project risks expensive and time-consuming errors or even catastrophic failure.Engineering Surveying 6th edition covers all the basic principles and practice of this complex subject and the authors bring expertise and clarity. Previous editions of this classic text have given readers a clear understanding of fundamentals such as vertical control, distance, angles and position right through to the most modern technologies, and this fully updated edition continues that tradition.This sixth edition includes:* An introduction to geodesy to facilitate greater understanding of satellite systems* A fully updated chapter on GPS, GLONASS and GALILEO for satellite positioning in surveying* Al...

  11. IT User Community Survey

    CERN Document Server

    Peter Jones (IT-CDA-WF)

    2016-01-01

    IT-CDA is gathering information to more accurately form a snapshot of the CERN IT user community and we would appreciate you taking time to complete the following survey.   We want to use this survey to better understand how the user community uses their devices and our services, and how the delivery of those services could be improved. You will need to authenticate to complete the survey. However please note that your responses are confidential and will be compiled together and analysed as a group. You can also volunteer to offer additional information if you so wish. This survey should take no longer than 5 minutes. Thanks in advance for your collaboration.

  12. GASS: THE PARKES GALACTIC ALL-SKY SURVEY. I. SURVEY DESCRIPTION, GOALS, AND INITIAL DATA RELEASE

    International Nuclear Information System (INIS)

    McClure-Griffiths, N. M.; Calabretta, M. R.; Ford, H. Alyson; Newton-McGee, K.

    2009-01-01

    The Parkes Galactic All-Sky Survey (GASS) is a survey of Galactic atomic hydrogen (H I) emission in the Southern sky covering declinations δ ≤ 1 0 using the Parkes Radio Telescope. The survey covers 2π steradians with an effective angular resolution of ∼16', at a velocity resolution of 1.0 km s -1 , and with an rms brightness temperature noise of 57 mK. GASS is the most sensitive, highest angular resolution survey of Galactic H I emission ever made in the Southern sky. In this paper, we outline the survey goals, describe the observations and data analysis, and present the first-stage data release. The data product is a single cube at full resolution, not corrected for stray radiation. Spectra from the survey and other data products are publicly available online.

  13. Remote sensing, airborne radiometric survey and aeromagnetic survey data processing and analysis

    International Nuclear Information System (INIS)

    Dong Xiuzhen; Liu Dechang; Ye Fawang; Xuan Yanxiu

    2009-01-01

    Taking remote sensing data, airborne radiometric data and aero magnetic survey data as an example, the authors elaborate about basic thinking of remote sensing data processing methods, spectral feature analysis and adopted processing methods, also explore the remote sensing data combining with the processing of airborne radiometric survey and aero magnetic survey data, and analyze geological significance of processed image. It is not only useful for geological environment research and uranium prospecting in the study area, but also reference to applications in another area. (authors)

  14. Plane and geodetic surveying

    CERN Document Server

    Johnson, Aylmer

    2014-01-01

    IntroductionAim And ScopeClassification Of SurveysThe Structure Of This BookGeneral Principles Of SurveyingErrorsRedundancyStiffnessAdjustmentPlanning And Record KeepingPrincipal Surveying ActivitiesEstablishing Control NetworksMappingSetting OutResectioningDeformation MonitoringAngle MeasurementThe Surveyor's CompassThe ClinometerThe Total StationMaking ObservationsChecks On Permanent AdjustmentsDistance MeasurementGeneralTape MeasurementsOptical Methods (Tachymetry)Electromagnetic Distance Measurement (EDM)Ultrasonic MethodsGNSSLevellingTheoryThe InstrumentTechniqueBookingPermanent Adjustmen

  15. Precision surveying system for PEP

    International Nuclear Information System (INIS)

    Gunn, J.; Lauritzen, T.; Sah, R.; Pellisier, P.F.

    1977-01-01

    A semi-automatic precision surveying system is being developed for PEP. Reference elevations for vertical alignment will be provided by a liquid level. The short range surveying will be accomplished using a Laser Surveying System featuring automatic data acquisition and analysis

  16. 75 FR 57217 - Direct Investment Surveys: BE-11, Annual Survey of U.S. Direct Investment Abroad

    Science.gov (United States)

    2010-09-20

    ... both U.S. and international definitions for foreign direct investment and must be represented in the...] RIN 0691-AA74 Direct Investment Surveys: BE-11, Annual Survey of U.S. Direct Investment Abroad AGENCY... the reporting requirements for the BE-11, Annual Survey of U.S. Direct Investment Abroad. The survey...

  17. Designing an Effective Survey

    National Research Council Canada - National Science Library

    Kasunic, Mark

    2005-01-01

    ... of them. However, to protect the validity of conclusions drawn from a survey, certain procedures must be followed throughout the process of designing, developing, and distributing the survey questionnaire...

  18. Beneficiários do trabalho voluntário: uma leitura a partir da bioética Beneficiarios del trabajo voluntario: una lectura a partir de la bioética Beneficiaries of volunteering: a bioethical perspective

    Directory of Open Access Journals (Sweden)

    Lucilda Selli

    2008-12-01

    datos complementarios. RESULTADOS: La visión de los voluntarios sobre los beneficiarios de la actividad voluntaria estuvo centrada más frecuentemente en el paciente (50,5%, en el voluntario (41,9% y en la institución y sociedad (7,6%. Paciente y voluntario fueron considerados simultáneamente beneficiarios, siendo el voluntario el que más recibe beneficios. Fue señalado también una comprensión del beneficio social de esa actividad. CONCLUSIONES: Se constató que existe, entre los voluntarios, una noción de la importancia social de su trabajo voluntario, faltando una articulación mayor entre motivaciones individuales y trabajo voluntario como espacio de enfrentamiento de problemas sociales.OBJECTIVE: To describe volunteers' perceptions of the beneficiaries of volunteering within the hospital setting and the influence that the theme of benefits exercises on their motivations. METHODS: This is an exploratory study with a qualitative approach. One hundred and ten volunteers working in health services that are references for the treatment of cancer in Rio de Janeiro (Southeastern Brazil are the subjects of this study. Data was collected between October and December 2001. Data was obtained by two instruments - a questionnaire which identifies the socioeconomic profile and the motivations for undertaking voluntary activity; and a semi-structured interview that provided complementary information. RESULTS: According to the volunteers' perception, the beneficiaries of voluntary activity were, primarily, the patient, (50.5%; secondarily the volunteer him/herself (41.9%; and least of all, the institution and the society in which these benefits are obtained (7.6%. Both the patient and the volunteer were considered simultaneously beneficiaries, being that the volunteer tends to receive more benefits. A comprehension of the social benefits of this activity was also reported. CONCLUSIONS: A notion of the social importance of their volunteering was verified among the volunteers

  19. Automatic surveying techniques

    International Nuclear Information System (INIS)

    Sah, R.

    1976-01-01

    In order to investigate the feasibility of automatic surveying methods in a more systematic manner, the PEP organization signed a contract in late 1975 for TRW Systems Group to undertake a feasibility study. The completion of this study resulted in TRW Report 6452.10-75-101, dated December 29, 1975, which was largely devoted to an analysis of a survey system based on an Inertial Navigation System. This PEP note is a review and, in some instances, an extension of that TRW report. A second survey system which employed an ''Image Processing System'' was also considered by TRW, and it will be reviewed in the last section of this note. 5 refs., 5 figs., 3 tabs

  20. 77 FR 19032 - Geological Survey

    Science.gov (United States)

    2012-03-29

    ... DEPARTMENT OF THE INTERIOR Geological Survey Announcement of National Geospatial Advisory Committee Meeting AGENCY: U.S. Geological Survey, Interior. ACTION: Notice of meeting. SUMMARY: The National.... Geological Survey (703-648-6283, [email protected] ). Registrations are due by April 13, 2012. While the...

  1. A Survey of the Innovation Surveys

    NARCIS (Netherlands)

    Hong, Shangqin; Oxley, Les; McCann, Philip

    Both theoretical and conceptual understanding of innovation has developed significantly since the early 1980s. More noticeable, however, are the major changes that have been experienced in empirically-oriented innovation research as a result of the introduction of firm level innovation surveys.

  2. Electronic surveys: how to maximise success.

    Science.gov (United States)

    McPeake, Joanne; Bateson, Meghan; O'Neill, Anna

    2014-01-01

    To draw on the researchers' experience of developing and distributing a UK-wide electronic survey. The evolution of electronic surveys in healthcare research will be discussed, as well as simple techniques that can be used to improve response rates for this type of data collection. There is an increasing use of electronic survey methods in healthcare research. However, in recent published research, electronic surveys have had lower response rates than traditional survey methods, such as postal and telephone surveys. This is a methodology paper. Electronic surveys have many advantages over traditional surveys, including a reduction in cost and ease of analysis. Drawbacks to this type of data collection include the potential for selection bias and poorer response rates. However, research teams can use a range of simple strategies to boost response rates. These approaches target the different stages of achieving a complete response: initial attraction through personalisation, engagement by having an easily accessible link to the survey, and transparency of survey length and completion though targeting the correct, and thereby interested, population. The fast, efficient and often 'free' electronic survey has many advantages over the traditional postal data collection method, including ease of analysis for what can be vast amounts of data. However, to capitalise on these benefits, researchers must carefully consider techniques to maximise response rates and minimise selection bias for their target population. Researchers can use a range of strategies to improve responses from electronic surveys, including sending up to three reminders, personalising each email, adding the updated response rate to reminder emails, and stating the average time it would take to complete the survey in the title of the email.

  3. Precision surveying the principles and geomatics practice

    CERN Document Server

    Ogundare, John Olusegun

    2016-01-01

    A comprehensive overview of high precision surveying, including recent developments in geomatics and their applications This book covers advanced precision surveying techniques, their proper use in engineering and geoscience projects, and their importance in the detailed analysis and evaluation of surveying projects. The early chapters review the fundamentals of precision surveying: the types of surveys; survey observations; standards and specifications; and accuracy assessments for angle, distance and position difference measurement systems. The book also covers network design and 3-D coordinating systems before discussing specialized topics such as structural and ground deformation monitoring techniques and analysis, mining surveys, tunneling surveys, and alignment surveys. Precision Surveying: The Principles and Geomatics Practice: * Covers structural and ground deformation monitoring analysis, advanced techniques in mining and tunneling surveys, and high precision alignment of engineering structures *...

  4. Inequity in ecosystem service delivery: Socioeconomic gaps in the public-private conservation network

    Science.gov (United States)

    Villamagna, Amy M.; Mogollón, Beatriz; Angermeier, Paul L.

    2017-01-01

    Conservation areas, both public and private, are critical tools to protect biodiversity and deliver important ecosystem services (ES) to society. Although societal benefits from such ES are increasingly used to promote public support of conservation, the number of beneficiaries, their identity, and the magnitude of benefits are largely unknown for the vast majority of conservation areas in the United States public-private conservation network. The location of conservation areas in relation to people strongly influences the direction and magnitude of ES flows as well as the identity of beneficiaries. We analyzed benefit zones, the areas to which selected ES could be conveyed to beneficiaries, to assess who benefits from a typical conservation network. Better knowledge of ES flows and beneficiaries will help land conservationists make a stronger case for the broad collateral benefits of conservation and help to address issues of social-environmental justice. To evaluate who benefits the most from the current public-private conservation network, we delineated the benefit zones for local ES (within 16 km) that are conveyed along hydrological paths from public (federal and state) and private (easements) conservation lands in the states of North Carolina and Virginia, USA. We also discuss the challenges and demonstrate an approach for delineating nonhydrological benefits that are passively conveyed to beneficiaries. We mapped and compared the geographic distribution of benefit zones within and among conservation area types. We further compared beneficiary demographics across benefit zones of the conservation area types and found that hydrological benefit zones of federal protected areas encompass disproportionately fewer minority beneficiaries compared to statewide demographic patterns. In contrast, benefit zones of state protected areas and private easements encompassed a much greater proportion of minority beneficiaries (~22–25%). Benefit zones associated with

  5. Conducting Web-based Surveys.

    OpenAIRE

    David J. Solomon

    2001-01-01

    Web-based surveying is becoming widely used in social science and educational research. The Web offers significant advantages over more traditional survey techniques however there are still serious methodological challenges with using this approach. Currently coverage bias or the fact significant numbers of people do not have access, or choose not to use the Internet is of most concern to researchers. Survey researchers also have much to learn concerning the most effective ways to conduct s...

  6. Patient survey (HCAHPS) - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The national average for the HCAHPS survey categories. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...

  7. MMT hypervelocity star survey. III. The complete survey

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Warren R.; Geller, Margaret J.; Kenyon, Scott J., E-mail: wbrown@cfa.harvard.edu, E-mail: mgeller@cfa.harvard.edu, E-mail: skenyon@cfa.harvard.edu [Smithsonian Astrophysical Observatory, 60 Garden Street, Cambridge, MA 02138 (United States)

    2014-05-20

    We describe our completed spectroscopic survey for unbound hypervelocity stars (HVSs) ejected from the Milky Way. Three new discoveries bring the total number of unbound late B-type stars to 21. We place new constraints on the nature of the stars and on their distances using moderate resolution MMT spectroscopy. Half of the stars are fast rotators; they are certain 2.5-4 M {sub ☉} main sequence stars at 50-120 kpc distances. Correcting for stellar lifetime, our survey implies that unbound 2.5-4 M {sub ☉} stars are ejected from the Milky Way at a rate of 1.5 × 10{sup –6} yr{sup –1}. These unbound HVSs are likely ejected continuously over the past 200 Myr and do not share a common flight time. The anisotropic spatial distribution of HVSs on the sky remains puzzling. Southern hemisphere surveys like SkyMapper will soon allow us to map the all-sky distribution of HVSs. Future proper motion measurements with Hubble Space Telescope and Gaia will provide strong constraints on origin. Existing observations are all consistent with HVS ejections from encounters with the massive black hole in the Galactic center.

  8. MMT hypervelocity star survey. III. The complete survey

    International Nuclear Information System (INIS)

    Brown, Warren R.; Geller, Margaret J.; Kenyon, Scott J.

    2014-01-01

    We describe our completed spectroscopic survey for unbound hypervelocity stars (HVSs) ejected from the Milky Way. Three new discoveries bring the total number of unbound late B-type stars to 21. We place new constraints on the nature of the stars and on their distances using moderate resolution MMT spectroscopy. Half of the stars are fast rotators; they are certain 2.5-4 M ☉ main sequence stars at 50-120 kpc distances. Correcting for stellar lifetime, our survey implies that unbound 2.5-4 M ☉ stars are ejected from the Milky Way at a rate of 1.5 × 10 –6 yr –1 . These unbound HVSs are likely ejected continuously over the past 200 Myr and do not share a common flight time. The anisotropic spatial distribution of HVSs on the sky remains puzzling. Southern hemisphere surveys like SkyMapper will soon allow us to map the all-sky distribution of HVSs. Future proper motion measurements with Hubble Space Telescope and Gaia will provide strong constraints on origin. Existing observations are all consistent with HVS ejections from encounters with the massive black hole in the Galactic center.

  9. Richer but fatter: the unintended consequences of microcredit financing on household health and expenditure in Jamaica.

    Science.gov (United States)

    Gordon-Strachan, Georgiana; Cunningham-Myrie, Colette; Fox, Kristin; Kirton, Claremont; Fraser, Raphael; McLeod, Georgia; Forrester, Terrence

    2015-01-01

    To determine whether there was a difference in wealth and cardiovascular disease (CVD) risk between microcredit loan beneficiaries and community-matched non-beneficiaries (controls). Seven hundred and twenty-six households of microcredit loan beneficiaries were matched with 726 controls by age, sex and community. A standardised interviewer administered questionnaire was used to collect data on health and household expenditure. Weights, heights, waist circumference and blood pressure measurements were taken for an adult and one child (6-16 years) from each household. Amongst adults, there was no difference in the prevalence of pre-hypertension and hypertension. More male (68.1% vs. 47.8%) and female beneficiaries (84.5% vs. 77.9%) were overweight/obese. More male (17.2% vs. 7.1%; P Microcredit financing is positively associated with wealth acquisition but worsened cardiovascular risk status. © 2014 John Wiley & Sons Ltd.

  10. Mobile-Only Web Survey Respondents

    NARCIS (Netherlands)

    Lugtig, P.J.|info:eu-repo/dai/nl/304824658; Toepoel, V.|info:eu-repo/dai/nl/304576034; amin, alerk

    2016-01-01

    Web surveys are no longer completed on just a desktop or laptop computer. Respondents increasingly use mobile devices, such as tablets and smartphones to complete web surveys. In this article, we study how respondents in the American Life Panel complete surveys using varying devices. We show that

  11. 77 FR 21086 - Patents External Quality Survey (formerly Customer Panel Quality Survey)

    Science.gov (United States)

    2012-04-09

    ... corporations (including those with 500+ employees), small and medium-size businesses, and universities and... DEPARTMENT OF COMMERCE United States Patent and Trademark Office Patents External Quality Survey... their name, address, or Social Security Number. In order to access and complete the online survey...

  12. MAX and Survey Linkages

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS is interested in linking MAX files with survey data, including four surveys conducted by the National Center for Health Statistics (NCHS) - the National Health...

  13. The Extended Northern ROSAT Galaxy Cluster Survey (NORAS II). I. Survey Construction and First Results

    International Nuclear Information System (INIS)

    Böhringer, Hans; Chon, Gayoung; Trümper, Joachim; Retzlaff, Jörg; Meisenheimer, Klaus; Schartel, Norbert

    2017-01-01

    As the largest, clearly defined building blocks of our universe, galaxy clusters are interesting astrophysical laboratories and important probes for cosmology. X-ray surveys for galaxy clusters provide one of the best ways to characterize the population of galaxy clusters. We provide a description of the construction of the NORAS II galaxy cluster survey based on X-ray data from the northern part of the ROSAT All-Sky Survey. NORAS II extends the NORAS survey down to a flux limit of 1.8 × 10 −12 erg s −1 cm −2 (0.1–2.4 keV), increasing the sample size by about a factor of two. The NORAS II cluster survey now reaches the same quality and depth as its counterpart, the southern REFLEX II survey, allowing us to combine the two complementary surveys. The paper provides information on the determination of the cluster X-ray parameters, the identification process of the X-ray sources, the statistics of the survey, and the construction of the survey selection function, which we provide in numerical format. Currently NORAS II contains 860 clusters with a median redshift of z  = 0.102. We provide a number of statistical functions, including the log N –log S and the X-ray luminosity function and compare these to the results from the complementary REFLEX II survey. Using the NORAS II sample to constrain the cosmological parameters, σ 8 and Ω m , yields results perfectly consistent with those of REFLEX II. Overall, the results show that the two hemisphere samples, NORAS II and REFLEX II, can be combined without problems into an all-sky sample, just excluding the zone of avoidance.

  14. The Extended Northern ROSAT Galaxy Cluster Survey (NORAS II). I. Survey Construction and First Results

    Energy Technology Data Exchange (ETDEWEB)

    Böhringer, Hans; Chon, Gayoung; Trümper, Joachim [Max-Planck-Institut für Extraterrestrische Physik, D-85748 Garching (Germany); Retzlaff, Jörg [ESO, D-85748 Garching (Germany); Meisenheimer, Klaus [Max-Planck-Institut für Astronomy, Königstuhl 17, D-69117 Heidelberg (Germany); Schartel, Norbert [ESAC, Camino Bajo del Castillo, Villanueva de la Cañada, E-28692 Madrid (Spain)

    2017-05-01

    As the largest, clearly defined building blocks of our universe, galaxy clusters are interesting astrophysical laboratories and important probes for cosmology. X-ray surveys for galaxy clusters provide one of the best ways to characterize the population of galaxy clusters. We provide a description of the construction of the NORAS II galaxy cluster survey based on X-ray data from the northern part of the ROSAT All-Sky Survey. NORAS II extends the NORAS survey down to a flux limit of 1.8 × 10{sup −12} erg s{sup −1} cm{sup −2} (0.1–2.4 keV), increasing the sample size by about a factor of two. The NORAS II cluster survey now reaches the same quality and depth as its counterpart, the southern REFLEX II survey, allowing us to combine the two complementary surveys. The paper provides information on the determination of the cluster X-ray parameters, the identification process of the X-ray sources, the statistics of the survey, and the construction of the survey selection function, which we provide in numerical format. Currently NORAS II contains 860 clusters with a median redshift of z  = 0.102. We provide a number of statistical functions, including the log N –log S and the X-ray luminosity function and compare these to the results from the complementary REFLEX II survey. Using the NORAS II sample to constrain the cosmological parameters, σ {sub 8} and Ω{sub m}, yields results perfectly consistent with those of REFLEX II. Overall, the results show that the two hemisphere samples, NORAS II and REFLEX II, can be combined without problems into an all-sky sample, just excluding the zone of avoidance.

  15. 76 FR 58420 - Direct Investment Surveys: BE-12, Benchmark Survey of Foreign Direct Investment in the United States

    Science.gov (United States)

    2011-09-21

    ...] RIN 0691-AA80 Direct Investment Surveys: BE-12, Benchmark Survey of Foreign Direct Investment in the... of Foreign Direct Investment in the United States. Benchmark surveys are conducted every five years; the prior survey covered 2007. The benchmark survey covers the universe of foreign direct investment...

  16. EPRINT ARCHIVE USER SURVEY

    CERN Multimedia

    2001-01-01

    University of Southampton invites the CERN community to participate in a survey Professor Stevan Harnad is conducting on current users and non-users of Eprint Archives. http://www.eprints.org/survey/ The findings will be used to suggest potential enhancements of the services as well as to get a deeper understanding of the very rapid developments in the on-line dissemination and use of scientific and scholarly research. (The survey is anonymous. Revealing your identity is optional and it will be kept confidential.)

  17. Reducing the Deficit: Spending and Revenue Options

    Science.gov (United States)

    1994-03-01

    357 B SPENDING OPTIONS BY BUDGET FUNCION ...... 363 TABLES 1. Baseline Deficit Projections, Fiscal Years 1993-2004...direct control of the Congress. abled beneficiaries and beneficiaries with end-stage renal disease. Nonhealth changes enacted in The total that is

  18. SURVEY, Lowndes County, MS

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Survey data includes spatial datasets and data tables necessary to digitally represent data collected in the survey phase of the study. (Source: FEMA Guidelines and...

  19. SURVEY, REFUGIO COUNTY, TEXAS

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Survey data includes spatial datasets and data tables necessary to digitally represent data collected in the survey phase of the study. (Source: FEMA Guidelines and...

  20. SURVEY, FAIRFIELD COUNTY, CT

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Survey data includes spatial datasets and data tables necessary to digitally represent data collected in the survey phase of the study. (Source: FEMA Guidelines and...

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