WorldWideScience

Sample records for health assessment plan

  1. Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

    Science.gov (United States)

    Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

    Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

  2. Health impact assessment in planning: Development of the design for health HIA tools

    International Nuclear Information System (INIS)

    Forsyth, Ann; Slotterback, Carissa Schively; Krizek, Kevin J.

    2010-01-01

    How can planners more systematically incorporate health concerns into practical planning processes? This paper describes a suite of health impact assessment tools (HIAs) developed specifically for planning practice. Taking an evidence-based approach the tools are designed to fit into existing planning activities. The tools include: a short audit tool, the Preliminary Checklist; a structured participatory workshop, the Rapid HIA; an intermediate health impact assessment, the Threshold Analysis; and a set of Plan Review Checklists. This description provides a basis for future work including assessing tool validity, refining specific tools, and creating alternatives.

  3. Building and measuring infrastructure and capacity for community health assessment and health improvement planning in Florida.

    Science.gov (United States)

    Abarca, Christine; Grigg, C Meade; Steele, Jo Ann; Osgood, Laurie; Keating, Heidi

    2009-01-01

    COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

  4. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning.

  5. Assessing the Financial Condition of Provider-Sponsored Health Plans.

    Science.gov (United States)

    McCue, Michael J

    2015-06-01

    The aim of this study was to assess the performance of health plans sponsored by provider organizations, with respect to plans generating strong positive cash flow relative to plans generating weaker cash flow. A secondary aim was to assess their capital adequacy. The study identified 24 provider-sponsored health plans (PSHPs) with an average positive cash flow margin from 2011 through 2013 at or above the top 75th percentile, defined as "strong cash flow PSHPs:" This group was compared with 72 PSHPs below the 75th percentile, defined as "weak cash flow PSHPs:" Atlantic Information Services Directory of Health Plans was used to identify the PSHPs. Financial ratios were computed from 2013 National Association of Insurance Commissioners Financial Filings. The study conducted a t test mean comparison between strong and weak cash flow PSHPs across an array of financial performance and capital adequacy measures. In 2013, the strong cash flow PSHPs averaged a cash-flow margin ratio of 6.6%. Weak cash flow PSHPs averaged a cash-flow margin of -0.4%. The net worth capital position of both groups was more than 4.5 times authorized capital. The operational analysis shows that strong cash-flow margin PSHPs are managing their medical costs to achieve this position. Although their medical loss ratio increased by almost 300 basis points from 2011 to 2013, it was still statistically significantly lower than the weaker cash flow PSHP group (P<.001). In terms of capital adequacy, both strong and weak cash-flow margin PSHP groups possessed sufficient capital to ensure the viability of these plans.

  6. Assessing the health equity impacts of regional land-use plan making: An equity focussed health impact assessment of alternative patterns of development of the Whitsunday Hinterland and Mackay Regional Plan, Australia (Short report)

    International Nuclear Information System (INIS)

    Gunning, Colleen; Harris, Patrick; Mallett, John

    2011-01-01

    Health service and partners completed an equity focussed health impact assessment to influence the consideration of health and equity within regional land-use planning in Queensland, Australia. This project demonstrated how an equity oriented assessment matrix can assist in testing regional planning scenarios. It is hoped that this HIA will contribute to the emerging interest in ensuring that potential differential health impacts continue to be considered as part of land-use planning processes.

  7. Joining up health and planning: how Joint Strategic Needs Assessment (JSNA) can inform health and wellbeing strategies and spatial planning.

    Science.gov (United States)

    Tomlinson, Paul; Hewitt, Stephen; Blackshaw, Neil

    2013-09-01

    There has been a welcome joining up of the rhetoric around health, the environment and land use or spatial planning in both the English public health white paper and the National Planning Policy Framework. However, this paper highlights a real concern that this is not being followed through into practical guidance needed by local authorities (LAs), health bodies and developers about how to deliver this at the local level. The role of Joint Strategic Needs Assessments (JSNAs) and Health and Wellbeing Strategies (HWSs) have the potential to provide a strong basis for integrated local policies for health improvement, to address the wider determinants of health and to reduce inequities. However, the draft JSNA guidance from the Department of Health falls short of providing a robust, comprehensive and practical guide to meeting these very significant challenges. The paper identifies some examples of good practice. It recommends that action should be taken to raise the standards of all JSNAs to meet the new challenges and that HWSs should be aligned spatially and temporally with local plans and other LA strategies. HWSs should also identify spatially targeted interventions that can be delivered through spatial planning or transport planning. Steps need to be taken to ensure that district councils are brought into the process.

  8. Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

    International Nuclear Information System (INIS)

    Bond, Alan; Cave, Ben; Ballantyne, Rob

    2013-01-01

    This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA

  9. Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Alan, E-mail: alan.bond@uea.ac.uk [InteREAM (Interdisciplinary Research in Environmental Assessment and Management), School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ (United Kingdom); Cave, Ben, E-mail: ben.cave@bcahealth.co.uk [Ben Cave Associates Ltd., Leeds (United Kingdom); Ballantyne, Rob, E-mail: robdballantyne@gmail.com [Planning and Health Consultant, Oxfordshire (United Kingdom)

    2013-09-15

    This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA.

  10. School Health Index: A Self-Assessment and Planning Guide. Middle School/High School.

    Science.gov (United States)

    Barrios, Lisa C.; Burgeson, Charlene R.; Crossett, Linda; Harrykissoon, Samantha D.; Pritzl, Jane; Wechsler, Howell; Kuester, Sarah A.; Pederson, Linda; Graffunder, Corinne; Rainford, Neil; Sleet, David

    2004-01-01

    The "School Health Index" is a self-assessment and planning guide that will enable schools to: (1) identify the strengths and weaknesses of school policies and programs for promoting health and safety; (2) develop an action plan for improving student health and safety, and (3) involve teachers, parents, students, and the community in improving…

  11. Indicators for planning of health services: assessing impacts of social and health care factors on population health.

    Science.gov (United States)

    Wan, T T; Broida, J H

    1983-01-01

    Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.

  12. Assessing and Planning Health Actions During a Crisis

    Directory of Open Access Journals (Sweden)

    Selim SUNER

    2015-10-01

    Full Text Available SUMMARY: Initial stage of a disaster is managed with existing resources. The following stages of disaster response often involve assistance from outside of the disaster zone. This may consist of mutual aid from neighboring communities for small-scale incidents but in major disasters, the response is from federal or international agencies or often both. Rapid needs assessment after an incident is a collaborative effort between responding agencies and local emergency preparedness and health authorities. Ideally, a team from responding agencies with intimate knowledge and experience regarding the capabilities and assets of the responding entity along with local authorities, with decision making capacity, who have knowledge of the community, the limitations of the responding agencies and can obtain near real-time information about the incident and subject matter experts (engineering, medical, law enforcement, etc. comprise the needs assessment team. Keywords: Crisis, health action, disaster planning

  13. Integration of health into urban spatial planning through impact assessment: Identifying governance and policy barriers and facilitators

    International Nuclear Information System (INIS)

    Carmichael, Laurence; Barton, Hugh; Gray, Selena; Lease, Helen; Pilkington, Paul

    2012-01-01

    This article presents the results of a review of literature examining the barriers and facilitators in integrating health in spatial planning at the local, mainly urban level, through appraisals. Our literature review covered the UK and non UK experiences of appraisals used to consider health issues in the planning process. We were able to identify four main categories of obstacles and facilitators including first the different knowledge and conceptual understanding of health by different actors/stakeholders, second the types of governance arrangements, in particular partnerships, in place and the political context, third the way institutions work, the responsibilities they have and their capacity and resources and fourth the timeliness, comprehensiveness and inclusiveness of the appraisal process. The findings allowed us to draw some lessons on the governance and policy framework regarding the integration of health impact into spatial planning, in particular considering the pros and cons of integrating health impact assessment (HIA) into other forms of impact assessment of spatial planning decisions such as environmental impact assessment (EIA) and strategic environment assessment (SEA). In addition, the research uncovered a gap in the literature that tends to focus on the mainly voluntary HIA to assess health outcomes of planning decisions and neglect the analysis of regulatory mechanisms such as EIA and SEA. - Highlights: ► Governance and policy barriers and facilitators to the integration of health into urban planning. ► Review of literature on impact assessment methods used across the world. ► Knowledge, partnerships, management/resources and processes can impede integration. ► HIA evaluations prevail uncovering research opportunities for evaluating other techniques.

  14. The role of community health centers in assessing the social determinants of health for planning and policy: the example of frontier New Mexico.

    Science.gov (United States)

    Bruna, Sean; Stone, Lisa Cacari; Wilger, Susan; Cantor, Jeremy; Guzman, Carolina

    2014-01-01

    This article examines the experience of a frontier-based community health center when it utilized the Tool for Health and Resilience in Vulnerable Environments (THRIVE) for assessing social determinants of health with a local health consortium. Community members (N = 357) rated safety, jobs, housing, and education among the top health issues. Community leaders integrated these health priorities in a countywide strategic planning process. This example of a frontier county in New Mexico demonstrates the critical role that community health centers play when engaging with local residents to assess community health needs for strategic planning and policy development.

  15. Assessing the integration of health center and community emergency preparedness and response planning.

    Science.gov (United States)

    Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M

    2007-11-01

    To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

  16. A GIS-based human health risk assessment for urban green space planning--an example from Grugliasco (Italy).

    Science.gov (United States)

    Poggio, Laura; Vrscaj, Borut

    2009-11-15

    The need to develop approaches for risk-based management of soil contamination, as well as the integration of the assessment of the human health risk (HHR) due to the soil contamination in the urban planning procedures has been the subject of recent attention of scientific literature and policy makers. The spatial analysis of environmental data offers multiple advantages for studying soil contamination and HHR assessment, facilitating the decision making process. The aim of this study was to explore the possibilities and benefits of spatial implementation of a quantitative HHR assessment methodology for a planning case in a typical urban environment where the soil is contaminated. The study area is located in the city of Grugliasco a part of the Turin (Italy) metropolitan area. The soils data were derived from a site specific soil survey and the land-use data from secondary sources. In the first step the soil contamination data were geo-statistically analysed and a spatial soil contamination data risk modelling procedure designed. In order to spatially assess the HHR computer routines were developed using GIS raster tools. The risk was evaluated for several different land uses for the planned naturalistic park area. The HHR assessment indicated that the contamination of soils with heavy metals in the area is not sufficient to induce considerable health problems due to typical human behaviour within the variety of urban land uses. An exception is the possibility of direct ingestion of contaminated soil which commonly occurs in playgrounds. The HHR evaluation in a planning case in the Grugliasco Municipality confirms the suitability of the selected planning option. The construction of the naturalistic park presents one solution for reducing the impacts of soil contamination on the health of citizens. The spatial HHR evaluation using GIS techniques is a diagnostic procedure for assessing the impacts of urban soil contamination, with which one can verify planning

  17. Financial Performance of Health Plans in Medicaid Mana...

    Data.gov (United States)

    U.S. Department of Health & Human Services — This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly...

  18. Ordinary risks and accepted fictions: how contrasting and competing priorities work in risk assessment and mental health care planning.

    Science.gov (United States)

    Coffey, Michael; Cohen, Rachel; Faulkner, Alison; Hannigan, Ben; Simpson, Alan; Barlow, Sally

    2017-06-01

    Communication and information sharing are considered crucial to recovery-focused mental health services. Effective mental health care planning and coordination includes assessment and management of risk and safety. Using data from our cross-national mixed-method study of care planning and coordination, we examined what patients, family members and workers say about risk assessment and management and explored the contents of care plans. Thematic analysis of qualitative research interviews (n = 117) with patients, family members and workers, across four English and two Welsh National Health Service sites. Care plans were reviewed (n = 33) using a structured template. Participants have contrasting priorities in relation to risk. Patients see benefit in discussions about risk, but cast the process as a worker priority that may lead to loss of liberty. Relationships with workers are key to family members and patients; however, worker claims of involving people in the care planning process do not extend to risk assessment and management procedures for fear of causing upset. Workers locate risk as coming from the person rather than social or environmental factors, are risk averse and appear to prioritize the procedural aspects of assessment. Despite limitations, risk assessment is treated as legitimate work by professionals. Risk assessment practice operates as a type of fiction in which poor predictive ability and fear of consequences are accepted in the interests of normative certainty by all parties. As a consequence, risk adverse options are encouraged by workers and patients steered away from opportunities for ordinary risks thereby hindering the mobilization of their strengths and abilities. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  19. EM Health and Safety Plan Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    This document contains information about the Health and Safety Plan Guidelines. Topics discussed include: Regulatory framework; key personnel; hazard assessment; training requirements; personal protective equipment; extreme temperature disorders or conditions; medical surveillance; exposure monitoring/air sampling; site control; decontamination; emergency response/contingency plan; emergency action plan; confined space entry; and spill containment.

  20. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assessment and performance improvement plan... assessment and performance improvement plan. (a) Basic rule. A PACE organization must have a written quality assessment and performance improvement plan. (b) Annual review. The PACE governing body must review the plan...

  1. [Consumer satisfaction study in philanthropic hospital health plans].

    Science.gov (United States)

    Gerschman, Silvia; Veiga, Luciana; Guimarães, César; Ugá, Maria Alicia Dominguez; Portela, Margareth Crisóstomo; Vasconcellos, Miguel Murat; Barbosa, Pedro Ribeiro; Lima, Sheyla Maria Lemos

    2007-01-01

    This paper presents the findings of research aimed at identifying and analyzing the argumentation and rationale that justify the satisfaction of consumers with their health plans. The qualitative method applied used the focus group technique, for which the following aspects were defined: the criteria for choosing the health plans which were considered, the composition of the group and its distribution, recruitment strategy, and infrastructure and dynamics of the meetings. The health plan beneficiaries were classified into groups according to their social class, the place where they lived, mainly, the relationship that they established with the health plan operators which enabled us to develop a typology for the plan beneficiaries. Initially, we indicated how the health plan beneficiaries assess and use the Brazilian Unified Health System (SUS), and, then, considering the types of plans defined, we evaluated their degree of satisfaction with the different aspects of health care, and identified which aspects mostly contributed explain their satisfaction.

  2. Accredited Health Department Partnerships to Improve Health: An Analysis of Community Health Assessments and Improvement Plans.

    Science.gov (United States)

    Kronstadt, Jessica; Chime, Chinecherem; Bhattacharya, Bulbul; Pettenati, Nicole

    The Public Health Accreditation Board (PHAB) Standards & Measures require the development and updating of collaborative community health assessments (CHAs) and community health improvement plans (CHIPs). The goal of this study was to analyze the CHAs and CHIPs of PHAB-accredited health departments to identify the types of partners engaged, as well as the objectives selected to measure progress toward improving community health. The study team extracted and coded data from documents from 158 CHA/CHIP processes submitted as part of the accreditation process. Extracted data included population size, health department type, data sources, and types of partner organizations. Health outcome objectives were categorized by Healthy People 2020 Leading Health Indicator (LHI), as well as by the 7 broad areas in the PHAB reaccreditation framework for population health outcomes reporting. Participants included health departments accredited between 2013 and 2016 that submitted CHAs and CHIPs to PHAB, including 138 CHAs/CHIPs from local health departments and 20 from state health departments. All the CHAs/CHIPs documented collaboration with a broad array of partners, with hospitals and health care cited most frequently (99.0%). Other common partners included nonprofit service organizations, education, business, and faith-based organizations. Small health departments more frequently listed many partner types, including law enforcement and education, compared with large health departments. The majority of documents (88.6%) explicitly reference Healthy People 2020 goals, with most addressing the LHIs nutrition/obesity/physical activity and access to health services. The most common broad areas from PHAB's reaccreditation framework were preventive health care and individual behavior. This study demonstrates the range of partners accredited health departments engage with to collaborate on improving their communities' health as well as the objectives used to measure community health

  3. Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

    Science.gov (United States)

    Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

    2017-05-01

    Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

  4. Using contingent choice methods to assess consumer preferences about health plan design.

    Science.gov (United States)

    Marquis, M Susan; Buntin, Melinda Beeuwkes; Kapur, Kanika; Yegian, Jill M

    2005-01-01

    American insurers are designing products to contain health care costs by making consumers financially responsible for their choices. Little is known about how consumers will view these new designs. Our objective is to examine consumer preferences for selected benefit designs. We used the contingent choice method to assess willingness to pay for six health plan attributes. Our sample included subscribers to individual health insurance products in California, US. We used fitted logistic regression models to explore how preferences for the more generous attributes varied with the additional premium and with the characteristics of the subscriber. High quality was the most highly valued attribute based on the amounts consumers report they are willing to pay. They were also willing to pay substantial monthly premiums to reduce their overall financial risk. Individuals in lower health were willing to pay more to reduce their financial risk than individuals in better health. Consumers may prefer tiered-benefit designs to those that involve overall increases in cost sharing. More consumer information is needed to help consumers better evaluate the costs and benefits of their insurance choices.

  5. Assessing Assessment Texts: Where Is Planning?

    Science.gov (United States)

    Fives, Helenrose; Barnes, Nicole; Dacey, Charity; Gillis, Anna

    2016-01-01

    We conducted a content analysis of 27 assessment textbooks to determine how assessment planning was framed in texts for preservice teachers. We identified eight assessment planning themes: alignment, assessment purpose and types, reliability and validity, writing goals and objectives, planning specific assessments, unpacking, overall assessment…

  6. Participatory quantitative health impact assessment of urban and transport planning in cities: A review and research needs.

    Science.gov (United States)

    Nieuwenhuijsen, Mark J; Khreis, Haneen; Verlinghieri, Ersilia; Mueller, Natalie; Rojas-Rueda, David

    2017-06-01

    Urban and transport planning have large impacts on public health, but these are generally not explicitly considered and/or quantified, partly because there are no comprehensive models, methods and tools readily available. Air pollution, noise, temperature, green space, motor vehicle crashes and physical activity are important pathways linking urban and transport planning and public health. For policy decision-making, it is important to understand and be able to quantify the full-chain from source through pathways to health effects and impacts to substantiate and effectively target actions. In this paper, we aim to provide an overview of recent studies on the health impacts related to urban and transport planning in cities, describe the need for novel participatory quantitative health impact assessments (HIA) and provide recommendations. To devise our searches and narrative, we were guided by a recent conceptual framework linking urban and transport planning, environmental exposures, behaviour and health. We searched PubMed, Web of Science, Science Direct, and references from relevant articles in English language from January 1, 1980, to November 1, 2016, using pre-defined search terms. The number of HIA studies is increasing rapidly, but there is lack of participatory integrated and full-chain HIA models, methods and tools. These should be based on the use of a systemic multidisciplinary/multisectorial approach and state-of-the-art methods to address questions such as what are the best, most feasible and needed urban and transport planning policy measures to improve public health in cities? Active citizen support and new forms of communication between experts and citizens and the involvement of all major stakeholders are crucial to find and successfully implement health promoting policy measures. We provided an overview of the current state-of-the art of HIA in cities and made recommendations for further work. The process on how to get there is as important and

  7. Health Workforce Planning

    Science.gov (United States)

    Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M.

    2015-01-01

    In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested. PMID:25685381

  8. Understanding health insurance plans

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...

  9. Organisational travel plans for improving health.

    Science.gov (United States)

    Hosking, Jamie; Macmillan, Alexandra; Connor, Jennie; Bullen, Chris; Ameratunga, Shanthi

    2010-03-17

    Dependence on car use has a number of broad health implications, including contributing to physical inactivity, road traffic injury, air pollution and social severance, as well as entrenching lifestyles that require environmentally unsustainable energy use. Travel plans are interventions that aim to reduce single-occupant car use and increase the use of alternatives such as walking, cycling and public transport, with a variety of behavioural and structural components. This review focuses on organisational travel plans for schools, tertiary institutes and workplaces. These plans are closely aligned in their aims and intervention design, having emerged from a shared theoretical base. To assess the effects of organisational travel plans on health, either directly measured, or through changes in travel mode. We searched the following electronic databases; Transport (1988 to June 2008), MEDLINE (1950 to June 2008), EMBASE (1947 to June 2008), CINAHL (1982 to June 2008), ERIC (1966 to June 2008), PSYCINFO (1806 to June 2008), Sociological Abstracts (1952 to June 2008), BUILD (1989 to 2002), Social Sciences Citation Index (1900 to June 2008), Science Citation Index (1900 to June 2008), Arts & Humanities Index (1975 to June 2008), Cochrane Database of Systematic Reviews (to August 2008), CENTRAL (to August 2008), Cochrane Injuries Group Register (to December 2009), C2-RIPE (to July 2008), C2-SPECTR (to July 2008), ProQuest Dissertations & Theses (1861 to June 2008). We also searched the reference lists of relevant articles, conference proceedings and Internet sources. We did not restrict the search by date, language or publication status. We included randomised controlled trials and controlled before-after studies of travel behaviour change programmes conducted in an organisational setting, where the measured outcome was change in travel mode or health. Both positive and negative health effects were included. Two authors independently assessed eligibility, assessed trial

  10. Iran's Health Reform Plan: Measuring Changes in Equity Indices.

    Science.gov (United States)

    Assari Arani, Abbas; Atashbar, Tohid; Antoun, Joseph; Bossert, Thomas

    2018-03-01

    Two years after the implementation of the Health Sector Evolution Plan (HSEP), this study evaluated the effects of the plan on health equity indices. The main indices assessed by the study were the Out-of-Pocket (OOP) health expenditures, the Fairness in Financial Contribution (FFC) to the health system index, the index of households' Catastrophic Health Expenditure (CHE) and the headcount ratio of Impoverishing Health Expenditure (IHE). The per capita share of costs for total health services has been decreased. The lowered costs have been more felt in rural areas, generally due to sharp decrease in inpatient costs. Per capita pay for outpatient services is almost constant or has slightly increased. The reform plan has managed to improve households' Catastrophic Health Expenditure (CHE) index from an average of 2.9% before the implementation of the plan to 2.3% after the plan. The Fairness in Financial Contribution (FFC) to the health system index has worsened from 0.79 to 0.76, and the headcount ratio of Impoverishing Health Expenditure (IHE) index deteriorated after the implementation of plan from 0.34 to 0.50. Considerable improvement, in decreasing the burden of catastrophic hospital costs in low income strata which is about 26% relative to the time before the implementation of the plan can be regarded as the main achievement of the plan, whereas the worsening in the headcount ratio of IHE and FFC are the equity bottlenecks of the plan.

  11. Can health feasibly be considered as part of the planning process in Scotland?

    International Nuclear Information System (INIS)

    Higgins, Martin; Douglas, Margaret; Muirie, Jill

    2005-01-01

    The planning system is significant because of its capacity to determine the quality of the built environment as well as the health, well-being and quality of life of the individuals and communities therein. Development planning is especially important because of the long-term impact of the decisions. This paper was developed in response to increasing recognition amongst HIA practitioners in Scotland of the importance of planning for health. It focuses on the relationship between the planning system in Scotland, specifically the Development Planning element of it, and population health and considers how the health impact assessment (HIA) approach can facilitate and support joint working with planners. In particular, consideration is given to the potential impact of the introduction of Strategic Environmental Assessment (SEA) on the linkages between health, HIA and planning

  12. Urban and Transport Planning Related Exposures and Mortality: A Health Impact Assessment for Cities.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

    2017-01-01

    By 2050, nearly 70% of the global population is projected to live in urban areas. Because the environments we inhabit affect our health, urban and transport designs that promote healthy living are needed. We estimated the number of premature deaths preventable under compliance with international exposure recommendations for physical activity (PA), air pollution, noise, heat, and access to green spaces. We developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona, Spain. Exposure estimates and mortality data were available for 1,357,361 residents. We compared recommended with current exposure levels. We quantified the associations between exposures and mortality and calculated population attributable fractions to estimate the number of premature deaths preventable. We also modeled life-expectancy and economic impacts. We estimated that annually, nearly 20% of mortality could be prevented if international recommendations for performance of PA; exposure to air pollution, noise, and heat; and access to green space were followed. Estimations showed that the greatest portion of preventable deaths was attributable to increases in PA, followed by reductions of exposure to air pollution, traffic noise, and heat. Access to green spaces had smaller effects on mortality. Compliance was estimated to increase the average life expectancy by 360 (95% CI: 219, 493) days and result in economic savings of 9.3 (95% CI: 4.9, 13.2) billion EUR/year. PA factors and environmental exposures can be modified by changes in urban and transport planning. We emphasize the need for a) the reduction of motorized traffic through the promotion of active and public transport and b) the provision of green infrastructure, both of which are suggested to provide opportunities for PA and for mitigation of air pollution, noise, and heat. Citation: Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M

  13. Using the Program Sustainability Assessment Tool to Assess and Plan for Sustainability

    Science.gov (United States)

    Mainor, Avia; Moreland-Russell, Sarah; Maier, Ryan C.; Brossart, Laura; Luke, Douglas A.

    2014-01-01

    Implementing and growing a public health program that benefits society takes considerable time and effort. To ensure that positive outcomes are maintained over time, program managers and stakeholders should plan and implement activities to build sustainability capacity within their programs. We describe a 3-part sustainability planning process that programs can follow to build their sustainability capacity. First, program staff and stakeholders take the Program Sustainability Assessment Tool to measure their program’s sustainability across 8 domains. Next, managers and stakeholders use results from the assessment to inform and prioritize sustainability action planning. Lastly, staff members implement the plan and keep track of progress toward their sustainability goals. Through this process, staff can more holistically address the internal and external challenges and pressures associated with sustaining a program. We include a case example of a chronic disease program that completed the Program Sustainability Assessment Tool and engaged in program sustainability planning. PMID:24456644

  14. Strategic Environmental Assessment as catalyst of healthier spatial planning: The Danish guidance and practice

    International Nuclear Information System (INIS)

    Kornov, Lone

    2009-01-01

    A wide range of factors within spatial planning can affect health. There is therefore an important scope for Strategic Environmental Assessment (SEA) of spatial plans to protect and improve human health. Due to the EU Directive 2001/42/EC on SEA, health has been made explicit in Danish legislation and guidance. This paper examines the inclusion of health as a formal component in impact assessment of spatial plans. Based upon a documentary study of 100 environmental reports, the paper analyses and discusses how health impact considerations are incorporated in SEA practice. It is found that health impacts are included in SEA practice and are being interpreted in a broader sense than what the national guidance exemplifies. The frequent included health aspects are noise, drinking water, air pollution, recreation/outdoor life and traffic safety. The primary determinant for health is transport-whether it is at the overall or local planning level. The main conclusion is that SEA shows a potential to catalyse healthier spatial planning. Despite the broad inclusion of health in SEA practice the examination shows potential improvements, hereunder qualification of assessments by better explaining the nature and significance of impacts and by including the distributional aspects of human health impacts. Inclusion from the health sector is put forward as an important institutional mean to secure cross disciplinarily and higher quality assessment

  15. Housing, health and master planning: rules of engagement.

    Science.gov (United States)

    Harris, P; Haigh, F; Thornell, M; Molloy, L; Sainsbury, P

    2014-04-01

    Knowledge about health focussed policy collaboration to date has been either tactical or technical. This article focusses on both technical and tactical issues to describe the experience of cross-sectoral collaboration between health and housing stakeholders across the life of a housing master plan, including but not limited to a health impact assessment (HIA). A single explanatory case study of collaboration on a master plan to regenerate a deprived housing estate in Western Sydney was developed to explain why and how the collaboration worked or did not work. Data collection included stakeholder interviews, document review, and reflections by the health team. Following a realist approach, data was analysed against established public policy theory dimensions. Tactically we did not know what we were doing. Despite our technical knowledge and skills with health focussed processes, particularly HIA, we failed to appreciate complexities inherent in master planning. This limited our ability to provide information at the right points. Eventually however the HIA did provide substantive connections between the master plan and health. We use our analysis to develop technical and tactical rules of engagement for future cross-sectoral collaboration. This case study from the field provides insight for future health focussed policy collaboration. We demonstrate the technical and tactical requirements for future intersectoral policy and planning collaborations, including HIAs, with the housing sector on master planning. The experience also suggested how HIAs can be conducted flexibly alongside policy development rather than at a specific point after a policy is drafted. Copyright © 2014 The Royal Society for Public Health. All rights reserved.

  16. Developing a Spanish-language consumer report for CAHPS health plan surveys.

    Science.gov (United States)

    Derose, Kathryn Pitkin; Kanouse, David E; Weidmer, Beverly; Weech-Maldonado, Robert; García, Rosa Elena; Hays, Ron D

    2007-11-01

    A Spanish-language consumer report on health plan quality was developed for the Consumer Assessments of Healthcare Providers and Systems (CAHPS) project. Multiple translations, a committee review, and a readability assessment were performed to produce a draft Spanish report. The report was revised on the basis of a series of cognitive interviews with 24 Latinos. The median age of participants was 41 years, and the median number of years in the United States was 9; 67% were female, and 63% had less than a high school education. In general, participants understood the report and said they would use it to choose a health plan. Less-educated respondents had difficulty understanding the segmented bar graphs that showed the proportion of health plan members' responses. A summary chart comparing all health plans on all dimensions was easier to comprehend when differences were represented by word icons rather than by stars. Concepts and terms about health care quality translated well from English to Spanish. Simplifying graphical information involves losing some detail but makes information more usable. Summary charts facilitate comparisons across plans, but differences relative to a mean are difficult for both Spanish- and English-speaking consumers to understand.

  17. Quality of Family Planning Services in Primary Health Centers of ...

    African Journals Online (AJOL)

    Background: Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted ...

  18. The consideration of health in land use planning: Barriers and opportunities

    International Nuclear Information System (INIS)

    Burns, Jennifer; Bond, Alan

    2008-01-01

    This research investigates the consideration of human health effects within the plan-making process in the East of England. It is based primarily upon questionnaires and interviews with those involved in plan-making. The results indicate that, prior to the implementation of the Strategic Environmental Assessment (SEA) Directive, which established a statutory requirement for the consideration of significant effects on human health in European Union member states, very limited consideration has been given to human health in land use plans. The capacity of the planning system to affect human health is clearly understood by those responsible for their production, but they lack the expertise to consider the health implications of their plans. The SEA Directive, along with reforms to the planning system, does provide a framework for improving the consideration of health, but the capacity of the planning system to consider health must be improved as should dialogue with health practitioners, and the evidence base for health outcomes. Also, analytical and methodological complexity may hinder the ability of planners to consider health, indicating that greater application of the precautionary principle is required to deal with the present uncertainty over human health impacts resulting from the implementation of land use plans

  19. How do African American men rate their health care? An analysis of the consumer assessment of health plans 2003-2006.

    Science.gov (United States)

    Elder, Keith; Meret-Hanke, Louise; Dean, Caress; Wiltshire, Jacqueline; Gilbert, Keon L; Wang, Jing; Shacham, Enbal; Barnidge, Ellen; Baker, Elizabeth; Wray, Ricardo; Rice, Shahida; Johns, Marquisha; Moore, Tondra

    2015-05-01

    African American (AA) men remain one of the most disconnected groups from health care. This study examines the association between AA men's rating of health care and rating of their personal physician. The sample included 12,074 AA men aged 18 years or older from the 2003 to 2006 waves of the Consumer Assessment of Healthcare Providers and Systems Adult Commercial Health Plan Survey. Multilevel models were used to obtain adjusted means rating of health care systems and personal physician, and the relationship of ratings with the rating of personal physician. The adjusted means were 80 (on a 100-point scale) for most health ratings and composite health care scores: personal physician (83.9), specialist (83.66), health care (82.34), getting needed care (89.57), physician communication (83.17), medical staff courtesy (86.58), and customer service helpfulness (88.37). Physician communication was the strongest predictor for physician rating. AA men's health is understudied, and additional research is warranted to improve how they interface with the health care system. © The Author(s) 2014.

  20. Health needs assessment

    Directory of Open Access Journals (Sweden)

    Ibrahim A Bani

    2008-01-01

    The findings of the assessment of the health needs of Jazan presented in this review could be utilized as a baseline and reference information for policy formulation, subsequent planning and cost effective intervention programs. It could also be utilized for the curriculum development or review for a community oriented medical schools.

  1. Consumer experiences in a consumer-driven health plan.

    Science.gov (United States)

    Christianson, Jon B; Parente, Stephen T; Feldman, Roger

    2004-08-01

    To assess the experience of enrollees in a consumer-driven health plan (CDHP). Survey of University of Minnesota employees regarding their 2002 health benefits. Comparison of regression-adjusted mean values for CDHP and other plan enrollees: customer service, plan paperwork, overall satisfaction, and plan switching. For CDHP enrollees only, use of plan features, willingness to recommend the plan to others, and reports of particularly negative or positive experiences. There were significant differences in experiences of CDHP enrollees versus enrollees in other plans with customer service and paperwork, but similar levels of satisfaction (on a 10-point scale) with health plans. Eight percent of CDHP enrollees left their plan after one year, compared to 5 percent of enrollees leaving other plans. A minority of CDHP enrollees used online plan features, but enrollees generally were satisfied with the amount and quality of the information provided by the CDHP. Almost half reported a particularly positive experience, compared to a quarter reporting a particularly negative experience. Thirty percent said they would recommend the plan to others, while an additional 57 percent said they would recommend it depending on the situation. Much more work is needed to determine how consumer experience varies with the number and type of plan options available, the design of the CDHP, and the length of time in the CDHP. Research also is needed on the factors that affect consumer decisions to leave CDHPs.

  2. Assessment of health community at the level of Health center Rakovica: Goals and opportunities

    Directory of Open Access Journals (Sweden)

    Šćepanović Aleksandar

    2017-01-01

    Full Text Available Assessment of the health status of the population is the foundation for troubleshooting health of the community. For this first step in solving the problems of health need to have adequate data. The basis for the registration of medical information is medical documentation. The aim is to assess the role and place of assessment of the health status of the community according to the literature in this field. We analyzed the available literature in the field of social medicine and health statistics, enlightened assessment of health in the community. The data necessary for determining the state of health can be related to many characteristics. The data can be accessed: review of available medical records and life statistics. Data analysis is performed with respect to the individual, family, group or the entire community. Based on the analysis and evaluation of health status can begin activities in the planning of preventive measures that should be implemented. To evaluate prevention plan is necessary to select and collect the appropriate data for the evaluation. The analysis and evaluation of individuals involved in cooperation with a team of health care health center for the level of Rakovica. Based on the good judgment of health condition can make appropriate plans of action to protect the health of the community.

  3. Assessment and development of implementation models of health ...

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

    Assessment and development of implementation models of health-related ... The Contribution of Civil Society Organizations in Achieving Health for All ... Health Information for Maternal and Child Health Planning in Urban Bangladesh.

  4. 75 FR 51831 - Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs

    Science.gov (United States)

    2010-08-23

    ... and health plans. The results of the planned survey may become an important source of information for... services and nurse advice lines, the quality and accessibility of health plan information on coverage...

  5. Responsive consumerism: empowerment in markets for health plans.

    Science.gov (United States)

    Elbel, Brian; Schlesinger, Mark

    2009-09-01

    American health policy is increasingly relying on consumerism to improve its performance. This article examines a neglected aspect of medical consumerism: the extent to which consumers respond to problems with their health plans. Using a telephone survey of five thousand consumers conducted in 2002, this article assesses how frequently consumers voice formal grievances or exit from their health plan in response to problems of differing severity. This article also examines the potential impact of this responsiveness on both individuals and the market. In addition, using cross-group comparisons of means and regressions, it looks at how the responses of "empowered" consumers compared with those who are "less empowered." The vast majority of consumers do not formally voice their complaints or exit health plans, even in response to problems with significant consequences. "Empowered" consumers are only minimally more likely to formally voice and no more likely to leave their plan. Moreover, given the greater prevalence of trivial problems, consumers are much more likely to complain or leave their plans because of problems that are not severe. Greater empowerment does not alleviate this. While much of the attention on consumerism has focused on prospective choice, understanding how consumers respond to problems is equally, if not more, important. Relying on consumers' responses as a means to protect individual consumers or influence the market for health plans is unlikely to be successful in its current form.

  6. Health transformation plan: Goals achievement in Nemazee hospital

    Directory of Open Access Journals (Sweden)

    Ali Akbar Ahmadi

    2016-01-01

    Full Text Available Introduction: The main purpose of this study was to assess fulfillment of goals about “Health Transformation Plan (HTP of Ministry of Health, Treatment and Medical Education” from the perspective of managers, which is as one of the most important management challenges in the Health System Reform Plan. These goals included six packages determined by the Ministry of Health, Treatment and Medical Education, the fulfillment of each of which one was evaluated separately as sub-goals in the current study. Finally, the rank of each package in comparison to other packages was determined and presented, using means rank test (Friedman test. Method: This study was conducted using a questionnaire in which comments of the senior and middle managers of Nemazee hospital were collected as the research data. Due to the fact that about one year has passed since the beginning of implementation of HTP and since there were no documented methods or questionnaires, the researcher designed a self-made questionnaire. The basis of designing the questionnaire was the set of guidelines developed for Health System Reform Plan. These guidelines include goals that a hospital should achieve during implementation of Health System Reform Plan. After sharing these goals with senior and middle managers of Nemazee hospital (as the place of research, they were converted to a questionnaire including 20 questions. The questionnaire included the goals that must be achieved in Nemazee hospital of Shiraz during the implementation of the plan. After designing the questionnaire, a preliminary test was taken to assess the reliability. Results: Cronbach’s alpha coefficient (0.88 showed a high rate of reliability in the above questionnaire. After the final data collection, the questionnaire was tested in a sample of 100 senior and middle managers; the results showed that about six packages were specified by the Ministry of Health, Treatment and Medical Education. The majority of

  7. Development, features and application of DIET ASSESS & PLAN (DAP) software in supporting public health nutrition research in Central Eastern European Countries (CEEC).

    Science.gov (United States)

    Gurinović, Mirjana; Milešević, Jelena; Kadvan, Agnes; Nikolić, Marina; Zeković, Milica; Djekić-Ivanković, Marija; Dupouy, Eleonora; Finglas, Paul; Glibetić, Maria

    2018-01-01

    In order to meet growing public health nutrition challenges in Central Eastern European Countries (CEEC) and Balkan countries, development of a Research Infrastructure (RI) and availability of an effective nutrition surveillance system are a prerequisite. The building block of this RI is an innovative tool called DIET ASSESS & PLAN (DAP), which is a platform for standardized and harmonized food consumption collection, comprehensive dietary intake assessment and nutrition planning. Its unique structure enables application of national food composition databases (FCDBs) from the European food composition exchange platform (28 national FCDBs) developed by EuroFIR (http://www.eurofir.org/) and in addition allows communication with other tools. DAP is used for daily menu and/or long-term diet planning in diverse public sector settings, foods design/reformulation, food labelling, nutrient intake assessment and calculation of the dietary diversity indicator, Minimum Dietary Diversity-Women (MDD-W). As a validated tool in different national and international projects, DAP represents an important RI in public health nutrition epidemiology in the CEEC region. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Assessing Emergency Preparedness and Response Capacity Using Community Assessment for Public Health Emergency Response Methodology: Portsmouth, Virginia, 2013.

    Science.gov (United States)

    Kurkjian, Katie M; Winz, Michelle; Yang, Jun; Corvese, Kate; Colón, Ana; Levine, Seth J; Mullen, Jessica; Ruth, Donna; Anson-Dwamena, Rexford; Bayleyegn, Tesfaye; Chang, David S

    2016-04-01

    For the past decade, emergency preparedness campaigns have encouraged households to meet preparedness metrics, such as having a household evacuation plan and emergency supplies of food, water, and medication. To estimate current household preparedness levels and to enhance disaster response planning, the Virginia Department of Health with remote technical assistance from the Centers for Disease Control and Prevention conducted a community health assessment in 2013 in Portsmouth, Virginia. Using the Community Assessment for Public Health Emergency Response (CASPER) methodology with 2-stage cluster sampling, we randomly selected 210 households for in-person interviews. Households were questioned about emergency planning and supplies, information sources during emergencies, and chronic health conditions. Interview teams completed 180 interviews (86%). Interviews revealed that 70% of households had an emergency evacuation plan, 67% had a 3-day supply of water for each member, and 77% had a first aid kit. Most households (65%) reported that the television was the primary source of information during an emergency. Heart disease (54%) and obesity (40%) were the most frequently reported chronic conditions. The Virginia Department of Health identified important gaps in local household preparedness. Data from the assessment have been used to inform community health partners, enhance disaster response planning, set community health priorities, and influence Portsmouth's Community Health Improvement Plan.

  9. Nonprofit to for-profit conversions by hospitals, health insurers, and health plans.

    Science.gov (United States)

    Needleman, J

    1999-01-01

    Conversion of hospitals, health insurers, and health plans from nonprofit to for-profit ownership has become a focus of national debate. The author examines why nonprofit ownership has been dominant in the US health system and assesses the strength of the argument that nonprofits provide community benefits that would be threatened by for-profit conversion. The author concludes that many of the specific community benefits offered by nonprofits, such as care for the poor, could be maintained or replaced by adequate funding of public programs and that quality and fairness in treatment can be better assured through clear standards of care and adequate monitoring systems. As health care becomes increasingly commercialized, the most difficult parts of nonprofits' historic mission to preserve are the community orientation, leadership role, and innovation that nonprofit hospitals and health plans have provided out of their commitment to a community beyond those to whom they sell services.

  10. Integrating Ecosystem Services Into Health Impact Assessment

    Science.gov (United States)

    Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

  11. Public Health Climate Change Adaptation Planning Using Stakeholder Feedback.

    Science.gov (United States)

    Eidson, Millicent; Clancy, Kathleen A; Birkhead, Guthrie S

    2016-01-01

    Public health climate change adaptation planning is an urgent priority requiring stakeholder feedback. The 10 Essential Public Health Services can be applied to adaptation activities. To develop a state health department climate and health adaptation plan as informed by stakeholder feedback. With Centers for Disease Control and Prevention (CDC) funding, the New York State Department of Health (NYSDOH) implemented a 2010-2013 climate and health planning process, including 7 surveys on perceptions and adaptation priorities. New York State Department of Health program managers participated in initial (n = 41, denominator unknown) and follow-up (72.2%) needs assessments. Surveillance system information was collected from 98.1% of surveillance system managers. For adaptation prioritization surveys, participants included 75.4% of NYSDOH leaders; 60.3% of local health departments (LHDs); and 53.7% of other stakeholders representing environmental, governmental, health, community, policy, academic, and business organizations. Interviews were also completed with 38.9% of other stakeholders. In 2011 surveys, 34.1% of state health program directors believed that climate change would impact their program priorities. However, 84.6% of state health surveillance system managers provided ideas for using databases for climate and health monitoring/surveillance. In 2012 surveys, 46.5% of state health leaders agreed they had sufficient information about climate and health compared to 17.1% of LHDs (P = .0046) and 40.9% of other stakeholders (nonsignificant difference). Significantly fewer (P climate and health into planning compared to state health leaders (55.8%) and other stakeholders (68.2%). Stakeholder groups agreed on the 4 highest priority adaptation categories including core public health activities such as surveillance, coordination/collaboration, education, and policy development. Feedback from diverse stakeholders was utilized by NYSDOH to develop its Climate and Health

  12. Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland.

    Science.gov (United States)

    Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah

    2016-01-01

    Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services

  13. Health impacts related to urban and transport planning: A burden of disease assessment.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

    2017-10-01

    Until now, estimates of the Global Burden of Disease (GBD) have mainly been produced on national or regional levels. These general estimates, however, are less useful for city governments who have to take decisions on local scales. To address this gap, we focused on the city-level burden of disease (BD) due to exposures affected by urban and transport planning. We conducted a BD assessment using the Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool to estimate annual preventable morbidity and disability-adjusted life-years (DALYs) under compliance with international exposure recommendations for physical activity (PA), exposure to air pollution, noise, heat, and access to green spaces in Barcelona, Spain. Exposure estimates and morbidity data were available for 1,357,361 Barcelona residents ≥20years (2012). We compared recommended with current exposure levels to estimate the associated BD. We quantified associations between exposures and morbidities and calculated population attributable fractions to estimate the number of attributable cases. We calculated DALYs using GBD Study 2015 background DALY estimates for Spain, which were scaled to Barcelona considering differences in population size, age and sex structures. We also estimated annual health costs that could be avoided under compliance with exposure recommendations. Not complying with recommended levels for PA, air pollution, noise, heat and access to green spaces was estimated to generate a large morbidity burden and resulted in 52,001 DALYs (95% CI: 42,866-61,136) in Barcelona each year (13% of all annual DALYs). From this BD 36% (i.e. 18,951 DALYs) was due to traffic noise with sleep disturbance and annoyance contributing largely (i.e. 10,548 DALYs). Non-compliance was estimated to result in direct health costs of 20.10 million € (95% CI: 15.36-24.83) annually. Non-compliance of international exposure recommendations was estimated to result in a considerable BD and in substantial

  14. Multistate Health Plans

    Directory of Open Access Journals (Sweden)

    Robert E. Moffit PhD

    2015-09-01

    Full Text Available We discuss and evaluate the Multi-State Plan (MSP Program, a provision of the Affordable Care Act that has not been the subject of much debate as yet. The MSP Program provides the Office of Personnel Management with new authority to negotiate and implement multistate insurance plans on all health insurance exchanges within the United States. We raise the concern that the MSP Program may lead to further consolidation of the health insurance industry despite the program’s stated goal of increasing competition by means of health insurance exchanges. The MSP Program arguably gives a competitive advantage to large insurers, which already dominate health insurance markets. We also contend that the MSP Program’s failure to produce increased competition may motivate a new effort for a public health insurance option.

  15. Field assessment of a model tuberculosis outbreak response plan for low-incidence areas

    Directory of Open Access Journals (Sweden)

    Pascopella Lisa

    2007-10-01

    Full Text Available Abstract Background For a regional project in four low-incidence states, we designed a customizable tuberculosis outbreak response plan. Prior to dissemination of the plan, a tuberculosis outbreak occurred, presenting an opportunity to perform a field assessment of the plan. The purpose of the assessment was to ensure that the plan included essential elements to help public health professionals recognize and respond to outbreaks. Methods We designed a semi-structured questionnaire and interviewed all key stakeholders involved in the response. We used common themes to assess validity of and identify gaps in the plan. A subset of participants provided structured feedback on the plan. Results We interviewed 11 public health and six community stakeholders. The assessment demonstrated that (1 almost all of the main response activities were reflected in the plan; (2 the plan added value by providing a definition of a tuberculosis outbreak and guidelines for communication and evaluation. These were areas that lacked written protocols during the actual outbreak response; and (3 basic education about tuberculosis and the interpretation and use of genotyping data were important needs. Stakeholders also suggested adding to the plan questions for evaluation and a section for specific steps to take when an outbreak is suspected. Conclusion An interactive field assessment of a programmatic tool revealed the value of a systematic outbreak response plan with a standard definition of a tuberculosis outbreak, guidelines for communication and evaluation, and response steps. The assessment highlighted the importance of education and training for tuberculosis in low-incidence areas.

  16. [Occupational health protection in business economics--business plan for health intervention].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2011-01-01

    One of the company's actions for strengthening human capital is the protection of health and safety of its employees. Its implementation needs financial resources, therefore, employers expect tangible effectiveness in terms of health and economics. Business plan as an element of company planning can be a helpful tool for new health interventions management. The aim of this work was to elaborate a business plan framework for occupational health interventions at the company level, combining occupational health practices with company management and economics. The business plan of occupational health interventions was based on the literature review, the author's own research projects and meta-analysis of research reports on economic relations between occupational health status and company productivity. The study resulted in the development of the business plan for occupational health interventions at the company level. It consists of summary and several sections that address such issues as the key elements of the intervention discussed against a background of the company economics and management, occupational health and safety status of the staff, employees' health care organization, organizational plan of providing the employees with health protection, marketing plan, including specificity of health interventions in the company marketing plan and financial plan, reflecting the economic effects of health care interventions on the overall financial management of the company. Business plan defines occupational health and safety interventions as a part of the company activities as a whole. Planning health care interventions without relating them to the statutory goals of the company may have the adverse impact on the financial balance and profitability of the company. Therefore, business plan by providing the opportunity of comparing different options of occupational health interventions to be implemented by employers is a key element of the management of employees

  17. Predictors of health plan satisfaction among employees in an academic setting.

    Science.gov (United States)

    Dembe, Allard E; Lu, Bo; Sieck, Cynthia J

    2010-01-01

    This study's goal was to identify the strongest predictors of satisfaction with a health plan offered to employees at a large university in the Midwestern United States. Survey responses from 1533 employees were analyzed (response rate of 51.2%). Unadjusted odds ratios (ORs) were calculated to identify factors that were statistically associated with plan satisfaction. Multivariate logistic regression analyses followed by likelihood ratio testing were conducted to assess the predictive value of particular variables. The strongest predictors of satisfaction with the health plan were the perceived quality of the plan's wellness and prevention services (OR = 3.69), having a personal doctor or nurse (OR = 2.70), being satisfied with the cost of the health plan (OR = 2.18), and having claims handled correctly (OR = 1.90). The factors that have the greatest individual effect on these findings were the quality of the plan's prevention and wellness services and how effectively the plan communicated how much particular services or visits would cost.

  18. Human Health and Ecological Risk Assessment Work Plan Mud Pit Release Sites, Amchitka Island, Alaska

    Energy Technology Data Exchange (ETDEWEB)

    DOE/NV

    2001-03-12

    This Work Plan describes the approach that will be used to conduct human health and ecological risk assessments for Amchitka Island, Alaska, which was utilized as an underground nuclear test site between 1965 and 1971. During this period, the U.S. Atomic Energy Commission (now the U.S. Department of Energy) conducted two nuclear tests (known as Long Shot and Milrow) and assisted the U.S. Department of Defense with a third test (known as Cannikin). Amchitka Island is approximately 42 miles long and located 1,340 miles west-southwest of Anchorage, Alaska, in the western end of the Aleutian Island archipelago in a group of islands known as the Rat Islands. Historically including deep drilling operations required large volumes of drilling mud, a considerable amount of which was left on the island in exposed mud pits after testing was completed. Therefore, there is a need for drilling mud pit remediation and risk assessment of historical mud pit releases. The scope of this work plan is to document the environmental objectives and the proposed technical site investigation strategies that will be utilized for the site characterization of the constituents in soil, surface water, and sediment at these former testing sites. Its goal is the collection of data in sufficient quantity and quality to determine current site conditions, support a risk assessment for the site surfaces, and evaluate what further remedial action is required to achieve permanent closure of these three sites that will protect both human health and the environment. Suspected compounds of potential ecological concern for investigative analysis at these sites include diesel-range organics, polyaromatic hydrocarbons, polychlorinated biphenyls, volatile organic compounds, and chromium. The results of these characterizations and risk assessments will be used to evaluate corrective action alternatives to include no further action, the implementation of institutional controls, capping on site, or off-sit e

  19. Environment, safety and health progress assessment manual

    International Nuclear Information System (INIS)

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 1O-Point Initiative to strengthen environment,safety, and health (ES ampersand H) programs, and waste management activities at involved conducting DOE production, research, and testing facilities. One of the points independent Tiger Team Assessments of DOE operating facilities. The Office of Special Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are ''more focused, concentrating on ES ampersand H management, ES ampersand H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES ampersand H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES ampersand H areas. This volume contains appendices to the Environment, Safety and Health Progress Assessment Manual

  20. Health Seeking Behavior and Family Planning Services Accessibility in Indonesia

    Directory of Open Access Journals (Sweden)

    Niniek Lely Pratiwi

    2014-11-01

    Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.

  1. Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education.

    Science.gov (United States)

    Phelps, Charles; Madhavan, Guruprasad; Rappuoli, Rino; Levin, Scott; Shortliffe, Edward; Colwell, Rita

    2016-03-01

    Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning. Public health agencies' current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost-effectiveness. As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost-effectiveness analyses widely recommended and used for public health planning. Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost-effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Our work employed a multicriteria systems analysis approach--specifically, multiattribute utility theory--to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost-effectiveness analysis approach. (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost-effectiveness analysis. (2) More sophisticated systems-level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become scarcer. The teaching of strategic planning in public

  2. Qualified Health Plan (QHP) Landscape

    Data.gov (United States)

    U.S. Department of Health & Human Services — QHP Landscape Files present basic information about certified Qualified Health Plans and Stand-alone Dental Plans for individuals-families and small businesses...

  3. [General aspects of planning and care in mental health].

    Science.gov (United States)

    Saforcada, E

    1976-09-01

    This paper reviews some general concepts on Planning, especially in public and welfare sectors, stressing those concerning the major flaws in the argentine system of mental health. The author considers the definition of planning levels, and sets forth three: general plan, program and project. The correlative implementation is also considered. The importance of feed-back from adequate evaluation is stressed, emphasizing three aspects: a) evaluation of dynamics, rate and extent of decrease, increase or stagnation; b) assessment of efficacity of factors involved; c) control and stabilization of goals already attained. The necessity to develop a human ecology, encompassing socio-cultural and psycho-social factors is stressed, together with fostering theoretical research and the use of its results by implementation agents. Several differences among prevailing mental health actions are pointed out which allow a distinction between two typical models: clinical and sanitarist. The main differences between them lye on: standard location of working sites, nature of basic actions, field of action, hypothesis for working, including ethiological and ecological assumptions, theoretical and methodological framework. A series of criteria for evaluating sanitary techniques and strategies are set forth, among which: operative procedures, length of treatments, degree of therapeutic concentration, and general pragmatic criteria. The indicators reviewed are: degree of efficacity, covering, degree of perseverance in treatments, cultural barriers between patient and therapist, delegation of functions into special, first-rate sanitary agents, needs for the training of mental health workers. An attempt is made at developping general evaluation criteria for mental health planning, and several indicators are proposed, among which: a) cost/efficacity ratio, including in costs the use of economical, human and physical resources; b) preventive capacities of the community; c) capacities for the

  4. [Primary and secondary data on dementia care as an example of regional health planning].

    Science.gov (United States)

    Ulrich, Lisa-R; Schatz, Tanja R; Lappe, Veronika; Ihle, Peter; Barthen, Linda; Gerlach, Ferdinand M; Erler, Antje

    2017-12-01

    Health service planning that takes into account as far as possible the regional needs and regional discrepancies is a controversial health issue in Germany. In a pilot scheme, we tested a planning process for regional healthcare services, based on the example of dementia care. The aim of this article is to present the strengths and limitations of this planning process. We developed an indicator set for dementia care based on routine regional data obtained from two German statutory health insurance companies. Additionally, primary data based on a questionnaire sent to all GPs in the area were evaluated. These data were expanded through the addition of official socio-demographic population data. Procedures and evaluation strategies, discussion of the results and the derivation of planning measures followed, in close agreement with a group of local experts. Few epidemiological data on regional variations in health care planning are publicly available. Secondary data from statutory health insurance companies can be assessed to support the estimation of regional health care needs, but interpretation is difficult. The use of surveys to collect primary data, and the assessment of results by the local health board may facilitate interpretation and may contribute towards more valid statements regarding regional health planning. Despite the limited availability of data and the considerable efforts involved in data analysis, the project demonstrates how needs-based health service planning can be carried out in a small region, taking into account the increasing demands of the local health care providers and the special local features.

  5. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior.

    Science.gov (United States)

    Akulume, Martha; Kiwanuka, Suzanne N

    2016-01-01

    Objective . The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology . One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation). Results . For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers' segregation behavior, but intention emerged as the strongest and most significant ( r = 0.524, P theory of planned behavior model explained 52.5% of the variance in health workers' segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion . Generally, health workers' health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers' health care waste segregation behaviors.

  6. Peer Review Plan for OPPT Work Plan Risk Assessment of 1 - Bromopropane (“1 - BP”)

    Science.gov (United States)

    This document outlines the peer review plan for a risk assessment which addresses occupational uses of 1-BP in dry-cleaning and foam gluing operations, consumer uses in aerosol solvent cleaners and spray adhesives, and its effects on human health.

  7. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review.

    Science.gov (United States)

    Gray, Selena; Carmichael, Laurence; Barton, Hugh; Mytton, Julie; Lease, Helen; Joynt, Jennifer

    2011-11-24

    Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries.The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes), lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury) more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Research is needed to assess (i) the degree to which statutory plan appraisal processes (SA in the UK) incorporate health; (ii) whether recommendations arising from health

  8. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review

    Directory of Open Access Journals (Sweden)

    Gray Selena

    2011-11-01

    Full Text Available Abstract Background Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. Methods A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. Results A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries. The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes, lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Conclusion Research is needed to assess (i the degree to which statutory plan appraisal processes (SA in the UK

  9. Behavioral Health Services in the Changing Landscape of Private Health Plans.

    Science.gov (United States)

    Horgan, Constance M; Stewart, Maureen T; Reif, Sharon; Garnick, Deborah W; Hodgkin, Dominic; Merrick, Elizabeth L; Quinn, Amity E

    2016-06-01

    Health plans play a key role in facilitating improvements in population health and may engage in activities that have an impact on access, cost, and quality of behavioral health care. Although behavioral health care is becoming more integrated with general medical care, its delivery system has unique aspects. The study examined how health plans deliver and manage behavioral health care in the context of the Affordable Care Act (ACA) and the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). This is a critical time to examine how health plans manage behavioral health care. A nationally representative survey of private health plans (weighted N=8,431 products; 89% response rate) was conducted in 2010 during the first year of MHPAEA, when plans were subject to the law but before final regulations, and just before the ACA went into effect. The survey addressed behavioral health coverage, cost-sharing, contracting arrangements, medical home innovations, support for technology, and financial incentives to improve behavioral health care. Coverage for inpatient and outpatient behavioral health services was stable between 2003 and 2010. In 2010, health plans were more likely than in 2003 to manage behavioral health care through internal arrangements and to contract for other services. Medical home initiatives were common and almost always included behavioral health, but financial incentives did not. Some plans facilitated providers' use of technology to improve care delivery, but this was not the norm. Health plans are key to mainstreaming and supporting delivery of high-quality behavioral health services. Since 2003, plans have made changes to support delivery of behavioral health services in the context of a rapidly changing environment.

  10. Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany.

    Science.gov (United States)

    Pilny, Adam; Wübker, Ansgar; Ziebarth, Nicolas R

    2017-12-01

    To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall RAS impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and investigates their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Martha Akulume

    2016-01-01

    Full Text Available Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation. Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers’ segregation behavior, but intention emerged as the strongest and most significant (r=0.524, P<0.001. The theory of planned behavior model explained 52.5% of the variance in health workers’ segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers’ health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers’ health care waste segregation behaviors.

  12. Eliciting consumer preferences for health plans.

    Science.gov (United States)

    Booske, B C; Sainfort, F; Hundt, A S

    1999-10-01

    To examine (1) what people say is important to them in choosing a health plan; (2) the effect, if any, that giving health plan information has on what people say is important to them; and (3) the effect of preference elicitation methods on what people say is important. A random sample of 201 Wisconsin state employees who participated in a health plan choice experiment during the 1995 open enrollment period. We designed a computer system to guide subjects through the review of information about health plan options. The system began by eliciting the stated preferences of the subjects before they viewed the information, at time 0. Subjects were given an opportunity to revise their preference structures first after viewing summary information about four health plans (time 1) and then after viewing more extensive, detailed information about the same options (time 2). At time 2, these individuals were also asked to rate the relative importance of a predefined list of health plan features presented to them. Data were collected on the number of attributes listed at each point in time and the importance weightings assigned to each attribute. In addition, each item on the attribute list was content analyzed. The provision of information changes the preference structures of individuals. Costs (price) and coverage dominated the attributes cited both before and after looking at health plan information. When presented with information on costs, quality, and how plans work, many of these relatively well educated consumers revised their preference structures; yet coverage and costs remained the primary cited attributes. Although efforts to provide health plan information should continue, decisions on the information to provide and on making it available are not enough. Individuals need help in understanding, processing, and using the information to construct their preferences and make better decisions.

  13. ERISA and health plans.

    Science.gov (United States)

    Schmidt, P; Mazo, J; Ladenheim, K

    1995-11-01

    This Issue Brief is designed to provide a basic understanding of the relationship of the Employee Retirement Income Security Act of 1974 (ERISA) to health plans. It is based, in part, on an Employee Benefit Research Institute-Education and Research Fund (EBRI-ERF) educational briefing held in March 1995. This report includes a section by Peter Schmidt of Arnold & Porter, a section about multiemployer plans written by Judy Mazo of The Segal Company; and a section about ERISA and state health reform written by Kala Ladenheim of the Intergovernmental Health Policy Project. Starting in the late 1980s, three trends converged to make ERISA a critical factor in state health reforms: increasingly comprehensive state health policy experimentation; changes in the makeup of the insurance market (including the rise in self-insurance and the growth of managed care); and increasingly expansive interpretations of ERISA by federal courts. The changing interpretations of ERISA's relationship to three categories of state health initiatives--insurance mandates, medical high risk pools, and uncompensated care pools--illustrate how these forces are playing out today. ERISA does have a very broad preemptive effect. Federal statutes do not need to say anything about preemption in order to preempt state law. For example, if there is a direct conflict, it would be quite clear under the Supremacy Clause [of the U.S. Constitution] that ERISA, or any federal statue, would preempt a directly conflicting state statute. States can indirectly regulate health care plans that provide benefits through insurance contracts by establishing the terms of the contract. And they also raise money by imposing premium taxes. But they cannot do the same with respect to self-funded plans. That is one of the factors that has caused a great rise in the number of self-funded plans. State regulation [of employee benefits] can create three kinds of problems: cost of taxes, fees, or other charges; cost of dealing

  14. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

    OpenAIRE

    Akulume, Martha; Kiwanuka, Suzanne N.

    2016-01-01

    Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and externa...

  15. State landscape in public health planning and quality improvement: results of the ASTHO survey.

    Science.gov (United States)

    Madamala, Kusuma; Sellers, Katie; Pearsol, Jim; Dickey, Michael; Jarris, Paul E

    2010-01-01

    Limited data exist on state public health agencies and their use of planning and quality improvement (QI) initiatives. Using the 2007 Association of State and Territorial Health Officials (ASTHO) State Public Health Survey, this article describes how state public health agencies perform tasks related to planning, performance management (PM), and QI. While 82 percent of respondents report having a QI process in place, only 9.8 percent have it fully implemented departmentwide. Seventy-six percent reported having a PM process in place, with 16 percent (n = 8) having it fully implemented departmentwide. A state health improvement plan was used by 80.4 percent of respondents, with 56.9 percent of respondents completing the plan more than 3 years ago. More than two-thirds (68.2%) of the respondents developed the plan by using results of their state health assessment. Analysis of state health department level planning, PM, and QI initiatives can inform states' efforts to ready themselves to meet the proposed national voluntary accreditation standards of the Public Health Accreditation Board.

  16. Review and action plan for oral health improvement in Sheffield special schools.

    Science.gov (United States)

    Worsley, D J; Jones, K; Harris, J C; Charlesworth, J; Marshman, Z

    2018-03-01

    A description of the process of a review of oral health improvement in special schools in Sheffield and the implementation of an action plan for these activities. Public health competencies encompassed: assessing the evidence on oral health and dental interventions, programmes and services; strategic leadership and collaborative working for health; oral health improvement. Copyright© 2018 Dennis Barber Ltd.

  17. Multiage Assessment: One School's Plan.

    Science.gov (United States)

    Arnold, Sue Beth; Kidwell, Barbara; Rossman, David

    1998-01-01

    Describes one elementary school's multiage assessment plan. Describes how standards were developed, and describes the assessment plan's guiding element: the progress report arranged as a continuum of objectives that serve as a goal indicator and a reporting mechanism. Discusses how objectives are assessed, record keeping and documentation, and the…

  18. Review of quality assessment tools for family planning programmes in low- and middle-income countries.

    Science.gov (United States)

    Sprockett, Andrea

    2017-03-01

    Measuring and tracking the quality of healthcare is a critical part of improving service delivery, clinic efficiency and health outcomes. However, no standardized or widely accepted tool exists to assess the quality of clinic-based family planning services in low- and middle-income countries. The objective of this literature review was to identify widely used public domain quality assessment tools with existing or potential application in clinic-based family planning programmes. Using PubMed, PopLine, Google Scholar and Google, key terms such as ‘quality assessment tool’, ‘quality assessment method’, ‘quality measurement’, ‘LMIC’, ‘developing country’, ‘family planning’ and ‘reproductive health’ were searched for articles, identifying 20 relevant tools. Tools were assessed to determine the type of quality components assessed, divided into structure and process components, level of application (national or facility), health service domain that can be assessed by the tool, cost and current use of the tool. Tools were also assessed for shortcomings based on application in a low- and middle-income clinic-based family planning programme, including personnel required, re-assessment frequency, assessment of structure, process and outcome quality, comparability of data over time and across facilities and ability to benchmark clinic results to a national benchmark. No tools met all criteria, indicating a critical gap in quality assessment for low- and middle-income family planning programmes. To achieve Universal Health Coverage, agreed on in the Sustainable Development Goals and to improve system-wide healthcare quality, we must develop and widely adopt a standardized quality assessment tool.

  19. Clean air plans and action plans: perspectives from the viewpoint of environmental and public health; Luftreinhalteplaene und Aktionsplaene - eine Bewertung aus umweltmedizinischer Sicht

    Energy Technology Data Exchange (ETDEWEB)

    Eikmann, T.; Herr, C. [Inst. fuer Hygiene und Umweltmedizin, Universitaetsklinikum Giessen und Marburg, Justus-Liebig-Univ. Giessen, Giessen (Germany); [Technische Univ. Dreden, Pirna (Germany). Inst. fuer Abfallwirtschaft und Altlasten; Koeckler, H. [Center for Environmental Systems Research (CESR), Univ. Kassel (Germany); [Mentec GmbH, Aue/Sa. (Germany); Nieden, A. zur [Inst. fuer Hygiene und Umweltmedizin, Universitaetsklinikum Giessen und Marburg, Justus-Liebig-Univ. Giessen, Giessen (Germany); FG Stadtklimatologie, Univ. Kassel (Germany); Katzschner, L. [FG Stadtklimatologie, Univ. Kassel (Germany); [INTECUS Dresden GmbH (Germany); Schimmelpfennig, M. [Gesundheitsamt der Stadt Kassel (Germany); Eikmann, S. [GUK - Gesellschaft fuer Umwelttoxikologie und Krankenhaushygiene mbH, Wetzlar (Germany)

    2005-07-01

    The present discussion on the health effects associated with airborne fine particulate matter has lead to an increased public interest in the general framework of compilation and evaluation of clean air plans and actions plans. While the surveys of the ''old'' clean air plans of the 80ies and 90ies of the last century relied on assessment of direct and indirect effects of air pollution on human health (and ecology), theses surveys are not part of the ''new'' clean air plans according to European law. This reduction of surveys and actions directed at threshold compliance only, abandons assessing, i.e., documentation and evaluation the health status and quality of life of populations. Assessment of individual and focus group specific sensibility and vulnerability becomes possible once health related, sociodemographic and environmental data are combined. By this, unequal life chance, i.e., unimpaired health as well as reasonable strategies towards minimizing environmental injustice can be identified. As of yet it is unclear, to what extend quality of life and quality of environment of populations living in air polluted areas are attributable to socioeconomic factors. Likewise, it is not known to which degree the environmental quality of individuals and families is self determined. This has to be considered especially for children, immigrants and women. These issues i.e., environmental justice/injustice should be considered in future projects on the development of clean air plans and especially actions plans derived thereof. Scientists, government officials and physicians working in field of preventive or environmental medicine cannot agree to a limitation of the cautionary principle to the bare compliance with thresholds. (orig.)

  20. Controlling for race/ethnicity: a comparison of California commercial health plans CAHPS scores to NCBD benchmarks

    Directory of Open Access Journals (Sweden)

    Lopez Rebeca A

    2010-01-01

    Full Text Available Abstract Background Because California has higher managed care penetration and the race/ethnicity of Californians differs from the rest of the United States, we tested the hypothesis that California's lower health plan Consumer Assessment of Healthcare Providers and Systems (CAHPS® survey results are attributable to the state's racial/ethnic composition. Methods California CAHPS survey responses for commercial health plans were compared to national responses for five selected measures: three global ratings of doctor, health plan and health care, and two composite scores regarding doctor communication and staff courtesy, respect, and helpfulness. We used the 2005 National CAHPS 3.0 Benchmarking Database to assess patient experiences of care. Multiple stepwise logistic regression was used to see if patient experience ratings based on CAHPS responses in California commercial health plans differed from all other states combined. Results CAHPS patient experience responses in California were not significantly different than the rest of the nation after adjusting for age, general health rating, individual health plan, education, time in health plan, race/ethnicity, and gender. Both California and national patient experience scores varied by race/ethnicity. In both California and the rest of the nation Blacks tended to be more satisfied, while Asians were less satisfied. Conclusions California commercial health plan enrollees rate their experiences of care similarly to enrollees in the rest of the nation when seven different variables including race/ethnicity are considered. These findings support accounting for more than just age, gender and general health rating before comparing health plans from one state to another. Reporting on race/ethnicity disparities in member experiences of care could raise awareness and increase accountability for reducing these racial and ethnic disparities.

  1. Environmental health action plan for Europe

    International Nuclear Information System (INIS)

    1994-06-01

    This Environmental Health Action Plan for Europe was endorsed by the second European Conference on Environment and Health, held in Helsinki, 20 to 22 June 1994. It sets out directions for the attainment of long term environment and health policy objectives define in the European Charter on Environment and Health. The Action Plan is primarily addressed at the public health and environmental protection sectors. 10 refs, 4 figs, 2 tabs

  2. 42 CFR 56.105 - Accord with health planning.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Accord with health planning. 56.105 Section 56.105... HEALTH SERVICES General Provisions § 56.105 Accord with health planning. A grant may be made under this... appropriate health planning agencies have been met. ...

  3. Animal health and welfare planning improves udder health and cleanliness but not leg health in Austrian dairy herds.

    Science.gov (United States)

    Tremetsberger, Lukas; Leeb, Christine; Winckler, Christoph

    2015-10-01

    Animal health and welfare planning is considered an important tool for herd management; however, its effectiveness is less well known. The aim of this study was to conduct animal health and welfare planning on 34 Austrian dairy farms and to evaluate changes in health and welfare after 1 yr. After an initial assessment using the Welfare Quality protocol (Welfare Quality Consortium, Lelystad, the Netherlands), results were reported back to the farmers. Health and welfare area(s) in which both the farmer and the researcher regarded improvement as important were discussed. Management practices and husbandry measures were chosen according to the respective farm situation. One year after interventions had been initiated, farms were reassessed, and the degree of implementation of improvement measures was recorded. The average implementation rate was 57% and thus relatively high when compared with other studies. High degrees of implementation were achieved related to cleanliness and udder health, at 77 and 63%, respectively. Intervention measures addressing udder health were mostly easy to incorporate in the daily routine and led to a reduced somatic cell score, whereas this score increased in herds without implementation of measures. The decrease in cows with dirty teats was more pronounced when measures were implemented compared with control farms. The implementation rate regarding leg health (46%) was comparably low in the present study, and leg health did not improve even when measures were implemented. Lying comfort, social behavior, and human-animal relationship did not require interventions and were therefore seldom chosen by farmers as part of health and welfare plans. In conclusion, the structured, participatory process of animal health and welfare planning appears to be a promising way to improve at least some animal health and welfare issues. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  4. How to choose a health plan

    Science.gov (United States)

    ... patientinstructions/000861.htm How to choose a health plan To use the sharing features on this page, ... paperwork for tax purposes. How to Compare Health Plans Employers and government sites, such as the Marketplace , ...

  5. Ecocity mapping using GIS: introducing a planning method for assessing and improving neighborhood vitality.

    Science.gov (United States)

    Smith, Richard; Miller, Kirstin

    2013-01-01

    Assessing neighborhood vitality is important to understanding how to improve quality of life and health outcomes. The ecocity model recognizes that cities are part of natural systems and favors walkable neighborhoods. This article introduces ecocity mapping, an innovative planning method, to the public health literature on community engagement by describing a pilot project with a new affordable housing development in Oakland, California between 2007 and 2009. Although ecocity mapping began as a paper technology, advances in geographic information systems (GIS) moved it forward. This article describes how Ecocity Builders used GIS to conduct ecocity mapping to (1) assess vitality of neighborhoods and urban centers to prioritize community health intervention pilot sites and (2) create scenario maps for use in community health planning. From fall 2007 to summer 2008, Ecocity Builders assessed neighborhood vitality using walking distance from parks, schools, rapid transit stops, grocery stores, and retail outlets. In 2008, ecocity maps were shared with residents to create a neighborhood health and sustainability plan. In 2009, Ecocity Builders developed scenario maps to show how changes to the built environment would improve air quality by reducing greenhouse gas emissions from vehicles, while increasing access to basic services and natural amenities. Community organizing with GIS was more useful than GIS alone for final site selection. GIS was useful in mapping scenarios after residents shared local neighborhood knowledge and ideas for change. Residents were interested in long-term environmental planning, provided they could meet immediate needs.

  6. A Study of Career Planning Assessments

    OpenAIRE

    Firkola, Peter

    2007-01-01

    This paper provides an overview of career planning assessments. Background on key career concepts is first introduced. A number of career planning assessments are then examined. These assessments included reviewing ones personal history, interest inventories, values assessments, personality assessments, and aptitude tests. The importance and limitations of these career assessments is then discussed.

  7. Public Health Agency Business plan 2010-2011

    OpenAIRE

    Public Health Agency

    2010-01-01

    This second corporate business plan explains the purpose of the PHA and focuses on health improvement, health protection and addressing health inequalities. The business plan is available to download below.

  8. Family planning and health: the Narangwal experiment.

    Science.gov (United States)

    Faruqee, R

    1983-06-01

    The findings of a 7-year field experiment conducted in the Indian Punjab show that integrating family planning with health services is more effective and efficient than providing family planning separately. The field experiment was conducted between 1968 and 1974 at Narangwal in the Indian State of Punjab. It involved 26 villages, with a total population of 35,000 in 1971-72. The demographic characteristics of the villages were found to be typical of the area. 5 groups of villages were provided with different combinations of services for health, nutrition and family planning. A control group received no project services. A population study was made of the effects of integrating family planning with maternal and child health services. A nutritional study looked at the results of integrating nutritional care and health services. The effectiveness of integration was evaluated by identifying it both with increased use of family planning and improved health. Efficiency was judged by relating effectiveness to input costs. Distribution of the benefits was also examined. The effectiveness of these different combinations of services on the use of family planning was measured: 1) by all changes in the use of modern methods of family planning, 2) by the number of new acceptors, 3) by the changes in the proportion of eligible women using contraceptives, and 4) by how many people started to use the more effective methods. Results showed the use of family planning increased substantially in the experimental groups, whereas the control group remained constant. It was also found that, though the services combining family planning with maternal health care stimulated more use of family planning, they were more costly than the more integrated srevices. The Narangwal experiment provides significant evidence in favor of combining the provision of family planning and health services, but its potential for replication on a large scale needs to be studied.

  9. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

  10. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  11. The strategic planning of health management information systems.

    Science.gov (United States)

    Smith, J

    1995-01-01

    This paper discusses the roles and functions of strategic planning of information systems in health services. It selects four specialised methodologies of strategic planning for analysis with respect to their applicability in the health field. It then examines the utilisation of information planning in case studies of three health organisations (two State departments of health and community services and one acute care institution). Issues arising from the analysis concern the planning process, the use to which plans are put, and implications for management.

  12. 48 CFR 1602.170-9 - Health benefits plan.

    Science.gov (United States)

    2010-10-01

    ... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy, contract... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Health benefits plan. 1602...

  13. Quality Assessment of Family Planning Services in Ife/Ijesa ...

    African Journals Online (AJOL)

    Context: Medical audit in healthcare has a goal to monitor and upgrade the standard of health care in a setting. Whether a client will accept, use effectively and continue to practice contraception depends on the quality of services rendered. Objective: To assess the quality of our family planning services as perceived by our ...

  14. Health care's new game changer. Thinking like a health plan.

    Science.gov (United States)

    Eggbeer, Bill; Bowers, Krista

    2014-10-01

    The transition for hospitals from having only a provider's perspective to thinking more like a health plan will require strategic alignment on four fronts: Health plan alignment. Hospital and physician alignment. Leadership alignment. Organizational alignment.

  15. Using multilevel modeling to assess case-mix adjusters in consumer experience surveys in health care.

    Science.gov (United States)

    Damman, Olga C; Stubbe, Janine H; Hendriks, Michelle; Arah, Onyebuchi A; Spreeuwenberg, Peter; Delnoij, Diana M J; Groenewegen, Peter P

    2009-04-01

    Ratings on the quality of healthcare from the consumer's perspective need to be adjusted for consumer characteristics to ensure fair and accurate comparisons between healthcare providers or health plans. Although multilevel analysis is already considered an appropriate method for analyzing healthcare performance data, it has rarely been used to assess case-mix adjustment of such data. The purpose of this article is to investigate whether multilevel regression analysis is a useful tool to detect case-mix adjusters in consumer assessment of healthcare. We used data on 11,539 consumers from 27 Dutch health plans, which were collected using the Dutch Consumer Quality Index health plan instrument. We conducted multilevel regression analyses of consumers' responses nested within health plans to assess the effects of consumer characteristics on consumer experience. We compared our findings to the results of another methodology: the impact factor approach, which combines the predictive effect of each case-mix variable with its heterogeneity across health plans. Both multilevel regression and impact factor analyses showed that age and education were the most important case-mix adjusters for consumer experience and ratings of health plans. With the exception of age, case-mix adjustment had little impact on the ranking of health plans. On both theoretical and practical grounds, multilevel modeling is useful for adequate case-mix adjustment and analysis of performance ratings.

  16. The Olympic and Paralympic Games 2012: literature review of the logistical planning and operational challenges for public health.

    Science.gov (United States)

    Enock, K E; Jacobs, J

    2008-11-01

    To undertake a review of the literature relating to public health planning and interventions at previous summer Olympic and Paralympic Games and other relevant major summer sporting events or mass gatherings, with a focus on official publications and peer-reviewed articles. Literature review. A literature review was undertaken using all biomedical databases and a freetext search using Google to widen the search beyond peer-reviewed publications. Search terms used were: Olympics; Paralympics; mass gatherings; mass gathering medicine; sporting events; weather; planning; and organisation. Citations within articles were searched to identify additional references that would inform this review. This literature review concentrates on the public health aspects of population care at mass gatherings, particularly the Olympic and Paralympic Games which are set over several weeks, focusing on surveillance, prevention and health service quality. The literature identified 10 areas of public health planning: public health command centre and communication; surveillance, assessment and control; environmental health and safety; infectious disease outbreaks; implications of weather conditions; health promotion; travel information; economic assessments; public transport and reduction of asthma events; and preparing athletes for potential allergies. The following themes emerged as crucial factors for the success of any public health interventions at Olympic and Paralympic Games: detailed planning of deliverables; pre-identification of critical success factors; management of risk; detailed contingency planning; and full testing of all plans prior to the event. The 2012 Olympic Games will provide an exciting challenge for public health providers and systems. Preparation requires early detailed planning of policies, procedures and on-site health promotion events, in addition to helping to set up the surveillance and monitoring systems that will capture public health activity alongside

  17. Environment, safety and health progress assessment manual

    International Nuclear Information System (INIS)

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 10-Point Initiative to strengthen environment, safety, and health (ES ampersand H) programs, and waste management activities at DOE production, research, and testing facilities. One of the points involved conducting dent Tiger Team Assessments of DOE operating facilities. The Office of Special independent Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are ''more focused, concentrating on ES ampersand H management, ES ampersand H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES ampersand H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES ampersand H areas. This manual documents the processes to be used to perform the ES ampersand H Progress Assessments. It was developed based upon the lessons learned from Tiger Team Assessments, the two pilot Progress Assessments, and Progress Assessments that have been completed. The manual will be updated periodically to reflect lessons learned or changes in policy

  18. Program Planning in Health Professions Education

    Science.gov (United States)

    Schmidt, Steven W.; Lawson, Luan

    2018-01-01

    In this chapter, the major concepts from program planning in adult education will be applied to health professions education (HPE). Curriculum planning and program planning will be differentiated, and program development and planning will be grounded in a systems thinking approach.

  19. Health contribution to local government planning

    International Nuclear Information System (INIS)

    France, Cheryl

    2004-01-01

    When local government considers future land-use plans, the local health authorities are not always included as a key partner. In Cambridgeshire, England, the former Cambridgeshire Health Authority formed a partnership with local government to address this issue. The relationship that developed and the subsequent health impact review provided an opportunity to influence strategic policy and ensure that health objectives are taken into account. Through partnership working, lessons were learned about how to incorporate health issues into a strategic land-use planning document to the overall benefit of the community

  20. 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

  1. Health Maintenance Organization (HMO) Plan

    Science.gov (United States)

    ... Find & compare doctors, hospitals, & other providers Health Maintenance Organization (HMO) Plan In most HMO Plans, you generally ... certain service when needed. Related Resources Preferred Provider Organization (PPO) Private Fee-for-Service (PFFS) Special Needs ...

  2. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    Science.gov (United States)

    Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa

    2008-01-01

    Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

  3. Planning for nuclear magnetic resonance services. Current health issues No. 2

    International Nuclear Information System (INIS)

    1983-01-01

    This document seeks to provide guidance in planning and in reviewing proposals for NMR services in the region, until a quantitative need assessment for those services can be developed. The Food and Drug Administration's determination that the diagnostic capabilities of NMR imaging have proven to provide substantial benefit vs. risk to patients proven by scientifically valid studies conducted by sponsors of investigational equipment at hospital sites, is pending. When the costs and benefits are clarified, then standards and criteria and a need assessment method, both on the institutional and regional levels, will be developed as an amendment to the Health Systems Plan

  4. Strategic Environmental Assessment as catalyst of healthier spatial planning: The Danish guidance and practice

    DEFF Research Database (Denmark)

    Kørnøv, Lone

    2009-01-01

    and guidance. This paper examines the inclusion of health as a formal component in impact assessment of spatial plans. Based upon a documentary study of 100 environmental reports, the paper analyses and discusses how health impact considerations are incorporated in SEA practice. It is found that health impacts...

  5. The consideration of health in strategic environmental assessment (SEA)

    International Nuclear Information System (INIS)

    Fischer, Thomas B; Matuzzi, Marco; Nowacki, Julia

    2010-01-01

    Following the requirements of the European Directive 2001/42/EC on strategic environmental assessment (SEA) and the Protocol on Strategic Environmental Assessment (Kiev, 2003) to the Convention on Environmental Impact Assessment in a Transboundary Context (Espoo, 1991), health is one of the aspects to be considered in SEA. In this paper, results of an evaluation of eight SEAs from Austria, the Czech Republic, Germany, the Netherlands and the United Kingdom (England and Wales) regarding the consideration of health are presented. This includes SEAs for five spatial plans, as well as one SEA for each, a transport, a waste management and an economic development plan. It is found that while all SEAs cover important physical and natural aspects that are related to health, social and behavioural aspects are considered to a much smaller extent. Based on the results, facilitating factors and barriers for health inclusive SEA are identified. Overall, good baseline data can be seen as an important starting point for effective health inclusive SEA, while an effective monitoring system is crucial for effective implementation of the measures and recommendations brought forward in health inclusive SEA. Crucially, health authorities/health experts need to engage more with SEA, as this provides a key platform for cross sectoral dialogue on a range of issues. SEA presents the health sector with an opportunity to influence the policy and decision-making process to improve people's health and well-being.

  6. Needs assessment in health research projects: a new approach to project management in iran.

    Science.gov (United States)

    Peykari, Niloofar; Owlia, Parviz; Malekafzali, Hossein; Ghanei, Mostafa; Babamahmoodi, Abdolreza; Djalalinia, Shirin

    2013-01-01

    The science and technology health plan has defined the outline of health research to the national vision of Iran by 2025. The aim of this study was to focus on the process of needs assessment of health research projects also health research priority setting in Iran. THE PROJECT MANAGEMENT LIFE CYCLE HAS FOUR PHASES: Initiation, Planning, Execution and Closure. Based on abovementioned points we conducted the study. Focusing on the needs assessment led to systematic implementation of needs assessment of health project in all of the medical sciences universities. Parallel with this achieved strategies health research priority setting was followed through specific process from empowerment to implementation. We should adopt with more systematic progressive methods of health project managements for both our national convenience as well as our international health research programs.

  7. Electronic health records: a valuable tool for dental school strategic planning.

    Science.gov (United States)

    Filker, Phyllis J; Cook, Nicole; Kodish-Stav, Jodi

    2013-05-01

    The objective of this study was to investigate if electronic patient records have utility in dental school strategic planning. Electronic health records (EHRs) have been used by all predoctoral students and faculty members at Nova Southeastern University's College of Dental Medicine (NSU-CDM) since 2006. The study analyzed patient demographic and caries risk assessment data from October 2006 to May 2011 extracted from the axiUm EHR database. The purpose was to determine if there was a relationship between high oral health care needs and patient demographics, including gender, age, and median income of the zip code where they reside in order to support dental school strategic planning including the locations of future satellite clinics. The results showed that about 51 percent of patients serviced by the Broward County-based NSU-CDM oral health care facilities have high oral health care needs and that about 60 percent of this population resides in zip codes where the average income is below the median income for the county ($41,691). The results suggest that EHR data can be used adjunctively by dental schools when proposing potential sites for satellite clinics and planning for future oral health care programming.

  8. UMTRA Project environmental, health, and safety plan

    International Nuclear Information System (INIS)

    1989-02-01

    The basic health and safety requirements established in this plan are designed to provide guidelines to be applied at all Uranium Mill Tailings Remedial Action (UMTRA) Project sites. Specific restrictions are given where necessary. However, an attempt has been made to provide guidelines which are generic in nature, and will allow for evaluation of site-specific conditions. Health and safety personnel are expected to exercise professional judgment when interpreting these guidelines to ensure the health and safety of project personnel and the general population. This UMTRA Project Environmental, Health, and Safety (EH ampersand S) Plan specifies the basic Federal health and safety standards and special DOE requirements applicable to this program. In addition, responsibilities in carrying out this plan are delineated. Some guidance on program requirements and radiation control and monitoring is also included. An Environmental, Health, and Safety Plan shall be developed as part of the remedial action plan for each mill site and associated disposal site. Special conditions at the site which may present potential health hazards will be described, and special areas that should should be addressed by the Remedial Action Contractor (RAC) will be indicated. Site-specific EH ampersand S concerns will be addressed by special contract conditions in RAC subcontracts. 2 tabs

  9. 42 CFR 51c.105 - Accord with health planning.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Accord with health planning. 51c.105 Section 51c... COMMUNITY HEALTH SERVICES General Provisions § 51c.105 Accord with health planning. A grant may be made... approval by the appropriate health planning agencies have been met. ...

  10. Awakening consumer stewardship of health benefits: prevalence and differentiation of new health plan models.

    Science.gov (United States)

    Rosenthal, Meredith; Milstein, Arnold

    2004-08-01

    Despite widespread publicity of consumer-directed health plans, little is known about their prevalence and the extent to which their designs adequately reflect and support consumerism. We examined three types of consumer-directed health plans: health reimbursement accounts (HRAs), premium-tiered, and point-of-care tiered benefit plans. We sought to measure the extent to which these plans had diffused, as well as to provide a critical look at the ways in which these plans support consumerism. Consumerism in this context refers to efforts to enable informed consumer choice and consumers' involvement in managing their health. We also wished to determine whether mainstream health plans-health maintenance organization (HMO), point of service (POS), and preferred provider organization (PPO) models-were being influenced by consumerism. Our study uses national survey data collected by Mercer Human Resource Consulting from 680 national and regional commercial health benefit plans on HMO, PPO, POS, and consumer-directed products. We defined consumer-directed products as health benefit plans that provided (1) consumer incentives to select more economical health care options, including self-care and no care, and (2) information and support to inform such selections. We asked health plans that offered consumer-directed products about 2003 enrollment, basic design features, and the availability of decision support. We also asked mainstream health plans about their activities that supported consumerism (e.g., proactive outreach to inform or influence enrollee behavior, such as self-management or preventive care, reminders sent to patients with identified medical conditions.) We analyzed survey responses for all four product lines in order to identify those plans that offer health reimbursement accounts (HRAs), premium-tiered, or point-of-care tiered models as well as efforts of mainstream health plans to engage informed consumer decision making. The majority of enrollees in

  11. Assessment, authorization and access to medicaid managed mental health care.

    Science.gov (United States)

    Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T

    2007-11-01

    Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

  12. Family Planning in the Context of Latin America's Universal Health Coverage Agenda.

    Science.gov (United States)

    Fagan, Thomas; Dutta, Arin; Rosen, James; Olivetti, Agathe; Klein, Kate

    2017-09-27

    Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from accessing their preferred method

  13. Case-mix adjustment of consumer reports about managed behavioral health care and health plans.

    Science.gov (United States)

    Eselius, Laura L; Cleary, Paul D; Zaslavsky, Alan M; Huskamp, Haiden A; Busch, Susan H

    2008-12-01

    To develop a model for adjusting patients' reports of behavioral health care experiences on the Experience of Care and Health Outcomes (ECHO) survey to allow for fair comparisons across health plans. Survey responses from 4,068 individuals enrolled in 21 managed behavioral health plans who received behavioral health care within the previous year (response rate = 48 percent). Potential case-mix adjustors were evaluated by combining information about their predictive power and the amount of within- and between-plan variability. Changes in plan scores and rankings due to case-mix adjustment were quantified. The final case-mix adjustment model included self-reported mental health status, self-reported general health status, alcohol/drug treatment, age, education, and race/ethnicity. The impact of adjustment on plan report scores was modest, but large enough to change some plan rankings. Adjusting plan report scores on the ECHO survey for differences in patient characteristics had modest effects, but still may be important to maintain the credibility of patient reports as a quality metric. Differences between those with self-reported fair/poor health compared with those in excellent/very good health varied by plan, suggesting quality differences associated with health status and underscoring the importance of collecting quality information.

  14. Consumer-directed health plans: what happened?

    Science.gov (United States)

    Goldsmith, Jeff

    2007-08-01

    CDHPs can stabilize growth in health costs, but the health plan-subscriber relationship should be more transparent. CFOs should ensure that increased cost exposure in CDHPs is paired with broad, deep disease management and employee assistance support. Hospitals should plan for the likelihood that, one way or another, consumers will be paying more of their healthcare bill.

  15. Developing an instrument for assessing fidelity of motivational care planning: The Aboriginal and Islander Mental health initiative adherence scale.

    Science.gov (United States)

    Prowse, Phuong-Tu; Nagel, Tricia

    2014-01-01

    The aim of this study was to design and trial an Adherence Scale to measure fidelity of Motivational Care Planning (MCP) within a clinical trial. This culturally adapted therapy MCP uses a client centered holistic approach that emphasises family and culture to motivate healthy life style changes. The Motivational Care Planning-Adherence Scale (MCP-AS) was developed through consultation with Aboriginal and Islander Mental Health Initiative (AIMhi) Indigenous and non-Indigenous trainers, and review of MCP training resources. The resultant ten-item scale incorporates a 9-Point Likert Scale with a supporting protocol manual and uses objective, behaviourally anchored criteria for each scale point. A fidelity assessor piloted the tool through analysis of four audio-recordings of MCP (conducted by Indigenous researchers within a study in remote communities in Northern Australia). File audits of the remote therapy sessions were utilised as an additional source of information. A Gold Standard Motivational Care Planning training video was also assessed using the MCP-AS. The Motivational Care Planning-Adherence Scale contains items measuring both process and content of therapy sessions. This scale was used successfully to assess therapy through observation of audio or video-recorded sessions and review of clinical notes. Treatment fidelity measured by the MCP-AS within the pilot study indicated high fidelity ratings. Ratings were high across the three domains of rapport, motivation, and self-management with especially high ratings for positive feedback and engagement, review of stressors and goal setting. The Motivational Care Planning-Adherence Scale has the potential to provide a measure of quality of delivery of Motivation Care Planning. The pilot findings suggest that despite challenges within the remote Indigenous community setting, Indigenous therapists delivered therapy that was of high fidelity. While developed as a research tool, the scale has the potential to

  16. 77 FR 38296 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

    Science.gov (United States)

    2012-06-27

    ... Prevention and Health Promotion, Division of Reproductive Health, Attn: National Public Health Action Plan... Disease Prevention and Health Promotion, Division of Reproductive Health, 4770 Buford Highway NE... topic's public health importance, existing challenges, and opportunities for action to decrease the...

  17. Community-based oral health promotion practices targeted at children and adolescents in Finland--developing an assessment tool.

    Science.gov (United States)

    Blomqvist, Pia; Ojala, Ellinoora; Kettunen, Tarja; Poskiparta, Marita; Kasila, Kirsti

    2014-06-01

    To develop an assessment tool for evaluating oral health promotion practices and to evaluate community-based oral health promotion practices targeted at children and adolescents with this tool. A theoretical framework about health promotion planning, implementation and evaluation was made on the basis of a literature review. Then, information about Finnish community-based oral health promotion practices (n=12) targeted at children and adolescents was collected using semi-structured interviews. Also, related documents, for example action plans and reports, were collected when available. Next, an assessment tool based on the theoretical framework was developed, and the recorded and transcribed interview data and other documents were evaluated with this tool. The assessment tool proved to be practical: it pointed out the strengths and weaknesses of the practices. The tool revealed strengths in the implementation and deficiencies in the planning and evaluation of oral health promotion practices. One-quarter of the 12 practices assessed could be considered 'good practices'. There is a need to improve the planning and evaluation of oral health promotion practices. The assessment tool developed in this study might be useful for practitioners both in the field of oral health promotion and general health promotion. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. A framework for health care planning and control

    NARCIS (Netherlands)

    Hans, Elias W.; van Houdenhoven, Mark; Hulshof, P.J.H.

    Rising expenditures spur health care organizations to organize their processes more efficiently and effectively. Unfortunately, health care planning and control lags far behind manufacturing planning and control. Successful manufacturing planning and control concepts can not be directly copied,

  19. Employee Health Service for Teaching and Nonteaching Staff: A Needs Assessment.

    Science.gov (United States)

    Long, Bonita C.; And Others

    1986-01-01

    A needs assessment was conducted to identify the health needs of school district employees in planning a comprehensive employee health service. Survey questionnaires were analyzed to determine characteristics of those individuals who may be at greatest health risk. Results indicate that degree of stress can differentiate health risk predictors.…

  20. Impact of animal health and welfare planning on medicine use, herd health and production in European organic dairy farms

    DEFF Research Database (Denmark)

    Ivemeyer, S; Smolders, G; Brinkmann, J

    2012-01-01

    medicine use through animal health and welfare planning (AHWP). Medicine use (excluding complementary treatments such as homeopathic remedies) was assessed as the total number of treatments and as the number of treatments of various disease categories (udder, fertility, metabolism, locomotion and others...... acidosis and imbalanced energy supply, respectively. Calving interval was used as an indicator for fertility. Milk recording data and treatment data were retrospectively collected for a one year period before and after the first farm visit. Focus areas of animal health and welfare plans were either...

  1. Health impacts of climate change in Vanuatu: an assessment and adaptation action plan.

    Science.gov (United States)

    Spickett, Jeffery T; Katscherian, Dianne; McIver, Lachlan

    2013-01-30

    Climate change is one of the greatest global challenges and Pacific island countries are particularly vulnerable due to, among other factors, their geography, demography and level of economic development. A Health Impact Assessment (HIA) framework was used as a basis for the consideration of the potential health impacts of changes in the climate on the population of Vanuatu, to assess the risks and propose a range of potential adaptive responses appropriate for Vanuatu. The HIA process involved the participation of a broad range of stakeholders including expert sector representatives in the areas of bio-physical, socio-economic, infrastructure, environmental diseases and food, who provided informed comment and input into the understanding of the potential health impacts and development of adaptation strategies. The risk associated with each of these impacts was assessed with the application of a qualitative process that considered both the consequences and the likelihood of each of the potential health impacts occurring. Potential adaptation strategies and actions were developed which could be used to mitigate the identified health impacts and provide responses which could be used by the various sectors in Vanuatu to contribute to future decision making processes associated with the health impacts of climate change.

  2. Provider-Sponsored Health Plans: Lessons Learned over Three Decades.

    Science.gov (United States)

    Breon, Richard C

    2016-01-01

    Healthcare's movement to value-based care is causing health systems across the country to consider whether owning or partnering with a health plan could benefit their organizations. Although organizations have different reasons for wanting to enter the insurance business, potential benefits include improving care quality, lowering costs, managing population health, expanding geographic reach, and diversifying the organization's revenue stream. However, the challenges and risks of owning a health plan are formidable: Assuming 100 percent financial risk for a patient population requires considerable financial resources, as well as competencies that are wholly different from those needed to run a hospital or physician group. For Spectrum Health, an integrated, not-for-profit health system based in Grand Rapids, Michigan, owning a health plan has been vital to fulfilling its mission of improving the health of the communities it serves, as well as its value proposition of providing highquality care at lower costs. This article weighs the pros and cons of operating a health plan; explores key business factors and required competencies that organizations need to consider when deciding whether to buy, build, or partner; examines the current environment for provider-sponsored health plans; and shares some of the lessons Spectrum Health has learned over three decades of running its health plan, Priority Health.

  3. A Hybrid Fuzzy Inference System Based on Dispersion Model for Quantitative Environmental Health Impact Assessment of Urban Transportation Planning

    Directory of Open Access Journals (Sweden)

    Behnam Tashayo

    2017-01-01

    Full Text Available Characterizing the spatial variation of traffic-related air pollution has been and is a long-standing challenge in quantitative environmental health impact assessment of urban transportation planning. Advanced approaches are required for modeling complex relationships among traffic, air pollution, and adverse health outcomes by considering uncertainties in the available data. A new hybrid fuzzy model is developed and implemented through hierarchical fuzzy inference system (HFIS. This model is integrated with a dispersion model in order to model the effect of transportation system on the PM2.5 concentration. An improved health metric is developed as well based on a HFIS to model the impact of traffic-related PM2.5 on health. Two solutions are applied to improve the performance of both the models: the topologies of HFISs are selected according to the problem and used variables, membership functions, and rule set are determined through learning in a simultaneous manner. The capabilities of this proposed approach is examined by assessing the impacts of three traffic scenarios involved in air pollution in the city of Isfahan, Iran, and the model accuracy compared to the results of available models from literature. The advantages here are modeling the spatial variation of PM2.5 with high resolution, appropriate processing requirements, and considering the interaction between emissions and meteorological processes. These models are capable of using the available qualitative and uncertain data. These models are of appropriate accuracy, and can provide better understanding of the phenomena in addition to assess the impact of each parameter for the planners.

  4. Assessing Culture and Climate of Federally Qualified Health Centers: A Plan for Implementing Behavioral Health Interventions.

    Science.gov (United States)

    Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M; Fortney, John C

    2017-01-01

    This study examines organizational factors relating to climate and culture that might facilitate or impede the implementation of evidence-based practices (EBP) targeting behavioral health in federally qualified health centers (FQHCs). Employees at six FQHCs participating in an evidence-based quality improvement (EBQI) initiative for mood disorders and alcohol abuse were interviewed (N=32) or surveyed using the Organizational Context Survey (OCS) assessing culture and climate (N=64). The FQHCs scored relatively well on proficiency, a previously established predictor of successful EBP implementation, but also logged high scores on scales assessing rigidity and resistance, which may hinder implementation. Qualitative data contextualized scores on FQHC culture and climate dimensions. Results suggest that the unique culture of FQHCs may influence implementation of evidence-based behavioral health interventions.

  5. Strengthening health professions regulation in Cambodia: a rapid assessment.

    Science.gov (United States)

    Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

    2016-03-10

    This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and

  6. Application of Group-Level Item Response Models in the Evaluation of Consumer Reports about Health Plan Quality

    Science.gov (United States)

    Reise, Steven P.; Meijer, Rob R.; Ainsworth, Andrew T.; Morales, Leo S.; Hays, Ron D.

    2006-01-01

    Group-level parametric and non-parametric item response theory models were applied to the Consumer Assessment of Healthcare Providers and Systems (CAHPS[R]) 2.0 core items in a sample of 35,572 Medicaid recipients nested within 131 health plans. Results indicated that CAHPS responses are dominated by within health plan variation, and only weakly…

  7. Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.

    Science.gov (United States)

    Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B

    2016-10-01

    This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess

  8. 76 FR 37119 - Development of Best Practices for Community Health Needs Assessment and Implementation Strategy...

    Science.gov (United States)

    2011-06-24

    ... Best Practices for Community Health Needs Assessment and Implementation Strategy; Public Forum AGENCY... processes relating to community health needs assessment (CHNA) and implementation strategy/plan development... practices in CHNA and implementation strategy development and execution for improved community health...

  9. Oak Ridge National Laboratory Corrective Action Plan in response to Tiger Team assessment

    International Nuclear Information System (INIS)

    1991-01-01

    This report presents a complete response to the Tiger Team assessment that was conducted to Oak Ridge National Laboratory (ORNL) and at the US Department of Energy (DOE) Oak Ridge Operations Office (ORO) from October 2, 1990, through November 30, 1990. The action plans have undergone both a discipline review and a cross-cutting review with respect to root cause. In addition, the action plans have been integrated with initiatives being pursued across Martin Marietta Energy Systems, Inc., in response to Tiger Team findings at other DOE facilities operated by Energy Systems. The root cause section is complete and describes how ORNL intends to address the root cause of the findings identified during the assessment. This report is concerned with reactors safety and health findings, responses, and planned actions. Specific areas include: organization and administration; quality verification; operations; maintenance; training and certification; auxiliary systems; emergency preparedness; technical support; nuclear criticality safety; security/safety interface; experimental activities; site/facility safety review; radiological protection; personnel protection; fire protection; management findings, responses, and planned actions; self-assessment findings, responses, and planned actions; and summary of planned actions, schedules, and costs

  10. [The Health Plan for Catalonia: an instrument to transform the health system].

    Science.gov (United States)

    Constante i Beitia, Carles

    2015-11-01

    The Department of Health of the Generalitat in Catalonia periodically draws up the Health Plan, which is the strategic document that brings together the reference framework for initiatives concerning public health in terms of the Catalan health administration. The 2011-2015 version of the Health Plan incorporates key care and system governance-related elements, which, in conjunction with health goals, make up the complete picture of what the health system in Catalonia should look like until 2015. The Plan was drawn up at a time when the environmental conditions were extremely particular, given the major economic crisis that began in 2007. This has meant that the system has been forced to address public health problems using a significant reduction in the economic resources available, while aiming to maintain the level of care provided, both quantitatively and qualitatively, and preserve the sustainability of the system whose defining traits are its universality, equity and the wide range of services on offer. The Health Plan focuses on three areas of action, 9 major courses of action and 32 strategic projects designed to respond to new social needs: addressing the most common health issues, comprehensive care for chronic patients and organizational modernization. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  11. Responding to the World Health Organization Gobal Disability Action Plan in Ukraine: Developing a National Disability, Health and Rehabilitation Plan

    Directory of Open Access Journals (Sweden)

    Christoph Gutenbrunner

    2017-11-01

    Full Text Available In order to support the development of a National Disability, Health and Rehabilitation Plan (NDHRP for Ukraine, a technical consultation was carried out by a Rehabilitation Advisory Team (RAT of the International Society of Physical and Rehabilitation Medicine (ISPRM in 2015. The consultation was based on assessment of the situation of persons with disabilities and the rehabilitation system in Ukraine. Recommendations for activities and projects to improve rehabilitation services within the healthcare system were developed and proposed. In order to reach consensus on the recommendations, dialogues were held with different stakeholders, including the Ministry of Public Health. The recommendations included: coordination of disability and rehabilitation policies within the Ministry of Public Health and among other involved ministries; translation and adaptation of international definitions of functioning, disability, and assessment tools into Ukrainian; data collection on the epidemiology of disability and the need for rehabilitation; implementation of health-related rehabilitation services; and implementation of international definitions and curricula of rehabilitation professions. The mission was regarded as successful and one year later a few changes had been adopted by the Ukrainian government. Further action based on this research is necessary. It will be important to track the changes and evaluate the results after an appropriate period of time.

  12. The need for health impact assessment in China: Potential benefits for public health and steps forward

    Energy Technology Data Exchange (ETDEWEB)

    Wu Liming, E-mail: lmwu@scdc.sh.c [Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336 (China); Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia); Rutherford, Shannon; Chu, Cordia [Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia)

    2011-07-15

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  13. The need for health impact assessment in China: Potential benefits for public health and steps forward

    International Nuclear Information System (INIS)

    Wu Liming; Rutherford, Shannon; Chu, Cordia

    2011-01-01

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  14. Hawai'i Island Health Workforce Assessment 2008.

    Science.gov (United States)

    Withy, Kelley; Andaya, January; Vitousek, Sharon; Sakamoto, David

    2009-12-01

    Anecdotal reports of a doctor shortage on the Big Island have been circulating for years, but a detailed assessment of the health care workforce had not previously been accomplished. The Hawai'i Island Health Workforce Assessment used licensure data, focus groups, telephone follow up to provider offices, national estimates of average provider supply and analysis of insurance claims data to assess the extent of the existing medical and mental health workforce, approximate how many additional providers might be effectively utilized, develop a population-based estimate of future demand and identify causes and potential solutions for the challenges faced. As of February 2008, the researchers were able to locate 310 practicing physicians, 36 nurse practitioners, 6 physician assistants, 51 psychologists, 57 social workers and 42 other mental health providers. Based on national averages, claims analysis and focus groups, the Island could use approximately 45 additional medical professionals to care for the 85% of the population that is medically insured; a larger number to care for the entire population. Ascertaining a complete roster of mental health professionals was not possible using this methodology. The researchers compared the current supply of physicians with the national average of physicians to population and the number of visits to different specialists for the year 2006 and found specific regional shortages of providers. The focus groups concentrated on solutions to the workforce crisis that include the formation of a well-organized, broad collaboration to coordinate recruitment efforts, expand and strengthen retention and renewal activities, and reinvigorate the health profession pipeline and training opportunities. The researchers recommend collaboration between the community, government, business, health center care providers, hospitals and centers to develop a plan before the tenuous state of healthcare on the Big Island worsens. In addition, continued

  15. Quality-of-life assessment of family planning adopters through user perspectives in the district of Karimnagar

    Directory of Open Access Journals (Sweden)

    Kameswararao Avasarala

    2009-01-01

    Full Text Available Background: Small families adopting family planning are usually considered happy families. They are expected to lead a better qualitative life. Quality-of-life (QOL is routinely assessed for knowing patients′ health status. Recently, the QOL concept has become increasingly popular for evaluating the impact of public health interventions. Hitherto, QOL is usually assessed by means of program achievements or indicators, which may sometimes be misleading. Hence, the new culture of QOL assessment by means of user perspectives is now becoming popular. Research Questions: 1 Is the quality-of-life of family planning (FP adopters better than that of non-FP adopters? 2 Are the user perspectives helpful in QOL assessment? Materials and Methods: A cross-sectional descriptive study was carried out among 50 FP adopting families and 50 non-FP adopting families from the village of Vutoor and the city of Karimnagar in Andhra Pradesh. Sampling Methods: Random sampling, Proportions and Chi square test. Results: Program perspectives revealed a better standard of living for FP adopters because they have amenities like housing, television, and vehicles and less mortality and morbidity ( P < 0.001. However, they lack positive feelings towards life, general adaptation, personal relationships, and leisure opportunities. Finally, self-assessment by FP adopters themselves revealed no significant increase in their qualitative life after family planning ( P = 0.05. Conclusions: While assessing the impact of a health program on quality-of-life, multiple methods of assessments including user perspectives are better than program indicators alone.

  16. Closing the gap: the potential of Christian Health Associations in expanding access to family planning

    Directory of Open Access Journals (Sweden)

    Lauren VanEnk

    2017-01-01

    Full Text Available Recognizing the health impact of timing and spacing pregnancies, the Sustainable Development Goals call for increased access to family planning globally. While faith-based organizations in Africa provide a significant proportion of health services, family planning service delivery has been limited. This evaluation seeks to assess the effectiveness of implementing a systems approach in strengthening the capacity of Christian Health Associations to provide family planning and increase uptake in their communities.From January 2014 to September 2015, the capacity of three Christian Health Associations in East Africa—Caritas Rwanda, Uganda Catholic Medical Bureau, and Uganda Protestant Medical Bureau—was strengthened with the aims of improving access to women with unmet need and harmonizing faith-based service delivery contributions with their national family planning programs. The key components of this systems approach to family planning included training, supervision, commodity availability, family planning promotion, data collection, and creating a supportive environment. Community-based provision of family planning, including fertility awareness methods, was introduced across intervention sites for the first time. Five hundred forty-seven facility- and community-based providers were trained in family planning, and 393,964 people were reached with family planning information. Uptake of family planning grew substantially in Year 1 (12,691 and Year 2 (19,485 across all Christian Health Associations as compared to the baseline year (3,551. Cumulatively, 32,176 clients took up a method during the intervention, and 43 percent of clients received this service at the community level. According to a provider competency checklist, facility- and community-based providers were able to adequately counsel clients on new fertility awareness methods. Integration of Christian Health Associations into the national family planning strategy improved through

  17. Environmental health and health planning

    International Nuclear Information System (INIS)

    1975-07-01

    Areas of environmental concern are identified and recommendations for improving environmental health are proposed by the Environmental Health Task Force of the Western Massachusetts Health Planning Council. Environmental health concerns in Western Massachusetts are in the areas of: air pollution; dental health and the specific problem of water flouridation; housing; injury control, including accidental death and disability; land use, and the specific problem of critical receptors; noise pollution; occupational hazards, specifically occupational accidents; pesticides; radiological exposure, particularly medical X-ray exposure and nuclear exposure; rural health care; sanitation; solid waste; and water quality including private and public water supplies, road salting, and rural sewerages. Each area of concern and specific problem are broken down into sections: background information; comments which incorporate recommendations for general problem-solving activities; and resources, including lists of key organization, individuals, laws and regulations, and publications relevant to the area of concern. Recommendations are presented based on long-term and short-term environmental goals. An inventory of environmental health organizations in Western Massachusetts is included. Appendices contain the charge to the Task Force, a definition of environmental health, sources of drinking water, the sanitation and sanitary codes, and housing and sanitation standards. Portions of this document are not fully legible

  18. 76 FR 46677 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Science.gov (United States)

    2011-08-03

    ... Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services... regulations published July 19, 2010 with respect to group health plans and health insurance coverage offered... plans, and health insurance issuers providing group health insurance coverage. The text of those...

  19. How to inject consumerism into your existing health plans.

    Science.gov (United States)

    Havlin, Linda J; McAllister, Michael F; Slavney, David H

    2003-09-01

    Consumerism seeks to create a behavior change on the part of consumers so that they become accountable, knowledgeable and actively engaged in managing their health. It can be used in any existing health plan through targeted plan design changes and consumer education efforts. Employers have many options in addition to consumer-directed health plans (CDHPs).

  20. Applying comprehensive environmental assessment to research planning for multiwalled carbon nanotubes: Refinements to inform future stakeholder engagement.

    Science.gov (United States)

    Powers, Christina M; Grieger, Khara; Meacham, Connie A; Gooding, Meredith Lassiter; Gift, Jeffrey S; Lehmann, Geniece M; Hendren, Christine O; Davis, J Michael; Burgoon, Lyle

    2016-01-01

    Risk assessments and risk management efforts to protect human health and the environment can benefit from early, coordinated research planning by researchers, risk assessors, and risk managers. However, approaches for engaging these and other stakeholders in research planning have not received much attention in the environmental scientific literature. The Comprehensive Environmental Assessment (CEA) approach under development by the United States Environmental Protection Agency (USEPA) is a means to manage complex information and input from diverse stakeholder perspectives on research planning that will ultimately support environmental and human health decision making. The objectives of this article are to 1) describe the outcomes of applying lessons learned from previous CEA applications to planning research on engineered nanomaterial, multiwalled carbon nanotubes (MWCNTs) and 2) discuss new insights and refinements for future efforts to engage stakeholders in research planning for risk assessment and risk management of environmental issues. Although framed in terms of MWCNTs, this discussion is intended to enhance research planning to support assessments for other environmental issues as well. Key insights for research planning include the potential benefits of 1) ensuring that participants have research, risk assessment, and risk management expertise in addition to diverse disciplinary backgrounds; 2) including an early scoping step before rounds of formal ratings; 3) using a familiar numeric scale (e.g., US dollars) versus ordinal rating scales of "importance"; 4) applying virtual communication tools to supplement face-to-face interaction between participants; and 5) refining criteria to guide development of specific, actionable research questions. © 2015 SETAC.

  1. Reproductive Health Needs Assessment of Girl and Boy Teenagers

    Directory of Open Access Journals (Sweden)

    M Shakour

    2016-11-01

    Full Text Available Background & aim: Reproductive health of puberty is very important in the cycle of Life. Adolescence is a very important period of time in cycle of life and it is followed by physical, psychological and social changes. Therefore the aim of this study was needs assessment of reproductive health for adolescence as a first and principal step in curriculum planning for health services. Methods: This study was qualitative like the most needs assessments and the method was content analysis. Data gathering was done by semi structured interview. We used two focus groups (7and 10persons for needs assessment of reproductive health between girls, and personal interview with 10 boys. We did content analysis and then extracted the main themes and sub themes. Results: Adolescent girls had diverse needs in four groups: experiences related to menstruation and hygiene, social needs, sexual needs and psychological needs. Also adolescent boys had three groups of needs like physical changes, psychological and sexual needs. In physical needs group they had some needs like no knowledge of symptoms of adolescence, no knowledge of hygiene related to puberty. In psychological needs group they had some needs like feeling depression and in sexual needs group they had some needs like tendency to make contacts with girls, no knowledge of communication with people with different sex. Conclusion: Education and the systematic planning in reproductive health matters are necessary for parents, teachers and adolescents, and they are known as the prior needs.

  2. Home health nurse decision-making regarding visit intensity planning for newly admitted patients: a qualitative descriptive study.

    Science.gov (United States)

    Irani, Elliane; Hirschman, Karen B; Cacchione, Pamela Z; Bowles, Kathryn H

    2018-04-13

    Despite patients referred to home health having diverse and complex needs, it is unknown how nurses develop personalized visit plans. In this qualitative descriptive study, we interviewed 26 nurses from three agencies about their decision-making process to determine visit intensity and analyzed data using directed content analysis. Following a multifactorial assessment of the patient, nurses relied on their experience and their agency's protocols to develop the personalized visit plan. They revised the plan based on changes in the patient's clinical condition, engagement, and caregiver availability. Findings suggest strategies to improve visit planning and positively influence outcomes of home health patients.

  3. Predicting health plan member retention from satisfaction surveys: the moderating role of intention and complaint voicing.

    Science.gov (United States)

    Huppertz, John W

    2008-01-01

    Many health plans have tried to increase member retention by improving their scores on customer satisfaction surveys. However, prior research has demonstrated weak relationships between member satisfaction and retention, suggesting that other variables are needed to understand how satisfaction impacts member retention. In a longitudinal study 4,806 health plan members who completed satisfaction surveys were re-assessed three years later; we compared measures of satisfaction, intention, and complaining behavior from voluntary disenrollees and retained members. The relationship between satisfaction and retention was moderated by members' intentions to disenroll. The findings suggest that health plans can enhance the predictive validity of their satisfaction surveys by including measures of both satisfaction and intentions.

  4. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  5. Empowering health personnel for decentralized health planning in India: The Public Health Resource Network

    Directory of Open Access Journals (Sweden)

    Prasad Vandana

    2009-07-01

    Full Text Available Abstract The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated

  6. Empowering health personnel for decentralized health planning in India: The Public Health Resource Network.

    Science.gov (United States)

    Kalita, Anuska; Zaidi, Sarover; Prasad, Vandana; Raman, V R

    2009-07-20

    The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated though often isolated health

  7. Reproductive health/family planning and the health of infants, girls and women.

    Science.gov (United States)

    Sadik, N

    1997-01-01

    The 1994 International Conference on Population and Development developed international consensus amongst health providers, policy makers, and group representing the whole of civil society regarding the concept of reproductive health and its definition. In line with this definition, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. Reproductive health care saves lives and prevents significant levels of morbidity through family planning programmes, antenatal, delivery and post-natal services, prevention and management programmes for reproductive tract infections (including sexually transmitted diseases and HIV/AIDS), prevention of abortion and management of its complications, cancers of the reproductive system, and harmful practices that impact on reproductive function. Reproductive health care needs are evident at all stages of the life cycle and account for a greater proportion of disability adjusted life years (DALYS) in girls and women than in boys and men. Reproductive health protects infant health by enabling birth spacing and birth limitation to be practiced through family planning. The prevention and early detection of reproductive tract infections, including sexually transmitted diseases and HIV, through the integration of preventive measures in family planning service delivery not only improves the quality of care provided but is also directly responsible for improvement in survival and health of infants. Addressing harmful practices such as son preference, sex selection, sexual violence and female genital mutilation complements the positive impact of planned and spaced children through family planning services on infant mortality and the reproductive health of young girls and women. They are also in addition to prenatal, delivery and postnatal services, positive determinants of low maternal mortality and

  8. Risk sharing between competing health plans and sponsors

    NARCIS (Netherlands)

    E.M. van Barneveld (Erik); W.P.M.M. van de Ven (Wynand); R.C.J.A. van Vliet (René)

    2001-01-01

    textabstractIn many countries, competing health plans receive capitation payments from a sponsor, whether government or a private employer. All capitation payment methods are far from perfect and have raised concerns about risk selection. Paying health plans partly on the basis

  9. 76 FR 37037 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Science.gov (United States)

    2011-06-24

    ... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... interim final regulations published July 23, 2010 with respect to group health plans and health insurance..., group health plans, and health insurance issuers providing group health insurance coverage. The text of...

  10. 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

  11. 76 FR 23755 - Release of Draft Risk and Exposure Assessments and Final Integrated Review Plan for the National...

    Science.gov (United States)

    2011-04-28

    ... titled, ``Ozone National Ambient Air Quality Standards: Scope and Methods Plan for Health Risk and... Standards: Scope and Methods Plan for Welfare Risk and Exposure Assessment'' (REA Plan for the secondary... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 50 and 58 [EPA-HQ-OAR-2008-0699; FRL-9300-4] RIN 2060...

  12. Implementing Trauma-Informed Partner Violence Assessment in Family Planning Clinics.

    Science.gov (United States)

    Decker, Michele R; Flessa, Sarah; Pillai, Ruchita V; Dick, Rebecca N; Quam, Jamie; Cheng, Diana; McDonald-Mosley, Raegan; Alexander, Kamila A; Holliday, Charvonne N; Miller, Elizabeth

    2017-09-01

    Intimate partner violence (IPV) and reproductive coercion (RC) are associated with poor reproductive health. Little is known about how family planning clinics implement brief IPV/RC assessment interventions in practice. We describe the uptake and impact of a brief, trauma-informed, universal IPV/RC assessment and education intervention. Intervention implementation was evaluated via a mixed methods study among women ages 18 and up receiving care at one of two family planning clinics in greater Baltimore, MD. This mixed methods study entailed a quasi-experimental, single group pretest-posttest study with family planning clinic patients (baseline and exit survey n = 132; 3-month retention n = 68; retention rate = 52%), coupled with qualitative interviews with providers and patients (total n = 35). Two thirds (65%) of women reported receiving at least one element of the intervention on their exit survey immediately following the clinic-visit. Patients reported that clinic-based IPV assessment is helpful, irrespective of IPV history. Relative to those who reported neither, participants who received either intervention element reported greater perceived caring from providers, confidence in provider response to abusive relationships, and knowledge of IPV-related resources at follow-up. Providers and patients alike described the educational card as a valuable tool. Participants described trade-offs of paper versus in-person, electronic medical record-facilitated screening, and patient reluctance to disclose current situations of abuse. In real-world family planning clinic settings, a brief assessment and support intervention was successful in communicating provider caring and increasing knowledge of violence-related resources, endpoints previously deemed valuable by IPV survivors. Results emphasize the merit of universal education in IPV/RC clinical interventions over seeking IPV disclosure.

  13. Operable Unit 3: Proposed Plan/Environmental Assessment for interim remedial action

    International Nuclear Information System (INIS)

    1993-12-01

    This document presents a Proposed Plan and an Environmental Assessment for an interim remedial action to be undertaken by the US Department of Energy (DOE) within Operable Unit 3 (OU3) at the Fernald Environmental Management Project (FEMP). This proposed plan provides site background information, describes the remedial alternatives being considered, presents a comparative evaluation of the alternatives and a rationnale for the identification of DOE's preferred alternative, evaluates the potential environmental and public health effects associated with the alternatives, and outlines the public's role in helping DOE and the EPA to make the final decision on a remedy

  14. The Contribution of Health Technology Assessment, Health Needs Assessment, and Health Impact Assessment to the Assessment and Translation of Technologies in the Field of Public Health Genomics

    DEFF Research Database (Denmark)

    Rosenkotter, N.; Vondeling, H.; Blancquaert, I.

    2011-01-01

    contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic...... into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [ health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could...... medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed...

  15. Management self assessment plan

    Energy Technology Data Exchange (ETDEWEB)

    Debban, B.L.

    1998-01-30

    Duke Engineering and Services Hanford Inc., Spent Nuclear Fuel Project is responsible for the operation of fuel storage facilities. The SNF project mission includes the safe removal, processing and transportation of Spent Nuclear Fuel from 100 K Area fuel storage basins to a new Storage facility in the Hanford 200 East Area. Its mission is the modification of the 100 K area fuel storage facilities and the construction of two new facilities: the 100 K Area Cold Vacuum Drying Facility, and the 200 East Area Canister Storage Building. The management self assessment plan described in this document is scheduled to begin in April of 1999 and be complete in May of 1999. The management self assessment plan describes line management preparations for declaring that line management is ready to commence operations.

  16. Management self assessment plan

    International Nuclear Information System (INIS)

    Debban, B.L.

    1998-01-01

    Duke Engineering and Services Hanford Inc., Spent Nuclear Fuel Project is responsible for the operation of fuel storage facilities. The SNF project mission includes the safe removal, processing and transportation of Spent Nuclear Fuel from 100 K Area fuel storage basins to a new Storage facility in the Hanford 200 East Area. Its mission is the modification of the 100 K area fuel storage facilities and the construction of two new facilities: the 100 K Area Cold Vacuum Drying Facility, and the 200 East Area Canister Storage Building. The management self assessment plan described in this document is scheduled to begin in April of 1999 and be complete in May of 1999. The management self assessment plan describes line management preparations for declaring that line management is ready to commence operations

  17. 76 FR 44491 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-07-26

    ... 37208) entitled, ``Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims..., ``Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and... external review processes for group health plans and health insurance issuers offering coverage in the...

  18. 75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-11-17

    ... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... contracts of insurance. The temporary regulations provide guidance to employers, group health plans, and health insurance issuers providing group health insurance coverage. The IRS is issuing the temporary...

  19. Life Cycle Assessment in Spatial Planning

    DEFF Research Database (Denmark)

    Bidstrup, Morten; Pizzol, Massimo; Schmidt, Jannick Højrup

    2015-01-01

    Spatial planning establishes conditions for societal patterns of production and consumption. However, the assigned Strategic Environmental Assessments (SEA) tend to have a too narrow focus. In particular, there is a need for applying a system perspective in SEA, extending assessment beyond...... towards operationalising LCA in SEA by adjusting LCA methodology to focus on the ways planners and planning processes can influence the environmental impacts of interconnected activities. The proposed procedure was tested on a case study of Danish extraction planning, and it was found to generate new...... knowledge for decision support. The procedure enabled identification of key systemic impacts, as well as it enabled formulation of recommendations for how to address these impacts in planning processes. On a more general level, this article demonstrates an application of LCA which until now has received...

  20. The family receiving home care: functional health pattern assessment.

    Science.gov (United States)

    Hooper, J I

    1996-01-01

    The winds of change in health care make assessment of the family more important than ever as a tool for health care providers seeking to assist the family move themselves toward high-level wellness. Limited medical care and imposed self-responsibility for health promotion and illness prevention, which are natural consequences of these changes, move the locus of control for health management back to the family. The family's teachings, modeling, and interactions are greater influences than ever on the health of the patient. Gordon's functional health patterns provide a holistic model for assessment of the family because assessment data are classified under 11 headings: health perception and health management, nutritional-metabolic, elimination, activity and exercise, sleep and rest, cognition and perception, self-perception and self-concept, roles and relationships, sexuality and reproduction, coping and stress tolerance, and values and beliefs. Questions posed under each of the health patterns can be varied to reflect the uniqueness of the individual family as well as to inquire about family strengths and weaknesses in all patterns. Data using this model provide a comprehensive base for including the family in designing a plan of care.

  1. Referral Practices Among U.S. Publicly Funded Health Centers That Offer Family Planning Services.

    Science.gov (United States)

    Carter, Marion W; Robbins, Cheryl L; Gavin, Loretta; Moskosky, Susan

    2018-01-29

    Referrals to other medical services are central to healthcare, including family planning service providers; however, little information exists on the nature of referral practices among health centers that offer family planning. We used a nationally representative survey of administrators from 1,615 publicly funded health centers that offered family planning in 2013-14 to describe the use of six referral practices. We focused on associations between various health center characteristics and frequent use of three active referral practices. In the prior 3 months, a majority of health centers (73%) frequently asked clients about referrals at clients' next visit. Under half (43%) reported frequently following up with referral sources to find out if their clients had been seen. A third (32%) of all health centers reported frequently using three active referral practices. In adjusted analysis, Planned Parenthood clinics (adjusted odds ratio 0.55) and hospital-based clinics (AOR 0.39) had lower odds of using the three active referral practices compared with health departments, and Title X funding status was not associated with the outcome. The outcome was positively associated with serving rural areas (AOR 1.39), having a larger client volume (AOR 3.16), being a part of an insurance network (AOR 1.42), and using electronic health records (AOR 1.62). Publicly funded family planning providers were heavily engaged in referrals. Specific referral practices varied widely and by type of care. More assessment of these and other aspects of referral systems and practices is needed to better characterize the quality of care.

  2. Health Aspects of Climate Change in Cities with Mediterranean Climate, and Local Adaptation Plans.

    Science.gov (United States)

    Paz, Shlomit; Negev, Maya; Clermont, Alexandra; Green, Manfred S

    2016-04-21

    Cities with a Mediterranean-type climate (Med-cities) are particularly susceptible to health risks from climate change since they are located in biogeographical hot-spots that experience some of the strongest effects of the changing climate. The study aims to highlight health impacts of climate change in Med-cities, analyze local climate adaptation plans and make adaptation policy recommendations for the Med-city level. We identified five Med-cities with a climate change adaptation plan: Adelaide, Barcelona, Cape Town, Los Angeles and Santiago. Beyond their similar Med-climate features (although Santiago's are slightly different), the cities have different socio-economic characteristics in various aspects. We analyzed each plan according to how it addresses climate change-related drivers of health impacts among city dwellers. For each driver, we identified the types of policy adaptation tools that address it in the urban climate adaptation plans. The surveyed cities address most of the fundamental climate change-related drivers of risks to human health, including rising temperatures, flooding and drought, but the policy measures to reduce negative impacts vary across cities. We suggest recommendations for Med-cities in various aspects, depending on their local needs and vulnerability challenges: assessment of health risks, extreme events management and long-term adaptation, among others.

  3. 75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-06-17

    ... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human Services... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

  4. Study protocol: cross-national comparative case study of recovery-focused mental health care planning and coordination (COCAPP).

    Science.gov (United States)

    Simpson, Alan; Hannigan, Ben; Coffey, Michael; Jones, Aled; Barlow, Sally; Cohen, Rachel; Všetečková, Jitka; Faulkner, Alison; Haddad, Mark

    2015-07-03

    The collaborative care planning study (COCAPP) is a cross-national comparative study of care planning and coordination in community mental healthcare settings. The context and delivery of mental health care is diverging between the countries of England and Wales whilst retaining points of common interest, hence providing a rich geographical comparison for research. Across England the key vehicle for the provision of recovery-focused, personalised, collaborative mental health care is the care programme approach (CPA). The CPA is a form of case management introduced in England in 1991, then revised in 2008. In Wales the CPA was introduced in 2003 but has now been superseded by The Mental Health (Care Co-ordination and Care and Treatment Planning) (CTP) Regulations (Mental Health Measure), a new statutory framework. In both countries, the CPA/CTP requires providers to: comprehensively assess health/social care needs and risks; develop a written care plan (which may incorporate risk assessments, crisis and contingency plans, advanced directives, relapse prevention plans, etc.) in collaboration with the service user and carer(s); allocate a care coordinator; and regularly review care. The overarching aim of this study is to identify and describe the factors that ensure CPA/CTP care planning and coordination is personalised, recovery-focused and conducted collaboratively. COCAPP will employ a concurrent transformative mixed methods approach with embedded case studies. Phase 1 (Macro-level) will consider the national context through a meta-narrative mapping (MNM) review of national policies and the relevant research literature. Phase 2 (Meso-level and Micro-level) will include in-depth micro-level case studies of everyday 'frontline' practice and experience with detailed qualitative data from interviews and reviews of individual care plans. This will be nested within larger meso-level survey datasets, senior-level interviews and policy reviews in order to provide

  5. 76 FR 37207 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-06-24

    ... Department of Health and Human Services 45 CFR Part 147 Group Health Plans and Health Insurance Issuers... SERVICES [CMS-9993-IFC2] 45 CFR Part 147 RIN 0938-AQ66 Group Health Plans and Health Insurance Issuers... for group health plans and health insurance coverage in the group and individual markets under...

  6. Planning a change project in mental health nursing.

    Science.gov (United States)

    Thorpe, Rebecca

    2015-09-02

    This article outlines a plan for a change project to improve the quality of physical health care on mental health wards. The plan was designed to improve the monitoring and recording of respiratory rates on mental health wards, through the implementation of a training programme for staff. A root cause analysis was used to explore the reasons for the low incidence of respiratory rate measurement on mental health wards, and the results of this establish the basis of the proposed change project and its aims and objectives. The article describes how the project could be implemented using a change management model, as well as how its effects could be measured and evaluated. Potential barriers to the planned change project are discussed, including the human dimensions of change. The article suggests methods to overcome such barriers, discusses the value of leadership as an important factor, and examines the principles of clinical governance in the context of the planned change project.

  7. FAMILY HEALTH STRATEGY OF PARTICIPATION IN MUNICIPAL HEALTH PLAN CONSTRUCTION: AN EXPERIENCE REPOR

    Directory of Open Access Journals (Sweden)

    Adilson Ribeiro dos Santos

    2015-08-01

    Full Text Available The Municipal Health Plan is an important planning tool in the management at the Unified Health System and at the same time, a mechanism for popular participation. This study aims to report the experience of the Municipal Health Plan’s workshop conducted by a Family Health Program team in a municipality in the south of Bahia Construção do Plano Municipal de Saúde. in the year 2014. This is an experience report that consolidates itself as a descriptive research tool that presents a reflection about an action that addresses a situation experienced in the professional interest of the scientific community. The workshop included the team and community members’ participation. The population's health problems follow a national trend, highlighting problems like diabetes, hypertension, worms, abuse of alcohol and other drugs inaddition to viruses. The health system problems reveal the weaknesses in local management of the Unified Health System by the insufficiency and/or lack of resources such as drugs, tests, equipment maintenance and others. Therefore, we emphasize the importance of the Municipal Health Plan as a management tool of the Unified Health System that allows closeness between users, workers and managers, as well as being a space for policy vocalization, contributing to the real effectiveness of the Unified Health System, based on participatory planning in accordance with the needs of users.

  8. 75 FR 27121 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Dependent...

    Science.gov (United States)

    2010-05-13

    ... 45 CFR Parts 144, 146, and 147 Group Health Plans and Health Insurance Issuers Relating to Dependent... 144, 146, and 147 RIN 0991-AB66 Interim Final Rules for Group Health Plans and Health Insurance... requirements for group health plans and health insurance issuers in the group and individual markets under...

  9. Self-assessment of managerial knowledge and skills of medical doctors in primary health care

    Directory of Open Access Journals (Sweden)

    Aida Pilav

    2016-03-01

    Full Text Available Introduction: The aim of this paper was to evaluate the managerial knowledge and skills of mid-level managers – medical doctors in Medical center of the Canton Sarajevo.Methods: A cross-sectional study of the mid-level managers in the Medical center of the Canton Sarajevo was conducted using an originally developed questionnaire for self-assessment of managerial knowledge and skills. The respondents answered each of the questions using a 5-point Likert scale. Apart from the quantitative section, the respondents could present their observations concerning the educational needs in the health care system.Results: Almost 40% of the respondents said that the process of assessing health care needs is not conducted. No statistical significance was observed in the responses according to the length of service in a managerial position. In total, 41% of the respondents were not sure whether a plan exists, even though the development of these plans should be a principal managerial responsibility in the quality management. Managers who were longer in the position reported no plans for corrective actions. This result was in contrast with the answers obtained from the managers who were in the position for a shorter period. In addition, 91% of the respondents said that they regularly discuss problems with their employees.Conclusions: Self- assessment and assessment of managerial competencies should be regular activities in a health care organization, in order to monitor the knowledge and skills, as well as to make the development plans. The results of this study could serve as the basis for planning and developing the health management education in the Canton Sarajevo.

  10. Performance Assessment Strategy Plan for the Geologic Repository Program

    International Nuclear Information System (INIS)

    1990-01-01

    Performance assessment is a major constituent of the program being conducted by the US Department of Energy (DOE) to develop a geologic repository. Performance assessment is the set of activities needed for quantitative evaluations to assess compliance with the performance requirements in the regulations for a geologic repository and to support the development of the repository. The strategy for these evaluations has been documented in the Performance Assessment Strategy Plan (DOE, 1989). The implementation of the performance assessment strategy is defined in this document. This paper discusses the scope and objectives of the implementation plan, the relationship of the plan to other program plans, summarizes the performance assessment areas and the integrated strategy of the performance assessment program. 1 fig., 3 tabs

  11. European network for health technology assessment, EUnetHTA: planning, development, and implementation of a sustainable European network for health technology assessment

    DEFF Research Database (Denmark)

    Kristensen, Finn Børlum; Mäkelä, Marjukka; Neikter, Susanna Allgurin

    2009-01-01

    OBJECTIVES: The European network on Health Technology Assessment (EUnetHTA) aimed to produce tangible and practical results to be used in the various phases of health technology assessment and to establish a framework and processes to support this. This article presents the background, objectives......, and organization of EUnetHTA, which involved a total of sixty-four partner organizations. METHODS: Establishing an effective and sustainable structure for a transnational network involved many managerial, policy, and methodological tools, according to the objective of each task or Work Package. Transparency...... the use of HTA at national and regional levels. Responsiveness to political developments in Europe should be balanced with maintaining a high level of ambition to promote independent, evidence-based information and well-tested tools for best practice based on a strong network of HTA institutions....

  12. Resource assessment/commercialization planning meeting

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-01-24

    The U.S. Department of Energy, Division of Geothermal Energy and Division of Geothermal Resource Management, sponsored a Resource Assessment/Commercialization Planning meeting in Salt Lake City on January 21-24, 1980. The meeting included presentations by state planning and resource teams from all DOE regions. An estimated 130 people representing federal, state and local agencies, industry and private developers attended.

  13. The Hemophilia Games: An Experiment in Health Education Planning.

    Science.gov (United States)

    National Heart and Lung Inst. (DHEW/PHS), Bethesda, MD.

    The Hemophilia Health Education Planning Project was designed to (1) create a set of tools useful in hemophilia planning and education, and (2) create a planning model for other diseases with similar factors. The project used the game-simulations technique which was felt to be particularly applicable to hemophilia health problems, since as a…

  14. Federal Employees Health Benefits Program (FEHBP) Plan Information

    Data.gov (United States)

    Office of Personnel Management — A list of all Federal Employees Health Benefits Program (FEHBP) plans available in each state, as well as links to the plan brochures, changes for each plan from the...

  15. Safety and health five-year plan, Fiscal years 1995--1999

    International Nuclear Information System (INIS)

    1994-10-01

    This report describes efforts by the Department of Energy (DOE) to size and allocate funding to safety and health activities that protect workers and the public from harm. Although it is well recognized that virtually every aspect of an operation has health and safety implications, this effort is directed at identifying planned efforts specifically directed at health and safety. The initial effort, to compile information for the period covering FY 1994--1998, served two primary needs: (1) to document what was actually taking place in the DOE Complex, from a budget and resource utilization standpoint (how the complex was reacting to the calls for greater protection for workers and the public); and (2) to embark on an effort to utilize forward-looking management plans to allocate resources to meet safety and health needs (to begin to be proactive). It was recognized that it would take several years to achieve full acceptance and implementation of a single, DOE-wide approach toward planning for safety and health, and to develop plans that emphasized the benefits from both risk management and accident prevention strategies. This report, describing safety and health plans and budgets for FY 1995, reflects the increasing acceptance of risk-based strategies in the development of safety and health plans. More operations are using the prioritization methodology recommended for the safety and health planning process, and more operations have begun to review planned expenditures of resources to better assure that resources are allocated to the highest risk reduction activities

  16. Assessing entrepreneurship in governmental public health.

    Science.gov (United States)

    Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

    2015-04-01

    We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

  17. Reconstruction of railroads at Klaipéda da National Seaport: Local Health Impact Assessment Case in Lithuania

    Directory of Open Access Journals (Sweden)

    Ingrida Zurlytè

    2007-09-01

    Full Text Available Background: Introduction of health impact assessment (HIA as a national legal requirement for planned economic activity projects in 2002 and the further development of related procedures and methodological requirements has boosted the number of HIAs carried out both as an integrated part of environmental impact assessment (EIA procedures as well as an independent activity. Most of HIAs have been conduct for local projects. The HIA for the reconstruction of the southern section of the railroads in Klaip da National Seaport is one of the local HIAs in Lithuania carried out as an independent procedure. Methods: The HIA for the reconstruction of the southern section of the railroads in Klaipda National Seaport was carried out following the national legal procedure for the cases not foreseen in the Law on Environmental Impact Assessment of Planned Economic Activity and the national HIA methodological regulations. The HIA included a literature review, analysis of related technical documentation, data on existing and estimated air pollution and environmental noise levels and possible health consequences, analysis of local demographic and health statistics; interviews with the residents living in proximity of the planned activity, analysis of public complaints on existing activities at Klaip da National Seaport, site visit and round table discussions with the proponent of the planned activity, planning company and representatives of the public health authority. The standard or intermediate type of perspective HIA was applied. Results: The HIA report has pointed out noise, vibration, ambient air pollution, psychological factors as related to possible negative impact on health of residents living in the mostly exposed locations. Interviews with inhabitants living in proximity of the planned activity have shown that majority of them knew nothing about the reconstruction plans. Recommendations were provided in the report how to minimise

  18. Quality improvement initiatives: the missed opportunity for health plans.

    Science.gov (United States)

    Fernandez-Lopez, Sara; Lennert, Barbara

    2009-11-01

    The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations.

  19. Evaluation of Croatian model of polycentric health planning and decision making.

    Science.gov (United States)

    Sogorić, Selma; Dzakula, Aleksandar; Rukavina, Tea Vukusić; Grozić-Zivolić, Sonja; Lazarić-Zec, Danijela; Dzono-Boban, Ankica; Brborović, Ognjen; Lang, Slobodan; Vuletić, Silvije

    2009-03-01

    To determine the progress in the development and implementation of health policies on a county level resulting from the learning-by-doing training provided through the County Public Health Capacity Building Program started in 2001 in Croatia. Modular training using management tools, public health theory and practice, and SMDP's Healthy Plan-it tool, followed by the self-evaluation of the progress made by county teams in health needs assessment and health policy development, implementation, and assurance. Fifteen county teams consisting of politicians, executive officers, public health professionals, and community members. Twelve of 15 county teams completed the program. The teams made progress in the evaluated areas, although to a different extent, which did not depend on the amount of time they had or the governance experience. The differences in improvement depended on the differences in the strength of political, executive, and professional components of the teams. Teams with a strong political and/or executive component, but weak public health professional and community components made major improvements in policy development and/or assurance function, but performed less well in the health needs assessment and constituency building. The reversed was also true. Learning-by-doing training program improved public health practices on a county level in Croatia.

  20. Federal, provincial and territorial public health response plan for biological events.

    Science.gov (United States)

    McNeill, R; Topping, J

    2018-01-04

    The Federal/Provincial/Territorial (FPT) Public Health Response Plan for Biological Events was developed for the Public Health Network Council (PHNC). This plan outlines how the national response to public health events caused by biological agents will be conducted and coordinated, with a focus on implementation of responses led by senior-level FPT public health decision-makers. The plan was developed by an expert task group and was approved by PHNC in October, 2017. The plan describes roles, responsibilities and authorities of FPT governments for public health and emergency management, a concept of operations outlining four scalable response levels and a governance structure that aims to facilitate an efficient, timely, evidence-informed and consistent approach across jurisdictions. Improving effective engagement amongst public health, health care delivery and health emergency management authorities is a key objective of the plan.

  1. Health and safety plan for operations performed for the Environmental Restoration Program

    Energy Technology Data Exchange (ETDEWEB)

    Trippet, W.A. II (IT Corp., (United States)); Reneau, M.; Morton, S.L. (EG and G Idaho, Inc., Idaho Falls, ID (United States))

    1992-04-01

    This document constitutes the generic health and safety plan for the Environmental Restoration Program (ERP). It addresses the health and safety requirements of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA); Occupational Safety and Health Administration (OSHA) 29 CFR 1910.120 standard; and EG G Idaho, Inc. This plan is a guide to individuals who must complete a health and safety plan for a task performed for the EPR. It contains a task specific addendum that, when completed, specifically addresses task specific health and safety issues. This health and safety plan reduces the time it takes to write a task specific health and safety plan by providing discussions of requirements, guidance on where specific information is located, and specific topics in the Addendum that must be discussed at a task level. This format encourages a complete task specific health and safety plan and a standard for all health and safety plans written for ERP.

  2. Health and safety plan for operations performed for the Environmental Restoration Program

    International Nuclear Information System (INIS)

    Trippet, W.A. II; Reneau, M.; Morton, S.L.

    1992-04-01

    This document constitutes the generic health and safety plan for the Environmental Restoration Program (ERP). It addresses the health and safety requirements of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA); Occupational Safety and Health Administration (OSHA) 29 CFR 1910.120 standard; and EG ampersand G Idaho, Inc. This plan is a guide to individuals who must complete a health and safety plan for a task performed for the EPR. It contains a task specific addendum that, when completed, specifically addresses task specific health and safety issues. This health and safety plan reduces the time it takes to write a task specific health and safety plan by providing discussions of requirements, guidance on where specific information is located, and specific topics in the Addendum that must be discussed at a task level. This format encourages a complete task specific health and safety plan and a standard for all health and safety plans written for ERP

  3. mHealth Assessment: Conceptualization of a Global Framework.

    Science.gov (United States)

    Bradway, Meghan; Carrion, Carme; Vallespin, Bárbara; Saadatfard, Omid; Puigdomènech, Elisa; Espallargues, Mireia; Kotzeva, Anna

    2017-05-02

    The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations. We aim to offer a collective description of a universally applicable description of mHealth assessment initiatives, given their current and, as we see it, potential impact. In doing so, we recommend a common foundation for the development or update of assessment initiatives by addressing the multistakeholder issues that mHealth technology adds to the traditional medical environment. Organized by the Mobile World Capital Barcelona Foundation, we represent a workgroup consisting of patient associations, developers, and health authority representatives, including medical practitioners, within Europe. Contributions from each group's diverse competencies has allowed us to create an overview of the complex yet similar approaches to mHealth evaluation that are being developed today, including common gaps in concepts and perspectives. In response, we summarize commonalities of existing initiatives and exemplify additional characteristics that we believe will strengthen and unify these efforts. As opposed to a universal standard or protocol in evaluating mHealth solutions, assessment frameworks should respect the needs and capacity of each medical system or country. Therefore, we expect that the medical system will specify the content, resources, and workflow of assessment protocols in order to ensure a sustainable plan for mHealth solutions within their respective countries. A common framework for all mHealth initiatives around the world will be useful in order to assess whatever mHealth solution is desirable in different areas, adapting it to the

  4. The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs.

    Science.gov (United States)

    Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A

    2012-02-10

    To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.

  5. Health effects of smoke from planned burns: a study protocol

    Directory of Open Access Journals (Sweden)

    David O’Keeffe

    2016-02-01

    Full Text Available Abstract Background Large populations are exposed to smoke from bushfires and planned burns. Studies investigating the association between bushfire smoke and health have typically used hospital or ambulance data and been done retrospectively on large populations. The present study is designed to prospectively assess the association between individual level health outcomes and exposure to smoke from planned burns. Methods/design A prospective cohort study will be conducted during a planned burn season in three locations in Victoria (Australia involving 50 adult participants who undergo three rounds of cardiorespiratory medical tests, including measurements for lung inflammation, endothelial function, heart rate variability and markers of inflammation. In addition daily symptoms and twice daily lung function are recorded. Outdoor particulate air pollution is continuously measured during the study period in these locations. The data will be analysed using mixed effect models adjusting for confounders. Discussion Planned burns depend on weather conditions and dryness of ‘fuels’ (i.e. forest. It is potentially possible that no favourable conditions occur during the study period. To reduce the risk of this occurring, three separate locations have been identified as having a high likelihood of planned burn smoke exposure during the study period, with the full study being rolled out in two of these three locations. A limitation of this study is exposure misclassification as outdoor measurements will be conducted as a measure for personal exposures. However this misclassification will be reduced as participants are only eligible if they live in close proximity to the monitors.

  6. IRIS Assessment Plan for Uranium (Scoping and Problem Formulation Materials)

    Science.gov (United States)

    In January 2018, EPA released the IRIS Assessment Plan for Uranium (Oral Reference Dose) (Scoping and Problem Formulation Materials). An IRIS Assessment Plan (IAP) communicates to the public the plan for assessing each individual chemical and includes summary informatio...

  7. Institutionalising health technology assessment: establishing the Medical Technology Assessment Board in India.

    Science.gov (United States)

    Downey, Laura E; Mehndiratta, Abha; Grover, Ashoo; Gauba, Vijay; Sheikh, Kabir; Prinja, Shankar; Singh, Ravinder; Cluzeau, Francoise A; Dabak, Saudamini; Teerawattananon, Yot; Kumar, Sanjiv; Swaminathan, Soumya

    2017-01-01

    India is at crossroads with a commitment by the government to universal health coverage (UHC), driving efficiency and tackling waste across the public healthcare sector. Health technology assessment (HTA) is an important policy reform that can assist policy-makers to tackle inequities and inefficiencies by improving the way in which health resources are allocated towards cost-effective, appropriate and feasible interventions. The equitable and efficient distribution of health budget resources, as well as timely uptake of good value technologies, are critical to strengthen the Indian healthcare system. The government of India is set to establish a Medical Technology Assessment Board to evaluate existing and new health technologies in India, assist choices between comparable technologies for adoption by the healthcare system and improve the way in which priorities for health are set. This initiative aims to introduce a more transparent, inclusive, fair and evidence-based process by which decisions regarding the allocation of health resources are made in India towards the ultimate goal of UHC. In this analysis article, we report on plans and progress of the government of India for the institutionalisation of HTA in the country. Where India is home to one-sixth of the global population, improving the health services that the population receives will have a resounding impact not only for India but also for global health.

  8. Stakeholder participation in health impact assessment: A multicultural approach

    International Nuclear Information System (INIS)

    Negev, Maya; Davidovitch, Nadav; Garb, Yaakov; Tal, Alon

    2013-01-01

    The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA

  9. Stakeholder participation in health impact assessment: A multicultural approach

    Energy Technology Data Exchange (ETDEWEB)

    Negev, Maya, E-mail: mayane@tau.ac.il [Hartog School of Government and Policy, Faculty of Social Sciences, Tel Aviv University, P.O.B. 39040, Tel Aviv 69978 (Israel); Davidovitch, Nadav, E-mail: nadavd@bgu.ac.il [Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University, P.O.B. 653, Be' er Sheva 84105 (Israel); Garb, Yaakov, E-mail: ygarb@bgu.ac.il [Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel); Tal, Alon, E-mail: alontal@bgu.ac.il [Mitrani Department of Dryland Ecology, Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel)

    2013-11-15

    The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA.

  10. Early Experience with Employee Choice of Consumer-Directed Health Plans and Satisfaction with Enrollment

    Science.gov (United States)

    Fowles, Jinnet Briggs; Kind, Elizabeth A; Braun, Barbara L; Bertko, John

    2004-01-01

    Objective To assess the initial impact of offering consumer-defined health plan (CDHP) options on employees. Data Sources/Study Setting A mail survey of 4,680 employees in the corporate offices of Humana Inc. in June 2001. Study Design The study was a cross-sectional mail survey of employees aged 18 and older who were eligible for health care benefits. The survey was conducted following open enrollment. The primary outcome is the choice of consumer-directed health plan or not; the secondary outcome is satisfaction with the enrollment process. Important covariates include sociodemographic characteristics (age, gender, race, educational level, exempt or nonexempt status, type of coverage), health status, health care utilization, and plan design preferences. Data Collection Methods A six-page questionnaire was mailed to the home of each employee, followed by a reminder postcard and two subsequent mailings to nonrespondents. Principal Findings The response rate was 66.2 percent. Seven percent selected one of the two new plan options. Because there were no meaningful differences between employees choosing either of the two new options, these groups were combined in multivariate analysis. A logistic regression modeled the likelihood of choosing the novel plan options. Those selecting the new plans were less likely to be black (odds ratio [OR] 0.46), less likely to have only Humana coverage (OR 0.30), and more likely to have single coverage (OR 1.77). They were less likely to have a chronic health problem (OR 0.56) and more likely to have had no recent medical visits (OR 3.21). They were more likely to believe that lowest premiums were the most important plan attribute (OR 2.89) and to think there were big differences in the premiums of available plans (OR 5.19). Employees in fair or poor health were more likely to have a difficult time during the online enrollment process. They were more likely to find the communications very helpful (OR 0.42) and the benefits

  11. Planning and Implementing Health Promotion in the Workplace: A Case Study of the Du Pont Company Experience.

    Science.gov (United States)

    Bertera, Robert L.

    1990-01-01

    The PRECEDE framework was used to focus planning and evaluation of key areas of health knowledge, attitudes, and behavior in designing a workplace health promotion program for Du Pont. One pilot location experienced a 47.5 percent decline in absenteeism over six years as a result of the comprehensive needs assessment and health intervention. (SK)

  12. Health technology assessment in Iran: challenges and views

    Science.gov (United States)

    Olyaeemanesh, Alireza; Doaee, Shila; Mobinizadeh, Mohammadreza; Nedjati, Mina; Aboee, Parisa; Emami-Razavi, Seyed Hassan

    2014-01-01

    Background: Various decisions have been made on technology application at all levels of the health system in different countries around the world. Health technology assessment is considered as one of the best scientific tools at the service of policy- makers. This study attempts to investigate the current challenges of Iran’s health technology assessment and provide appropriate strategies to establish and institutionalize this program. Methods: This study was carried out in two independent phases. In the first, electronic databases such as Medline (via Pub Med) and Scientific Information Database (SID) were searched to provide a list of challenges of Iran’s health technology assessment. The views and opinions of the experts and practitioners on HTA challenges were studied through a questionnaire in the second phase which was then analyzed by SPSS Software version 16. This has been an observational and analytical study with a thematic analysis. Results: In the first phase, seven papers were retrieved; from which, twenty- two HTA challenges in Iran were extracted by the researchers; and they were used as the base for designing a structured questionnaire of the second phase. The views of the experts on the challenges of health technology assessment were categorized as follows: organizational culture, stewardship, stakeholders, health system management, infrastructures and external pressures which were mentioned in more than 60% of the cases and were also common in the views. Conclusion: The identification and prioritization of HTA challenges which were approved by those experts involved in the strategic planning of the Department of Health Technology Assessment will be a step forward in the promotion of an evidence- based policy- making and in the production of comprehensive scientific evidence. PMID:25695015

  13. 76 FR 13197 - National Institute of Environmental Health Sciences Strategic Planning

    Science.gov (United States)

    2011-03-10

    ... parties. The goal of this strategic planning process is to define an overarching Vision Statement... this planning process, visit the NIEHS Strategic Planning Web site at Request for Visionary Ideas The... Environmental Health Sciences Strategic Planning AGENCY: National Institutes of Health (NIH), National Institute...

  14. Local health care expenditure plans and their opportunity costs.

    Science.gov (United States)

    Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew

    2015-09-01

    In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. The contribution of health technology assessment, health needs assessment, and health impact assessment to the assessment and translation of technologies in the field of public health genomics.

    Science.gov (United States)

    Rosenkötter, N; Vondeling, H; Blancquaert, I; Mekel, O C L; Kristensen, F B; Brand, A

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation. Copyright © 2010 S. Karger AG, Basel.

  16. Predicting Intentions to Eat a Healthful Diet by College Baseball Players: Applying the Theory of Planned Behavior

    Science.gov (United States)

    Pawlak, Roman; Malinauskas, Brenda; Rivera, David

    2009-01-01

    Objective: To assess factors important to college baseball players regarding intention to eat a healthful diet within the Theory of Planned Behavior. Design: A survey based on the Theory of Planned Behavior was administered during the 2006 summer league season from 5 of the Northern Division teams of the Coastal Plain League. Participants: Male…

  17. Health Careers Planning Guide--Illinois. Second Edition.

    Science.gov (United States)

    Illinois Univ., Champaign.

    This notebook of career counseling materials is a compilation of career information on nursing and the allied health fields. The first section provides general information useful in choosing a health career on such topics as career planning, career mobility, employment prospects, financial aid, terminology in health job titles, and an annotated…

  18. An economic analysis of health plan conversions: are they in the public interest?

    Science.gov (United States)

    Beaulieu, Nancy Dean

    2004-01-01

    that quality appears to be somewhat lower in for-profit national managed-care companies. Additional research is needed to assess the viability of true nonprofits, the potential effects of nonprofits and for-profit national managed-care plans on the evolution of local insurance and provider markets, and methods for effective oversight of nonprofit health plans.

  19. Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans.

    Science.gov (United States)

    Walter, Angela Wangari; Yuan, Yiyang; Cabral, Howard J

    2017-05-01

    Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used. Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010-2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs. Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans. Copyright © 2017 by the American Academy of Pediatrics.

  20. 75 FR 41726 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Science.gov (United States)

    2010-07-19

    ... Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under the Patient... and health insurance coverage in the group and individual markets under provisions of the Patient... plans and group health insurance issuers for plan years beginning on or after September 23, 2010. These...

  1. Do individuals respond to cost-sharing subsidies in their selections of marketplace health insurance plans?

    Science.gov (United States)

    DeLeire, Thomas; Chappel, Andre; Finegold, Kenneth; Gee, Emily

    2017-12-01

    The Affordable Care Act (ACA) provides assistance to low-income consumers through both premium subsidies and cost-sharing reductions (CSRs). Low-income consumers' lack of health insurance literacy or information regarding CSRs may lead them to not take-up CSR benefits for which they are eligible. We use administrative data from 2014 to 2016 on roughly 22 million health insurance plan choices of low-income individuals enrolled in ACA Marketplace coverage to assess whether they behave in a manner consistent with being aware of the availability of CSRs. We take advantage of discontinuous changes in the schedule of CSR benefits to show that consumers are highly sensitive to the value of CSRs when selecting insurance plans and that a very low percentage select dominated plans. These findings suggest that CSR subsidies are salient to consumers and that the program is well designed to account for any lack of health insurance literacy among the low-income population it serves. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. 75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

    Science.gov (United States)

    2010-06-17

    ... 45 CFR Part 147 Group Health Plans and Health Insurance Coverage Relating to Status as a... for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan... and Insurance Oversight, Department of Health and Human Services. ACTION: Interim final rules with...

  3. Assessment of time management attitudes among health managers.

    Science.gov (United States)

    Sarp, Nilgun; Yarpuzlu, Aysegul Akbay; Mostame, Fariba

    2005-01-01

    These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management.

  4. Strategic planning--a plan for excellence for South Haven Health System.

    Science.gov (United States)

    Urbanski, Joanne; Baskel, Maureen; Martelli, Mary

    2011-01-01

    South Haven Health System has developed an innovative approach to strategic planning. The key to success of this process has been the multidisciplinary involvement of all stakeholders from the first planning session through the final formation of a strategic plan with measurable objectives for each goal. The process utilizes a Conversation Café method for identifying opportunities and establishing goals, Strategic Oversight Teams to address each goal and a Champion for implementation of each objective. Progress is measured quarterly by Strategic Oversight Team report cards. Transparency of communication within the organization and the sharing of information move the plan forward. The feedback from participant evaluations has been overwhelmingly positive. They are involved and excited.

  5. Health policies planning: methodological standards, boundaries and possibilities

    Directory of Open Access Journals (Sweden)

    Cassius Guimarães Chai

    2016-12-01

    Full Text Available Before the health right recognition and expansion brought about by the Federal Constitution of 1988,the impact on public accounts and the need to rationalize the system, now bound to the universalisation matrix, place “planning” as fundamental for the operationalization of actions and services of health accessing. The objective of this article is to carry out an integrative literature review in order to know the factors related to the methodological frameworks, challenges and possibilities for structuring a Municipal Health Plan (Administration. The following databases were searched: Lilacs, Library Digital Thesis and Dissertation (BDTD, in Google Scholar, the Coordination of Improvement of Higher Education Personnel (CAPES Thesis Bank. For the composition of the sample, the following descriptors were associated: Health Policy, Decentralization and Municipalization with Health Planning. In addition, papers were selected among dissertations, theses and scientific articles, as well as institutional handbooks of the Ministry of Health-MS Publics of PlanejaSUS, adopting scientific works published between 2005 and 2015 as a time cut. The results found synthesize the scenario of the intersectoral and tripartite arrangement of health management, contributing to a critical and evaluative exercise of experience, challenges and possibility Of advances in the understanding of the importance of SUS municipal planning.

  6. Impact of a mobile health aplication in the nursing care plan compliance of a home care service in Belo Horizonte, Minas Gerais, Brazil.

    Science.gov (United States)

    de Britto, Felipe A; Martins, Tatiana B; Landsberg, Gustavo A P

    2015-01-01

    To assess impact of a mobile health solution in the nursing care plan compliance of a home care service. A retrospective cohort study was performed with 3,036 patients. Compliance rates before and after the implementation were compared. After the implementation of a mobile health aplication, compliance with the nursing care plan increased from 53% to 94%. The system reduced IT spending, increased the nursing team efficiency and prevented planned hiring. The use of a mobile health solution with geolocating feature by a nursing home care team increased compliance to the care plan.

  7. 75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

    Science.gov (United States)

    2010-06-28

    ... Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... guidance to employers, group health plans, and health insurance issuers providing group health insurance...

  8. 26 CFR 54.9831-1 - Special rules relating to group health plans.

    Science.gov (United States)

    2010-04-01

    ... this section. In addition, benefits provided under a health flexible spending arrangement are excepted... of a group health plan. For purposes of this paragraph (c)(3), benefits are not an integral part of a group health plan (whether the benefits are provided through the same plan or a separate plan) only if...

  9. Planning Support Systems (PSS-Based Spatial Plan Alternatives and Environmental Assessment

    Directory of Open Access Journals (Sweden)

    Hee-Sun Choi

    2016-03-01

    Full Text Available Spatial planning is at the core of national land and urban development. Many countries and cities seek sustainable development through various means such as coordinated environmental planning, environmental assessment, and internalization of environmental analysis and planning. A Planning Support System (PSS is a GIS (Geographic Information System-based, spatial decision-making support system that incorporates a variety of theories and pertinent models. This study adopted the “What if?” model to design an alternative spatial plan that includes generation of predictive scenarios and is relatively easy to use. In the cities studied, we identified a total of six scenarios based on the main drivers of development—namely, population and spatial policies. Subsequently, we assessed the alternatives for their environmental impact, preparing sensitivity maps for each major environmental issue in the target area (natural ecosystem, air and microclimate, natural disasters. One projected advantage of the “What if?” model is that its digital visualization of proposed plans may improve public awareness and involvement. Furthermore, the tool is expected to be highly useful in ensuring the objectivity of quantitative analyses. However, it is necessary to develop a PSS that is both standardized and tailored to the particular needs of each area. Finally, the development of an e-governance system will be beneficial in ensuring public access to the decision making process.

  10. Radiological/Health physics program assessement at Rocky Flats, the process

    International Nuclear Information System (INIS)

    Psomas, P.O.

    1996-01-01

    The Department of Energy, Rocky Flats Office, Safety and Health Group, Health Physics Team (HPT) is responsible for oversight of the Radiation Protection and Health Physics Program (RPHP) of the Integrating Management Contractor (IMC), Kaiser-Hill (K-H) operations at the Rocky Flats Environmental Technology Site (RFETS). As of 1 January 1996 the Rocky Flats Plant employed 300 DOE and 4,300 contractor personnel (K-H and their subcontractors). WSI is a subcontractor and provides plant security. To accomplish the RPHP program oversight HPT personnel developed a systematic methodology for performing a functional RPHP Assessment. The initial process included development of a flow diagram identifying all programmatic elements and assessment criteria documents. Formulation of plans for conducting interviews and performance of assessments constituted the second major effort. The generation of assessment reports was the final step, based on the results of this process. This assessment will be a 6 person-year effort, over the next three years. This process is the most comprehensive assessment of any Radiation Protection and Health Physics (RPHP) Program ever performed at Rocky Flats. The results of these efforts will establish a baseline for future RPHP Program assessments at RFETS. This methodology has been well-received by contractor personnel and creates no Privacy Act violations or other misunderstandings

  11. Risk assessment of integrated electronic health records.

    Science.gov (United States)

    Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

    2010-01-01

    The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

  12. Planning Environmental Impact Assessment Orienting Sustainable Development:Opportunities and Challenges

    Institute of Scientific and Technical Information of China (English)

    Sun Yanjun; Chen Xingeng; Bao Yun; Peng Xiaochun; Gao Changbo

    2005-01-01

    Strategic Environmental Assessment is a frontier subject in the field of Environmental Impact Assessment. In the past two decades, especially in recent years, much more importance has been attached to Strategic Environmental Assessment. The Environmental Impact Assessment Law of the P.R.China which was promulgated provides a great opportunity for the development of Planning Environmental Impact Assessment and brings great challenges for the development of traditional Project Environmental Impact Assessment and Planning Environmental Impact Assessment at the same time.In order to promote the implementation of"The EIA Law", the inherent limitations of Project Environmental Impact Assessment must be identified sufficiendy and the theory research and practice of Planning Environmental Impact Assessment should be strengthened as well. Measures should be taken currendy to enforce the operation system. The authors wish to offer a few references to the progress and implementation of Planning Environmental Impact Assessment in China.

  13. Quasi-experimental Study of Systematic Screening for Family Planning Services among Postpartum Women Attending Village Health and Nutrition Days in Jharkhand, India.

    Science.gov (United States)

    Balasubramaniam, Sudharsanam; Kumar, Somesh; Sethi, Reena; Charurat, Elaine; Lalchandani, Kamlesh; Schuster, Anne; Sood, Bulbul

    2018-01-25

    Systematic screening helps increase family planning uptake through integration with other services, including immunization. Though successfully demonstrated at health facilities, this strategy has not been demonstrated in communities. This study assessed the effectiveness of systematic screening to increase postpartum family planning use during community health days in India without adversely affecting immunization services. The study was conducted during 180 individual Village Health and Nutrition Days in Jharkhand, India. All health workers were trained in postpartum family planning counseling. Intervention providers were also trained in systematic screening. 217 postpartum women aged 15-49 years participated in baseline and endline exit interviews and routine service statistics were analyzed from 2,485 facility visits at affiliated health centers. No difference in family planning service use was found in the intervention group, but significantly fewer interviewed women reported receiving family planning services at endline in the comparison group (p = 0.014). Family planning acceptance at affiliated health centers increased significantly in intervention areas (p family planning services when integrated with community-based services in Jharkhand.

  14. 45 CFR 162.925 - Additional requirements for health plans.

    Science.gov (United States)

    2010-10-01

    ... clearinghouse to receive, process, or transmit a standard transaction may not charge fees or costs in excess of... RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS General Provisions for Transactions § 162.925 Additional... transaction as a standard transaction, the health plan must do so. (2) A health plan may not delay or reject a...

  15. Integrating authorities and disciplines into the preparedness-planning process: a study of mental health, public health, and emergency management.

    Science.gov (United States)

    Robertson, Madeline; Pfefferbaum, Betty; Codispoti, Catherine R; Montgomery, Juliann M

    2007-01-01

    The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were (1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, (2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, (3) to employ a theory for organizational change to organize and synthesize this information, and (4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we (1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; (2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and (3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

  16. Health and aging: development of the Irish Longitudinal Study on Ageing health assessment.

    Science.gov (United States)

    Cronin, Hilary; O'Regan, Clare; Finucane, Ciaran; Kearney, Patricia; Kenny, Rose Anne

    2013-05-01

    To assist researchers planning studies similar to The Irish Longitudinal Study on Ageing (TILDA), concerning the development of the health assessment component, to promote use of the archived data set, to inform researchers of the methods employed, and to complement the accompanying article on normative values. Prospective, longitudinal study of older adults. Republic of Ireland. Eight thousand five hundred four community-dwelling adults who participated in wave 1 of the TILDA study. The main areas of focus for the TILDA health assessments are neurocardiovascular instability, locomotion, and vision. The article describes the scientific rationale for the choice of assessments and seeks to determine the potential advantages of incorporating novel biomeasures and technologies in population-based studies to advance understanding of aging-related disorders. The detailed description of the physical measures will facilitate cross-national comparative research and put into context the normative values outlined in the subsequent article. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  17. 75 FR 43329 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal...

    Science.gov (United States)

    2010-07-23

    ... 45 CFR Part 147 Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to... Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and... of Labor; Office of Consumer Information and Insurance Oversight, Department of Health and Human...

  18. 75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

    Science.gov (United States)

    2010-05-13

    ... Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age 26 Under... Information and Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage...

  19. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2011-08-03

    ... to the interim final regulations implementing the rules for group health plans and health insurance... dates. These interim final regulations generally apply to group health plans and group health insurance... from HHS on private health insurance for consumers can be found on the Centers for Medicare & Medicaid...

  20. 75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

    Science.gov (United States)

    2010-07-19

    ... Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive Services... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage offered in...

  1. Occupational health policies on risk assessment in Japan.

    Science.gov (United States)

    Horie, Seichi

    2010-09-01

    Industrial Safety and Health Law (ISH Law) of Japan requires abnormalities identified in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording "employers shall endeavor." Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifies criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer significant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, financial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

  2. Occupational Health Policies on Risk Assessment in Japan

    Directory of Open Access Journals (Sweden)

    Seichi Horie

    2010-09-01

    Full Text Available Industrial Safety and Health Law (ISH Law of Japan requires abnormalities identifi ed in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording “employers shall endeavor.” Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifi es criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer signifi cant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, fi nancial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

  3. [World plan for reproductive autonomy and health].

    Science.gov (United States)

    Ospina, P

    1994-06-01

    The principal objective of the Third International Conference on Population and Development to be held in Cairo in 1994 is to achieve consensus on a Plan of Action to reinforce reproductive rights of individuals, who bear ultimate responsibility for slowing population growth. The Plan of Action should be adopted by all the peoples of the world in order to stabilize population growth during the next twenty years by means of programs to provide family planning and reproductive health services. The preliminary conference document incorporated recommendations and proposals of two preparatory committees, five regional conferences, six expert meetings, 109 countries, and over 400 nongovernmental organizations from around the world. At current rates of growth, the world's 5.7 billion inhabitants will increase to 9.1 billion by the year 2025, vastly increasing pressure on already limited resources and ecosystems. The central theme of the first World Population Conference in Bucharest in 1974 was the close relationship between population growth and socioeconomic development. The 1974 World Population Plan of Action stressed development of strategies to achieve a better quality of life and rapid socioeconomic development. Recommendations of the 1984 World Population Conference in Mexico remained centered on implementation of the Bucharest Plan of Action with a few additions. Although progress has been achieved in meeting the goals of the Bucharest Plan of Action, growth rates of some developing countries have actually increased. Poverty, unemployment, illiteracy, and discrimination against women are still obstacles to socioeconomic development, and contraceptive usage has not reached optimal levels. Urban migration remains excessive. Progress for many countries over the past decade has been directly related to increasing the access of women to health care and family planning. Themes related to women's status and rights will be incorporated in the 1994 Cairo Conference. The

  4. 75 FR 43109 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Science.gov (United States)

    2010-07-23

    ... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

  5. A case study: planning a statewide information resource for health professionals: an evidence-based approach

    Science.gov (United States)

    Chew, Katherine; Watson, Linda; Parker, Mary

    2009-01-01

    Question: What is the best approach for implementing a statewide electronic health library (eHL) to serve all health professionals in Minnesota? Setting: The research took place at the University of Minnesota Health Sciences Libraries. Methods: In January 2008, the authors began planning a statewide eHL for health professionals following the five-step process for evidence-based librarianship: formulating the question, finding the best evidence, appraising the evidence, assessing costs and benefits, and evaluating the effectiveness of resulting actions. Main Results: The authors identified best practices for developing a statewide eHL for health professionals relating to audience or population served, information resources, technology and access, funding model, and implementation and sustainability. They were compared to the mission of the eHL project to drive strategic directions by developing recommendations. Conclusion: EBL can guide the planning process for a statewide eHL, but findings must be tailored to the local environment to address information needs and ensure long-term sustainability. PMID:19851487

  6. Policy Watch: The Federal Employees Health Benefits Plan

    OpenAIRE

    Roger Feldman; Kenneth E. Thorpe; Bradley Gray

    2002-01-01

    This short feature describes the Federal Employees Health Benefits Plan (FEHBP), which provides health insurance benefits to active and retired federal employees and their dependents. The article discusses the FEHBP as a touchstone for research on employment-based health insurance and as a touchstone for health policy reform.

  7. [Philanthropic hospitals and the operation of provider-owned health plans in Brazil].

    Science.gov (United States)

    Lima, Sheyla Maria Lemos; Portela, Margareth C; Ugá, Maria Alicia Dominguez; Barbosa, Pedro Ribeiro; Gerschman, Silvia; Vasconcellos, Miguel Murat

    2007-02-01

    To describe the management performance of philanthropic hospitals that operate their own health plans, in comparison with philanthropic hospitals as a whole in Brazil. The managerial structures of philanthropic hospitals that operated their own health plans were compared with those seen in a representative group from the philanthropic hospital sector, in six dimensions: management and planning, economics and finance, human resources, technical services, logistics services and information technology. Data from a random sample of 69 hospitals within the philanthropic hospital sector and 94 philanthropic hospitals that operate their own health plans were evaluated. In both cases, only the hospitals with less than 599 beds were included. The results identified for the hospitals that operate their own health plans were more positive in all the managerial dimensions compared. In particular, the economics and finance and information technology dimensions were highlighted, for which more than 50% of the hospitals that operated their own health plans presented almost all the conditions considered. The philanthropic hospital sector is important in providing services to the Brazilian Health System (SUS). The challenges in maintaining and developing these hospitals impose the need to find alternatives. Stimulation of a public-private partnership in this segment, by means of operating provider-owned health plans or providing services to other health plans that work together with SUS, is a field that deserves more in-depth analysis.

  8. A Critical Review of Studies on Health Needs Assessment of Elderly in the World

    Directory of Open Access Journals (Sweden)

    Sima Ghasemi

    2017-06-01

    Full Text Available Introduction: Health improvement, control of communicable diseases and increase in life expectancy among the elderly of developed and developing countries has greatly increased. Since the health care and social needs of older adults differ from that of other adults, it is necessary to identify the needs of the elderly in order to make proper plans that will promote their health. The aim of this paper is to critically review these researches. Methods: A comprehensive literature review on the needs assessment of elderly health was applied searching English and Persian databases in Pub Med, Science Direct, ProQuest, Elsevier, Magiran, ISC and using key words including, Health need, Assessment, Elderly, Aging, Older adults, Aged and Health care needs. Results: Initial search yielded 745 references, considering the inclusion criteria, 21 papers were reviewed. Results revealed that in conducting needs assessment, various methods and procedures in various health dimensions including physical health, mental health, emotional, care, social, cultural, economic, nutritional, service, security, legal and educational needs have been utilized. Some of the dimensions had been more explored and some rarely. Conclusion: Most of the conducted studies had mainly focused on the elderly physical health needs and had neglected to take in to account other needs such as social and health care needs. In order to comprehensively recognize the health needs of the elderly, identifying their health care and care services is also important. Furthermore, in addition to quantitative studies, discovering the older adults’ perceptions of their own health needs is also necessary. It seems that the challenge ahead of managers, experts and researchers on elderly health is trying to design comprehensive mechanisms of health need assessment and considering it as a reference for any future planning.

  9. Health Plan Performance Measurement within Medicare Subvention.

    Science.gov (United States)

    1998-06-01

    the causes of poor performance (Siren & Laffel, 1996). Although outcomes measures such as nosocomial infection rates, admission rates for select...defined. Traditional outcomes measures include infection rates, morbidity, and mortality. The problem with these traditional measures is... Maternal /Child Care Indicators Nursing Staffing Indicators Outcome Indicators Technical Outcomes Plan Performance Stability of Health Plan

  10. 77 FR 42462 - Hawaii State Plan for Occupational Safety and Health; Proposed Modification of 18(e) Plan Approval

    Science.gov (United States)

    2012-07-19

    ... DEPARTMENT OF LABOR Occupational Safety and Health Administration 29 CFR Part 1952 [Docket ID. OSHA 2012-0029] RIN 1218-AC78 Hawaii State Plan for Occupational Safety and Health; Proposed Modification of 18(e) Plan Approval AGENCY: Occupational Safety and Health Administration (OSHA), Department of...

  11. 24 CFR 401.421 - Rental Assistance Assessment Plan.

    Science.gov (United States)

    2010-04-01

    ... PROGRAM (MARK-TO-MARKET) Restructuring Plan § 401.421 Rental Assistance Assessment Plan. (a) Plan required..., comparable, and affordable housing in the local market; (2) The types of tenants residing in the project (such as elderly families, disabled families, large families, and cooperative homeowners); (3) The local...

  12. Should cities hosting mass gatherings invest in public health surveillance and planning? Reflections from a decade of mass gatherings in Sydney, Australia.

    Science.gov (United States)

    Thackway, Sarah; Churches, Timothy; Fizzell, Jan; Muscatello, David; Armstrong, Paul

    2009-09-08

    Mass gatherings have been defined by the World Health Organisation as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation". This paper explores the public health response to mass gatherings in Sydney, the factors that influenced the extent of deployment of resources and the utility of planning for mass gatherings as a preparedness exercise for other health emergencies. Not all mass gatherings of people require enhanced surveillance and additional response. The main drivers of extensive public health planning for mass gatherings reflect geographical spread, number of international visitors, event duration and political and religious considerations. In these instances, the implementation of a formal risk assessment prior to the event with ongoing daily review is important in identifying public health hazards.Developing and utilising event-specific surveillance to provide early-warning systems that address the specific risks identified through the risk assessment process are essential. The extent to which additional resources are required will vary and depend on the current level of surveillance infrastructure.Planning the public health response is the third step in preparing for mass gatherings. If the existing public health workforce has been regularly trained in emergency response procedures then far less effort and resources will be needed to prepare for each mass gathering event. The use of formal emergency management structures and co-location of surveillance and planning operational teams during events facilitates timely communication and action. One-off mass gathering events can provide a catalyst for innovation and engagement and result in opportunities for ongoing public health planning, training and surveillance enhancements that outlasted each event.

  13. Should cities hosting mass gatherings invest in public health surveillance and planning? Reflections from a decade of mass gatherings in Sydney, Australia

    Directory of Open Access Journals (Sweden)

    Muscatello David

    2009-09-01

    Full Text Available Abstract Background Mass gatherings have been defined by the World Health Organisation as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation". This paper explores the public health response to mass gatherings in Sydney, the factors that influenced the extent of deployment of resources and the utility of planning for mass gatherings as a preparedness exercise for other health emergencies. Discussion Not all mass gatherings of people require enhanced surveillance and additional response. The main drivers of extensive public health planning for mass gatherings reflect geographical spread, number of international visitors, event duration and political and religious considerations. In these instances, the implementation of a formal risk assessment prior to the event with ongoing daily review is important in identifying public health hazards. Developing and utilising event-specific surveillance to provide early-warning systems that address the specific risks identified through the risk assessment process are essential. The extent to which additional resources are required will vary and depend on the current level of surveillance infrastructure. Planning the public health response is the third step in preparing for mass gatherings. If the existing public health workforce has been regularly trained in emergency response procedures then far less effort and resources will be needed to prepare for each mass gathering event. The use of formal emergency management structures and co-location of surveillance and planning operational teams during events facilitates timely communication and action. Summary One-off mass gathering events can provide a catalyst for innovation and engagement and result in opportunities for ongoing public health planning, training and surveillance enhancements that outlasted each event.

  14. Reviewing the quality of strategic environmental assessment reports for English spatial plan core strategies

    International Nuclear Information System (INIS)

    Fischer, Thomas B.

    2010-01-01

    This paper summarises the results of a research project from early 2008, involving the author of this paper, as well as 18 post-graduate University of Liverpool students, in which the quality of European Directive based strategic environmental assessment (SEA) reports of English spatial plan core strategies (conducted within the context of the spatial planning sustainability appraisal-SA-regime) was reviewed. The project aimed at establishing the extensiveness of emerging spatial plan related SEA practice, as well as highlighting shortcomings and problems. Overall, it was found that whilst some aspects of assessment were done well, others were not of a satisfactory quality. Shortcomings were connected particularly with the practice of listing potentially relevant baseline documents and data without distinguishing sufficiently between those that are important in terms of significant impacts and those that are not. Problems were also found to exist with the evaluation of options and impacts, the consideration of substantive aspects, such as health, as well as regarding the formulation of final recommendations and monitoring.

  15. Final Action Plan to Tiger Team

    International Nuclear Information System (INIS)

    1992-01-01

    This document presents planned actions, and their associated costs, for addressing the findings in the Environmental, Safety and Health Tiger Team Assessment of the Sandia National Laboratories, Albuquerque, May 1991, hereafter called the Assessment. This Final Action Plan should be read in conjunction with the Assessment to ensure full understanding of the findings addressed herein. The Assessment presented 353 findings in four general categories: (1)Environmental (82 findings); (2) Safety and Health (243 findings); (3) Management and Organization (18 findings); and (4) Self-Assessment (10 findings). Additionally, 436 noncompliance items with Occupational Safety and Health Administration (OSHA) standards were addressed during and immediately after the Tiger Team visit

  16. Is health workforce planning recognising the dynamic interplay between health literacy at an individual, organisation and system level?

    Science.gov (United States)

    Naccarella, Lucio; Wraight, Brenda; Gorman, Des

    2016-02-01

    The growing demands on the health system to adapt to constant change has led to investment in health workforce planning agencies and approaches. Health workforce planning approaches focusing on identifying, predicting and modelling workforce supply and demand are criticised as being simplistic and not contributing to system-level resiliency. Alternative evidence- and needs-based health workforce planning approaches are being suggested. However, to contribute to system-level resiliency, workforce planning approaches need to also adopt system-based approaches. The increased complexity and fragmentation of the healthcare system, especially for patients with complex and chronic conditions, has also led to a focus on health literacy not simply as an individual trait, but also as a dynamic product of the interaction between individual (patients, workforce)-, organisational- and system-level health literacy. Although it is absolutely essential that patients have a level of health literacy that enables them to navigate and make decisions, so too the health workforce, organisations and indeed the system also needs to be health literate. Herein we explore whether health workforce planning is recognising the dynamic interplay between health literacy at an individual, organisation and system level, and the potential for strengthening resiliency across all those levels.

  17. 77 FR 8725 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2012-02-15

    ... regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by... plans and group health insurance issuers on April 16, 2012. FOR FURTHER INFORMATION CONTACT: Amy Turner... addition, information from HHS on private health insurance for consumers can be found on the CMS Web site...

  18. The Coffs Harbour 'Our Living City Settlement Strategy' Health Impact Assessment

    International Nuclear Information System (INIS)

    Tugwell, Andrew; Johnson, Pamela

    2011-01-01

    Aim: The short report reviews an experience of conducting a Health Impact Assessment (HIA) in the local government context. The aim of this review was to identify if carrying out an HIA would result in recommendations that could influence council planning and help establish ongoing working relationships between North Coast Area Health Service (NCAHS) staff and the Coffs Harbour City Council. Methods: A process and impact evaluation was conducted on the Coffs Harbour 'Our Living City Settlement Strategy' HIA, which focused on the Coffs Harbour City Council's strategic planning document. Information gained through the evaluation was themed and the findings were reviewed against published information on HIA experience. Main findings: HIA has reported benefits for both the Coffs Harbour City Council and NCAHS as it provides a tool to address many of the issues facing these organisations. Local council has increasing responsibilities including the environment, housing and urban planning, which all have health implications. HIA has been demonstrated as an effective tool for NCAHS staff and the Coffs Harbour City Council to engage and build relationships, increase the understanding of all planning aspects related to health, and most importantly utilise evidence to inform decision making. Conclusion: HIA should be adopted as a key tool to facilitate effective working partnerships between organisations. Improved engagement, partnerships and use of evidence to produce shared outcomes can result from utilising this tool.

  19. Mathematical assessment of Canada's pandemic influenza preparedness plan.

    Science.gov (United States)

    Gumel, Abba B; Nuño, Miriam; Chowell, Gerardo

    2008-03-01

    The presence of the highly pathogenic avian H5N1 virus in wild bird populations in several regions of the world, together with recurrent cases of H5N1 influenza arising primarily from direct contact with poultry, have highlighted the urgent need for prepared-ness and coordinated global strategies to effectively combat a potential influenza pandemic. The purpose of the present study was to evaluate the Canadian pandemic influenza preparedness plan. A mathematical model of the transmission dynamics of influenza was used to keep track of the population according to risk of infection (low or high) and infection status (susceptible, exposed or infectious). The model was parametrized using available Canadian demographic data. The model was then used to evaluate the key components outlined in the Canadian plan. The results indicated that the number of cases, mortalities and hospitalizations estimated in the Canadian plan may have been underestimated; the use of antivirals, administered therapeutically, prophylactically or both, is the most effective single intervention followed by the use of a vaccine and basic public health measures; and the combined use of pharmaceutical interventions (antivirals and vaccine) can dramatically minimize the burden of the pending influenza pandemic in Canada. Based on increasing concerns of Oseltamivir resistance (wide-scale implementation), coupled with the expected unavailability of a suitable vaccine during the early stages of a pandemic, the present study evaluated the potential impact of non-pharmaceutical interventions (NPIs) which were not emphasized in the current Canadian plan. To this end, the findings suggest that the use of NPIs can drastically reduce the burden of a pandemic in Canada. A deterministic model was designed and used to assess Canada's pandemic preparedness plan. The study showed that the estimates of pandemic influenza burden given in the Canada pandemic preparedness plan may be an underestimate, and that Canada

  20. Animal Health and Welfare Planning in Organic Dairy Cattle Farms

    DEFF Research Database (Denmark)

    Vaarst, Mette; Winckler, Christoph; Roderick, Stephen

    2011-01-01

    Continuous development is needed within the farm to reach the goal of good animal health and welfare in organic livestock farming. The very different conditions between countries call for models that are relevant for different farming types and can be integrated into local practice and be relevant...... for each type of farming context. This article reviews frameworks, principles and practices for animal health and welfare planning which are relevant for organic livestock farming. This review is based on preliminary analyses carried out within a European project (acronym ANIPLAN) with participants from...... as well as animal health and welfare professionals (veterinarians and advisors) is paramount. This paper provides an overview of some current animal health and welfare planning initiatives and explains the principles of animal health and welfare planning which are being implemented in ANIPLAN partner...

  1. How institutional forces, ideas and actors shaped population health planning in Australian regional primary health care organisations.

    Science.gov (United States)

    Javanparast, Sara; Freeman, Toby; Baum, Fran; Labonté, Ronald; Ziersch, Anna; Mackean, Tamara; Reed, Richard; Sanders, David

    2018-03-20

    Worldwide, there are competing norms driving health system changes and reorganisation. One such norm is that of health systems' responsibilities for population health as distinct from a focus on clinical services. In this paper we report on a case study of population health planning in Australian primary health care (PHC) organisations (Medicare Locals, 2011-2015). Drawing on institutional theory, we describe how institutional forces, ideas and actors shaped such planning. We reviewed the planning documents of the 61 Medicare Locals and rated population health activities in each Medicare Local. We also conducted an online survey and 50 interviews with Medicare Local senior staff, and an interview and focus group with Federal Department of Health staff. Despite policy emphasis on population health, Medicare Locals reported higher levels of effort and capacity in providing clinical services. Health promotion and social determinants of health activities were undertaken on an ad hoc basis. Regulatory conditions imposed by the federal government including funding priorities and time schedules, were the predominant forces constraining population health planning. In some Medicare Locals, this was in conflict with the normative values and what Medicare Locals felt ought to be done. The alignment between the governmental and the cultural-cognitive forces of a narrow biomedical approach privileged clinical practice and ascribed less legitimacy to action on social determinants of health. Our study also shed light on the range of PHC actors and how their agency influenced Medicare Locals' performance in population health. The presence of senior staff or community boards with a strong commitment to population health were important in directing action towards population health and equity. There are numerous institutional, normative and cultural factors influencing population health planning. The experience of Australian Medicare Locals highlights the difficulties of planning in

  2. Development and Validity Testing of the Worksite Health Index: An Assessment Tool to Help and Improve Korean Employees' Health-Related Outcome.

    Science.gov (United States)

    Yun, Young Ho; Sim, Jin Ah; Lim, Ye Jin; Lim, Cheol Il; Kang, Sung-Choon; Kang, Joon-Ho; Park, Jun Dong; Noh, Dong Young

    2016-06-01

    The objective of this study was to develop the Worksite Health Index (WHI) and validate its psychometric properties. The development of the WHI questionnaire included item generation, item construction, and field testing. To assess the instrument's reliability and validity, we recruited 30 different Korean worksites. We developed the WHI questionnaire of 136 items categorized into five domains, namely Governance and Infrastructure, Need Assessment and Planning, Health Prevention and Promotion Program, Occupational Safety, and Monitoring and Feedback. All WHI domains demonstrated a high reliability with good internal consistency. The total WHI scores differentiated worksite groups effectively according to firm size. Each domain was associated significantly with employees' health status, absence, and financial outcome. The WHI can assess comprehensive worksite health programs. This tool is publicly available for addressing the growing need for worksite health programs.

  3. Subjective risk assessment for planning conservation projects

    International Nuclear Information System (INIS)

    Game, Edward T; Fitzsimons, James A; Lipsett-Moore, Geoff; McDonald-Madden, Eve

    2013-01-01

    Conservation projects occur under many types of uncertainty. Where this uncertainty can affect achievement of a project’s objectives, there is risk. Understanding risks to project success should influence a range of strategic and tactical decisions in conservation, and yet, formal risk assessment rarely features in the guidance or practice of conservation planning. We describe how subjective risk analysis tools can be framed to facilitate the rapid identification and assessment of risks to conservation projects, and how this information should influence conservation planning. Our approach is illustrated with an assessment of risks to conservation success as part of a conservation plan for the work of The Nature Conservancy in northern Australia. Risks can be both internal and external to a project, and occur across environmental, social, economic and political systems. Based on the relative importance of a risk and the level of certainty in its assessment we propose a series of appropriate, project level responses including research, monitoring, and active amelioration. Explicit identification, prioritization, and where possible, management of risks are important elements of using conservation resources in an informed and accountable manner. (letter)

  4. Results from a national survey on chronic care management by health plans.

    Science.gov (United States)

    Mattke, Soeren; Higgins, Aparna; Brook, Robert

    2015-05-01

    The growing burden of chronic disease necessitates innovative approaches to help patients and to ensure the sustainability of our healthcare system. Health plans have introduced chronic care management models, but systematic data on the type and prevalence of different approaches are lacking. Our goal was to conduct a systematic examination of chronic care management programs offered by health plans in the commercial market (ie, in products sold to employers and individuals. We undertook a national survey of a representative sample of health plans (70 plans, 36% response rate) and 6 case studies on health plans' programs to improve chronic care in the commercial market. The data underwent descriptive and bivariate analyses. All plans, regardless of size, location, and ownership, offer chronic care management programs, which identify eligible members from claims data and match them to interventions based on overall risk and specific care gaps. Plans then report information on care gaps to providers and offer self-management support to their members. While internal evaluations suggest that the interventions improve care and reduce cost, plans report difficulties in engaging members and providers. To overcome those obstacles, plans are integrating their programs into provider work flow, collaborating with providers on care redesign and leveraging patient support technologies. Our study shows that chronic care management programs have become a standard component of the overall approach used by health plans to manage the health of their members.

  5. Community health assessment tool: a patterns approach to data collection and diagnosis.

    Science.gov (United States)

    Kriegler, N F; Harton, M K

    1992-01-01

    Creation of an assessment tool to apply Gordon's functional patterns to the community as a client was a rewarding and stimulating project. Through use of the CHAT, students developed an appreciation of the complexity and inter-relationship of numerous aspects of the community. They completed the nursing process by developing appropriate nursing diagnoses, and planning, implementing, and evaluating a health promotion project. As the students continue to use this tool in the health promotion course, the diagnoses which they generate are being collected. From this accumulated input the plan is to compile a list of common diagnoses which are appropriate to use when the community is the client.

  6. Curricula for Health Planning, Policy, and Marketing: Conference Papers 1981-82.

    Science.gov (United States)

    Bergwall, David F., Ed.

    Papers from a 1981 conference on curriculum for health planning, policy, and marketing and from a 1982 conference on curriculum for strategic planning are presented. Responses to the papers and summaries of the proceedings are also presented. Titles and authors are as follows: "A Curriculum in Community Health Planning: An Approach for Today…

  7. Planning for exercises of the Federal Radiological Monitoring and Assessment Plan

    International Nuclear Information System (INIS)

    Adler, M.V.

    1985-11-01

    This report is to be used in planning radiological emergency exercises to test the Federal Radiological Monitoring and Assessment Plan (FRMAP). Although developed for this specific purpose, the document also contains material that may be useful for planning other types of exercises. This report describes the types of exercises that might be used, the steps in planning and conducting the exercises, and the special considerations required for exercises to test the FRMAP. FRMAP exercises typically involve several federal and state agencies. General and specific objectives that could guide these exercises, as well as the possible activities of all the participants - players, controllers, and evaluators - are discussed. The resources that each participating federal agency might provide during an exercise are listed

  8. Is it time to abandon care planning in mental health services? A qualitative study exploring the views of professionals, service users and carers.

    Science.gov (United States)

    Brooks, Helen L; Lovell, Karina; Bee, Penny; Sanders, Caroline; Rogers, Anne

    2018-06-01

    It has been established that mental health-care planning does not adequately respond to the needs of those accessing services. Understanding the reasons for this and identifying whose needs care plans serve requires an exploration of the perspectives of service users, carers and professionals within the wider organizational context. To explore the current operationalization of care planning and perceptions of its function within mental health services from the perspectives of multiple stakeholders. Participants included 21 mental health professionals, 29 service users and 4 carers from seven Mental Health Trusts in England. All participants had experience of care planning processes within secondary mental health-care services. Fifty-four semi-structured interviews were conducted with participants and analysed utilizing a qualitative framework approach. Care plans and care planning were characterized by a failure to meet the complexity of mental health needs, and care planning processes were seen to prioritize organizational agendas and risk prevention which distanced care planning from the everyday lives of service users. Care planning is recognized, embedded and well established in the practices of mental health professionals and service users. However, it is considered too superficial and mainly irrelevant to users for managing mental health in their everyday lives. Those responsible for the planning and delivery of mental health services should consider ways to increase the relevance of care planning to the everyday lives of service users including separating risk from holistic needs assessment, using support aids and utilizing a peer workforce in this regard. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

  9. Assessing the knowledge, attitude and practice of family planning among women living in the Mbouda health district, Cameroon.

    Science.gov (United States)

    Nansseu, Jobert Richie N; Nchinda, Emmanuel Choffor; Katte, Jean-Claude; Nchagnouot, Fatima M; Nguetsa, Guylaine D

    2015-10-09

    Promotion of family planning has been shown to reduce poverty, hunger, maternal and infant mortality, and contribute to women's empowerment. But many resource-limited countries still have very low rates of contraceptive use. The present study aimed to assess the knowledge, attitude and practice of family planning among women living in a resource-poor rural setting. We conducted a cross-sectional study in January 2010 in the Mbouda Health District, Cameroon. After a multistage random selection, 120 households were selected. Participants were women aged at least 15 years old, sexually active, and who volunteered to participate in the study. Data were collected during an anonymous interview using a structured pre-tested questionnaire. A total of 101 women were enrolled, their ages ranging from 18-58 years with a mean of 31.7 ± 8.8 years. Ninety-six percent of these women had already heard about family planning. Almost all respondents (98 %) were aware of at least one contraceptive method, the most cited being the male condom (96 %), the safe period (86.1 %), injectables (76.2 %) and oral pills (75.2 %), Sixty-six women (65.3 %) were currently practicing at least one contraceptive method, and the three prevailing methods used were: the safe period (50 %), the male condom (34.8 %), and injectables (12.1 %). The main reasons precluding women from practicing contraception were lack of knowledge (31.4 %), uselessness (31.4 %) and unbearable side effects (8.6 %). Fourteen of these women (42.4 %) expressed the willingness to start practicing contraception if they received more information about the subject. Decision on the number of children to have was made by both the man and the woman in 59.5 % of cases. The practice of contraception had been decided by the couple in 39.6 % of cases, and 9.4 % of men were not aware that their wives were currently practicing contraception. Although the level of awareness about family planning and contraceptive methods is quite

  10. A tool for enhancing strategic health planning: a modeled use of the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Sinclair, Lisa Bundara; Fox, Michael H; Betts, Donald R

    2013-01-01

    This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan. Published 2012. This article is a US Government work and is in the public domain in the USA.

  11. Strategic planning for public health practice using macroenvironmental analysis.

    Science.gov (United States)

    Ginter, P M; Duncan, W J; Capper, S A

    1991-01-01

    Macroenvironmental analysis is the initial stage in comprehensive strategic planning. The authors examine the benefits of this type of analysis when applied to public health organizations and present a series of questions that should be answered prior to committing resources to scanning, monitoring, forecasting, and assessing components of the macroenvironment. Using illustrations from the public and private sectors, each question is examined with reference to specific challenges facing public health. Benefits are derived both from the process and the outcome of macroenvironmental analysis. Not only are data acquired that assist public health professionals to make decisions, but the analytical process required assures a better understanding of potential external threats and opportunities as well as an organization's strengths and weaknesses. Although differences exist among private and public as well as profit and not-for-profit organizations, macroenvironmental analysis is seen as more essential to the public and not-for-profit sectors than the private and profit sectors. This conclusion results from the extreme dependency of those areas on external environmental forces that cannot be significantly influenced or controlled by public health decision makers. PMID:1902305

  12. Lessons learned in planning ALARA/health physics support for major nuclear power plant outages

    International Nuclear Information System (INIS)

    Gilman, T.R.; Lesinski, M.L.

    1987-01-01

    Although as low as reasonably achievable (ALARA)/health physics is viewed as necessary support for nuclear power plant outage work, it can be the last area to which attention is given in preparing for a large-scope outage. Inadequate lead times cause last-minute preparations resulting in delays in planned work. The Dresden Unit 3 Recirculation Piping Replacement Project is examined from a planning viewpoint. The attention that was given the various areas of a comprehensive ALARA/health physics program is examined, and approximate recommended lead times are discussed. The discussion will follow a chronological path from project inception to the beginning stages of outage work. Initially, the scope of work needs to be assessed by individuals familiar with similar projects of equivalent magnitude. Those individuals need to be health physics professionals who understand the particular utility and/or the site's way of doing business. They should also possess a good understanding of preferred industry practices

  13. Assessment of the Health Impacts of Climate Change in Kiribati

    Science.gov (United States)

    McIver, Lachlan; Woodward, Alistair; Davies, Seren; Tibwe, Tebikau; Iddings, Steven

    2014-01-01

    Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. PMID:24830452

  14. Hawaii State Plan for Occupational Safety and Health. Final rule.

    Science.gov (United States)

    2012-09-21

    This document announces the Occupational Safety and Health Administration's (OSHA) decision to modify the Hawaii State Plan's ``final approval'' determination under Section 18(e) of the Occupational Safety and Health Act (the Act) and to transition to ``initial approval'' status. OSHA is reinstating concurrent federal enforcement authority over occupational safety and health issues in the private sector, which have been solely covered by the Hawaii State Plan since 1984.

  15. USGCRP's Sustained Assessment Process: Progress to date and future plans

    Science.gov (United States)

    DeAngelo, B. J.; Reidmiller, D.; Lipschultz, F.; Cloyd, E. T.

    2016-12-01

    One of the four main objectives of the U.S. Global Change Research Program's (USGCRP's) Strategic Plan is to "Conduct Sustained Assessments", which seeks to build a process that synthesizes and advances the state of scientific knowledge on global change, develops future scenarios and potential impacts, and evaluates how effectively science is being and can be used to inform and support the Nation's response to climate change. To do so, USGCRP strives to establish a standing capacity to conduct national climate assessments with sectoral and regional information to evaluate climate risks and opportunities, and to inform decision-making, especially with regard to resiliency planning and adaptation measures. Building on the success of the 3rd National Climate Assessment (NCA) (2014), we discuss the range of USGCRP activities that embody the sustained assessment concept. Special reports, such as the recent Climate and Human Health Assessment and upcoming Climate Science Special Report, fill gaps in our understanding and provide crucial building blocks for next NCA report (NCA4). To facilitate the use of consistent assumptions across NCA4, new scenario products for climate, population, and land use will be made available through initiatives such as NOAA's Climate Resilience Toolkit. NCA4 will be informed by user engagement to advance the customization of knowledge. The report will strive to advance our ability to quantify various risks, monetize certain impacts, and communicate the benefits (i.e., avoided impacts) of various mitigation pathways. NCAnet (a national network of climate-interested stakeholders) continues to grow and foster collaborations across levels of governance and within civil society. Finally, USGCRP continues to actively engage with other assessment processes, at international, state, city, and tribal levels, to exchange ideas and to facilitate the potential for "linked" assessments across spatial scales.

  16. Planning for land use and conservation: Assessing GIS-based conservation software for land use planning

    Science.gov (United States)

    Rob Baldwin; Ryan Scherzinger; Don Lipscomb; Miranda Mockrin; Susan Stein

    2014-01-01

    Recent advances in planning and ecological software make it possible to conduct highly technical analyses to prioritize conservation investments and inform local land use planning. We review these tools, termed conservation planning tools, and assess the knowledge of a key set of potential users: the land use planning community. We grouped several conservation software...

  17. The North Carolina State Health Plan for Teachers and State Employees: Strategies in Creating Financial Stability While Improving Member Health.

    Science.gov (United States)

    Jones, Dee; Horner, Beth

    2018-01-01

    The North Carolina State Health Plan provides health care coverage to more than 700,000 members, including teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents. The State Health Plan is a division of the North Carolina Department of State Treasurer, self-insured, and exempt from the Employee Retirement Income Security Act as a government-sponsored plan. With health care costs rising at rates greater than funding, the Plan must take measures to stem cost growth while ensuring access to quality health care. The Plan anticipates focusing on strategic initiatives that drive results and cost savings while improving member health to protect the Plan's financial future. ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  18. [Planning a Health Residence for Prison Security Measures, Tuscany (Italy)].

    Science.gov (United States)

    Porfido, Eugenio; Colombai, Renato; Scarpa, Franco; Totaro, Michele; Tani, Luca; Baldini, Claudio; Baggiani, Angelo

    2016-01-01

    Health Residences for Prison Security Measures are facilities hosting psychotic persons who have committed crimes and providing them with personalized rehabilitation and treatment plans to promote their reinstatement in society. The aim of this study was to describe the criteria for planning and designing a prison health residence in the Tuscany region (Italy), to be managed by the regional healthcare service, in line with current regulations, with dedicated staff for providing specific treatment plans and programmes.

  19. Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption.

    Science.gov (United States)

    van Osch, Liesbeth; Beenackers, Mariëlle; Reubsaet, Astrid; Lechner, Lilian; Candel, Math; de Vries, Hein

    2009-10-13

    Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572) and one on high-caloric snack consumption (N = 585) in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health risk behaviors. Future interventions in dietary modification may

  20. Framing health for land-use planning legislation: A qualitative descriptive content analysis.

    Science.gov (United States)

    Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Thow, Anne Marie

    2016-01-01

    Framing health as a relevant policy issue for other sectors is not well understood. A recent review of the New South Wales (Australia) land-use planning system resulted in the drafting of legislation with an internationally unprecedented focus on human health. We apply a political science approach to investigate the question 'how and to what extent were health and wider issues framed in submissions to the review?' We investigated a range of stakeholder submissions including health focussed agencies (n = 31), purposively identified key stakeholders with influence on the review (n = 24), and a random sample of other agencies and individuals (n = 47). Using qualitative descriptive analysis we inductively coded for the term 'health' and sub-categories. We deductively coded for 'wider concerns' using a locally endorsed 'Healthy Urban Development Checklist'. Additional inductive analysis uncovered further 'wider concerns'. Health was explicitly identified as a relevant issue for planning policy only in submissions by health-focussed agencies. This framing concerned the new planning system promoting and protecting health as well as connecting health to wider planning concerns including economic issues, transport, public open space and, to a slightly lesser extent, environmental sustainability. Key stakeholder and other agency submissions focussed on these and other wider planning concerns but did not mention health in detail. Health agency submissions did not emphasise infrastructure, density or housing as explicitly as others. Framing health as a relevant policy issue has the potential to influence legislative change governing the business of other sectors. Without submissions from health agencies arguing the importance of having health as an objective in the proposed legislation it is unlikely health considerations would have gained prominence in the draft bill. The findings have implications for health agency engagement with legislative change processes and beyond in

  1. Legislations and policies to expand mental health and substance abuse benefits in health insurance plans: a community guide systematic economic review.

    Science.gov (United States)

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A; Goetzel, Ron Z; Finnie, Ramona; Thota, Anilkrishna B

    2015-03-01

    Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. This review is unable to determine the overall economic value of policies that expanded MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when long-term MH/SA patient-level data becomes available to researchers. A

  2. Improving the physical health of people with severe mental illness in a low secure forensic unit: An uncontrolled evaluation study of staff training and physical health care plans.

    Science.gov (United States)

    Haddad, Mark; Llewellyn-Jones, Sian; Yarnold, Steve; Simpson, Alan

    2016-12-01

    The life expectancy of people with severe mental illnesses is substantially reduced, and monitoring and screening for physical health problems is a key part of addressing this health inequality. Inpatient admission presents a window of opportunity for this health-care activity. The present study was conducted in a forensic mental health unit in England. A personal physical health plan incorporating clearly-presented and easily-understood values and targets for health status in different domains was developed. Alongside this, a brief physical education session was delivered to health-care staff (n = 63). Printed learning materials and pedometers and paper tape measures were also provided. The impact was evaluated by a single-group pretest post-test design; follow-up measures were 4 months' post-intervention. The feasibility and acceptability of personal health plans and associated resources were examined by free-text questionnaire responses. Fifty-seven staff provided measures of attitudes and knowledge before training and implementation of the physical health plans. Matched-pairs analysis indicated a modest but statistically-significant improvement in staff knowledge scores and attitudes to involvement in physical health care. Qualitative feedback indicated limited uptake of the care plans and perceived need for additional support for better adoption of this initiative. Inpatient admission is a key setting for assessing physical health and promoting improved management of health problems. Staff training and purpose-designed personalized care plans hold potential to improve practice and outcomes in this area, but further support for such innovations appears necessary for their uptake in inpatient mental health settings. © 2016 Australian College of Mental Health Nurses Inc.

  3. The impact of the survivorship care plan on health care use

    DEFF Research Database (Denmark)

    Jeppesen, Mette Moustgaard; Ezendam, Nicole P M; Pijnenborg, Johanna M A

    2018-01-01

    PURPOSE: The purpose of this paper was to assess the impact of survivorship care plan (SCP) provision and moderating factors on health care use following endometrial cancer treatment. METHODS: Women newly diagnosed with endometrial cancer were included in a pragmatic cluster randomized trial at 12...... of general practitioner, specialist, and additional health care was collected through questionnaires after diagnosis and at 6-, 12-, and 24-month follow-up and compared using linear multilevel regression analyses. RESULTS: Women who received an SCP had more cancer-related primary care visits compared...... to the usual care arm during the first year after diagnosis (β = 0.7, p women in the SCP group used more additional health care compared to women receiving usual care (24 vs. 11%, p = 0.04). Women with anxious symptoms (p = 0.03) and women who received radiotherapy (p = 0.01) had...

  4. R7 VU Born-Assessed Demo Plan

    Energy Technology Data Exchange (ETDEWEB)

    Robert Nourgaliev

    2010-02-01

    This is an initial draft of a born-assessed VU plan for the RELAP7 (R7) code development effort. The plan will continue to evolve based on the growth of code capability. This growth will be reflected as additional testing is identified and done. Later versions of this document will reflect that growth.

  5. Health Plans Can't Ignore The Customer Experience Any Longer.

    Science.gov (United States)

    Swanson, Erik

    2017-10-01

    With regulations limiting differentiation between products, health plans must rethink consumer experience to meet expectations of today's consumers, who seek convenience, quality, and speed from their health care organizations. Many plans understand they need to connect more effectively with their end customers, but technological, cultural, and other obstacles are in the way.

  6. Core competency model for the family planning public health nurse.

    Science.gov (United States)

    Hewitt, Caroline M; Roye, Carol; Gebbie, Kristine M

    2014-01-01

    A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance. © 2014 Wiley Periodicals, Inc.

  7. Environmental development plan: magnetic fusion

    International Nuclear Information System (INIS)

    1979-09-01

    This Environmental Development Plan (EDP) identifies the planning and management requirements and schedules needed to evaluate and assess the environmental, health and safety (EH and S) aspects of the Magnetic Fusion Energy Program (MFE). Environment is defined to include the environmental, health (occupational and public), and safety aspects

  8. Cumulative effects in strategic environmental assessment: The influence of plan boundaries

    Energy Technology Data Exchange (ETDEWEB)

    Bidstrup, Morten, E-mail: bidstrup@plan.aau.dk [Aalborg University (Denmark); Kørnøv, Lone, E-mail: lonek@plan.aau.dk [Aalborg University (Denmark); Partidário, Maria Rosário, E-mail: mariapartidario@tecnico.ulisboa.pt [CEG-IST, Instituto Superior Técnico, Universidade de Lisboa (Portugal)

    2016-02-15

    Cumulative effects (CE) assessment is lacking quality in impact assessment (IA) worldwide. It has been argued that the strategic environmental assessment (SEA) provides a suitable IA framework for addressing CE because it is applied to developments with broad boundaries, but few have tested this claim. Through a case study on the Danish mining sector, this article explores how plan boundaries influence the analytical boundaries applied for assessing CE in SEA. The case was studied through document analysis in combination with semi-structured group interviews of the responsible planners, who also serve as SEA practitioners. It was found that CE are to some extent assessed and managed implicitly throughout the planning process. However, this is through a focus on lowering the cumulative stress of mining rather than the cumulative stress on and capacity of the receiving environment. Plan boundaries do influence CE assessment, though all boundaries are not equally influential. The geographical and time boundaries of the Danish mining plans are broad or flexible enough to accommodate a meaningful assessment of CE, but the topical boundary is restrictive. The study indicates that collaboration among planning authorities and legally appointed CE leadership may facilitate better practice on CE assessment in sector-specific SEA contexts. However, most pressing is the need for relating assessment to the receiving environment as opposed to solely the stress of a proposed plan.

  9. Cumulative effects in strategic environmental assessment: The influence of plan boundaries

    International Nuclear Information System (INIS)

    Bidstrup, Morten; Kørnøv, Lone; Partidário, Maria Rosário

    2016-01-01

    Cumulative effects (CE) assessment is lacking quality in impact assessment (IA) worldwide. It has been argued that the strategic environmental assessment (SEA) provides a suitable IA framework for addressing CE because it is applied to developments with broad boundaries, but few have tested this claim. Through a case study on the Danish mining sector, this article explores how plan boundaries influence the analytical boundaries applied for assessing CE in SEA. The case was studied through document analysis in combination with semi-structured group interviews of the responsible planners, who also serve as SEA practitioners. It was found that CE are to some extent assessed and managed implicitly throughout the planning process. However, this is through a focus on lowering the cumulative stress of mining rather than the cumulative stress on and capacity of the receiving environment. Plan boundaries do influence CE assessment, though all boundaries are not equally influential. The geographical and time boundaries of the Danish mining plans are broad or flexible enough to accommodate a meaningful assessment of CE, but the topical boundary is restrictive. The study indicates that collaboration among planning authorities and legally appointed CE leadership may facilitate better practice on CE assessment in sector-specific SEA contexts. However, most pressing is the need for relating assessment to the receiving environment as opposed to solely the stress of a proposed plan.

  10. School-Sponsored Health Insurance: Planning for a New Reality

    Science.gov (United States)

    Liang, Bryan A.

    2010-01-01

    Health care reform efforts in both the Clinton and Obama administrations have attempted to address college and university health. Yet, although the world of health care delivery has almost universally evolved to managed care, school health programs have not. In general, school-sponsored health plans do little to improve access and have adopted…

  11. The need to include Health Impact Assessment at the International Monetary Fund.

    Science.gov (United States)

    Cave, Ben; Birley, Martin

    2010-01-01

    The lending and technical support provided by the International Monetary Fund affect the determinants of health and healthy equity. Most health determinants lie outside the control of the health sector, and thus non-health-sector policies have profound positive and negative effects on population health. Health Impact Assessment (HIA) is an instrument for identifying the effect of policies, plans, programs, and projects on population health and health equity. It is a feasible, cost-effective, and transparent process that has been adopted by several financial institutions, including members of the World Bank Group. Adopting HIA would assist the IMF in ensuring that the potential health consequences of its policies are identified and addressed.

  12. Assessing the congruence of transition preparedness as reported by parents and their adolescents with special health care needs.

    Science.gov (United States)

    Knapp, Caprice; Huang, I-Chan; Hinojosa, Melanie; Baker, Kimberly; Sloyer, Phyllis

    2013-02-01

    Several studies have investigated how prepared adolescents are to transition to adult health care and barriers to transition for adolescents with special health care needs. The majority of these studies, however, have only assessed these experiences from the parents' point of view. Our study aims to assess the congruence of adolescents and parents reported transition planning and the factors associated with planning. A secondary data analysis was conducted using telephone survey data. Data were collected from parents and adolescents with special health care needs who received health care through Florida's Title V public insurance program. The final sample included 376 matched pairs of adolescent-parent surveys. To assess health care transition planning, respondents were asked if discussions had occurred with the adolescents' doctor, nurse, or with each other. Parents reported higher levels of planning than adolescents. Results show the lowest level of agreement between the parent and adolescent reports (κ < 0.2) and the highest level of agreement when parents and adolescents were asked if they discussed transition with each other (κ = 0.19). Regression results suggest that older adolescents are more prepared (vs. younger) and that adolescents whose parents have lower educational attainment are less prepared for transition. Results from this study suggest that there may be miscommunication around discussions related to transition, although further research is warranted. It is important to ensure that adolescents, not just parents, have a thorough understanding of transition since they will ultimately be responsible for their own health care once they reach adulthood.

  13. A practical scale for Multi-Faceted Organizational Health Climate Assessment.

    Science.gov (United States)

    Zweber, Zandra M; Henning, Robert A; Magley, Vicki J

    2016-04-01

    The current study sought to develop a practical scale to measure 3 facets of workplace health climate from the employee perspective as an important component of a healthy organization. The goal was to create a short, usable yet comprehensive scale that organizations and occupational health professionals could use to determine if workplace health interventions were needed. The proposed Multi-faceted Organizational Health Climate Assessment (MOHCA) scale assesses facets that correspond to 3 organizational levels: (a) workgroup, (b) supervisor, and (c) organization. Ten items were developed and tested on 2 distinct samples, 1 cross-organization and 1 within-organization. Exploratory and confirmatory factor analyses yielded a 9-item, hierarchical 3-factor structure. Tests confirmed MOHCA has convergent validity with related constructs, such as perceived organizational support and supervisor support, as well as discriminant validity with safety climate. Lastly, criterion-related validity was found between MOHCA and health-related outcomes. The multi-faceted nature of MOHCA provides a scale that has face validity and can be easily translated into practice, offering a means for diagnosing the shortcomings of an organization or workgroup's health climate to better plan health and well-being interventions. (c) 2016 APA, all rights reserved).

  14. Robustness in practice--the regional planning of health services.

    Science.gov (United States)

    Best, G; Parston, G; Rosenhead, J

    1986-05-01

    Earlier work has criticized the dominant tendencies in operational research contributions to health services planning as characterized by optimization, implausible demands for data, depoliticization, hierarchy and inflexibility. This paper describes an effort which avoids at least some of these pitfalls. The project was to construct a planning system for a regional health council in Ontario, Canada, which would take account of the possible alternative future states of the health-care system's environment and would aim to keep options for future development open. The planning system devised is described in the paper. It is based on robustness analysis, which evaluates alternative initial action sets in terms of the useful flexibility they preserve. Other features include the explicit incorporation of pressures for change generated outside the health-care system, and a satisficing approach to the identification of both initial action sets and alternative future configurations of the health-care system. It was found possible to borrow and radically 're-use' techniques or formulations from the mainstream of O.R. contributions. Thus the 'reference projection' method was used to identify inadequacies in performance which future health-care system configurations must repair. And Delphi analysis, normally a method for generating consensus, was used in conjunction with cluster analysis of responses to generate meaningfully different alternative futures.

  15. Prioritizing health: a systematic approach to scoping determinants in health impact assessment

    Directory of Open Access Journals (Sweden)

    Lindsay McCallum

    2016-08-01

    Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  16. Choosing a health plan: are Dutch consumers loyal to their health insurer?

    NARCIS (Netherlands)

    Hendriks, M.; Groenewegen, P.P.; Delnoij, D.M.J.

    2006-01-01

    In 2006, a number of far-reaching reforms have been implemented in the Dutch health insurance system. Giving Dutch consumers the freedom to change health plans every year increases consumer mobility. The idea is that especially consumers who are dissatisfied with their insurer will decide to switch

  17. Health Manpower Planning and Employment Policies for Turkey

    Directory of Open Access Journals (Sweden)

    Bulent Kilic

    2007-12-01

    Full Text Available Health manpower planning in health care should be done strategically while considering the following factors: health care needs and demands for community, health care organizations' objectives, goals and resources, goal of a high quality health workforce of sufficient size which has been appropriately distributed, their full employment realized within the appropriate time frame. A good health manpower planning consists of eight components: quantity (size, quality (skill, distribution, timing, employment, necessity, goals and resources. According to the calculations in this article, it must be 1515 people per general practitioner (GP and 1333 people per midwife. There must be 44.755 GP and 50.866 midwife for primary level in Turkey. However there are 51.530 GP and 41.513 midwife in Turkey in 2002. In this situation there is no more need for GP but there is a big need for 10.000 midwife as totally and actually 30.000 midwife for working at health centres for Turkey. As a result, this article discusses the shortcomings of Health Ministry's employment policies in Turkey. It is suggested that in the short run concepts such as physician unemployment, under-employment and flexible work hours will become frequently discussed in Turkey health care public discourse. [TAF Prev Med Bull 2007; 6(6.000: 501-514

  18. Health Manpower Planning and Employment Policies for Turkey

    Directory of Open Access Journals (Sweden)

    Bulent Kilic

    2007-12-01

    Full Text Available Health manpower planning in health care should be done strategically while considering the following factors: health care needs and demands for community, health care organizations' objectives, goals and resources, goal of a high quality health workforce of sufficient size which has been appropriately distributed, their full employment realized within the appropriate time frame. A good health manpower planning consists of eight components: quantity (size, quality (skill, distribution, timing, employment, necessity, goals and resources. According to the calculations in this article, it must be 1515 people per general practitioner (GP and 1333 people per midwife. There must be 44.755 GP and 50.866 midwife for primary level in Turkey. However there are 51.530 GP and 41.513 midwife in Turkey in 2002. In this situation there is no more need for GP but there is a big need for 10.000 midwife as totally and actually 30.000 midwife for working at health centres for Turkey. As a result, this article discusses the shortcomings of Health Ministry's employment policies in Turkey. It is suggested that in the short run concepts such as physician unemployment, under-employment and flexible work hours will become frequently discussed in Turkey health care public discourse. [TAF Prev Med Bull. 2007; 6(6: 501-514

  19. The World Health Organization-United Nations Population Fund Strategic Partnership Programme's implementation of family planning guidelines and tools in Asia-Pacific countries.

    Science.gov (United States)

    Mody, Sheila K; Ba-Thike, Katherine; Gaffield, Mary E

    2013-04-01

    The aim of this study was to assess the impact of the Strategic Partnership Programme, a collaboration between the World Health Organization and the United Nations Population Fund to improve evidence-based guidance for country programs through the introduction of selected practice guidelines to improve sexual and reproductive health. Information for this report is from questionnaires sent to Ministries of Health in 2004 (baseline assessment) and in 2007 (assessment of outcome), annual country reports and personal communication with focal points from Ministries of Health and World Health Organization regional and country offices. Following the Strategic Partnership Programme, family planning guidance was used extensively to: formulate and update reproductive health policy; update standards and guidelines; improve training curricula; conduct training activities; develop advocacy and communication materials; and promote change in service. The Strategic Partnership Programme was successful in promoting the introduction of evidence-based guidelines for reproductive health in several Asian countries. The countries that adapted the family planning guidance observed an increase in demand for contraceptives commodities. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  20. Value in Pediatric Orthopaedic Surgery Health Care: the Role of Time-driven Activity-based Cost Accounting (TDABC) and Standardized Clinical Assessment and Management Plans (SCAMPs).

    Science.gov (United States)

    Waters, Peter M

    2015-01-01

    The continuing increases in health care expenditures as well as the importance of providing safe, effective, timely, patient-centered care has brought government and commercial payer pressure on hospitals and providers to document the value of the care they deliver. This article introduces work at Boston Children's Hospital on time-driven activity-based accounting to determine cost of care delivery; combined with Systemic Clinical Assessment and Management Plans to reduce variation and improve outcomes. The focus so far has been on distal radius fracture care for children and adolescents.

  1. Trajectories of Depressive Symptoms Among Web-Based Health Risk Assessment Participants.

    Science.gov (United States)

    Bedrosian, Richard; Hawrilenko, Matt; Cole-Lewis, Heather

    2017-03-31

    Health risk assessments (HRAs), which often screen for depressive symptoms, are administered to millions of employees and health plan members each year. HRA data provide an opportunity to examine longitudinal trends in depressive symptomatology, as researchers have done previously with other populations. The primary research questions were: (1) Can we observe longitudinal trajectories in HRA populations like those observed in other study samples? (2) Do HRA variables, which primarily reflect modifiable health risks, help us to identify predictors associated with these trajectories? (3) Can we make meaningful recommendations for population health management, applicable to HRA participants, based on predictors we identify? This study used growth mixture modeling (GMM) to examine longitudinal trends in depressive symptomatology among 22,963 participants in a Web-based HRA used by US employers and health plans. The HRA assessed modifiable health risks and variables such as stress, sleep, and quality of life. Five classes were identified: A "minimal depression" class (63.91%, 14,676/22,963) whose scores were consistently low across time, a "low risk" class (19.89%, 4568/22,963) whose condition remained subthreshold, a "deteriorating" class (3.15%, 705/22,963) who began at subthreshold but approached severe depression by the end of the study, a "chronic" class (4.71%, 1081/22,963) who remained highly depressed over time, and a "remitting" class (8.42%, 1933/22,963) who had moderate depression to start, but crossed into minimal depression by the end. Among those with subthreshold symptoms, individuals who were male (PInternet Research (http://www.jmir.org), 31.03.2017.

  2. Health impact assessment of the Atlanta BeltLine.

    Science.gov (United States)

    Ross, Catherine L; Leone de Nie, Karen; Dannenberg, Andrew L; Beck, Laurie F; Marcus, Michelle J; Barringer, Jason

    2012-03-01

    Although a health impact assessment (HIA) is a tool that can provide decision makers with recommendations to promote positive health impacts and mitigate adverse health impacts of proposed projects and policies, it is not routinely conducted on most major projects or policies. To make health a decision criterion for the Atlanta BeltLine, a multibillion-dollar transit, trails, parks, and redevelopment project. An HIA was conducted in 2005-2007 to anticipate and influence the BeltLine's effect on health determinants. Changes in access and equity, environmental quality, safety, social capital, and physical activity were forecast, and steps to maximize health benefits and reduce negative effects were recommended. Key recommendations included giving priority to the construction of trails and greenspace rather than residential and retail construction, making health an explicit goal in project priority setting, adding a public health professional to decision-making boards, increasing the connectivity between the BeltLine and civic spaces, and ensuring that affordable housing is built. BeltLine project decision makers have incorporated most of the HIA recommendations into the planning process. The HIA was cited in the awarding of additional funds of $7,000,000 for brownfield clean-up and greenspace development. The project is expected to promote the health of local residents more than in the absence of the HIA. This report is one of the first HIAs to tie specific assessment findings to specific recommendations and to identifiable impacts from those recommendations. The lessons learned from this project may help others engaged in similar efforts. Copyright © 2012. Published by Elsevier Inc.

  3. Soil Health Assessment Approaches and the Cornell Framework

    Science.gov (United States)

    van Es, Harold

    2016-04-01

    Soil health constraints beyond nutrient limitations and excesses currently limit agroecosystem productivity and sustainability, resilience to drought and extreme rainfall, and progress in soil and water conservation. With mounting pressure to produce food, feed, fiber, and even fuel for an increasing population, the concept of soil health is gaining national and international attention. Multiple regional, national, and global efforts are now leveraging that work to reach new stakeholder audiences, so that soil health management is expanding into mainstream agriculture. Each grower is generally faced with a unique situation in the choice of management options to address soil health constraints and each system affords its own set of opportunities or limitations to soil management. A more comprehensive understanding of soil health status can better guide farmers' management decisions. Until recently, there has not been a formalized decision making process for implementing a soil health management system that alleviates field-specific constrains identified through standard measurements and then maintains improved soil health. This presentation will discuss current US-based efforts related to soil health assessment, including efforts to build national consensus on appropriate methods for simple (inexpensive) and comprehensive tests. This includes the Cornell Soil Health Management Planning and Implementation Framework. The most relevant components of the framework are 1) measurement of indicators that represent critical soil processes, 2) scoring of measured values that allows for interpretation, and 3) linkage of identified constraints with management practices. Land managers can monitor changes over time through further assessment, and adapt management practices to achieve chosen goals. We will discuss the full tests and approaches for simplification.

  4. Joint Venture Health Plans May Give ACOs a Run for Their Money.

    Science.gov (United States)

    Reinke, Thomas

    2016-12-01

    Joint venture plans are starting to demonstrate their ability to implement clinical management and financial management reforms. A JV health plan replaces the offloading of financial risk by health plans to ill-equipped providers with an executive-level cost management committee stated jointly by the hospital and payer.

  5. Tank farm health and safety plan. Revision 2

    International Nuclear Information System (INIS)

    Mickle, G.D.

    1995-01-01

    This Tank Farm Health and Safety Plan (HASP) for the conduct of all operations and work activities at the Hanford Site 200 Area Tank Farms is provided in order to minimize health and safety risks to workers and other onsite personnel. The HASP accomplishes this objective by establishing requirements, providing general guidelines, and conveying farm and facility-specific hazard communication information. The HASP, in conjunction with the job-specific information required by the HASP, is provided also as a reference for use during the planning of work activities at the tank farms. This HASP applies to Westinghouse Hanford Company (WHC), other prime contractors to the U.S. Department of Energy (DOE), and subcontractors to WHC who may be involved in tank farm work activities. This plan is intended to be both a requirements document and a useful reference to aid tank farm workers in understanding the safety and health issues that are encountered in routine and nonroutine work activities. The HASP defines the health and safety responsibilities of personnel working at the tank farms. It has been prepared in recognition of and is consistent with National Institute of Safety and Health (NIOSH), and Occupational Safety and Health Administration (OSHA)/Unlimited State Coast Guard (USCG)/U.S. Environmental Protection Agency (EPA), Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities (NIOSH 1985); WHC-CM-4-3, Industrial Safety Manual, Volume 4, open-quotes Health and Safety Programs for Hazardous Waste Operations;close quotes 29 CFR 1910.120, Hazardous Waste Operations and Emergency Response; WHC-CM-1-1, Management Policies; and WHC-CM-1-3, Management Requirements and Procedures. When differences in governing regulations or policies exist, the more stringent requirements shall apply until the discrepancy can be resolved

  6. Tank farm health and safety plan. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Mickle, G.D.

    1995-03-29

    This Tank Farm Health and Safety Plan (HASP) for the conduct of all operations and work activities at the Hanford Site 200 Area Tank Farms is provided in order to minimize health and safety risks to workers and other onsite personnel. The HASP accomplishes this objective by establishing requirements, providing general guidelines, and conveying farm and facility-specific hazard communication information. The HASP, in conjunction with the job-specific information required by the HASP, is provided also as a reference for use during the planning of work activities at the tank farms. This HASP applies to Westinghouse Hanford Company (WHC), other prime contractors to the U.S. Department of Energy (DOE), and subcontractors to WHC who may be involved in tank farm work activities. This plan is intended to be both a requirements document and a useful reference to aid tank farm workers in understanding the safety and health issues that are encountered in routine and nonroutine work activities. The HASP defines the health and safety responsibilities of personnel working at the tank farms. It has been prepared in recognition of and is consistent with National Institute of Safety and Health (NIOSH), and Occupational Safety and Health Administration (OSHA)/Unlimited State Coast Guard (USCG)/U.S. Environmental Protection Agency (EPA), Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities (NIOSH 1985); WHC-CM-4-3, Industrial Safety Manual, Volume 4, {open_quotes}Health and Safety Programs for Hazardous Waste Operations;{close_quotes} 29 CFR 1910.120, Hazardous Waste Operations and Emergency Response; WHC-CM-1-1, Management Policies; and WHC-CM-1-3, Management Requirements and Procedures. When differences in governing regulations or policies exist, the more stringent requirements shall apply until the discrepancy can be resolved.

  7. ASSESSMENT OF LOGISTICS MANAGEMENT IN GHANA HEALTH SERVICE

    Directory of Open Access Journals (Sweden)

    john frimpong manso

    2013-08-01

    Full Text Available Ghana Public Health Sector runs a three-tier system of managing health commodities. Suppliers, the Central Medical Store, The Regional Medical Store, Service Delivery Points and the transportation system form the supply chain.  Ghana Health Service logistics system is centralized and the health care delivery system is decentralized. Logistics management in the health system is crucial. This is because there are instances where medicines and health commodities are not available at the Central Medical Stores and the Regional Medical Stores. Consequently, there is no commodity security at the service delivery points. Upon this backdrop the study seeks to assess the logistics management system in order to bring efficiency in the system. The study adopts a multi-case study approach to assess the practices of logistics management, the causes of inadequacy of logistics and the strengths and weaknesses in Ghana Health Service logistics system.  Two categories of participants that is, the key players of health logistics management and end-users were involved in the study.  Four variables; finance for procurement of health commodities, evenly distribution of health commodities, effective supervision and constant monitoring and evaluation were found crucial in effective and efficient logistics management. Moreover, it was found that poor procurement planning and budgeting, lack of financial resources for procurement, poor quantification and forecasting, delay in procurement process and order processing, and delay in receiving insurance claims are some of the causes of inadequacy of logistics in the health systems. It is recommended that Ghana Health Service logistics or supply system must receive constant monitoring and evaluation. Further, Ghana Health Service must ensure that there is effective top-down supervision in the system to bring up efficiency. Again, Ghana Health Service and Ministry of Health must ensure enough funds are secured from the

  8. Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption

    Directory of Open Access Journals (Sweden)

    Candel Math

    2009-10-01

    Full Text Available Abstract Background Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Methods Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572 and one on high-caloric snack consumption (N = 585 in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Results Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. Conclusion The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health

  9. Health plans and selection: formal risk adjustment vs. market design and contracts.

    Science.gov (United States)

    Frank, R G; Rosenthal, M B

    2001-01-01

    In this paper, we explore the demand for risk adjustment by health plans that contract with private employers by considering the conditions under which plans might value risk adjustment. Three factors reduce the value of risk adjustment from the plans' point of view. First, only a relatively small segment of privately insured Americans face a choice of competing health plans. Second, health plans share much of their insurance risk with payers, providers, and reinsurers. Third, de facto experience rating that occurs during the premium negotiation process and management of coverage appear to substitute for risk adjustment. While the current environment has not generated much demand for risk adjustment, we reflect on its future potential.

  10. [Quality planning of Family Health Units using Quality Function Deployment (QFD)].

    Science.gov (United States)

    Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

    2010-08-01

    Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.

  11. Roundtable on health and climate change : Strategic plan on health and climate change : a framework for collaborative action, final report

    International Nuclear Information System (INIS)

    2001-03-01

    Climate change will have a significant impact on human health, arising from direct effects such as increased extreme weather events, and indirect effects resulting from changes in ecological systems on which humans depend. This paper is a compilation of discussions and input from the many stakeholders and representatives that contributed to the Roundtable on Health and Climate Change held in September 2000. The goal of the Roundtable was to raise the profile and inform policy makers of the health issues associated with climate change and to engage the health sector in the National Implementation Strategy on Climate Change. The strategic framework for collaborative action in addressing the health implications of climate change were presented. The strategic plan is based on the following key principles: (1) incorporating both mitigation and adaptation in all aspects of the plan, (2) maximizing co-benefits, associated with climate change and other key health priorities, (3) building on existing capacity within governments and non-governmental organizations, (4) forming multi-disciplinary alliances, (5) emphasizing collaboration and cooperation, and (6) recognizing the shared responsibility for action on climate change. The major recommendation from the Roundtable was to urge governments to place a high priority on the implementation of measures that will reduce greenhouse gas emissions in Canada, thereby improving health of Canadians. It was recommended that governments should insist that all analyses and modeling of climate change policy options include the assessment and consideration of health implications. 1 tab

  12. Jordan's 2002 to 2012 Fertility Stall and Parallel USAID Investments in Family Planning: Lessons From an Assessment to Guide Future Programming.

    Science.gov (United States)

    Spindler, Esther; Bitar, Nisreen; Solo, Julie; Menstell, Elizabeth; Shattuck, Dominick

    2017-12-28

    Health practitioners, researchers, and donors are stumped about Jordan's stalled fertility rate, which has stagnated between 3.7 and 3.5 children per woman from 2002 to 2012, above the national replacement level of 2.1. This stall paralleled United States Agency for International Development (USAID) funding investments in family planning in Jordan, triggering an assessment of USAID family planning programming in Jordan. This article describes the methods, results, and implications of the programmatic assessment. Methods included an extensive desk review of USAID programs in Jordan and 69 interviews with reproductive health stakeholders. We explored reasons for fertility stagnation in Jordan's total fertility rate (TFR) and assessed the effects of USAID programming on family planning outcomes over the same time period. The assessment results suggest that the increased use of less effective methods, in particular withdrawal and condoms, are contributing to Jordan's TFR stall. Jordan's limited method mix, combined with strong sociocultural determinants around reproduction and fertility desires, have contributed to low contraceptive effectiveness in Jordan. Over the same time period, USAID contributions toward increasing family planning access and use, largely focused on service delivery programs, were extensive. Examples of effective initiatives, among others, include task shifting of IUD insertion services to midwives due to a shortage of female physicians. However, key challenges to improved use of family planning services include limited government investments in family planning programs, influential service provider behaviors and biases that limit informed counseling and choice, pervasive strong social norms of family size and fertility, and limited availability of different contraceptive methods. In contexts where sociocultural norms and a limited method mix are the dominant barriers toward improved family planning use, increased national government investments

  13. Environmental impact assessment based on planning support system

    NARCIS (Netherlands)

    Carsjens, G.J.; Chen, W.

    2011-01-01

    How to assess environmental impact is one of the keys in land use planning. This article described in detail the concepts of activities, impact zones, functions, and sensitivities, as well as the development of STEPP (strategic tool for integrating environmental aspects in planning procedures) based

  14. [The family planning program in Rwanda: assessment of ten years (1981-1991) and prospects].

    Science.gov (United States)

    Munyakazi, A

    1990-12-01

    Rwanda's official family planning policy dates back to 1981 and creation of the National Office of Population (ONAPO). Among its other function, ONAPO monitors proper use of family planning methods and studies the integration of family planning services into public health. Pilot family planning programs began in the prefectures of Butare, Kigali, and Ruhengeri and were extended to the other 7 around 1985. The development of family planning services in Rwanda is based on their integration into existing services, especially those devoted to maternal-child health. In 1989, 277 of the 350 health centers of all kinds in Rwanda and 12 secondary posts offered family planning services. The rate of integration was 79.4%. 185 of the 277 health services with family planning services were in the public sector. As of December 1989, the rate of integration in different prefectures varied from a high of 95.5% in Kibungo to a low of 64.9% in Gisenyi. Integration is particularly weak in health facilities administered by the Catholic Church. The 2 strategies to confront this situation are continuing dialogue with Catholic Church officials and creation of secondary family planning posts to improve accessibility to family planning for populations served by Church health services. The number of new and continuing family planning users increased from 1178 and 1368 respectively in 1982 to 66,950 and 104,604 through September 1990. There is wide variation from 1 prefecture to another in recruitment of new acceptors and in the number of acceptors per health facility. Recruitment of new acceptors is greatest in Ruhengeri, followed by Kigali and Byumba. As of September 1990, 28,943 women used pills, 2037 used IUDs, 66,515 used injectables, 3051 used barrier methods, 2888 used auto-observation methods, 343 used implants, and 588 were sterilized. The overall rate of contraceptive prevalence increased from .9% in 1983 to 6.2% in 1989 and 10% in 1990. The strategy for promoting family planning

  15. Health workforce governance and integration: the fit between planning and system.

    NARCIS (Netherlands)

    Batenburg, R.

    2014-01-01

    Background: The EU Joint Action on Health Workforce Planning and Forecasting has taken up the challenge to let countries share and exchange practices in health workforce planning. It appears however, that not many countries actually apply (needs-based forecasting) models to support this. But does

  16. The impact of social franchising on the use of reproductive health and family planning services at public commune health stations in Vietnam.

    Science.gov (United States)

    Ngo, Anh D; Alden, Dana L; Pham, Van; Phan, Ha

    2010-02-28

    Service franchising is a business model that involves building a network of outlets (franchisees) that are locally owned, but act in coordinated manner with the guidance of a central headquarters (franchisor). The franchisor maintains quality standards, provides managerial training, conducts centralized purchasing and promotes a common brand. Research indicates that franchising private reproductive health and family planning (RHFP) services in developing countries improves quality and utilization. However, there is very little evidence that franchising improves RHFP services delivered through community-based public health clinics. This study evaluates behavioral outcomes associated with a new approach - the Government Social Franchise (GSF) model - developed to improve RHFP service quality and capacity in Vietnam's commune health stations (CHSs). The project involved networking and branding 36 commune health station (CHS) clinics in two central provinces of Da Nang and Khanh Hoa, Vietnam. A quasi-experimental design with 36 control CHSs assessed GSF model effects on client use as measured by: 1) clinic-reported client volume; 2) the proportion of self-reported RHFP service users at participating CHS clinics over the total sample of respondents; and 3) self-reported RHFP service use frequency. Monthly clinic records were analyzed. In addition, household surveys of 1,181 CHS users and potential users were conducted prior to launch and then 6 and 12 months after implementing the GSF network. Regression analyses controlled for baseline differences between intervention and control groups. CHS franchise membership was significantly associated with a 40% plus increase in clinic-reported client volumes for both reproductive and general health services. A 45% increase in clinic-reported family planning service clients related to GSF membership was marginally significant (p = 0.05). Self-reported frequency of RHFP service use increased by 20% from the baseline survey to the

  17. Consumer beliefs and health plan performance: it's not whether you are in an HMO but whether you think you are.

    Science.gov (United States)

    Reschovsky, James D; Hargraves, J Lee; Smith, Albert F

    2002-06-01

    Surveys that rate how persons enrolled in HMOs and other types of health coverage feel about their health care are used to bolster claims that HMOs provide inferior quality care, providing justification for patient protection legislation. This research illustrates that the conventional wisdom regarding inferior care in HMOs may color how people assess their health care in surveys, resulting in survey findings biased toward showing HMOs provide inferior care and reinforcing existing stereotypes. Using merged data from the Community Tracking Study Household and Insurance Followback surveys, we identify privately insured persons who correctly and incorrectly know what kind of health plan they are covered by. Nearly a quarter misidentified their type of health coverage. Differences between responses by HMO and non-HMO enrollees to questions covering satisfaction with health care and physician choice, the quality of the last physician's visit, and patient trust in their physician shrink or disappear when we control for beliefs about what type of plan they are covered by. Results suggest that researchers and policy makers should be cautious about using consumer surveys to assess the relative quality of care provided under different types of health insurance.

  18. Preliminary assessments the shortcut to remediation (category III-surplus facility assessments)

    International Nuclear Information System (INIS)

    Byars, L.L.

    1995-01-01

    This report presents the details of the preliminary assessments for the shortcut of decontamination of surplus nuclear facilities. Topics discussed include: environment, health and safety concerns; economic considerations; reduction of transition time; preliminary characterization reports; preliminary project plan; health and safety plan; quality assurance plan; surveillance and maintenance plan; and waste management plan

  19. Hospital and Health Plan Partnerships: The Affordable Care Act's Impact on Promoting Health and Wellness

    Science.gov (United States)

    Vu, Michelle; White, Annesha; Kelley, Virginia P.; Hopper, Jennifer Kuca; Liu, Cathy

    2016-01-01

    Background The Affordable Care Act (ACA) healthcare reforms, centered on achieving the Centers for Medicare & Medicaid Services (CMS) Triple Aim goals of improving patient care quality and satisfaction, improving population health, and reducing costs, have led to increasing partnerships between hospitals and insurance companies and the implementation of employee wellness programs. Hospitals and insurance companies have opted to partner to distribute the risk and resources and increase coordination of care. Objective To examine the ACA's impact on the health and wellness programs that have resulted from the joint ventures of hospitals and health plans based on the published literature. Method We conducted a review of the literature to identify successful mergers and best practices of health and wellness programs. Articles published between January 2007 and January 2015 were compiled from various search engines, using the search terms “corporate,” “health and wellness program,” “health plan,” “insurance plan,” “hospital,” “joint venture,” and “vertical merger.” Publications that described consolidations or wellness programs not tied to health insurance plans were excluded. Noteworthy characteristics of these programs were summarized and tabulated. Results A total of 44 eligible articles were included in the analysis. The findings showed that despite rising healthcare costs, joint ventures prevent hospitals from trading-off quality and services for cost reductions. Administrators believed that partnering would allow the companies to meet ACA standards for improving clinical outcomes at reduced costs. Before the implementation of the ACA, some employers had wellness programs, but these were not standardized and did not need to produce measurable results. The ACA encouraged improvement of employee wellness programs by providing funding for expanded health services and by mandating quality care. Successful workplace health and wellness

  20. How to anticipate the assessment of the public health benefit of new medicines?

    Science.gov (United States)

    Massol, Jacques; Puech, Alain; Boissel, Jean-Pierre

    2007-01-01

    The Public Health Benefit (PHB) of new medicines is a recent and French-specific criterion (October 1999 decree) which is often only partially documented in the transparency files due to a lack of timely information. At the time of the first reimbursement application for a new medicine to the "Transparency Committee", the file is exclusively based on data from randomised clinical trials. These data are generated from a global clinical development plan which was designed a long time before the new medicine's submission for reimbursement. And this plan does not systematically provide the data needed to assess the PHB. Thus, one easily understands the difficulty to anticipate and document this recent French criterion. In France, the PHB is both one of the necessary criteria for the reimbursement submission and an indicator for the national health policy management. Its assessment also helps to identify the needs and objectives of the post-registration studies (nowadays in the scope of responsibilities of the "Drug Economics Committee"). The assessment of the PHB criterion is carried through after the marketing authorization process and is an addition to it. To understand how to anticipate the assessment of the new medicines' PHB, one needs to consider how it differs from the preliminary step of the marketing authorization process. Whereas the evaluation for marketing authorization seeks to determine if the new medicine could be useful in a specific indication, the PHB assessment aims at quantifying the therapeutic benefit in a population, taking into account the reference treatments in this population. A new medicine receives a marketing authorization based on the data of the registration file which provides information on the clinical benefit of the new medicine in the populations of the trials and in the context of the trials. On the other side, the PHB looks at the effects of the new medicine at the scale of the general population, in real practice. The PHB

  1. Water-sensitivity assessment of regional spatial plan based on the relation between watershed imperviousness and aquatic ecosystem health

    Science.gov (United States)

    Sutjiningsih, D.; Soeryantono, H.; Anggraheni, E.

    2018-04-01

    Upper Ciliwung watershed in the JABODETABEKPUNJUR area experiencing rapid population growth, which in turn promotes the pace of infrastructure development especially increasing impervious land cover. This will trigger various stressors to the abiotic and biotic elements in the aquatic ecosystem. This study aims to examine whether the relationship between imperviousness in the subwatersheds in Upper Ciliwung and abiotic/biotic elements of its aquatic ecosystems can be used to assess the degree of water-sensitivity of the related regional spatial plan. Two scenarios of impervious cover changes have been assessed, scenario 1 using constant growth of 7.56% per annum, while scenario 2 refers to regional spatial plan of Bogor Regency. Although there are inconsistencies in four (out of 13) subwatersheds, the tests proved that the procedure is succesful to be applied in Upper Ciliwung.

  2. Bechtel Hanford, Inc./ERC team health and safety plan Environmental Restoration Disposal Facility operations

    International Nuclear Information System (INIS)

    Turney, S.R.

    1996-02-01

    A comprehensive safety and health program is essential for reducing work-related injuries and illnesses while maintaining a safe and health work environment. This document establishes Bechtel Hanford, Inc. (BHI)/Environmental Restoration Contractor (ERC) team requirements, policies, and procedures and provides preliminary guidance to the Environmental Restoration Disposal Facility (ERDF) subcontractor for use in preparing essential safety and health documents. This health and safety plan (HASP) defines potential safety and health issues associated with operating and maintaining the ERDF. A site-specific HASP shall be developed by the ERDF subcontractor and shall be implemented before operations and maintenance work can proceed. An activity hazard analysis (AHA) shall also be developed to provide procedures to identify, assess, and control hazards or potential incidents associated with specific operations and maintenance activities

  3. Health and environmental effects of the national energy plan: a critical review of some selected issues

    International Nuclear Information System (INIS)

    Morris, S.C.; Fischer, H.; Calef, C.; Crowther, M.A.; Finch, S.J.; Hamilton, L.D.; Moskowitz, P.D.; Nagy, J.; Rowe, M.D.; Sevian, W.A.; Thode, H.C.

    1980-09-01

    This is the first Health and Environmental Effects Document (HEED) on the National Energy Plan (NEP). As such, it can provide: (a) an overview of the health and environmental effects that may be expected from current US energy planning; (b) quantitative approaches to the analysis of these impacts, in the form of dose-response functions and example applications in context; (c) a framework for individual technology-based HEEDs; and (d) a background against which emerging technologies may be measured. Thus, this first NEP-HEED deals in depth with general and continuing thrusts of the NEP process: increased use of coal, continued reliance on nuclear, and eventual increased application of renewable technologies. Special attention is directed to the public health aspects of air pollution from coal, including an overview of recent health studies on effects of particles, sulfur dioxide, hydrocarbons, and radionuclides. Environmental topics including acid rain, the carbon dioxide problem, crop damage, coal mining, and solid waste disposal are also discussed. Nuclear safety and mill tailings are analyzed. Finally, a general assessment of the health effects of renewable technologies is given

  4. Double-shell tank waste transfer facilities integrity assessment plan

    International Nuclear Information System (INIS)

    Hundal, T.S.

    1998-01-01

    This document presents the integrity assessment plan for the existing double-shell tank waste transfer facilities system in the 200 East and 200 West Areas of Hanford Site. This plan identifies and proposes the integrity assessment elements and techniques to be performed for each facility. The integrity assessments of existing tank systems that stores or treats dangerous waste is required to be performed to be in compliance with the Washington State Department of Ecology Dangerous Waste Regulations, Washington Administrative Code WAC-173-303-640 requirements

  5. The Search Conference as a Method in Planning Community Health Promotion Actions

    Science.gov (United States)

    Magnus, Eva; Knudtsen, Margunn Skjei; Wist, Guri; Weiss, Daniel; Lillefjell, Monica

    2016-01-01

    Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives. Significance for public health This article describe and discuss how the Search conference can be used as a method when working with knowledge based health promotion actions in local communities. The article describe the sequences of the conference and shows how this have been adapted when planning and prioritizing health promotion actions in three Norwegian municipalities. The significance of the article is that it shows how central elements in the planning of health promotion actions, as participation and involvements as well as evidence was a fundamental thinking in how the conference were accomplished. The article continue discussing how the method function as both a top-down and a bottom-up strategy, and in what way working evidence based can be in conflict with a bottom-up strategy. The experiences described can be used as guidance planning knowledge based health promotion actions in communities. PMID:27747199

  6. Health workforce development planning in the Sultanate of Oman: a case study

    Directory of Open Access Journals (Sweden)

    Ghosh Basu

    2009-06-01

    Full Text Available Abstract Introduction Oman's recent experience in health workforce development may be viewed against the backdrop of the situation just three or four decades ago, when it had just a few physicians and nurses (mostly expatriate. All workforce categories in Oman have grown substantially over the last two decades. Increased self-reliance was achieved despite substantial growth in workforce stocks. Stocks of physicians and nurses grew significantly during 1985–2007. This development was the outcome of well-considered national policies and plans. This case outlines how Oman is continuing to turn around its excessive dependence on expatriate workforce through strategic workforce development planning. Case description The Sultanate's early development initiatives focused on building a strong health care infrastructure by importing workforce. However, the policy-makers stressed national workforce development for a sustainable future. Beginning with the formulation of a strategic health workforce development plan in 1991, the stage was set for adopting workforce planning as an essential strategy for sustainable health development and workforce self-reliance. Oman continued to develop its educational infrastructure, and began to produce as much workforce as possible, in order to meet health care demands and achieve workforce self-reliance. Other policy initiatives with a beneficial impact on Oman's workforce development scenario were: regionalization of nursing institutes, active collaboration with universities and overseas specialty boards, qualitative improvement of the education system, development of a strong continuing professional development system, efforts to improve workforce management, planned change management and needs-based micro/macro-level studies. Strong political will and bold policy initiatives, dedicated workforce planning and educational endeavours have all contributed to help Oman to develop its health workforce stocks and gain

  7. Health workforce development planning in the Sultanate of Oman: a case study.

    Science.gov (United States)

    Ghosh, Basu

    2009-06-11

    Oman's recent experience in health workforce development may be viewed against the backdrop of the situation just three or four decades ago, when it had just a few physicians and nurses (mostly expatriate). All workforce categories in Oman have grown substantially over the last two decades. Increased self-reliance was achieved despite substantial growth in workforce stocks. Stocks of physicians and nurses grew significantly during 1985-2007. This development was the outcome of well-considered national policies and plans. This case outlines how Oman is continuing to turn around its excessive dependence on expatriate workforce through strategic workforce development planning. The Sultanate's early development initiatives focused on building a strong health care infrastructure by importing workforce. However, the policy-makers stressed national workforce development for a sustainable future. Beginning with the formulation of a strategic health workforce development plan in 1991, the stage was set for adopting workforce planning as an essential strategy for sustainable health development and workforce self-reliance. Oman continued to develop its educational infrastructure, and began to produce as much workforce as possible, in order to meet health care demands and achieve workforce self-reliance. Other policy initiatives with a beneficial impact on Oman's workforce development scenario were: regionalization of nursing institutes, active collaboration with universities and overseas specialty boards, qualitative improvement of the education system, development of a strong continuing professional development system, efforts to improve workforce management, planned change management and needs-based micro/macro-level studies. Strong political will and bold policy initiatives, dedicated workforce planning and educational endeavours have all contributed to help Oman to develop its health workforce stocks and gain self-reliance. Oman has successfully innovated workforce

  8. A spatial national health facility database for public health sector planning in Kenya in 2008

    Directory of Open Access Journals (Sweden)

    Gething Peter W

    2009-03-01

    Full Text Available Abstract Background Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. Methods A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. Findings The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries. This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79% and the majority were dispensaries (91%. 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. Conclusion We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for

  9. A spatial national health facility database for public health sector planning in Kenya in 2008.

    Science.gov (United States)

    Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W

    2009-03-06

    Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries). This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79%) and the majority were dispensaries (91%). 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for improving planning. Expansion in public health care in Kenya has

  10. Patterns of service use in two types of managed behavioral health care plans.

    Science.gov (United States)

    Merrick, Elizabeth L; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Azzone, Vanessa; McCann, Bernard; Ritter, Grant; Zolotusky, Galima; McGuire, Thomas G; Reif, Sharon

    2010-01-01

    The study examined service use patterns by level of care in two managed care plans offered by a national managed behavioral health care organization (MBHO): an employee assistance program (EAP) combined with a standard behavioral health plan (integrated plan) and a standard behavioral health plan. The cross-sectional analysis used 2004 administrative data from the MBHO. Utilization of 11 specific service categories was compared. The weighted sample reflected exact matching on sociodemographic characteristics (unweighted N=710,014; weighted N=286,750). A larger proportion of enrollees in the integrated plan than in the standard plan used outpatient mental health and substance abuse office visits (including EAP visits) (p<.01) and substance abuse intensive outpatient or day treatment (p<.05), and the proportion using residential substance abuse rehabilitation was lower (p<.05). The integrated and standard products had distinct utilization patterns in this large MBHO. In particular, greater use of certain outpatient services was observed in the integrated plan.

  11. Do employers know the quality of health care benefits they provide? Use of HEDIS depression scores for health plans.

    Science.gov (United States)

    Robst, John; Rost, Kathryn; Marshall, Donna

    2013-11-01

    OBJECTIVE Dissemination of health quality measures is a necessary ingredient of efforts to harness market-based forces, such as value-based purchasing by employers, to improve health care quality. This study examined reporting of Healthcare Effectiveness Data and Information Set (HEDIS) measures for depression to firms interested in improving depression care. METHODS During surveys conducted between 2009 and 2011, a sample of 325 employers that were interested in improving depression treatment were asked whether their primary health plan reports HEDIS scores for depression to the National Committee for Quality Assurance (NCQA) and if so, whether they knew the scores. Data about HEDIS reporting by the health plans were collected from the NCQA. RESULTS HEDIS depression scores were reported by the primary health plans of 154 (47%) employers, but only 7% of employers knew their plan's HEDIS scores. Because larger employers were more likely to report knowing the scores, 53% of all employees worked for employers who reported knowing the scores. A number of structural, health benefit, and need characteristics predicted knowledge of HEDIS depression scores by employers. CONCLUSIONS The study demonstrated that motivated employers did not know their depression HEDIS scores even when their plan publicly reported them. Measures of health care quality are not reaching the buyers of insurance products; however, larger employers were more likely to know the HEDIS scores for their health plan, suggesting that value-based purchasing may have some ability to affect health care quality.

  12. Educational impact of an assessment of medical students' collaboration in health care teams.

    Science.gov (United States)

    Olupeliyawa, Asela; Balasooriya, Chinthaka; Hughes, Chris; O'Sullivan, Anthony

    2014-02-01

    This paper explores how structured feedback and other features of workplace-based assessment (WBA) impact on medical students' learning in the context of an evaluation of a workplace-based performance assessment: the teamwork mini-clinical evaluation exercise (T-MEX). The T-MEX enables observation-based measurement of and feedback on the behaviours required to collaborate effectively as a junior doctor within the health care team. The instrument is based on the mini-clinical evaluation exercise (mini-CEX) format and focuses on clinical encounters such as consultations with medical and allied health professionals, discharge plan preparation, handovers and team meetings. The assessment was implemented during a 6-week period in 2010 with 25 medical students during their final clinical rotation. Content analysis was conducted on the written feedback provided by 23 assessors and the written reflections and action plans proposed by the 25 student participants (in 88 T-MEX forms). Semi-structured interviews with seven assessors and three focus groups with 14 student participants were conducted and the educational impact was explored through thematic analysis. The study enabled the identification of features of WBA that promote the development of collaborative competencies. The focus of the assessment on clinical encounters and behaviours important for collaboration provided opportunities for students to engage with the health care team and highlighted the role of teamwork in these encounters. The focus on specific behaviours and a stage-appropriate response scale helped students identify learning goals and facilitated the provision of focused feedback. Incorporating these features within an established format helped students and supervisors to engage with the instrument. Extending the format to include structured reflection enabled students to self-evaluate and develop plans for improvement. The findings illuminate the mechanisms by which WBA facilitates learning. The

  13. The joint action on health workforce planning and forecasting: results of a European programme to improve health workforce policies.

    NARCIS (Netherlands)

    Kroezen, M.; Hoegaerden, M. van; Batenburg, R.

    2017-01-01

    Health workforce (HWF) planning and forecasting is faced with a number of challenges, most notably a lack of consistent terminology, a lack of data, limited model-, demand-based- and future-based planning, and limited inter-country collaboration. The Joint Action on Health Workforce Planning and

  14. 42 CFR 417.801 - Agreements between CMS and health care prepayment plans.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Agreements between CMS and health care prepayment... CMS and health care prepayment plans. (a) General requirement. (1) In order to participate and receive... written agreement with CMS. (2) An existing group practice prepayment plan (GPPP) that continues as an...

  15. UMTRA Project: Environment, Safety, and Health Plan

    International Nuclear Information System (INIS)

    1995-02-01

    The US Department of Energy has prepared this UMTRA Project Environment, Safety, and Health (ES and H) Plan to establish the policy, implementing requirements, and guidance for the UMTRA Project. The requirements and guidance identified in this plan are designed to provide technical direction to UMTRA Project contractors to assist in the development and implementation of their ES and H plans and programs for UMTRA Project work activities. Specific requirements set forth in this UMTRA Project ES and H Plan are intended to provide uniformity to the UMTRA Project's ES and H programs for processing sites, disposal sites, and vicinity properties. In all cases, this UMTRA Project ES and H Plan is intended to be consistent with applicable standards and regulations and to provide guidance that is generic in nature and will allow for contractors' evaluation of site or contract-specific ES and H conditions. This plan specifies the basic ES and H requirements applicable to UMTRA Project ES and H programs and delineates responsibilities for carrying out this plan. DOE and contractor ES and H personnel are expected to exercise professional judgment and apply a graded approach when interpreting these guidelines, based on the risk of operations

  16. Developing and assessing accident management plans for nuclear power plants

    International Nuclear Information System (INIS)

    Hanson, D.J.; Johnson, S.P.; Blackman, H.S.; Stewart, M.A.

    1992-07-01

    This document is the second of a two-volume NUREG/CR that discusses development of accident management plans for nuclear power plants. The first volume (a) describes a four-phase approach for developing criteria that could be used for assessing the adequacy of accident management plans, (b) identifies the general attributes of accident management plans (Phase 1), (c) presents a prototype process for developing and implementing severe accident management plans (Phase 2), and (d) presents criteria that can be used to assess the adequacy of accident management plans. This volume (a) describes results from an evaluation of the capabilities of the prototype process to produce an accident management plan (Phase 3) and (b), based on these results and preliminary criteria included in NUREG/CR-5543, presents modifications to the criteria where appropriate

  17. Assessing family planning service-delivery skills in Kenya.

    Science.gov (United States)

    Valadez, J J; Transgrud, R; Mbugua, M; Smith, T

    1997-06-01

    This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.

  18. Assessment of the 2004 Danish National Action Plan for Emplyment

    DEFF Research Database (Denmark)

    Emerek, Ruth

    The report gives the economic, employment and policy context for the National Action Plan for employment, and assess the NAP from a gender persepctive......The report gives the economic, employment and policy context for the National Action Plan for employment, and assess the NAP from a gender persepctive...

  19. [Diffusion of clinical governance among the Italian Local Health Units (LHUs). Analysis of the Health Surveys, the Firm Acts and the Health Plans].

    Science.gov (United States)

    de Belvis, A G; Biasco, A; Pelone, F; Romaniello, A; De Micco, F; Volpe, M; Ricciardi, W

    2009-01-01

    The objective of our research is to report on the diffusion of Clinical Governance, as introduced with the National Health Plan 2006-2008, by analysing the planning instruments set up by each Region (Regional Health Plans and Emergency Plans in regions with budget deficit), the organizational frameworks (Atti Aziendali, firm acts), and the surveys on performance and quality of healthcare among the Italian Local Health Units (Health Surveys). Our research was realized on September-December 2007 and consisted of the collection of all retrieved documents available on the web and on the online public access catalog (OPAC SBN) of the National Library Service. Futhermore, each document has been classified and analysed according to Chambers' Clinical Governance definition. A descriptive statistical and inferential analysis by applying the Chi-2 Test was performed to test the correlation between the diffusion of such a classified documents and the geographical partition of each LHU. Our results show a scarce diffusion of Firm acts (43%) and Health Surveys (24.9% of the total). Any remind to Clinical Governance instruments and methods inside each document resulted even poorer among both the organizational and performance surveys and the regional health planning frameworks, respectively.

  20. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  1. The potential and peril of health insurance tobacco surcharge programs: evidence from Georgia's State Employees' Health Benefit Plan.

    Science.gov (United States)

    Liber, Alex C; Hockenberry, Jason M; Gaydos, Laura M; Lipscomb, Joseph

    2014-06-01

    A rapidly growing number of U.S. employers are charging health insurance surcharges for tobacco use to their employees. Despite their potential to price-discriminate, little systematic empirical evidence of the impacts of these tobacco surcharges has been published. We attempted to assess the impact of a health insurance surcharge for tobacco use on cessation among enrollees in Georgia's State Health Benefit Plan (GSHBP). We identified a group of enrollees in GSHBP who began paying the tobacco surcharge at the program's inception in July 2005. We examined the proportion of these enrollees who certified themselves and their family members as tobacco-free and no longer paid the surcharge through April 2011, and we defined this as implied cessation. We compared this proportion to a national expected annual 2.6% cessation rate. We also compared our observation group to a comparison group to assess surcharge avoidance. By April 2011, 45% of enrollees who paid a tobacco surcharge starting in July 2005 had certified themselves as tobacco-free. This proportion exceeded the expected cessation based on 3 times the national rate (p health insurance surcharges in changing behavior, are tempered by the important limitation that enrollees' certification of quitting was self-reported and not subject to additional, clinical verification.

  2. Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

    Science.gov (United States)

    Appleton, Jane V; Cowley, Sarah

    2008-02-01

    Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

  3. Institutional capacity for health systems research in East and Central African schools of public health: experiences with a capacity assessment tool.

    Science.gov (United States)

    Jessani, Nasreen; Lewy, Daniela; Ekirapa-Kiracho, Elizabeth; Bennett, Sara

    2014-06-02

    Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans. Between June and November 2011, seven SPHs across the Democratic Republic of Congo, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda implemented this co-created tool. The objectives of the institutional assessments were to assess existing capacities for HSR and to develop capacity development plans to address prioritized gaps. A mixed-method approach was employed consisting of document analysis, self-assessment questionnaires, in-depth interviews, and institutional dialogues aimed at capturing individual perceptions of institutional leadership, collective HSR skills, knowledge translation, and faculty incentives to engage in HSR. Implementation strategies for the capacity assessment varied across the SPHs. This paper reports findings from semi-structured interviews with focal persons from each SPH, to reflect on the process used at each SPH to execute the institutional assessments as well as the perceived strengths and weaknesses of the assessment process. The assessment tool was robust enough to be utilized in its entirety across all seven SPHs resulting in a thorough HSR capacity assessment and a capacity development plan for each SPH. Successful implementation of the capacity assessment exercises depended on four factors: (i) support from senior leadership and collaborators, (ii) a common understanding of HSR, (iii) adequate human and financial resources for the exercise, and (iv) availability of data. Methods of extracting information from the results of the assessments, however, were tailored to the unique objectives of each SPH. This institutional HSR capacity assessment tool and the process for its utilization

  4. Final Report: Evaluation of Tools and Metrics to Support Employer Selection of Health Plans.

    Science.gov (United States)

    Mattke, Soeren; Van Busum, Kristin R; Martsolf, Grant R

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) places strong emphasis on quality of care as a means to improve outcomes for Americans and promote the financial sustainability of our health care system. Included in the ACA are new disclosure requirements that require health plans to provide a summary of benefits and coverage that accurately describes the benefits under the plan or coverage. These requirements are intended to support employers' procurement of high-value health coverage for their employees. This study attempts to help employers understand the structural differences between health plans and the performance dimensions along which plans can differ, as well as to educate employers about available tools that can be used to evaluate plan options. The study also discusses the extent to which these and other tools or resources are used by employers to inform choices between health plans.

  5. Strategic Planning for Health Care Cost Controls in a Constantly Changing Environment.

    Science.gov (United States)

    Hembree, William E

    2015-01-01

    Health care cost increases are showing a resurgence. Despite recent years' comparatively modest increases, the projections for 2015 cost increases range from 6.6% to 7%--three to four times larger than 2015's expected underlying inflation. This resurgence is just one of many rapidly changing external and internal challenges health plan sponsors must overcome (and this resurgence advances the date when the majority of employers will trigger the "Cadillac tax"). What's needed is a planning approach that is effective in overcoming all known and yet-to-be-discovered challenges, not just affordability. This article provides detailed guidance in adopting six proven strategic planning steps. Following these steps will proactively and effectively create a flexible strategic plan for the present and future of employers' health plans that will withstand all internal and external challenges.

  6. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

    Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency,...... findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.......Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency......, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA...

  7. Use of technology to support information needs for continuity of operations planning in public health: a systematic review.

    Science.gov (United States)

    Reeder, Blaine; Turner, Anne; Demiris, George

    2010-01-01

    Continuity of operations planning focuses on an organization's ability to deliver essential services before, during and after an emergency. Public health leaders must make decisions based on information from many sources and their information needs are often facilitated or hindered by technology. The aim of this study is to provide a systematic review of studies of technology projects that address public health continuity of operations planning information needs and to discuss patterns, themes, and challenges to inform the design of public health continuity of operations information systems. To return a comprehensive results set in an under-explored area, we searched broadly in the Medline and EBSCOHost bibliographic databases using terms from prior work in public health emergency management and continuity of operations planning in other domains. In addition, we manually searched the citation lists of publications included for review. A total of 320 publications were reviewed. Twenty studies were identified for inclusion (twelve risk assessment decision support tools, six network and communications-enabled decision support tools, one training tool and one dedicated video-conferencing tool). Levels of implementation for information systems in the included studies range from proposed frameworks to operational systems. There is a general lack of documented efforts in the scientific literature for technology projects about public health continuity of operations planning. Available information about operational information systems suggest inclusion of public health practitioners in the design process as a factor in system success.

  8. Health Libraries and Information Services in Tanzania: A Strategic Assessment.

    Science.gov (United States)

    Haruna, Hussein; Mtoroki, Majaliwa; Gerendasy, Dan D; Detlefsen, Ellen G

    The intention of the Government of Tanzania is to establish more health information resource canters in all health facilities. With this regard, health information science personnel are needed to provide adequate and accurate health information services. However, availability of these personnel remains to be a challenge because of their non-existence. To identify the current status and local impact of health sciences libraries and user perception of these libraries, as a prerequisite to the development of a competence-based curriculum for health information science training in Tanzania. A needs assessment was carried out using a convenience sample of local respondents, including librarians, trainers, academicians, students, health care providers, and patients and families, drawn from national, referral, regional, district hospitals, health training institutions, and universities from both government and nongovernment entities in Tanzania. A focus group approach was used to gather data from respondents. Results from this assessment revealed that health science libraries in Tanzania are faced with the challenges of insufficient infrastructure, old technology, limited facilities and furniture, inadequate and incompetent library staff, lack of health sciences librarians, outdated and insufficient resources, and low knowledge and use of information technologies by library clients. Most respondents would prefer to have both physical and electronic libraries, as well as librarians with specialized health information science skills, to cope with changing nature of the medical field. The findings obtained from this assessment are strong enough to guide the development of a curriculum and training strategy and an operational plan and training packages for health information professionals. The development of a training curriculum for health information science professionals will mean better health information service delivery for Tanzania. Copyright © 2016 Icahn School of

  9. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    than assessing a present situation. As part of this process, however, methods applied in risk assessment are used. Risk assessment typically characterises relation of a well-defined risk factor to a well-defined health outcome. Within HIA usually several individual risk assessments are needed...... of the causal chain from the proposal through related health determinants and risk factors to health outcomes. The stepwise analysis, systematic prioritization and consideration of horizontal interactions between the causal pathways make it feasible to use widely recognized risk assessment methods in the HIA......The level and distribution of health risks in a society is substantially influenced by measures of various policies, programmes or projects. Risk assessment can evaluate the nature, likelihood and severity of an adverse effect. Health impact assessment (HIA) provides similar function when used...

  10. Environment, Safety, Health and Waste Management Plan

    International Nuclear Information System (INIS)

    1988-01-01

    The mission of the Feed Materials Production Center (FMPC) is the production of high qaulity uranium metal for use by the US Department of Energy (DOE) in Defense Programs. In order to accomplish this mission and to maintain the FMPC as a viable facility in the DOE production complex, the facility must be brought into full compliance with all federal and state regulations and industry standards for environmental protection and worker safety. Where past practices have resulted in environmental insult, a comprehensive program of remediation must be implemented. The purpose of this combined Environment, Safety, Health and Waste Management Plan is to provide a road map for achieving needed improvements. The plan is structured to provide a comprehensive projection from the current fiscal year (FY) through FY 1994 of the programs, projects and funding required to achieve compliance. To do this, the plan is subdivided into chapters which discuss the applicable regulations;project schedules and funding requirements;details of the various programs for environment, safety, health and waste management;details of the ongoing National Environmental Policy Act (NEPA);the quality assurance program and the environmental monitoring program. 14 refs., 30 figs., 29 tabs

  11. Economic Effects of Legislations and Policies to Expand Mental Health and Substance Abuse Benefits in Health Insurance Plans: A Community Guide Systematic Review

    Science.gov (United States)

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A.; Goetzel, Ron Z.; Finnie, Ramona; Thota, Anilkrishna B.

    2015-01-01

    Background Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. Aims of the Study This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. Methods The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. Results The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. Discussion and Limitations This review is unable to determine the overall economic value of policies that expand MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when

  12. Health Canada unveils plan to distribute marijuana for medical use.

    Science.gov (United States)

    Thaczuk, Derek

    2003-08-01

    Under pressure from the courts, Health Canada reluctantly comes up with a distribution plan to provide dried cannabis and seeds to patients using medical marijuana. The plan has been greeted with considerable criticism

  13. Integrating Planning, Assessment, and Improvement in Higher Education

    Science.gov (United States)

    Sherlock, Barbara J.

    2009-01-01

    Based on Penn State's popular "Innovation Insights" series, this book brings together in one handy reference nearly a decade of tried and true insights into continuous quality improvements in higher education. Their five-step model for integrating planning, assessment, and improvement moves plans off the shelf and into the weekly and daily…

  14. Strategic Teleconference Planning in Rural Health Education.

    Science.gov (United States)

    Nagel, Liza; Boswell, Judy

    1997-01-01

    An introduction to planning interactive health education teleconferences via satellite discusses participant recruitment, satellite transmission coordination, scheduling considerations, format design, and use of site facilitators. Teleconference training of community service providers and community leaders should combine passive delivery of…

  15. Assessment of Tooth Wear Among Glass Factory Workers: WHO 2013 Oral Health Survey.

    Science.gov (United States)

    Chaturvedi, Pulkit; Bhat, Nagesh; Asawa, Kailash; Tak, Mridula; Bapat, Salil; Gupta, Vivek Vardhan

    2015-08-01

    Glass factory workers are often exposed to the hazardous environment that leads to deleterious oral health and subsequently, general health. We planned to determine the effects of the particulates present in the milieu on the tooth wear among workers. To assess tooth wear among glass factory workers in Jaipur, Rajasthan, India. A descriptive cross-sectional survey was conducted among 936 glass workers in Jaipur, Rajasthan, India from January-June 2014. A survey proforma was designed for tooth wear evaluation with the help of WHO Oral Health Assessment form 2013 (for adults). Information regarding oral health practices, adverse habits and dietary habits, demographic details was gathered and clinical parameters were recorded. The Chi-square test, t-test, One-way Analysis of Variance and a Stepwise multiple linear regression analysis. The most prevalent form of erosion was enamel erosion (589, 62.93%) with few subjects of deeper dentinal erosion and the difference was statistically significant (p=0.001). Dental erosion was found to be higher among males compared to females. Years of experience and educational status were identified as best predictors for dental erosion. It was concluded that there was considerable evidence of dental erosion found among the factory workers. Due to ignorance on social, cultural and health aspects, professional approach with regular dental care services for detection of early symptoms and planning of preventive strategies is warranted.

  16. Sanitation health risk and safety planning in urban residential ...

    African Journals Online (AJOL)

    The aim of this review paper was to determine the best sanitation health risk and safety planning approach for sustainable management of urban environment. This was achieved by reviewing the concept of sanitation safety planning as a tool. The review adopted exploratory research approach and used secondary data ...

  17. Assessment of knowledge and perception regarding male sterilization (Non-Scalpel Vasectomy) among community health workers in Jharkhand, India

    OpenAIRE

    Swati Mahapatra; Chahat Narula; Chander Pal Thakur; Tapan Jyoti Kalita; Rakesh Mehra

    2014-01-01

    Introduction: In India, community health workers are the main source of information for family planning services and male population want to interact and discuss with them to clear their doubts about male oriented family planning methods. Objective: The objective of the study was to assess the knowledge and perception of community health workers regarding the modern male sterilization method. Methodology: This was a cross-sectional study conducted in Simdega district of Jharkhand. The target ...

  18. A technology-supported collaboration between a health plan and a community pharmacy to improve blood pressure control.

    Science.gov (United States)

    Frail, Caitlin K; Cooper, Susan; Gallagher, Tim; Sarkis, Josh; Topor, Laura; Bruzek, Richard J

    To assess the impact of a health plan and community pharmacy partnership to improve blood pressure control. A midwestern health plan and a regional community pharmacy chain. Health plan members with a hypertension diagnosis and attributed to the pharmacy chain based on prescription claims were invited to participate. Interested patients enrolled in the program at their pharmacies and were assigned a "smart card" for use with a blood pressure kiosk in the pharmacy. When the card was used at the kiosk, individual patient readings were linked directly to their electronic pharmacy record and an online patient portal. Pharmacists intervened with patients and prescribers as necessary to address adherence issues and adjust therapy as needed. Before and after blood pressure readings were assessed to determine the impact of patient self-monitoring and pharmacist intervention for patients with 1) uncontrolled blood pressure at first reading and 2) multiple readings throughout the pilot period. Fifty-six of 276 eligible patients (20%) were enrolled in the program. Fourteen patients qualified for before and after assessments, having uncontrolled blood pressure on initial reading and multiple readings throughout the pilot. These patients demonstrated a mean reduction in systolic blood pressure of 12 mm Hg and diastolic blood pressure of 8 mm Hg. Nine of 16 eligible pharmacy locations enrolled patients at their sites. Challenges faced in the initiative included gaining adequate pharmacist and patient engagement. The pilot demonstrated promising early results in a model that has potential to improve blood pressure monitoring and management in a community pharmacy setting. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  19. Health Impacts of Climate Change in Pacific Island Countries: A Regional Assessment of Vulnerabilities and Adaptation Priorities.

    Science.gov (United States)

    McIver, Lachlan; Kim, Rokho; Woodward, Alistair; Hales, Simon; Spickett, Jeffery; Katscherian, Dianne; Hashizume, Masahiro; Honda, Yasushi; Kim, Ho; Iddings, Steven; Naicker, Jyotishma; Bambrick, Hilary; McMichael, Anthony J; Ebi, Kristie L

    2016-11-01

    Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries-Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a "likelihood versus impact" matrix, and adaptation strategies were prioritized and planned accordingly. The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, non-communicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate change, the health risks entailed, and the limited capacity

  20. Integrating impact assessment and conflict management in urban planning: Experiences from Finland

    International Nuclear Information System (INIS)

    Peltonen, Lasse; Sairinen, Rauno

    2010-01-01

    The article examines the interlinkages between recent developments in conflict management and impact assessment procedures in the context of urban planning in Finland. It sets out by introducing the fields of impact assessment and conflict mediation. It then proceeds to discuss the development of impact assessment practices and the status of conflict mediation in Finnish land use planning. The case of Korteniitty infill development plan in Jyvaeskylae is used to demonstrate how the Finnish planning system operates in conflict situations - and how social impact assessment can contribute to managing planning conflicts. The authors ask how the processes of impact assessment contribute to conflict management. Based on the Finnish experience, it is argued that social impact assessment of land use plans can contribute to conflict management, especially in the absence of institutionalised conflict mediation processes. In addition, SIA may acquire features of conflict mediation, depending on extent and intensity of stakeholder participation in the process, and the quality of linkages it between knowledge production and decision-making. Simultaneously, conflict mediation practices and theoretical insights can inform the application of SIA to help it address land use conflicts more consciously.

  1. Assessment of LANL waste minimization plan

    International Nuclear Information System (INIS)

    Davis, K.D.; McNair, D.A.; Jennrich, E.A.; Lund, D.M.

    1991-04-01

    The objective of this report is to evaluate the Los Alamos National Laboratory (LANL) Waste Minimization Plan to determine if it meets applicable internal (DOE) and regulatory requirements. The intent of the effort is to assess the higher level elements of the documentation to determine if they have been addressed rather than the detailed mechanics of the program's implementation. The requirement for a Waste Minimization Plan is based in several DOE Orders as well as environmental laws and regulations. Table 2-1 provides a list of the major documents or regulations that require waste minimization efforts. The table also summarizes the applicable requirements

  2. A national assessment of colleges and university school health education methods courses.

    Science.gov (United States)

    Fisher, Christine M; Price, James H; Telljohann, Susan K; Dake, Joseph A

    2015-04-01

    Across the United States, school health education programs provide a wide variety of knowledge and skills to their students. There are currently no guidelines for school health methods courses. Using a 2-wave mailing followed by a third wave e-mail reminder, a final population of 226 university school health methods instructors at school health preparation programs were surveyed. A total of 138 completed surveys (61%) were returned. The topics taught in school health education methods courses emphasized the most included aligning objectives, instruction, and assessment (79%); development of lesson plans (73%); teaching methods that engage learners (72%); and application of the National Health Education Standards and performance indicators (69%). The content taught and how the instructors assessed their students differed statistically by 1 or more of the following: whether they had a health education degree, had experience teaching in the public schools, and if their program was accredited. This study provides information regarding what school health methods instructors across the United States are teaching in their classes. Using this information as a baseline can serve as a guide for preservice faculty teaching a school health methods course. © 2015, American School Health Association.

  3. Phase 2 sampling and analysis plan, Quality Assurance Project Plan, and environmental health and safety plan for the Clinch River Remedial Investigation: An addendum to the Clinch River RCRA Facility Investigation plan

    International Nuclear Information System (INIS)

    Cook, R.B.; Adams, S.M.; Beauchamp, J.J.; Bevelhimer, M.S.; Blaylock, B.G.; Brandt, C.C.; Etnier, E.L.; Ford, C.J.; Frank, M.L.; Gentry, M.J.; Greeley, M.S.; Halbrook, R.S.; Harris, R.A.; Holladay, S.K.; Hook, L.A.; Howell, P.L.; Kszos, L.A.; Levine, D.A.; Skiles, J.L.; Suter, G.W.

    1992-12-01

    This document contains a three-part addendum to the Clinch River Resource Conservation and Recovery Act (RCRA) Facility Investigation Plan. The Clinch River RCRA Facility Investigation began in 1989, as part of the comprehensive remediation of facilities on the US Department of Energy Oak Ridge Reservation (ORR). The ORR was added to the National Priorities List in December 1989. The regulatory agencies have encouraged the adoption of Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) terminology; therefore, the Clinch River activity is now referred to as the Clinch River Remedial Investigation (CRRI), not the Clinch River RCRA Facility Investigation. Part 1 of this document is the plan for sampling and analysis (S ampersand A) during Phase 2 of the CRRI. Part 2 is a revision of the Quality Assurance Project Plan for the CRRI, and Part 3 is a revision of the Environmental Health and Safety Plan for the CRRI. The Clinch River RI (CRRI) is designed to address the transport, fate, and distribution of waterborne contaminants (radionuclides, metals, and organic compounds) released from the DOE Oak Ridge Reservation (ORR) and to assess potential risks to human health and the environment associated with these contaminants. Primary areas of investigation are Melton Hill Reservoir, the Clinch River from Melton Hill Dam to its confluence with the Tennessee River, Poplar Creek, and Watts Bar Reservoir. The contaminants identified in the Clinch River/Watts Bar Reservoir (CR/WBR) downstream of the ORR are those associated with the water, suspended particles, deposited sediments, aquatic organisms, and wildlife feeding on aquatic organisms. The purpose of the Phase 2 S ampersand A Plan is to describe the proposed tasks and subtasks developed to meet the primary objectives of the CRRI

  4. Phase 2 sampling and analysis plan, Quality Assurance Project Plan, and environmental health and safety plan for the Clinch River Remedial Investigation: An addendum to the Clinch River RCRA Facility Investigation plan

    Energy Technology Data Exchange (ETDEWEB)

    Cook, R.B.; Adams, S.M.; Beauchamp, J.J.; Bevelhimer, M.S.; Blaylock, B.G.; Brandt, C.C.; Etnier, E.L.; Ford, C.J.; Frank, M.L.; Gentry, M.J.; Greeley, M.S.; Halbrook, R.S.; Harris, R.A.; Holladay, S.K.; Hook, L.A.; Howell, P.L.; Kszos, L.A.; Levine, D.A.; Skiles, J.L.; Suter, G.W.

    1992-12-01

    This document contains a three-part addendum to the Clinch River Resource Conservation and Recovery Act (RCRA) Facility Investigation Plan. The Clinch River RCRA Facility Investigation began in 1989, as part of the comprehensive remediation of facilities on the US Department of Energy Oak Ridge Reservation (ORR). The ORR was added to the National Priorities List in December 1989. The regulatory agencies have encouraged the adoption of Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) terminology; therefore, the Clinch River activity is now referred to as the Clinch River Remedial Investigation (CRRI), not the Clinch River RCRA Facility Investigation. Part 1 of this document is the plan for sampling and analysis (S A) during Phase 2 of the CRRI. Part 2 is a revision of the Quality Assurance Project Plan for the CRRI, and Part 3 is a revision of the Environmental Health and Safety Plan for the CRRI. The Clinch River RI (CRRI) is designed to address the transport, fate, and distribution of waterborne contaminants (radionuclides, metals, and organic compounds) released from the DOE Oak Ridge Reservation (ORR) and to assess potential risks to human health and the environment associated with these contaminants. Primary areas of investigation are Melton Hill Reservoir, the Clinch River from Melton Hill Dam to its confluence with the Tennessee River, Poplar Creek, and Watts Bar Reservoir. The contaminants identified in the Clinch River/Watts Bar Reservoir (CR/WBR) downstream of the ORR are those associated with the water, suspended particles, deposited sediments, aquatic organisms, and wildlife feeding on aquatic organisms. The purpose of the Phase 2 S A Plan is to describe the proposed tasks and subtasks developed to meet the primary objectives of the CRRI.

  5. K basins interim remedial action health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    DAY, P.T.

    1999-09-14

    The K Basins Interim Remedial Action Health and Safety Plan addresses the requirements of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), as they apply to the CERCLA work that will take place at the K East and K West Basins. The provisions of this plan become effective on the date the US Environmental Protection Agency issues the Record of Decision for the K Basins Interim Remedial Action, currently planned in late August 1999.

  6. A national action plan for workforce development in behavioral health.

    Science.gov (United States)

    Hoge, Michael A; Morris, John A; Stuart, Gail W; Huey, Leighton Y; Bergeson, Sue; Flaherty, Michael T; Morgan, Oscar; Peterson, Janice; Daniels, Allen S; Paris, Manuel; Madenwald, Kappy

    2009-07-01

    Across all sectors of the behavioral health field there has been growing concern about a workforce crisis. Difficulties encompass the recruitment and retention of staff and the delivery of accessible and effective training in both initial, preservice training and continuing education settings. Concern about the crisis led to a multiphased, cross-sector collaboration known as the Annapolis Coalition on the Behavioral Health Workforce. With support from the Substance Abuse and Mental Health Services Administration, this public-private partnership crafted An Action Plan for Behavioral Health Workforce Development. Created with input from a dozen expert panels, the action plan outlines seven core strategic goals that are relevant to all sectors of the behavioral health field: expand the role of consumers and their families in the workforce, expand the role of communities in promoting behavioral health and wellness, use systematic recruitment and retention strategies, improve training and education, foster leadership development, enhance infrastructure to support workforce development, and implement a national research and evaluation agenda. Detailed implementation tables identify the action steps for diverse groups and organizations to take in order to achieve these goals. The action plan serves as a call to action and is being used to guide workforce initiatives across the nation.

  7. Strengthening government health and family planning programs: findings from an action research project in rural Bangladesh.

    Science.gov (United States)

    Simmons, R; Phillips, J F; Rahman, M

    1984-01-01

    An ongoing study at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is based on the premise that public sector health and family planning programs can be improved through an assessment of the dysfunctional aspects of their operations, the development of problem-solving capabilities, and the transfer of strategies successfully tested in a small-scale pilot project. This paper reports findings from a field trial implemented in a subunit of the project area at an early stage of the project. Operational barriers to public sector program implementation are discussed with regard to the quantity of work, the quality of work, supplies and facilities, integration of health and family planning, and leadership, supervision, and decision making. Initial results of the ICDDR,B intervention on these managerial processes are also indicated.

  8. How Home Health Nurses Plan Their Work Schedules: A Qualitative Descriptive Study.

    Science.gov (United States)

    Irani, Elliane; Hirschman, Karen B; Cacchione, Pamela Z; Bowles, Kathryn H

    2018-06-12

    To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process. Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting. Qualitative descriptive design. Semi-structured interviews were conducted with 20 registered nurses who had greater than 2 years of experience in home health and were employed by one of the three participating home health agencies in the mid-Atlantic region of the United States. Data were analyzed using conventional content analysis. Four themes emerged about planning work schedules and daily itineraries: identifying patient needs to prioritize visits accordingly, partnering with patients to accommodate their preferences, coordinating visit timing with other providers to avoid overwhelming patients, and working within agency standards to meet productivity requirements. Scheduling challenges included readjusting the schedule based on patient needs and staffing availability, anticipating longer visits, and maintaining continuity of care with patients. Home health nurses make autonomous decisions regarding their work schedules while considering specific patient and agency factors, and overcome challenges related to the unpredictable nature of providing care in a home health setting. Future research is needed to further explore nurse productivity in home health and improve home health work environments. Home health nurses plan their work schedules to provide high quality care that is patient-centered and timely. The findings also highlight organizational priorities to facilitate continuity of care and support nurses while alleviating the burnout

  9. Role of GIS in Health Management Information System and Medical Plan: A Case Study of Gangtok area, Sikkim, India

    Directory of Open Access Journals (Sweden)

    Ashok Kumar Sharma

    2015-03-01

    Full Text Available Geographical Information System (GIS in a Health Management Information System (HMIS can be a powerful tool to make health care delivery more effective and far more efficient. It includes database management, planning, risk service area mapping, location identification, etc. One of the causes for this sudden surge of GIS use in healthcare application is the spatial dependency of health related factors. The use of GIS helps capture, store, combine, analyze and display data using Remote Sensing, topographical surveys, urban survey and town planning, geology, hydrology, traffic and transport engineering, land use pattern, rainfall pattern, and drainage. (Mathew, 2005. In the research work use of GIS software ILWIS for assessing the social network and health services available in Gangtok area, East Sikkim. Mapping of essential resources like road networks, locate the health facility in the study area and find out the population density using GIS techniques.

  10. Using a social justice and health framework to assess European climate change adaptation strategies.

    Science.gov (United States)

    Boeckmann, Melanie; Zeeb, Hajo

    2014-11-28

    Climate change puts pressure on existing health vulnerabilities through higher frequency of extreme weather events, changes in disease vector distribution or exacerbated air pollution. Climate change adaptation policies may hold potential to reduce societal inequities. We assessed the role of public health and social justice in European climate change adaptation using a three-fold approach: a document analysis, a critical discourse analysis of a subgroup of strategies, and a ranking of strategies against our social justice framework. The ranking approach favored planning that includes various adaptation types, social issues and infrastructure changes. Themes on values identified in the five subgroup documents showed that risks are perceived as contradictory, technology is viewed as savior, responsibilities need to be negotiated, and social justice is advocated by only a few countries. Of 21 strategy documents assessed overall, those from Austria, England and Sweden received the highest scores in the ranking. Our qualitative assessment showed that in European adaptation planning, progress could still be made through community involvement into adaptation decisions, consistent consideration of social and demographic determinants, and a stronger link between infrastructural adaptation and the health sector. Overall, a social justice framework can serve as an evaluation guideline for adaptation policy documents.

  11. Performance assessment plans and methods for the Salt Repository Project

    International Nuclear Information System (INIS)

    1984-08-01

    This document presents the preliminary plans and anticipated methods of the Salt Repository Project (SRP) for assessing the postclosure and radiological aspects of preclosure performance of a nuclear waste repository in salt. This plan is intended to be revised on an annual basis. The emphasis in this preliminary effort is on the method of conceptually dividing the system into three subsystems (the very near field, the near field, and the far field) and applying models to analyze the behavior of each subsystem and its individual components. The next revision will contain more detailed plans being developed as part of Site Characterization Plan (SCP) activities. After a brief system description, this plan presents the performance targets which have been established for nuclear waste repositories by regulatory agencies (Chapter 3). The SRP approach to modeling, including sensitivity and uncertainty techniques is then presented (Chapter 4). This is followed by a discussion of scenario analysis (Chapter 5), a presentation of preliminary data needs as anticipated by the SRP (Chapter 6), and a presentation of the SRP approach to postclosure assessment of the very near field, the near field, and the far field (Chapters 7, 8, and 9, respectively). Preclosure radiological assessment is discussed in Chapter 10. Chapter 11 presents the SRP approach to code verification and validation. Finally, the Appendix lists all computer codes anticipated for use in performance assessments. The list of codes will be updated as plans are revised

  12. Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods.

    Science.gov (United States)

    Sandsund, Catherine; Towers, Richard; Thomas, Karen; Tigue, Ruth; Lalji, Amyn; Fernandes, Andreia; Doyle, Natalie; Jordan, Jake; Gage, Heather; Shaw, Clare

    2017-08-28

    Holistic needs assessment (HNA) and care planning are proposed to address unmet needs of people treated for cancer. We tested whether HNA and care planning by an allied health professional improved cancer-specific quality of life for women following curative treatment for stage I-III gynaecological cancer. Consecutive women were invited to participate in a randomised controlled study (HNA and care planning vs usual care) at a UK cancer centre. Data were collected by questionnaire at baseline, 3 and 6 months. The outcomes were 6-month change in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (version 3), global score (primary) and, in EORTC subscales, generic quality of life and self-efficacy (secondary). The study was blinded for data management and analysis. Differences in outcomes were compared between groups. Health service utilisation and quality-adjusted life years (QALY) (from Short Form-6) were gathered for a cost-effectiveness analysis. Thematic analysis was used to interpret data from an exit interview. 150 women consented (75 per group); 10 undertook interviews. For 124 participants (61 intervention, 63 controls) with complete data, no statistically significant differences were seen between groups in the primary endpoint. The majority of those interviewed reported important personal gains they attributed to the intervention, which reflected trends to improvement seen in EORTC functional and symptom scales. Economic analysis suggests a 62% probability of cost-effectiveness at a £30 000/QALY threshold. Care plan development with an allied health professional is cost-effective, acceptable and useful for some women treated for stage I-III gynaecological cancer. We recommend its introduction early in the pathway to support person-centred care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless

  13. Assessment Planning within the Context of University English Language Teaching (ELT) in China: Implications for Teacher Assessment Literacy

    Science.gov (United States)

    Xu, Yueting

    2016-01-01

    Teacher assessment literacy (AL) is a concern for both educational assessment and teacher education research. As part of teacher AL, teacher competency of assessment planning has remained underexplored. To address this gap, this study explored how a group of 20 contest-winning university English teachers in China planned for assessment through…

  14. [A decade of reflection on health plans in Spain. SESPAS report 2010].

    Science.gov (United States)

    Fiuza Pérez, María Dolores; Aguiar Rodríguez, Juan Francisco; Monzón Batista, Nayra

    2010-12-01

    This article reports the experience of the Working Group of the SESPAS-SCSP (Spanish Society of Public Health and Healthcare Administration-Canary Islands Society of Public Health) in health policy and planning during the first decade of the 21st century and its possible impact on the design of health planning. We review the conclusions reached from 2000 to 2008 in the first five Biannual Planning and Health Policy meetings that took place during that period. The workshops were designed with two speakers who presented different views of the subject under discussion, a moderator, who led the debate on the findings, and a narrator who served as a notary and also took responsibility for the text summary of each table. Two general narrators were responsible for the final wording of the conclusions of each workshop or biannual meeting. From 2000 to 2008, there were 25 round tables with 121 conclusions and 160 participants. We believe that the SESPAS working groups provide multidisciplinary professional values within a context of debate in a professional environment, and create spaces for reflection, thus helping to improve the health planning system in Spain. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. The impact of social franchising on the use of reproductive health and family planning services at public commune health stations in Vietnam

    Science.gov (United States)

    2010-01-01

    Background Service franchising is a business model that involves building a network of outlets (franchisees) that are locally owned, but act in coordinated manner with the guidance of a central headquarters (franchisor). The franchisor maintains quality standards, provides managerial training, conducts centralized purchasing and promotes a common brand. Research indicates that franchising private reproductive health and family planning (RHFP) services in developing countries improves quality and utilization. However, there is very little evidence that franchising improves RHFP services delivered through community-based public health clinics. This study evaluates behavioral outcomes associated with a new approach - the Government Social Franchise (GSF) model - developed to improve RHFP service quality and capacity in Vietnam's commune health stations (CHSs). Methods The project involved networking and branding 36 commune health station (CHS) clinics in two central provinces of Da Nang and Khanh Hoa, Vietnam. A quasi-experimental design with 36 control CHSs assessed GSF model effects on client use as measured by: 1) clinic-reported client volume; 2) the proportion of self-reported RHFP service users at participating CHS clinics over the total sample of respondents; and 3) self-reported RHFP service use frequency. Monthly clinic records were analyzed. In addition, household surveys of 1,181 CHS users and potential users were conducted prior to launch and then 6 and 12 months after implementing the GSF network. Regression analyses controlled for baseline differences between intervention and control groups. Results CHS franchise membership was significantly associated with a 40% plus increase in clinic-reported client volumes for both reproductive and general health services. A 45% increase in clinic-reported family planning service clients related to GSF membership was marginally significant (p = 0.05). Self-reported frequency of RHFP service use increased by 20% from

  16. The impact of social franchising on the use of reproductive health and family planning services at public commune health stations in Vietnam

    Directory of Open Access Journals (Sweden)

    Pham Van

    2010-02-01

    Full Text Available Abstract Background Service franchising is a business model that involves building a network of outlets (franchisees that are locally owned, but act in coordinated manner with the guidance of a central headquarters (franchisor. The franchisor maintains quality standards, provides managerial training, conducts centralized purchasing and promotes a common brand. Research indicates that franchising private reproductive health and family planning (RHFP services in developing countries improves quality and utilization. However, there is very little evidence that franchising improves RHFP services delivered through community-based public health clinics. This study evaluates behavioral outcomes associated with a new approach - the Government Social Franchise (GSF model - developed to improve RHFP service quality and capacity in Vietnam's commune health stations (CHSs. Methods The project involved networking and branding 36 commune health station (CHS clinics in two central provinces of Da Nang and Khanh Hoa, Vietnam. A quasi-experimental design with 36 control CHSs assessed GSF model effects on client use as measured by: 1 clinic-reported client volume; 2 the proportion of self-reported RHFP service users at participating CHS clinics over the total sample of respondents; and 3 self-reported RHFP service use frequency. Monthly clinic records were analyzed. In addition, household surveys of 1,181 CHS users and potential users were conducted prior to launch and then 6 and 12 months after implementing the GSF network. Regression analyses controlled for baseline differences between intervention and control groups. Results CHS franchise membership was significantly associated with a 40% plus increase in clinic-reported client volumes for both reproductive and general health services. A 45% increase in clinic-reported family planning service clients related to GSF membership was marginally significant (p = 0.05. Self-reported frequency of RHFP service use

  17. Health impact assessment in the United States: Has practice followed standards?

    International Nuclear Information System (INIS)

    Schuchter, Joseph; Bhatia, Rajiv; Corburn, Jason; Seto, Edmund

    2014-01-01

    As an emerging practice, Health Impact Assessment is heterogeneous in purpose, form, and scope and applied in a wide range of decision contexts. This heterogeneity challenges efforts to evaluate the quality and impact of practice. We examined whether information in completed HIA reports reflected objectively-evaluable criteria proposed by the North American HIA Practice Standards Working Group in 2009. From publically-available reports of HIAs conducted in the U.S. and published from 2009 to 2011, we excluded those that were components of, or comment letters on, Environmental Impact Assessments (5) or were demonstration projects or student exercises (8). For the remaining 23 reports, we used practice standards as a template to abstract data on the steps of HIA, including details on the rationale, authorship, funding, decision and decision-makers, participation, pathways and methods, quality of evidence, and recommendations. Most reports described screening, scoping, and assessment processes, but there was substantial variation in the extent of these processes and the degree of stakeholder participation. Community stakeholders participated in screening or scoping in just two-thirds of the HIAs (16). On average, these HIAs analyzed 5.5 determinants related to 10.6 health impacts. Most HIA reports did not include evaluation or monitoring plans. This study identifies issues for field development and improvement. The standards might be adapted to better account for variability in resources, produce fit-for-purpose HIAs, and facilitate innovation guided by the principles. - Highlights: • Our study examined reported HIAs in the U.S. against published practice standards. • Most HIAs used some screening, scoping and assessment elements from the standards. • The extent of these processes and stakeholder participation varied widely. • The average HIA considered multiple health determinants and impacts. • Evaluation or monitoring plans were generally not included in

  18. Health impact assessment in the United States: Has practice followed standards?

    Energy Technology Data Exchange (ETDEWEB)

    Schuchter, Joseph, E-mail: jws@berkeley.edu [University of California, Berkeley, School of Public Health, Department of Environmental Health Sciences, 50 University Hall, Berkeley, CA 94720-7360 (United States); Bhatia, Rajiv [University of California, Berkeley, Institute of Urban and Regional Development (United States); Corburn, Jason [University of California, Berkeley, College of Environmental Design, Department of City and Regional Planning (United States); Seto, Edmund [University of Washington, School of Public Health, Department of Environmental and Occupational Health (United States)

    2014-07-01

    As an emerging practice, Health Impact Assessment is heterogeneous in purpose, form, and scope and applied in a wide range of decision contexts. This heterogeneity challenges efforts to evaluate the quality and impact of practice. We examined whether information in completed HIA reports reflected objectively-evaluable criteria proposed by the North American HIA Practice Standards Working Group in 2009. From publically-available reports of HIAs conducted in the U.S. and published from 2009 to 2011, we excluded those that were components of, or comment letters on, Environmental Impact Assessments (5) or were demonstration projects or student exercises (8). For the remaining 23 reports, we used practice standards as a template to abstract data on the steps of HIA, including details on the rationale, authorship, funding, decision and decision-makers, participation, pathways and methods, quality of evidence, and recommendations. Most reports described screening, scoping, and assessment processes, but there was substantial variation in the extent of these processes and the degree of stakeholder participation. Community stakeholders participated in screening or scoping in just two-thirds of the HIAs (16). On average, these HIAs analyzed 5.5 determinants related to 10.6 health impacts. Most HIA reports did not include evaluation or monitoring plans. This study identifies issues for field development and improvement. The standards might be adapted to better account for variability in resources, produce fit-for-purpose HIAs, and facilitate innovation guided by the principles. - Highlights: • Our study examined reported HIAs in the U.S. against published practice standards. • Most HIAs used some screening, scoping and assessment elements from the standards. • The extent of these processes and stakeholder participation varied widely. • The average HIA considered multiple health determinants and impacts. • Evaluation or monitoring plans were generally not included in

  19. The Bambuí Health and Aging Study (BHAS: private health plan and medical care utilization by older adults

    Directory of Open Access Journals (Sweden)

    Lima-Costa Maria Fernanda F.

    2002-01-01

    Full Text Available The aim of this cross sectional study was to investigate whether holding a private health plan affects the consumption of medical services (hospitalization and visits to a doctor and use of medications by older adults. All residents in Bambuí town (Minas Gerais, Brazil aged > or = 60 years (n = 1,742 were selected. From these, 92.2% were interviewed and 85.9% were examined (blood tests and physical measurements. After adjustments for counfounders, those under exclusive public coverage (n = 1,296, compared with those holding a private health plan (n = 310, presented some evidence of having worse health status, reported less visits to a doctor, and used a small number of prescribed medications. The main explanation for the aged holding a private health plan was economic, not health. Even though those who had only public health coverage complained more in relation to medical care (70.9%, an important proportion of the aged with a private health care plan presented some kind of complaint (45.2%. Another worrying factor was the difficulty to acquire medication because of financial problems (47.2 and 25.2% reported, respectively. Further investigations are needed to verify whether our results can be generalized to other communities of the country.

  20. Environmental and health impact assessment for ports in Thailand.

    Science.gov (United States)

    Chanchang, Chamchan; Sithisarankul, Pornchai; Supanitayanon, Thanawat

    2016-01-01

    Port development in Thailand is an essential part of the national maritime interest in connection with ship and shore activities. The growth of maritime industry and transportation has led to the expansion of ports' areas and capacity. Each port type causes different environmental impacts. Therefore, the Port Authority of Thailand has set up guidelines on ports' environmental management. This is divided into 3 major phases; namely, planning, construction and operation commencement periods. The Report of Environmental and Health Impact Assessment (EIA, HIA and EHIA) is regarded as the environmental management process in the planning period. It is a key tool to anticipate and prevent any adverse effects that might occur on the environment as well as community health resulting from the project implementation. This measure, in turn, creates advance preparation on both the preventive and problem-solving means before the project gets off the ground. At present, the majority of new projects on port development have still been in the process of information gathering for EHIA submission. Some cannot start to operate due to their EHIA failure. For example, the Tha-sala port which did not pass EHIA, mainly because emphasis had been focused on adhering to legal regulations without taking into consideration the in-depth analysis of data being conducted by community entities in the area. Thus caused the project to be finally abolished. Impact assessment on environment and health should be aimed at detailed understanding of the community in each particular area so that effective data of objective achievement in preventing environmental problems could actually be carried out and welcomed by the concerned society.

  1. Assessment report for Hanford analytical services quality assurance plan

    International Nuclear Information System (INIS)

    Taylor, L.H.

    1994-11-01

    This report documents the assessment results of DOE/RL-94-55, Hanford Analytical Services Quality Assurance Plan. The assessment was conducted using the Requirement and Self-Assessment Database (RSAD), which contains mandatory and nonmandatory DOE Order statements for the relevant DOE orders

  2. How Do Countries' Health Information Systems Perform in Assessing Asylum Seekers' Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries.

    Science.gov (United States)

    Bozorgmehr, Kayvan; Goosen, Simone; Mohsenpour, Amir; Kuehne, Anna; Razum, Oliver; Kunst, Anton E

    2017-08-08

    Background: Accurate data on the health status, health behaviour and access to health care of asylum seekers is essential, but such data is lacking in many European countries. We hence aimed to: (a) develop and pilot-test an instrument that can be used to compare and benchmark the country health information systems (HIS) with respect to the ability to assess the health status and health care situation of asylum seekers and (b) present the results of that pilot for The Netherlands (NL) and Germany (DE). Materials and Methods : Reviewing and adapting existing tools, we developed a Health Information Assessment Tool on Asylum Seekers (HIATUS) with 50 items to assess HIS performance across three dimensions: (1) availability and detail of data across potential data sources; (2) HIS resources and monitoring capacity; (3) general coverage and timeliness of publications on selected indicators. We piloted HIATUS by applying the tool to the HIS in DE and NL. Two raters per country independently assessed the performance of country HIS and the inter-rater reliability was analysed by Pearson's rho and the intra-class correlation (ICC). We then applied a consensus-based group rating to obtain the final ratings which were transformed into a weighted summary score (range: 0-97). We assessed HIS performance by calculating total and domain-specific HIATUS scores by country as well as absolute and relative gaps in scores within and between countries. Results : In the independent rating, Pearson's rho was 0.14 (NL) and 0.30 (DE), the ICC yielded an estimated reliability of 0.29 (NL) and 0.83 (DE) respectively. In the final consensus-based rating, the total HIATUS score was 47 in NL and 15 in DE, translating into a relative gap in HIS capacity of 52% (NL) and 85% (DE) respectively. Shortfalls in HIS capacity in both countries relate to the areas of HIS coordination, planning and policies, and to limited coverage of specific indicators such as self-reported health, mental health, socio

  3. Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan.

    Science.gov (United States)

    Gutenbrunner, Christoph; Nugraha, Boya

    2018-04-18

    A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP) for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

  4. Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example

    Directory of Open Access Journals (Sweden)

    Van Greuningen Malou

    2012-08-01

    Full Text Available Abstract Introduction In many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years. Case description Since 1970, the Dutch government has explored different approaches to determine the inflow in medical schools. In 2000, a simulation model for health workforce planning was developed to estimate the required and available capacity of health professionals in the Netherlands. In this paper, this model is explained, using the Dutch general practitioners as an example. After the different steps in the model are clarified, it is shown how elements can be added to arrive at different versions of the model, or ‘scenarios’. A comparison is made of the results of different scenarios for different years. In addition, the subsequent stakeholder decision-making process is considered. Discussion and evaluation Discussion of this paper shows that workforce planning in the Netherlands is a complex modelling task, which is sensitive to different developments influencing the balance between supply and demand. It seems plausible that workforce planning has resulted in a balance between supply and demand of general practitioners. Still, it remains important that the modelling process is accepted by the different stakeholders. Besides calculating the balance between supply and demand, there needs to be an agreement between the stakeholders to implement the advised training inflow. The Dutch simulation model was evaluated using six criteria to be met by models suitable for policy objectives. This model meets these criteria, as it is a comprehensive and parsimonious model that can include all relevant factors. Conclusion Over the last decade, health workforce planning in the Netherlands has become an accepted instrument for calculating the required supply of

  5. National ignition facility environment, safety, and health management plan

    International Nuclear Information System (INIS)

    1995-11-01

    The ES ampersand H Management Plan describes all of the environmental, safety, and health evaluations and reviews that must be carried out in support of the implementation of the National Ignition Facility (NIF) Project. It describes the policy, organizational responsibilities and interfaces, activities, and ES ampersand H documents that will be prepared by the Laboratory Project Office for the DOE. The only activity not described is the preparation of the NIF Project Specific Assessment (PSA), which is to be incorporated into the Programmatic Environmental Impact Statement for Stockpile Stewardship and Management (PEIS). This PSA is being prepared by Argonne National Laboratory (ANL) with input from the Laboratory participants. As the independent NEPA document preparers ANL is directly contracted by the DOE, and its deliverables and schedule are agreed to separately with DOE/OAK

  6. Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape

    Directory of Open Access Journals (Sweden)

    Kiran Sukeri

    2016-05-01

    Full Text Available Objectives: No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. Results: During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. Conclusions: Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic

  7. Assessment of the Dutch National Air Quality Plan 2004; Beoordeling van het Nationaal Luchtkwaliteitsplan 2004

    Energy Technology Data Exchange (ETDEWEB)

    Beck, J.P.; Buringh, E.; Wieringa, K.

    2005-02-01

    The Dutch government expects that targets for the reduction of emission of particulates and nitrogen dioxide can not be reached in time. Therefore, the Netherlands is obliged to draft a plan of actions in order to realize those targets within the period that has been agreed upon in the context of the European Union air quality policy. The present plan of action has been assessed by the Netherlands Environmental Assessment Agency (MNP) with regard to the feasibility of the boundary values and the preconditions for action plans as formulated by the European Committee. Also, the plan has been assessed for the prevention or limitation of health effects and the Dutch position with regard to particulates. [Dutch] Het luchtbeleid heeft als doelstelling dat op lange termijn de gezondheidsrisico's en de effecten op ecosystemen en biodiversiteit moeten dalen tot een verwaarloosbaar niveau. Daartoe zijn in Europees verband normen voor de luchtkwaliteit vastgesteld. Nederland verwacht dat met het vastgestelde beleid niet tijdig aan de grenswaarden voor fijn stof en stikstofdioxide zal worden voldaan. Hierdoor is Nederland verplicht om een actieplan op te stellen. De uitvoering ervan zal er toe moeten leiden dat Nederland alsnog de doelen binnen de gestelde termijn haalt. Het Milieu- en Natuurplanbureau (MNP) van het RIVM heeft het actieplan getoetst aan de haalbaarheid van grenswaarden en aan de voorwaarden die door de Europese Commissie voor actieplannen zijn opgesteld. Daarnaast is het plan beoordeeld in het perspectief van de doelstelling van de richtlijn: het voorkomen of verminderen van gezondheidseffecten. Tenslotte geeft de evaluatie aanknopingspunten voor het herijken van de Nederlandse positie in de fijnstofproblematiek.

  8. Enhancing the Career Planning Self-Determination of Young Adults with Mental Health Challenges.

    Science.gov (United States)

    Sowers, Jo-Ann; Swank, Paul

    2017-01-01

    The impact of an intervention on the self-determination and career planning engagement of young adults with mental health challenges was studied. Sixty-seven young adults, 20 to 30 years of age, with mental health diagnoses (e.g., depression, bipolar disorder) were randomly assigned to intervention and control groups. Statistically significant greater increases were made by the intervention group versus the control group for self-determination and career planning engagement, and self-determination at least partially mediated increases in career planning engagement. With career planning self-determination interventions, young adults with mental health challenges might be able to achieve better career and life outcomes than is typical for this population.

  9. Use of the Home Safety Self-Assessment Tool (HSSAT) within Community Health Education to Improve Home Safety.

    Science.gov (United States)

    Horowitz, Beverly P; Almonte, Tiffany; Vasil, Andrea

    2016-10-01

    This exploratory research examined the benefits of a health education program utilizing the Home Safety Self-Assessment Tool (HSSAT) to increase perceived knowledge of home safety, recognition of unsafe activities, ability to safely perform activities, and develop home safety plans of 47 older adults. Focus groups in two senior centers explored social workers' perspectives on use of the HSSAT in community practice. Results for the health education program found significant differences between reported knowledge of home safety (p = .02), ability to recognize unsafe activities (p = .01), safely perform activities (p = .04), and develop a safety plan (p = .002). Social workers identified home safety as a major concern and the HSSAT a promising assessment tool. Research has implications for reducing environmental fall risks.

  10. Health effects assessment summary tables

    International Nuclear Information System (INIS)

    1999-01-01

    The document is an excellent pointer system to identify current literature or changes in assessment criteria for many chemicals of interest to Superfund. It was prepared for Superfund use by the Environmental Criteria and Assessment Office (ECAO-Cin) in EPA's Office of Health and Environmental Assessment. Chemicals considered are those for which Health Effects Assessment Documents, Health and Environmental Effects Profiles, Health Assessment Documents or Air Quality Criteria Documents have been prepared by ECAO. Radionuclides considered are those believed to be most common at Superfund sites. Tables summarize reference doses (RfDs) for toxicity from subchronic and chronic inhalation, oral exposure, slope factors and unit risk values for carcinogenicity based on lifetime inhalation and oral exposure, and radionuclide carcinogenicity

  11. The Joint Action on Health Workforce Planning and Forecasting: Results of a European programme to improve health workforce policies.

    Science.gov (United States)

    Kroezen, Marieke; Van Hoegaerden, Michel; Batenburg, Ronald

    2018-02-01

    Health workforce (HWF) planning and forecasting is faced with a number of challenges, most notably a lack of consistent terminology, a lack of data, limited model-, demand-based- and future-based planning, and limited inter-country collaboration. The Joint Action on Health Workforce Planning and Forecasting (JAHWF, 2013-2016) aimed to move forward on the HWF planning process and support countries in tackling the key challenges facing the HWF and HWF planning. This paper synthesizes and discusses the results of the JAHWF. It is shown that the JAHWF has provided important steps towards improved HWF planning and forecasting across Europe, among others through the creation of a minimum data set for HWF planning and the 'Handbook on Health Workforce Planning Methodologies across EU countries'. At the same time, the context-sensitivity of HWF planning was repeatedly noticeable in the application of the tools through pilot- and feasibility studies. Further investments should be made by all actors involved to support and stimulate countries in their HWF efforts, among others by implementing the tools developed by the JAHWF in diverse national and regional contexts. Simultaneously, investments should be made in evaluation to build a more robust evidence base for HWF planning methods. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Applying social science and public health methods to community-based pandemic planning.

    Science.gov (United States)

    Danforth, Elizabeth J; Doying, Annette; Merceron, Georges; Kennedy, Laura

    2010-11-01

    Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 ('swine flu') outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.

  13. Incorporating the Six Core Elements of Health Care Transition Into a Medicaid Managed Care Plan: Lessons Learned From a Pilot Project.

    Science.gov (United States)

    McManus, Margaret; White, Patience; Pirtle, Robin; Hancock, Catina; Ablan, Michael; Corona-Parra, Raquel

    2015-01-01

    This pediatric-to-adult health care transition pilot project describes the process and results of incorporating the "Six Core Elements of Health Care Transition (2.0)" into a Medicaid managed care plan with a group of 35 18-23 year olds who have chronic mental health, developmental, and complex medical conditions. The pilot project demonstrated an effective approach for customizing and delivering recommended transition services. At the start of the 18-month project, the Medicaid plan was at the basic level (1) of transition implementation of the Six Core Elements with no transition policy, member transition readiness assessment results, health care transition plans of care, updated medical summaries, transfer package for the adult-focused provider, and assurance of transfer completion and consumer feedback. At the conclusion of the pilot project, the plan scored at level 3 on each core element. The primary reason for not scoring at the highest level (4) was because the transition elements have not been incorporated into services for all enrollees within the plan. Future efforts in managed care will benefit from starting the transition process much earlier (ages 12-14), expanding the role of nurse care managers and participating pediatric and adult-focused clinicians in transition, and offering payment incentives to clinicians to implement the Six Core Elements of Health Care Transition. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Employee choice of a high-deductible health plan across multiple employers.

    Science.gov (United States)

    Lave, Judith R; Men, Aiju; Day, Brian T; Wang, Wei; Zhang, Yuting

    2011-02-01

    To determine factors associated with selecting a high-deductible health plan (HDHP) rather than a preferred provider plan (PPO) and to examine switching and market segmentation after initial selection. Claims and benefit information for 2005-2007 from nine employers in western Pennsylvania first offering HDHP in 2006. We examined plan growth over time, used logistic regression to determine factors associated with choosing an HDHP, and examined the distribution of healthy and sick members across plan types. We linked employees with their dependents to determine family-level variables. We extracted risk scores, covered charges, employee age, and employee gender from claims data. We determined census-level race, education, and income information. Health status, gender, race, and education influenced the type of individual and family policies chosen. In the second year the HDHP was offered, few employees changed plans. Risk segmentation between HDHPs and PPOs existed, but it did not increase. When given a choice, those who are healthier are more likely to select an HDHP leading to risk segmentation. Risk segmentation did not increase in the second year that HDHPs were offered. © Health Research and Educational Trust.

  15. Alberta oil sands community exposure and health effects assessment : analysis of health records as a proxy for health outcomes

    International Nuclear Information System (INIS)

    Wang, F.; Mackenzie, A.; Schopflocher, D.; Shaw, S.; Robb, J.; Gabos, S.

    2002-01-01

    A large scale study was conducted to assess potential links between air quality and human health outcomes. Health records were used as a proxy measure for health outcomes. Residents of Fort McMurray and Lethbridge, Alberta, Canada were used in the comparison of risks of selected morbidity and mortality measures during a 3 year period between 1995 and 1998. Data on the socio-demography, morbidity, and mortality were linked by PI and geographic area from the Health Care Insurance Plan, physical and hospital billing systems, and vital statistics death registration. Age was the most important confounder. Asthma incidence for children 3 years or less was examined along with prevalence and mortality of selected diseases for each sex and age group. Results showed that the incidence of asthma varied by age and sex but not by study area. There was no major difference in death from lung cancer, cardiovascular disease, coronary heart disease, respiratory disorders and COPD between residents of the target and control communities. 6 figs

  16. The Malaysian health care system: Ecology, plans, and reforms

    Directory of Open Access Journals (Sweden)

    Andrea Sebastian

    2016-08-01

    Full Text Available Malaysia is on its way to achieving developed nation status in the next 4 years. Currently, Malaysia is on track for three Millennium Development Goals (MDG1, MDG4, and MDG7. The maternal mortality rate, infant mortality rate, and mortality rate of children younger than 5 years improved from 25.6% (2012 to 6.6% (2013, and 7.7% (2012 per 100,000 live births, respectively whereas immunization coverage for infants increased to an average of 90%. As of 2013 the ratio of physicians to patients improved to 1:633 while the ratio of health facilities to the population was 1:10,272. The current government administration has proposed a reform in the form of the 10th Malaysian Plan coining the term “One Care for One Malaysia” as the newly improved and reorganized health care plan, where efficiency, effectiveness, and equity are the main focus. This review illustrates Malaysia’s transition from pre-independence to the current state, and its health and socioeconomic achievement as a country. It aims to contribute knowledge through identifying the plans and reforms by the Malaysian government while highlighting the challenges faced as a nation.

  17. Association Between Health Plan Exit From Medicaid Managed Care and Quality of Care, 2006-2014.

    Science.gov (United States)

    Ndumele, Chima D; Schpero, William L; Schlesinger, Mark J; Trivedi, Amal N

    2017-06-27

    State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences. To determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality. Retrospective cohort of all comprehensive Medicaid managed care plans (N = 390) during the interval 2006-2014. Plan exit, defined as the withdrawal of a managed care plan from a state's Medicaid program. Eight measures from the Healthcare Effectiveness Data and Information Set were used to construct 3 composite indicators of quality (preventive care, chronic disease care management, and maternity care). Four measures from the Consumer Assessment of Healthcare Providers and Systems were combined into a composite indicator of patient experience, reflecting the proportion of beneficiaries rating experiences as 8 or above on a 0-to-10-point scale. Outcome data were available for 248 plans (68% of plans operating prior to 2014, representing 78% of beneficiaries). Of the 366 comprehensive Medicaid managed care plans operating prior to 2014, 106 exited Medicaid. These exiting plans enrolled 4 848 310 Medicaid beneficiaries, with a mean of 606 039 beneficiaries affected by plan exits annually. Six states had a mean of greater than 10% of Medicaid managed care recipients enrolled in plans that exited, whereas 10 states experienced no plan exits. Plans that exited from a state's Medicaid market performed significantly worse prior to exiting than those that remained in terms of preventive care (57.5% vs 60.4%; difference, 2.9% [95% CI, 0.3% to 5.5%]), maternity care (69.7% vs 73.6%; difference, 3.8% [95% CI, 1.7% to 6.0%]), and patient experience (73.5% vs 74.8%; difference, 1.3% [95% CI, 0.6% to 1

  18. Planning an integrated agriculture and health program and designing its evaluation: Experience from Western Kenya.

    Science.gov (United States)

    Cole, Donald C; Levin, Carol; Loechl, Cornelia; Thiele, Graham; Grant, Frederick; Girard, Aimee Webb; Sindi, Kirimi; Low, Jan

    2016-06-01

    Multi-sectoral programs that involve stakeholders in agriculture, nutrition and health care are essential for responding to nutrition problems such as vitamin A deficiency among pregnant and lactating women and their infants in many poor areas of lower income countries. Yet planning such multi-sectoral programs and designing appropriate evaluations, to respond to different disciplinary cultures of evidence, remain a challenge. We describe the context, program development process, and evaluation design of the Mama SASHA project (Sweetpotato Action for Security and Health in Africa) which promoted production and consumption of a bio-fortified, orange-fleshed sweetpotato (OFSP). In planning the program we drew upon information from needs assessments, stakeholder consultations, and a first round of the implementation evaluation of a pilot project. The multi-disciplinary team worked with partner organizations to develop a program theory of change and an impact pathway which identified aspects of the program that would be monitored and established evaluation methods. Responding to the growing demand for greater rigour in impact evaluations, we carried out quasi-experimental allocation by health facility catchment area, repeat village surveys for assessment of change in intervention and control areas, and longitudinal tracking of individual mother-child pairs. Mid-course corrections in program implementation were informed by program monitoring, regular feedback from implementers and partners' meetings. To assess economic efficiency and provide evidence for scaling we collected data on resources used and project expenses. Managing the multi-sectoral program and the mixed methods evaluation involved bargaining and trade-offs that were deemed essential to respond to the array of stakeholders, program funders and disciplines involved. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Assessment of implementation of the health management ...

    African Journals Online (AJOL)

    Background Despite Malawi's introduction of a health management information system (HMIS) in 1999, the country's health sector still lacks accurate, reliable, complete, consistent and timely health data to inform effective planning and resource management. Methods A cross-sectional survey was conducted wherein ...

  20. Federal Employees Health Benefits Program: Enrollment Options Following the Termination of a Plan or Plan Option. Final rule.

    Science.gov (United States)

    2015-10-28

    The U.S. Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Employees Health Benefits (FEHB) Program regulations regarding enrollment options following the termination of a plan or plan option.

  1. Paying for individual health insurance through tax-sheltered cafeteria plans.

    Science.gov (United States)

    Hall, Mark A; Monahan, Amy B

    2010-01-01

    When employees without group health insurance buy individual coverage, they do so using after-tax income--costing them from 20% to 50% more than others pay for equivalent coverage. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA), several states promoted a potential solution that would allow employees to buy individual insurance through tax-sheltered payroll deduction. This technical but creative approach would allow insurers to combine what is known as "list-billing" with a Section 125 "cafeteria plan." However, these state-level reform attempts have failed to gain significant traction because state small-group reform laws and federal restrictions on medical underwriting cloud the legality of tax-sheltered list-billing. Several authorities have taken the position that insurance paid for through a cafeteria plan must meet the nondiscrimination requirements of the Health Insurance Portability and Accountability Act with respect to eligibility, premiums, and benefits. The recently enacted Patient Protection and Affordable Care Act addresses some of the legal uncertainty in this area, but much remains. For health reform to have its greatest effect, federal regulators must clarify whether individual health insurance can be purchased on a pre-tax basis through a cafeteria plan.

  2. Employee choice of flexible spending account participation and health plan.

    Science.gov (United States)

    Hamilton, Barton H; Marton, James

    2008-07-01

    Despite the fact that flexible spending accounts (FSAs) are becoming an increasingly popular employer-provided health benefit, there has been very little empirical study of FSA use among employees at the individual level. This study contributes to the literature on FSAs using a unique data set that provides three years of employee-level-matched benefits data. Motivated by the theoretical model of FSA choice presented in Cardon and Showalter (J. Health Econ. 2001; 20(6):935-954), we examine the determinants of FSA participation and contribution levels using cross-sectional and random-effect two-part models. FSA participation and health plan choice are also modeled jointly in each year using conditional logit models. We find that, even after controlling for a number of other demographic characteristics, non-whites are less likely to participate in the FSA program, have lower contributions conditional on participation, and have a lower probability of switching to new lower cost share, higher premium plans when they were introduced. We also find evidence that choosing health plans with more expected out-of-pocket expenses is correlated with participation in the FSA program. Copyright (c) 2007 John Wiley & Sons, Ltd.

  3. Marketing health care to employees: the structure of employee health care plan satisfaction.

    Science.gov (United States)

    Mascarenhas, O A

    1993-01-01

    Providing cost-contained comprehensive quality health care to maintain healthy and productive employees is a challenging problem for all employers. Using a representative panel of metropolitan employees, the author investigates the internal and external structure of employee satisfaction with company-sponsored health care plans. Employee satisfaction is differentiated into four meaningful groups of health care benefits, whereas its external structure is supported by the traditional satisfaction paradigms of expectation-disconfirmation, attribution, and equity. Despite negative disconfirmation, employees register sufficiently high health care satisfaction levels, which suggests some useful strategies that employers may consider implementing.

  4. The search conference as a method in planning community health promotion actions

    Directory of Open Access Journals (Sweden)

    Eva Magnus

    2016-08-01

    Full Text Available Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives.

  5. Contingency planning for electronic health record-based care continuity: a survey of recommended practices.

    Science.gov (United States)

    Sittig, Dean F; Gonzalez, Daniel; Singh, Hardeep

    2014-11-01

    Reliable health information technology (HIT) in general, and electronic health record systems (EHRs) in particular are essential to a high-performing healthcare system. When the availability of EHRs are disrupted, alternative methods must be used to maintain the continuity of healthcare. We developed a survey to assess institutional practices to handle situations when EHRs were unavailable for use (downtime preparedness). We used literature reviews and expert opinion to develop items that assessed the implementation of potentially useful practices. We administered the survey to U.S.-based healthcare institutions that were members of a professional organization that focused on collaboration and sharing of HIT-related best practices among its members. All members were large integrated health systems. We received responses from 50 of the 59 (84%) member institutions. Nearly all (96%) institutions reported at least one unplanned downtime (of any length) in the last 3 years and 70% had at least one unplanned downtime greater than 8h in the last 3 years. Three institutions reported that one or more patients were injured as a result of either a planned or unplanned downtime. The majority of institutions (70-85%) had implemented a portion of the useful practices we identified, but very few practices were followed by all organizations. Unexpected downtimes related to EHRs appear to be fairly common among institutions in our survey. Most institutions had only partially implemented comprehensive contingency plans to maintain safe and effective healthcare during unexpected EHRs downtimes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Clinical Significance: a Therapeutic Approach Topsychological Assessment in Treatment Planning

    Directory of Open Access Journals (Sweden)

    Afolabi Olusegun Emmanuel

    2015-06-01

    Full Text Available Psychological assessment has long been reported as a key component of clinical psychology. This paper examines the complexities surrounding the clinical significance of therapeutic approach to treatment planning. To achieve this objective, the paper searched and used the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to analysed, 1 a strong basis for the usage of therapeutic approach to psychological assessment in treatment plans, 2 explained the conceptual meaning of clinical significant change in therapeutic assessment, 3 answered some of the questions regarding practicability and the clinical significance of therapeutic approach to treatment plans, particularly during or before treatment, 4 linked therapeutic assessment to change in clients’ clinical impression, functioning and therapeutic needs 5 analysed the empirically documenting clinically significant change in therapeutic assessment. Finally, the study suggested that though therapeutic assessment is not sufficient for the systematic study of psychotherapy outcome and process, it is still consistent with both the layman and professional expectations regarding treatment outcome and also provides a precise method for classifying clients as ‘changed’ or ‘unchanged’ on the basis of clinical significance criteria.

  7. Environment, Safety, and Health Self-Assessment Report, Fiscal Year 2008

    Energy Technology Data Exchange (ETDEWEB)

    Chernowski, John

    2009-02-27

    Division Self-Assessment annually. The primary focus of the review is workplace safety. The MESH review is an evaluation of division management of ES&H in its research and operations, focusing on implementation and effectiveness of the division's ISM plan. It is a peer review performed by members of the LBNL Safety Review Committee (SRC), with staff support from OCA. Each division receives a MESH review every two to four years, depending on the results of the previous review. The ES&H Technical Assurance Program (TAP) provides the framework for systematic reviews of ES&H programs and processes. The intent of ES&H Technical Assurance assessments is to provide assurance that ES&H programs and processes comply with their guiding regulations, are effective, and are properly implemented by LBNL divisions. The Appendix B Performance Evaluation and Measurement Plan (PEMP) requires that LBNL sustain and enhance the effectiveness of integrated safety, health, and environmental protection through a strong and well-deployed system. Information required for Appendix B is provided by EH&S Division functional managers. The annual Appendix B report is submitted at the close of the fiscal year. This assessment is the Department of Energy's (DOE) primary mechanism for evaluating LBNL's contract performance in ISM.

  8. The Obama health care plan: what it means for mental health care of older adults.

    Science.gov (United States)

    Sorrell, Jeanne M

    2009-01-01

    Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.

  9. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  10. Salubridad Chicana: Su Preservacion Y Mantenimiento -- The Chicano Plan for Mental Health.

    Science.gov (United States)

    Duran, Ruben, Ed.; And Others

    In devising the mental health plan for Chicanos, the social, economic, and political forces that adversely affect their emotional well-being must be considered. While defining mental health needs and proposing ways to meet those needs, the cultural background of the Chicano people must seriously be considered. The plan should stress the importance…

  11. 78 FR 12676 - Timing Requirements for the Submission of a Site Assessment Plan (SAP) or General Activities Plan...

    Science.gov (United States)

    2013-02-25

    ...: BOEM-2012-0077] RIN 1010-AD77 Timing Requirements for the Submission of a Site Assessment Plan (SAP) or... would amend the timing requirements for submitting a Site Assessment Plan (SAP) or General Activities... and grants will have a preliminary term of 12 months in which a lessee or grantee must submit a SAP or...

  12. Perspectives of planning from the point of view of professional Family Health Strategy.

    Directory of Open Access Journals (Sweden)

    Polyana da Costa RIBEIRO

    2015-02-01

    Full Text Available The article looks at similarities and differences of the community diagnosis within the local planning of family health teams in Teresina. Was based on case study and focus group with teams belonging to the same territorial basis, involving hospital, health center of urban and rural area. Discusses three analytical dimensions: planning process, diagnosis in the planning of health teams and facilities/limits. It was evidenced that the planning is in its incipient, short-term, individualized and unsatisfactory demand needs. The interventions of the social actors have not involved sustainable actions, reflecting the verticality of the programmes and of distortions in the deployment process of the teams. Urge vigilance to managers with the organizational foundation of primary care, which is the diagnosis, in addition to implementing strategies for men’s health, adolescent, bedridden and caregivers and collective education, neglected.

  13. PLAN Bicol, Philippines: health manpower development program in action.

    Science.gov (United States)

    Lind, K

    1994-06-01

    PLAN Bicol in the Philippines is a community based Health Manpower Development Program (HMDP) geared toward training and mobilization of indigenous health practitioners, providing infrastructural and logistical support to individual families, and educating the community about health, nutrition, and the environment. The field officer recommends at the initiation of a project that program staff have roles that are well defined. New programs should be introduced to the community first and should involve the community in the planning stages. The HMDP program is directed to 38 villages located around national parks that have suffered from deforestation. Community health issues are malnutrition, low immunization, and lack of access to health services. HMDP established a training program for auxiliary health workers (AHWs), who make a commitment to return to their villages after training. Midwives are being trained at local schools. Village houses are being built and repaired; water systems and sanitary toilet facilities are being installed. Village health stations have been constructed and equipped with basic medicines, supplies, and equipment, and are open 5 days a week. Health education classes inform the community about nutrition and health. The problems at inception were the unwillingness of field staff to participate in the program and a high drop out rate among AHWs. Problems were worked out as the program progressed. Facilitative factors are the close coordination with the provincial health office, community acceptance, and the availability of qualified people.

  14. Health insurance: how does your plan compare? Plus, a look to new reforms.

    Science.gov (United States)

    2012-11-01

    A good insurance plan can steer you to the care that helps and away from wasting your time and money on unnecessary tests and treatments. For the third year running, we are presenting health plan rankings from the National Committee for Quality Assurance (NCQA), a nonprofit health care accreditation and quality measurement group, of a record 984 plans on their quality of care, customer satisfaction, and commitment to improvement and disclosure of information. This year, the NCQA ranked 474 private plans (which consumers obtain through a job or purchase on their own), 395 Medicare Advantage plans, and 115 Medicaid HMOs.

  15. Are Integrated Plan Providers Associated With Lower Premiums on the Health Insurance Marketplaces?

    Science.gov (United States)

    La Forgia, Ambar; Maeda, Jared Lane K; Banthin, Jessica S

    2018-04-01

    As the health insurance industry becomes more consolidated, hospitals and health systems have started to enter the insurance business. Insurers are also rapidly acquiring providers. Although these "vertically" integrated plan providers are small players in the insurance market, they are becoming more numerous. The health insurance marketplaces (HIMs) offer a unique setting to study integrated plan providers relative to other insurer types because the HIMs were designed to promote competition. In this descriptive study, the authors compared the premiums of the lowest priced silver plans of integrated plan providers with other insurer types on the 2015 and 2016 HIMs. Integrated plan providers were associated with modestly lower premiums relative to most other insurer types. This study provides early insights into premium competition on the HIMs. Examining integrated plan providers as a separate insurer type has important policy implications because they are a growing segment of the marketplaces and their pricing behavior may influence future premium trends.

  16. Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan

    Directory of Open Access Journals (Sweden)

    Christoph Gutenbrunner

    2018-01-01

    Full Text Available Objective: A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. Methods: The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. Results and discussion: The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

  17. Reduction of inequalities in health: assessing evidence-based tools

    Directory of Open Access Journals (Sweden)

    Shea Beverley

    2006-09-01

    Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

  18. 30 CFR 285.605 - What is a Site Assessment Plan (SAP)?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What is a Site Assessment Plan (SAP)? 285.605... Assessment Plan (SAP)? (a) A SAP describes the activities (e.g., installation of meteorological towers... project easement, or to test technology devices. (1) Your SAP must describe how you will conduct your...

  19. Effects of Early Dual-Eligible Special Needs Plans on Health Expenditure.

    Science.gov (United States)

    Zhang, Yongkang; Diana, Mark L

    2017-10-18

    To examine the effects of the penetration of dual-eligible special needs plans (D-SNPs) on health care spending. Secondary state-level panel data from Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) public use file and Special Needs Plan Comprehensive Reports, Area Health Resource Files, and Medicaid Managed Care Enrollment Report between 2007 and 2011. A difference-in-difference strategy that adjusts for dual-eligibles' demographic and socioeconomic characteristics, state health resources, beneficiaries' health risk factors, Medicare/Medicaid enrollment, and state- and year-fixed effects. Data from MMLEADS were summarized from Centers for Medicare and Medicaid Services (CMS)'s Chronic Conditions Data Warehouse, which contains 100 percent of Medicare enrollment data, claims for beneficiaries who are enrolled in the fee-for-service (FFS) program, and Medicaid Analytic Extract files. The MMLEADS public use file also includes payment information for managed care. Data in Special Needs Plan Comprehensive Reports were from CMS's Health Plan Management System. Results indicate that D-SNPs penetration was associated with reduced Medicare spending per dual-eligible beneficiary. Specifically, a 1 percent increase in D-SNPs penetration was associated with 0.2 percent reduction in Medicare spending per beneficiary. We found no association between D-SNPs penetration and Medicaid or total spending. Involving Medicaid services in D-SNPs may be crucial to improve coordination between Medicare and Medicaid programs and control Medicaid spending among dual-eligible beneficiaries. Starting from 2013, D-SNPs were mandated to have contracts with state Medicaid agencies. This change may introduce new effects of D-SNPs on health care spending. More research is needed to examine the impact of D-SNPs on dual-eligible spending. © Health Research and Educational Trust.

  20. Corrective Action Plan in response to the March 1992 Tiger Team Assessment of the Ames Laboratory

    International Nuclear Information System (INIS)

    1992-01-01

    On March 5, 1992, a Department of Energy (DOE) Tiger Team completed an assessment of the Ames Laboratory, located in Ames, Iowa. The purpose of the assessment was to provide the Secretary of Energy with a report on the status and performance of Environment, Safety and Health (ES ampersand H) programs at Ames Laboratory. Detailed findings of the assessment are presented in the report, DOE/EH-0237, Tiger Team Assessment of the Ames Laboratory. This document, the Ames Laboratory Corrective Action Plan (ALCAP), presents corrective actions to overcome deficiencies cited in the Tiger Team Assessment. The Tiger Team identified 53 Environmental findings, from which the Team derived four key findings. In the Safety and Health (S ampersand H) area, 126 concerns were identified, eight of which were designated Category 11 (there were no Category I concerns). Seven key concerns were derived from the 126 concerns. The Management Subteam developed 19 findings which have been summarized in four key findings. The eight S ampersand H Category 11 concerns identified in the Tiger Team Assessment were given prompt management attention. Actions to address these deficiencies have been described in individual corrective action plans, which were submitted to DOE Headquarters on March 20, 1992. The ALCAP includes actions described in this early response, as well as a long term strategy and framework for correcting all remaining deficiencies. Accordingly, the ALCAP presents the organizational structure, management systems, and specific responses that are being developed to implement corrective actions and to resolve root causes identified in the Tiger Team Assessment. The Chicago Field Office (CH), IowaState University (ISU), the Institute for Physical Research and Technology (IPRT), and Ames Laboratory prepared the ALCAP with input from the DOE Headquarters, Office of Energy Research (ER)

  1. The Effect of Florida Medicaid's State-Mandated Formulary Provision on Prescription Drug Use and Health Plan Costs in a Medicaid Managed Care Plan.

    Science.gov (United States)

    Munshi, Kiraat D; Mager, Douglas; Ward, Krista M; Mischel, Brian; Henderson, Rochelle R

    2018-02-01

    Formulary or preferred drug list (PDL) management is an effective strategy to ensure clinically efficient prescription drug management by managed care organizations (MCOs). Medicaid MCOs participating in Florida's Medicaid program were required to use a state-mandated PDL between May and August 2014. To examine differences in prescription drug use and plan costs between a single Florida Medicaid managed care (MMC) health plan that implemented a state-mandated PDL policy on July 1, 2014, and a comparable MMC health plan in another state without a state-mandated PDL, controlling for sociodemographic confounders. A retrospective analysis with a pre-post design was conducted using deidentified administrative claims data from a large pharmacy benefit manager. The prepolicy evaluation period was January 1 through June 30, 2014, and the postpolicy period was January 1 through June 30, 2015. Continuously eligible Florida MMC plan members were matched on sociodemographic and health characteristics to their counterparts enrolled in a comparable MMC health plan in another state without a state-mandated formulary. Outcomes were drug use, measured as the number of 30-day adjusted nonspecialty drug prescriptions per member per period, and total drug plan costs per member per period for all drugs, with separate measures for generic and brand drugs. Bivariate comparisons were conducted using t-tests. Employing a difference-in-differences (DID) analytic approach, multivariate negative binomial regression and generalized estimating equation models were used to analyze prescription drug use and costs. The final analytical sample consisted of 18,372 enrollees, evenly divided between the 2 groups. In the postpolicy evaluation period, overall and generic use declined, while brand use increased for members in the Florida health plan. Drug costs, especially for brands, significantly increased for Florida health plan members. No significant changes were observed over the same time period

  2. The U.S. National Action Plan to Improve Health Literacy: A Model for Positive Organizational Change.

    Science.gov (United States)

    Baur, Cynthia; Harris, Linda; Squire, Elizabeth

    2017-01-01

    This chapter presents the U.S. National Action Plan to Improve Health Literacy and its unique contribution to public health and health care in the U.S. The chapter details what the National Action Plan is, how it evolved, and how it has influenced priorities for health literacy improvement work. Examples of how the National Action Plan fills policy and research gaps in health care and public health are included. The first part of the chapter lays the foundation for the development of the National Action Plan, and the second part discusses how it can stimulate positive organizational change to help create health literate organizations and move the nation towards a health literate society.

  3. Health and safety plan for the Environmental Restoration Program at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Clark, C. Jr.; Burman, S.N.; Cipriano, D.J. Jr.; Uziel, M.S.; Kleinhans, K.R.; Tiner, P.F.

    1994-08-01

    This Programmatic Health and Safety plan (PHASP) is prepared for the U.S. Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Program. This plan follows the format recommended by the U.S. Environmental Protection Agency (EPA) for remedial investigations and feasibility studies and that recommended by the EM40 Health and Safety Plan (HASP) Guidelines (DOE February 1994). This plan complies with the Occupational Safety and Health Administration (OSHA) requirements found in 29 CFR 1910.120 and EM-40 guidelines for any activities dealing with hazardous waste operations and emergency response efforts and with OSHA requirements found in 29 CFR 1926.65. The policies and procedures in this plan apply to all Environmental Restoration sites and activities including employees of Energy Systems, subcontractors, and prime contractors performing work for the DOE ORNL ER Program. The provisions of this plan are to be carried out whenever activities are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices to minimize hazards to human health and safety and to the environment from event such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water

  4. Health and safety plan for the Environmental Restoration Program at Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Clark, C. Jr.; Burman, S.N.; Cipriano, D.J. Jr.; Uziel, M.S.; Kleinhans, K.R.; Tiner, P.F.

    1994-08-01

    This Programmatic Health and Safety plan (PHASP) is prepared for the U.S. Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Program. This plan follows the format recommended by the U.S. Environmental Protection Agency (EPA) for remedial investigations and feasibility studies and that recommended by the EM40 Health and Safety Plan (HASP) Guidelines (DOE February 1994). This plan complies with the Occupational Safety and Health Administration (OSHA) requirements found in 29 CFR 1910.120 and EM-40 guidelines for any activities dealing with hazardous waste operations and emergency response efforts and with OSHA requirements found in 29 CFR 1926.65. The policies and procedures in this plan apply to all Environmental Restoration sites and activities including employees of Energy Systems, subcontractors, and prime contractors performing work for the DOE ORNL ER Program. The provisions of this plan are to be carried out whenever activities are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices to minimize hazards to human health and safety and to the environment from event such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water.

  5. Three years in - changing plan features in the U.S. health insurance marketplace.

    Science.gov (United States)

    McKillop, Caitlin N; Waters, Teresa M; Kaplan, Cameron M; Kaplan, Erin K; Thompson, Michael P; Graetz, Ilana

    2018-06-15

    A central objective of recent U.S. healthcare policy reform, most notably the Affordable Care Act's (ACA) Health Insurance Marketplace, has been to increase access to stable, affordable health insurance. However, changing market dynamics (rising premiums, changes in issuer participation and plan availability) raise significant concerns about the marketplaces' ability to provide a stable source of healthcare for Americans that rely on them. By looking at the effect of instability on changes in the consumer choice set, we can analyze potential incentives to switch plans among price-sensitive enrollees, which can then be used to inform policy going forward. Data on health plan features for non-tobacco users in 2512 counties in 34 states participating in federally-facilitated exchanges from 2014 to 2016 was obtained from the Centers for Medicaid & Medicare Services. We examined how changes in individual plan features, including premiums, deductibles, issuers, and plan types, impact consumers who had purchased the lowest-cost silver or bronze plan in their county the previous year. We calculated the cost of staying in the same plan versus switching to another plan the following year, and analyzed how costs vary across geographic regions. In most counties in 2015 and 2016 (53.7 and 68.2%, respectively), the lowest-cost silver plan from the previous year was still available, but was no longer the cheapest plan. In these counties, consumers who switched to the new lowest-cost plan would pay less in monthly premiums on average, by $51.48 and $55.01, respectively, compared to staying in the same plan. Despite potential premium savings from switching, however, the majority would still pay higher average premiums compared to the previous year, and most would face higher deductibles and an increased probability of having to change provider networks. While the ACA has shown promise in expanding healthcare access, continued changes in the availability and affordability of health

  6. eHealth and IMIA's Strategic Planning Process - IMIA conference introductory address.

    Science.gov (United States)

    Murray, Peter; Haux, Reinhold; Lorenzi, Nancy

    2008-01-01

    The International Medical Informatics Association (IMIA) is the only organization in health and biomedical informatics which is fully international in scope, bridging the academic, health practice, education, and health industry worlds through conferences, working groups, special interest groups and publications. Authored by the IMIA Interim Vice President for Strategic Planning Implementation and co-authored by the current IMIA President and the IMIA Past-President, the intention of this paper is to introduce IMIA's current strategic planning process and to set this process in relation to 'eHealth: Combining Health Telematics, Telemedicine, Biomedical Engineering and Bioinformatics to the Edge', the theme of this conference. From the viewpoint of an international organization such as IMIA, an eHealth strategy needs to be considered in a comprehensive way, including broadly stimulating high-quality health and biomedical informatics research and education, as well as providing support to bridging outcomes towards a new practice of health care in a changing world.

  7. Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

    Science.gov (United States)

    Hutchinson, Paul L; Do, Mai; Agha, Sohail

    2011-08-24

    Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory

  8. Joint Community Health Needs Assessments as a Path for Coordinating Community-Wide Health Improvement Efforts Between Hospitals and Local Health Departments.

    Science.gov (United States)

    Carlton, Erik L; Singh, Simone Rauscher

    2018-05-01

    To examine the association between hospital-local health department (LHD) collaboration around community health needs assessments (CHNAs) and hospital investment in community health. We combined 2015 National Association of County and City Health Officials (NACCHO) Forces of Change, 2013 NACCHO Profile, and 2014-2015 Area Health Resource File data to identify a sample of LHDs (n = 439) across the United States. We included data on hospitals' community benefit from their 2014 tax filings (Internal Revenue Service Form 990, Schedule H). We used bivariate and multivariate regression analyses to examine LHDs' involvement in hospitals' CHNAs and implementation strategies and the relationship with hospital investment in community health. The LHDs that collaborated with hospitals around CHNAs were significantly more likely to be involved in joint implementation planning activities than were those that did not. Importantly, LHD involvement in hospitals' implementation strategies was associated with greater hospital investment in community health improvement initiatives. Joint CHNAs may improve coordination of community-wide health improvement efforts between hospitals and LHDs and encourage hospital investment in community health improvement activities. Public Health Implications. Policies that strengthen LHD-hospital collaboration around the CHNA may enhance hospital investments in community health.

  9. 77 FR 22691 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-04-17

    ... 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... certain health insurance policies and plan sponsors of certain self-insured health plans to fund the... health insurance policies) or R. Lisa Mojiri-Azad at (202) 622-6080 (regarding self- insured health...

  10. Assessing ecological sustainability in urban planning - EcoBalance model

    Energy Technology Data Exchange (ETDEWEB)

    Wahlgren, I., Email: irmeli.wahlgren@vtt.fi

    2012-06-15

    Urban planning solutions and decisions have large-scale significance for ecological sustainability (eco-efficiency) the consumption of energy and other natural resources, the production of greenhouse gas and other emissions and the costs caused by urban form. Climate change brings new and growing challenges for urban planning. The EcoBalance model was developed to assess the sustainability of urban form and has been applied at various planning levels: regional plans, local master plans and detailed plans. The EcoBalance model estimates the total consumption of energy and other natural resources, the production of emissions and wastes and the costs caused directly and indirectly by urban form on a life cycle basis. The results of the case studies provide information about the ecological impacts of various solutions in urban development. (orig.)

  11. Developing rural community health risk assessments for climate change: a Tasmanian pilot study.

    Science.gov (United States)

    Bell, Erica J; Turner, Paul; Meinke, Holger; Holbrook, Neil J

    2015-01-01

    This article examines the development and pilot implementation of an approach to support local community decision-makers to plan health adaptation responses to climate change. The approach involves health and wellbeing risk assessment supported through the use of an electronic tool. While climate change is a major foreseeable public health threat, the extent to which health services are prepared for, or able to adequately respond to, climate change impact-related risks remains unclear. Building health decision-support mechanisms in order to involve and empower local stakeholders to help create the basis for agreement on these adaptive actions is an important first step. The primary research question was 'What can be learned from pilot implementation of a community health and well-being risk assessment (CHWRA) information technology-based tool designed to support understanding of, and decision-making on, local community challenges and opportunities associated with health risks posed by climate change? The article examines the complexity of climate change science to adaptation translational processes, with reference to existing research literature on community development. This is done in the context of addressing human health risks for rural and remote communities in Tasmania, Australia. This process is further examined through the pilot implementation of an electronic tool designed to support the translation of physically based climate change impact information into community-level assessments of health risks and adaptation priorities. The procedural and technical nature of the CHWRA tool is described, and the implications of the data gathered from stakeholder workshops held at three rural Tasmanian local government sites are considered and discussed. Bushfire, depression and waterborne diseases were identified by community stakeholders as being potentially 'catastrophic' health effects 'likely' to 'almost certain' to occur at one or more Tasmanian rural sites

  12. [Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

    Science.gov (United States)

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

    Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance

  13. Assessing Your Weight and Health Risk

    Science.gov (United States)

    ... Health Professional Resources Assessing Your Weight and Health Risk Assessment of weight and health risk involves using ... risk for developing obesity-associated diseases or conditions. Risk Factors for Health Topics Associated With Obesity Along ...

  14. Awareness and pattern of utilizing family planning services among women attending urban health care center Azizabad Sukkur

    International Nuclear Information System (INIS)

    Shah, N.A.; Nisar, N.

    2008-01-01

    To assess level of awareness and pattern of utilizing family planning services among women (15-49 years) of reproductive age at Urban Health Center, Azizabad Sukkur, Sindh. A cross-sectional study was conducted from April to June 2005 at Urban Health Care Center Azizabad Sukkur. Two hundred women of reproductive age group were interviewed by using a pre tested semi structured questionnaire visiting the health care center during the study period. Information was obtained after taking informed consent regarding socio demographic characteristics, knowledge, attitude and pattern of utilizing family planning services. The data was entered and analyzed by using statistical package SPSS version 13. About 75% of women and 42.5% husbands were found illiterate, 85% women were housewives, 69.5% were married before 18 years of age and 54% had nuclear family. Regarding desired number of children women responded one child (3%), 2-3 children (11%), 4-5 (37.5%), more than five children (36%), 5.5% said that children are God gifted and 7% did not answer. About 60% of women reported use of at least one contraceptive method and 40% had never used any contraceptive method. The women who received counseling from the health care provider were 48.5% and only 6% received information through media. Religious prohibition, shortage of female staff and cost of family planning contraceptive methods were the main reasons identified for not utilizing contraceptive methods. The unsatisfactory variables were long waiting hours at the center, non-availability of contraceptive, shortage of the female staff and cost. Limited number of women was aware and practice contraception in the area and utilization of family planning services were low. The efforts should be made for providing information to couple and improving quality of family planning services in the area. (author)

  15. Research Quality Assessment and Planning Journals. The Italian Perspective.

    Directory of Open Access Journals (Sweden)

    Bruno Zanon

    2014-02-01

    Full Text Available Assessment of research products is a crucial issue for universities and research institutions faced with internationalization and competition. Disciplines are reacting differently to this challenge, and planning, in its various forms – from urban design to process­oriented sectors – is under strain because the increasingly common assessment procedures based on the number of articles published in ranked journals and on citation data are not generally accepted. The reputation of journals, the impact of publications, and the profiles of scholars are increasingly defined by means of indexes such as impact factor and citations counts, but these metrics are questioned because they do not take account of all journals and magazines – in particular those published in languages other than English – and they do not consider teaching and other activities typical of academics and which have a real impact on planning practices at the local level. In Italy the discussion is particularly heated because assessment procedures are recent, the disciplinary community is not used to publishing in ranked international journals, and the Italian literature is not attuned to the international quality criteria. The paper reviews the recent debate on planning journals and research assessment. It focuses on the Italian case from the perspective of improving current practices.

  16. General Plan Environmental Assessment, Hurlburt Field, Florida

    Science.gov (United States)

    2005-10-01

    sebiferum) and cogon grass (Imperata Resource/Issue Areas Hurlburt Field General Plan Environmental Assessment 4-9 cylindrica) are most...habitat on the western portion of the installation. The restoration of a native long-leaf pine/wire grass community on Hurlburt is associated with a

  17. Integrating evidence-based interventions into client care plans.

    Science.gov (United States)

    Doran, Diane; Carryer, Jennifer; Paterson, Jane; Goering, Paula; Nagle, Lynn; Kushniruk, Andre; Bajnok, Irmajean; Clark, Carrie; Srivastava, Rani

    2009-01-01

    Within the mental health care system, there is an opportunity to improve patient safety and the overall quality of care by integrating clinical practice guidelines with the care planning process through the use of information technology. Electronic assessment tools such as the Resident Assessment Inventory - Mental Health (RAI-MH) are widely used to identify the health care needs and outcomes of clients. In this knowledge translation initiative, an electronic care planning tool was enhanced to include evidence-based clinical interventions from schizophrenia guidelines. This paper describes the development of a mental health decision support prototype, a field test by clinicians, and user experiences with the application.

  18. Kenya's health workforce information system: a model of impact on strategic human resources policy, planning and management.

    Science.gov (United States)

    Waters, Keith P; Zuber, Alexandra; Willy, Rankesh M; Kiriinya, Rose N; Waudo, Agnes N; Oluoch, Tom; Kimani, Francis M; Riley, Patricia L

    2013-09-01

    Countries worldwide are challenged by health worker shortages, skill mix imbalances, and maldistribution. Human resources information systems (HRIS) are used to monitor and address these health workforce issues, but global understanding of such systems is minimal and baseline information regarding their scope and capability is practically non-existent. The Kenya Health Workforce Information System (KHWIS) has been identified as a promising example of a functioning HRIS. The objective of this paper is to document the impact of KHWIS data on human resources policy, planning and management. Sources for this study included semi-structured interviews with senior officials at Kenya's Ministry of Medical Services (MOMS), Ministry of Public Health and Sanitation (MOPHS), the Department of Nursing within MOMS, the Nursing Council of Kenya, Kenya Medical Practitioners and Dentists Board, Kenya's Clinical Officers Council, and Kenya Medical Laboratory Technicians and Technologists Board. Additionally, quantitative data were extracted from KHWIS databases to supplement the interviews. Health sector policy documents were retrieved from MOMS and MOPHS websites, and reviewed to assess whether they documented any changes to policy and practice as having been impacted by KHWIS data. Interviews with Kenyan government and regulatory officials cited health workforce data provided by KHWIS influenced policy, regulation, and management. Policy changes include extension of Kenya's age of mandatory civil service retirement from 55 to 60 years. Data retrieved from KHWIS document increased relicensing of professional nurses, midwives, medical practitioners and dentists, and interviewees reported this improved compliance raised professional regulatory body revenues. The review of Government records revealed few references to KHWIS; however, documentation specifically cited the KHWIS as having improved the availability of human resources for health information regarding workforce planning

  19. Assessment of health risks of policies

    International Nuclear Information System (INIS)

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana

    2014-01-01

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals

  20. Assessment of health risks of policies

    Energy Technology Data Exchange (ETDEWEB)

    Ádám, Balázs, E-mail: badam@cmss.sdu.dk [Unit for Health Promotion Research, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg (Denmark); Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Molnár, Ágnes, E-mail: MolnarAg@smh.ca [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael' s Hospital, Victoria 209, Rm. 3-26.22, M5B 1C6 Toronto, Ontario (Canada); Ádány, Róza, E-mail: adany.roza@sph.unideb.hu [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Bianchi, Fabrizio, E-mail: Fabriepi@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Bitenc, Katarina, E-mail: katarina.bitenc@ivz-rs.si [National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana (Slovenia); Chereches, Razvan, E-mail: razvan.m.chereches@gmail.com [Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Strada Mihail Kogalniceanu 1, 3400 Cluj (Romania); Cori, Liliana, E-mail: liliana.cori@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [NRW Centre for Health, Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Kobza, Joanna, E-mail: koga1@poczta.onet.pl [Public Health Department, Silesian Medical University, 18 Medykow Street, 40-752 Katowice (Poland); Kollarova, Jana, E-mail: janakollarova@yahoo.com [Department of Health Promotion, Regional Public Health Authority, Ipelska 1, 04011 Kosice (Slovakia); and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  1. What health plans do people prefer? The trade-off between premium and provider choice.

    Science.gov (United States)

    Determann, Domino; Lambooij, Mattijs S; de Bekker-Grob, Esther W; Hayen, Arthur P; Varkevisser, Marco; Schut, Frederik T; Wit, G Ardine de

    2016-09-01

    Within a healthcare system with managed competition, health insurers are expected to act as prudent buyers of care on behalf of their customers. To fulfil this role adequately, understanding consumer preferences for health plan characteristics is of vital importance. Little is known, however, about these preferences and how they vary across consumers. Using a discrete choice experiment (DCE) we quantified trade-offs between basic health plan characteristics and analysed whether there are differences in preferences according to age, health status and income. We selected four health plan characteristics to be included in the DCE: (i) the level of provider choice and associated level of reimbursement, (ii) the primary focus of provider contracting (price, quality, social responsibility), (iii) the level of service benefits, and (iv) the monthly premium. This selection was based on a literature study, expert interviews and focus group discussions. The DCE consisted of 17 choice sets, each comprising two hypothetical health plan alternatives. A representative sample (n = 533) of the Dutch adult population, based on age, gender and educational level, completed the online questionnaire during the annual open enrolment period for 2015. The final model with four latent classes showed that being able to choose a care provider freely was by far the most decisive characteristic for respondents aged over 45, those with chronic conditions, and those with a gross income over €3000/month. Monthly premium was the most important choice determinant for young, healthy, and lower income respondents. We conclude that it would be very unlikely for half of the sample to opt for health plans with restricted provider choice. However, a premium discount up to €15/month by restricted health plans might motivate especially younger, healthier, and less wealthy consumers to choose these plans. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Strategic Medicines Planning in Primary Health Care | Adindu ...

    African Journals Online (AJOL)

    Strategic medicines planning requires broad understanding of health and medicines realities within a context. Pharmacists viewing the community from a holistic perspective promote effectiveness in pharmacy, and facilitate synergy among the various groups to solve intractable medicines problems. Strategic medicines ...

  3. Study on environmental impact assessment of uranium mining and milling base planning

    International Nuclear Information System (INIS)

    Liu Xiaochao; Song Liquan

    2008-01-01

    Environmental impact assessment (EIA) of project planning is part of strategic EIA, which provides full consideration and evaluation of the potential environmental impact on tiered basis in the process of plan implementation. With account being taken of EIA of uranium mining/milling base and the current situation of mining/milling industry, this paper determined environmental protection objectives of EIA, screened assessment indexes and identified weighting factors. Based on the characteristics of mines planned, restrictive score values are estimated each for EIA weighting factor. Finally some suggestions were made for adjusting the plan. (authors)

  4. Study on environmental impact assessment index system of uranium production base construction plan

    International Nuclear Information System (INIS)

    Liu Xiaochao; Song Liquan

    2008-01-01

    The index system on planning environmental impact assessment of uranium mining base construction is discussed by using the hiberarchy method according to characteristics of uranium production and environmental protection object of planning assessment. The suggested index system is in favor of persistent exploitation of uranium resource and environmental protection in the uranium mining area, and can provide a reference for planning environmental impact assessment of uranium mining base construction in China. (authors)

  5. Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

    Science.gov (United States)

    Wong, Charlene A; Kulhari, Sajal; McGeoch, Ellen J; Jones, Arthur T; Weiner, Janet; Polsky, Daniel; Baker, Tom

    2018-05-29

    The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the total cost estimates on public versus private exchanges for a standardized consumer. Nearly all studied consumer decision aids saw increased deployment in the public marketplaces in OEP4 compared to OEP3. Over half of the public exchanges (n = 7 of 13) had total cost estimators (versus 5 of 14 in OEP3) in window-shopping and integrated provider lookups (window-shopping: 7; real-shopping: 8). The most common default plan orders were by premium or total cost estimate. Notable features on private health insurance exchanges were unique data presentation (e.g., infographics) and further personalized shopping (e.g., recommended plan flags). Health plan total cost estimates varied substantially between the public and private exchanges (average difference $1526). The ACA's public health insurance exchanges offered more tools in OEP4 to help consumers select a plan. While private health insurance exchanges presented notable features, the total cost estimates for a standardized consumer varied widely on public

  6. Oak Ridge National Laboratory Environmenal, Safety, and Health Management Plan

    International Nuclear Information System (INIS)

    1991-12-01

    The 1990 Tiger Team Appraisal of Oak Ridge National Laboratory (ORNL) revealed that neither Martin Marietta Energy Systems, Inc. (Energy Systems) nor ORNL had a strategic plan for Environmental, Safety, and Health (ES ampersand H) activities. There were no detailed plans describing ORNL's mission, objectives, and strategies for ES ampersand H activities. A number of plans do exist that cover various aspects of ES ampersand H. Their scope ranges from multiyear program plans to annual audit schedules to compliance plans to action plans from specific audits. However, there is not a single document that identifies the plans and the objectives they are to address. This document describes the strategic plan for ORNL and provides the linkage among existing plans. It gives a brief description of the organization and management of ES ampersand H activities at ORNL. The plan identifies the general strategies to be taken by ORNL, using the overall guidance from Energy Systems in its corporate ES ampersand H Strategic Plan. It also identifies more detailed plans for implementation of these strategies, where appropriate

  7. Ebola Preparedness Planning and Collaboration by Two Health Systems in Wisconsin, September to December 2014.

    Science.gov (United States)

    Leonhardt, Kathryn Kraft; Keuler, Megan; Safdar, Nasia; Hunter, Paul

    2016-08-01

    We describe the collaborative approach used by 2 health systems in Wisconsin to plan and prepare for the threat of Ebola virus disease. This was a descriptive study of the preparedness planning, infection prevention, and collaboration with public health agencies undertaken by 2 health systems in Wisconsin between September and December 2014. The preparedness approach used by the 2 health systems relied successfully on their robust infrastructure for planning and infection prevention. In the setting of rapidly evolving guidance and unprecedented fear regarding Ebola, the 2 health systems enhanced their response through collaboration and coordination with each other and government public health agencies. Key lessons learned included the importance of a rigorous planning process, robust infection prevention practices, and coalitions between public and private health sectors. The potential threat of Ebola virus disease stimulated emergency preparedness in which acute care facilities played a leading role in the public health response. Leveraging the existing expertise of health systems is essential when faced with emerging infectious diseases. (Disaster Med Public Health Preparedness. 2016;10:691-697).

  8. Work plan, health and safety plan, and site characterization for the Rust Spoil Area (D-106)

    International Nuclear Information System (INIS)

    Bohrman, D.E.; Uziel, M.S.; Landguth, D.C.; Hawthorne, S.W.

    1990-06-01

    As part of the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) of the Department of Energy's Y-12 Plant located in Oak Ridge, Tennessee, this work plan has been developed for the Rust Spoil Area (a solid waste disposal area). The work plan was developed by the Measurement Applications and Development Group (MAD) of the Health and Safety Research Division (HASRD) at Oak Ridge National Laboratory (ORNL) and will be implemented jointly by ORNL/MAD and the Y-12 Environmental Surveillance Section. This plan consists of four major sections: (1) a project description giving the scope and objectives of the investigation at the Rust Spoil Area; (2) field and sampling procedures describing sample documentation, soil sampling techniques, sample packaging and preservation, equipment decontamination, and disposal of investigation generated wastes; (3) sample analysis procedures detailing necessary analytical laboratory procedures to ensure the quality of chemical results from sample receipt through analysis and data reporting; and (4) a health and safety plan which describes general site hazards and particular hazards associated with specific tasks, assigns responsibilities, establishes personnel protection standards and mandatory safety procedures, and provides emergency information for contingencies that may arise during the course of field operations

  9. Impact of noise on self-rated job satisfaction and health in open-plan offices: a structural equation modelling approach.

    Science.gov (United States)

    Lee, Pyoung Jik; Lee, Byung Kwon; Jeon, Jin Yong; Zhang, Mei; Kang, Jian

    2016-01-01

    This study uses a structural equation model to examine the effects of noise on self-rated job satisfaction and health in open-plan offices. A total of 334 employees from six open-plan offices in China and Korea completed a questionnaire survey. The questionnaire included questions assessing noise disturbances and speech privacy, as well as job satisfaction and health. The results indicated that noise disturbance affected self-rated health. Contrary to popular expectation, the relationship between noise disturbance and job satisfaction was not significant. Rather, job satisfaction and satisfaction with the environment were negatively correlated with lack of speech privacy. Speech privacy was found to be affected by noise sensitivity, and longer noise exposure led to decreased job satisfaction. There was also evidence that speech privacy was a stronger predictor of satisfaction with environment and job satisfaction for participants with high noise sensitivity. In addition, fit models for employees from China and Korea showed slight differences. This study is motivated by strong evidence that noise is the key source of complaints in open-plan offices. Survey results indicate that self-rated job satisfaction of workers in open-plan offices was negatively affected by lack of speech privacy and duration of disturbing noise.

  10. Assessment of university student health literacy toward Influenza

    Directory of Open Access Journals (Sweden)

    Marzieh Meraji

    2016-12-01

    Full Text Available Background and objective: Outbreak of influenza A/H1N1 become serious concern. Student in academic institutions can play effective role in prevention and control of influenza. Here paramedical faculty student health literacy toward Influenza was assessed. Methods: A cross sectional-descriptive study was conducted among 139 students in Medical Records, Physiotherapy, Radiology, Health Information Technology, Speech Therapy and Optometry discipline at paramedical faculty of Mashhad medical university in 2016. A pandemic influenza questionnaire was translated and edited. Demographic characteristics of student, level of knowledge and perception toward influenza and perception toward government and media were collected. Results: More than half of student correctly identified influenza symptoms as fever 95/1%, body ache 51/2%, cough 46/3% and headaches 43/9%.person to person transmission and contact with infected objects were recognized by 87/8% and 68/3% of student as a mode of transmission. Students Covering identified nose and mouth 87/8%, hand washing with soap and water 80/5% and throwing tissues in rubbish bin as precutions.48/6% of student believed that influenza is not fatal; despite 88/9% of student perceived influenza as serious disease. In Government and media assessment, 39% of student agreed health department and other health authorities had a good control plan, 51/4% of student agreed with transparency of necessary intervention during flu outbreak. Conclusion: This study shows that paramedical faculty student has appropriate influenza health literacy. Delivering more information about mode of transmission, high risk group and precaution intervention and playing more effective role by media is recommended. Paper Type: Research Article.

  11. 48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

    Science.gov (United States)

    2010-10-01

    ..., safety, and health into work planning and execution. 970.5223-1 Section 970.5223-1 Federal Acquisition... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and...

  12. Statistical Models to Assess the Health Effects and to Forecast Ground Level Ozone

    Czech Academy of Sciences Publication Activity Database

    Schlink, U.; Herbath, O.; Richter, M.; Dorling, S.; Nunnari, G.; Cawley, G.; Pelikán, Emil

    2006-01-01

    Roč. 21, č. 4 (2006), s. 547-558 ISSN 1364-8152 R&D Projects: GA AV ČR 1ET400300414 Institutional research plan: CEZ:AV0Z10300504 Keywords : statistical models * ground level ozone * health effects * logistic model * forecasting * prediction performance * neural network * generalised additive model * integrated assessment Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.992, year: 2006

  13. Promoting Health Literacy through the Health Education Assessment Project

    Science.gov (United States)

    Marx, Eva; Hudson, Nancy; Deal, Tami B.; Pateman, Beth; Middleton, Kathleen

    2007-01-01

    Background: The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is…

  14. 77 FR 58488 - Hawaii State Plan for Occupational Safety and Health

    Science.gov (United States)

    2012-09-21

    ... DEPARTMENT OF LABOR Occupational Safety and Health Administration 29 CFR Part 1952 [Docket ID. OSHA 2012-0029] RIN 1218-AC78 Hawaii State Plan for Occupational Safety and Health AGENCY: Occupational... announces the Occupational Safety and Health Administration's (OSHA) decision to modify the Hawaii State...

  15. Some factors affecting acceptance of family planning in Manus.

    Science.gov (United States)

    Avue, B; Freeman, P

    1991-12-01

    This paper examines selected factors affecting the acceptance and delivery of modern family planning from health centres in Manus. A survey was carried out of mothers attending Maternal and Child Health clinics and a written questionnaire was given to health workers. The survey of mothers demonstrated the importance of the husband's approval for contraceptive practice and showed that knowledge about traditional methods of family planning is widespread. The health workers' questionnaire demonstrated a high level of dissatisfaction with the current family planning program delivered by health clinics: 45% found the program ineffective; 68% wrote that health workers' attitudes discouraged mothers from attending for family planning. The perceived and actual benefits and costs of children and the role of men should be assessed locally before planning future family planning programs. Widespread retraining and motivating of health workers is essential if improved coverage is to be achieved through health services. The efficacy of alternative methods of delivery of family planning such as local community-based and social marketing programs should also be investigated.

  16. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

  17. Linking global scenarios to national assessments: Experiences from the Resources Planning Act (RPA) Assessment

    Science.gov (United States)

    Linda L. Langner; Peter J. Ince

    2012-01-01

    The Resources Planning Act (RPA) Assessment provides a nationally consistent analysis of the status and trends of the Nation's renewable forest resources. A global scenario approach was taken for the 2010 RPA Assessment to provide a shared world view of potential futures. The RPA Assessment scenarios were linked to the global scenarios and climate projections used...

  18. Assessing river health in Europe and Switzerland

    Science.gov (United States)

    Milano, Marianne; Chèvre, Nathalie; Reynard, Emmanuel

    2017-04-01

    River conditions and welfare of aquatic ecosystems are threatened by anthropogenic and climatic changes. The release of personal-care products, pharmaceuticals and crop protection products is increasing and climate change is likely to cause significant changes in hydrological regimes affecting water resources' capacity to dissolve pollutants. Assessing river health, i.e. the ability of a river to support and maintain a balanced ecosystem close to the natural habitat, is thus of major concern to ensure the development of ecosystems and to provide enough clean useable water to users. Such studies involve physical, chemical and biological processes and characteristics. In Europe and Switzerland, standardized procedures have been developed to assess the hydromorphological, ecological and toxicological status of rivers. The European Water Framework Directive sets ecological requirements and chemical guidelines while the Swiss Modular Stepwise Procedure suggests methods to apprehend ecological deficits and promote water management plans. In this study, both procedures were applied and compared in order (i) to address their capacity to follow-up the spatial and temporal variability of the river's water quality and (ii) to identify challenges that still need to be addressed to assess river's health. Applied on the Boiron River (canton of Vaud, Switzerland) for a 11-year period (2005-2015), both frameworks highlight that no section of the river currently meets a good environmental state. This river flows through a diversified agricultural area causing a progressive deterioration of its chemical and biological quality. The two methods also identify two periods of time with significant changes of the river's water quality. The 2009-2011 period is characterized by a significant deterioration of the river's ecological and toxicological state due to severe low flows and an increased use of pesticides. However, since 2013, an improvement in water quality is identified in

  19. Assessing the Value of Moving More-The Integral Role of Qualified Health Professionals.

    Science.gov (United States)

    Arena, Ross; McNeil, Amy; Lavie, Carl J; Ozemek, Cemal; Forman, Daniel; Myers, Jonathan; Laddu, Deepika R; Popovic, Dejana; Rouleau, Codie R; Campbell, Tavis S; Hills, Andrew P

    2018-04-01

    Being physically active or, in a broader sense, simply moving more throughout each day is one of the most important components of an individual's health plan. In conjunction with regular exercise training, taking more steps in a day and sitting less are also important components of one's movement portfolio. Given this priority, health care professionals must develop enhanced skills for prescribing and guiding individualized movement programs for all their patients. An important component of a health care professional's ability to prescribe movement as medicine is competency in assessing an individual's risk for untoward events if physical exertion was increased. The ability to appropriately assess one's risk before advising an individual to move more is integral to clinical decision-making related to subsequent testing if needed, exercise prescription, and level of supervision with exercise training. At present, there is a lack of clarity pertaining to how a health care professional should go about assessing an individual's readiness to move more on a daily basis in a safe manner. Therefore, this perspectives article clarifies key issues related to prescribing movement as medicine and presents a new process for clinical assessment before prescribing an individualized movement program. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. RCRA Assessment Plan for Single-Shell Tank Waste Management Area TX-TY

    Energy Technology Data Exchange (ETDEWEB)

    Horton, Duane G.

    2007-03-26

    WMA TX-TY contains underground, single-shell tanks that were used to store liquid waste that contained chemicals and radionuclides. Most of the liquid has been removed, and the remaining waste is regulated under the RCRA as modi¬fied in 40 CFR Part 265, Subpart F and Washington State’s Hazardous Waste Management Act . WMA TX-TY was placed in assessment monitoring in 1993 because of elevated specific conductance. A groundwater quality assessment plan was written in 1993 describing the monitoring activities to be used in deciding whether WMA TX-TY had affected groundwater. That plan was updated in 2001 for continued RCRA groundwater quality assessment as required by 40 CFR 265.93 (d)(7). This document further updates the assessment plan for WMA TX-TY by including (1) information obtained from ten new wells installed at the WMA after 1999 and (2) information from routine quarterly groundwater monitoring during the last five years. Also, this plan describes activities for continuing the groundwater assessment at WMA TX TY.

  1. Innovative Models of Dental Care Delivery and Coverage: Patient-Centric Dental Benefits Based on Digital Oral Health Risk Assessment.

    Science.gov (United States)

    Martin, John; Mills, Shannon; Foley, Mary E

    2018-04-01

    Innovative models of dental care delivery and coverage are emerging across oral health care systems causing changes to treatment and benefit plans. A novel addition to these models is digital risk assessment, which offers a promising new approach that incorporates the use of a cloud-based technology platform to assess an individual patient's risk for oral disease. Risk assessment changes treatment by including risk as a modifier of treatment and as a determinant of preventive services. Benefit plans are being developed to use risk assessment to predetermine preventive benefits for patients identified at elevated risk for oral disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Evaluating the balanced scorecard at the University Health Network: an impact assessment.

    Science.gov (United States)

    Young, Justin; Bell, Robert; Khalfan, Adil; Lindquist, Evert

    2008-01-01

    The balanced scorecard (BSC) has become increasing popular in healthcare organizations. A recent study conducted at the University Health Network in Toronto explored the extent to which the BSC has focused and aligned various organizational units and departments around shared goals and objectives. The evaluation also assessed the BSC's impact on front-line staff and how the development and rollout of the BSC should be modified in the next planning iteration.

  3. Tooth wear risk assessment and care-planning in general dental practice.

    Science.gov (United States)

    O'Toole, S; Khan, M; Patel, A; Patel, N J; Shah, N; Bartlett, D; Movahedi, S

    2018-03-09

    Objective To assess charting, risk assessment and treatment-planning of tooth wear between recently qualified and experienced dentists in general dental practice.Design Service evaluation.Setting Multi-setting evaluation of three mixed NHS/Private general dental practices in North-East London.Methods The clinical notes of new patient examinations on dentate adults presenting from the 1 October 2016 to 31 December 2016 were audited collecting data on tooth wear charting, risk assessment and treatment planning. Data were analysed using descriptives, chi square and logistic regressions in SPSS. Significance was inferred at p charted for 48% of those attending foundation dentists and 5% of those attending experienced dentists. Diet was assessed in 50.6% of patients examined by foundation dentists and 1.0% of patients examined by experienced dentists. Foundation dentists were more likely to chart tooth wear, risk assess and preventively manage tooth wear compared to experienced dentists (p <0.001).Conclusion This service evaluation highlights that improvements are required in recording, risk assessing and preventive treatment planning of erosive tooth wear. Experienced dentists were less likely to risk assess tooth wear and less likely to provide preventive treatment. Experienced GDPs may benefit from re-training in this area.

  4. AVLIS Production Plant Preliminary Quality Assurance Plan and Assessment

    International Nuclear Information System (INIS)

    1984-01-01

    This preliminary Quality Assurance Plan and Assessment establishes the Quality Assurance requirements for the AVLIS Production Plant Project. The Quality Assurance Plan defines the management approach, organization, interfaces, and controls that will be used in order to provide adequate confidence that the AVLIS Production Plant design, procurement, construction, fabrication, installation, start-up, and operation are accomplished within established goals and objectives. The Quality Assurance Program defined in this document includes a system for assessing those elements of the project whose failure would have a significant impact on safety, environment, schedule, cost, or overall plant objectives. As elements of the project are assessed, classifications are provided to establish and assure that special actions are defined which will eliminate or reduce the probability of occurrence or control the consequences of failure. 8 figures, 18 tables

  5. Introducing the World Health Organization Postpartum Family Planning Compendium.

    Science.gov (United States)

    Sonalkar, Sarita; Gaffield, Mary E

    2017-01-01

    The postpartum period offers multiple opportunities for healthcare providers to assist with family planning decision making. However, there are also many changing factors during the first year after delivery that can affect family planning choices. Given that several different documents have addressed WHO guidance on postpartum family planning, the electronic WHO Postpartum Family Planning Compendium (http://srhr.org/postpartumfp) has been introduced. This resource integrates essential guidance on postpartum family planning for clinicians, program managers, and policy makers. The development of the Compendium included consultations with family planning experts, key international stakeholders, and web developers. Once the website had been created, user testing by family planning experts allowed for improvements to be made before the official launch. Future directions are adaptation of the website into a mobile application that can be more easily integrated to low-resource settings, and translation of the content into French and Spanish. © 2016 World Health Organization. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  6. Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making.

    Science.gov (United States)

    Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

    2008-12-18

    In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health.

  7. 75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

    Science.gov (United States)

    2010-11-17

    ... HEALTH AND HUMAN SERVICES Office of Consumer Information and Insurance Oversight 45 CFR Part 147 RIN 0950-AA17 [OCIIO-9991-IFC2] Amendment to the Interim Final Rules for Group Health Plans and Health Insurance... Administration, Department of Labor; Office of Consumer Information and Insurance Oversight, Department of Health...

  8. Provision of Family Planning Services in Tanzania: A Comparative ...

    African Journals Online (AJOL)

    Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health ...

  9. 20 CFR 1002.163 - What types of health plans are covered by USERRA?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What types of health plans are covered by USERRA? 1002.163 Section 1002.163 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS... by USERRA? (a) USERRA defines a health plan to include an insurance policy or contract, medical or...

  10. Public Health Planning for Vulnerable Populations and Pandemic Influenza

    National Research Council Canada - National Science Library

    Cameron, Wendy K

    2008-01-01

    This thesis addresses planning for vulnerable populations, those segments of each community that are normally independent but that may require special assistance during a health emergency such as an influenza pandemic...

  11. 1997 Operating plan for the Office of International Health Programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    One year ago, the Office of International Health Programs provided you with our 1996 Operating Plan, which defined our ideas and ideals for conducting business in 1996. We have again this year undertaken an intensive planning effort, first reviewing our accomplishments and shortcomings during 1996, and then developing plans and priorities for the upcoming year, taking into account input from customers and outside review panels, and ensuring that the demands on the office have been balanced with anticipated human, financial, and material resources.

  12. IRIS Assessment Plan for Ammonia and Ammonium Salts Noncancer Oral (Scoping and Problem Formulation Materials)

    Science.gov (United States)

    In April 2018, EPA released the draft IRIS Assessment Plan for Ammonia and Ammonium Salts Noncancer Oral. An IRIS Assessment Plan (IAP) communicates to the public the plan for assessing each individual chemical and includes summary information on the IRIS Program’s sco...

  13. Service user involvement in care planning: the mental health nurse's perspective.

    Science.gov (United States)

    Anthony, P; Crawford, P

    2000-10-01

    A dissonance between espoused values of consumerism within mental health care and the 'reality' of clinical practice has been firmly established in the literature, not least in terms of service user involvement in care planning. In order to begin to minimize such dissonance, it is vital that mental health nurse perceptions of service user involvement in the core activity of care planning are better understood. The main findings of this qualitative study, which uses semistructured interviews, suggest that mental health nurses value the concept of user involvement but consider it to be problematic in certain circumstances. The study reveals that nurses hold similar views about the 'meaning' of patient involvement in care planning but limited resources, individual patients characteristics and limitations in nursing care are the main inhibiting factors. Factors perceived as promoting and increasing user involvement included: provision of accurate information, 'user-friendly' documentation, mechanisms for gaining service user feedback, and high staff morale.

  14. Self-Efficacy and Planning as Predictors of Physical Activity in the Context of Workplace Health Promotion.

    Science.gov (United States)

    Keller, Jan; Gellert, Paul; Knoll, Nina; Schneider, Michael; Ernsting, Anna

    2016-11-01

    Fostering self-efficacy and planning in individuals can support the uptake and maintenance of regular physical activity. This study examined self-efficacy and planning as mechanisms of an online-delivered workplace health promotion intervention to enhance employees' physical activity. A special focus lay on reciprocal interrelations among self-efficacy and planning over time, as previous work predominantly accounted for only one predictive direction at a time. Data from N = 1,063 employees of a pharmaceutical company who reported an intention to increase their physical activity levels were assessed at three measurement points up to 12 weeks following the intervention. Cross-lagged panel analyses were performed to examine effects of self-efficacy and planning on physical activity as well as reciprocal interrelations between self-efficacy and planning. Findings indicated an increase in self-efficacy, planning, and physical activity following the intervention. Planning was consistently linked to subsequent physical activity, whereas self-efficacy was not associated. Also, reciprocal interrelations among self-efficacy and planning were found across both measurement lags. Planning was confirmed as a predictor of physical activity, whereas self-efficacy was not. However, cross-lagged interrelations indicated reciprocal reactivation among self-efficacy and planning over time, suggesting beneficial effects of including strategies that foster both volitional constructs in interventions. © 2016 The International Association of Applied Psychology.

  15. Navy Health Care Strategic Planning Process: A Draft Functional Description

    Science.gov (United States)

    1993-09-01

    are: 1. Conduct Health Care Planning 2. Manage Human Resoutrce 3. Manage Finances 4. Manag Education and Training 5. Provide Health Care Support to...and general officer medical records. This module is underdevelopment. 3. Manage Finances . This module is designed to be used by comptrollers. It assists

  16. Successful business process design. Business plan development for the occupational health services unit.

    Science.gov (United States)

    Kalina, C M; Fitko, J

    1997-02-01

    1. The occupational health nurse is often mandated by management to validate health services offered and programs developed for employees as valuable to the business and company mission. 2. The business plan of the occupational health service is a working document, changing as needs of the client/customer and internal and external business and socio-economic environment evolve. 3. Alignment with and support of the company mission, goals, and objectives is another method of proving good occupational health is good business. 4. Business planning is a basic business tool the wise and prudent occupational health nurse can use in proving good occupational health is vital to the success of a company.

  17. User Satisfaction with Family Planning Services in Government Health Centres in the Congo.

    Science.gov (United States)

    Ndziessi, Gilbert; Bintsene-Mpika, Gickelle; Bileckot, Richard

    2017-09-01

    Patient satisfaction is considered an indicator of quality of care. This study aimed to assess the degree of clients' satisfaction with family planning (FP) services in government health centers in Congo. A cross-sectional study was conducted. A total of 635 clients nested in 27 health facilities were included in the analysis. Satisfaction was defined as "having a good perception of provider technical skills, being satisfied with the service organization and having a general positive appreciation of FP services. Statistical analyses were performed using SPSS v15. Among 635 clients, 57% perceived lack of technical competence in providers, 88% perceived good organization in FP services and 77% declared having general positive appreciation of FP services. Global level of client satisfaction was 42%. In conclusion client satisfaction with FP service was low and strengthening health workers technical competence is crucial. But, as the quality is multidimensional, other aspects especially significant funding investment and quality-assurance interventions must be taken into account.

  18. [Implementation of a safety and health planning system in a teaching hospital].

    Science.gov (United States)

    Mariani, F; Bravi, C; Dolcetti, L; Moretto, A; Palermo, A; Ronchin, M; Tonelli, F; Carrer, P

    2007-01-01

    University Hospital "L. Sacco" had started in 2006 a two-year project in order to set up a "Health and Safety Management System (HSMS)" referring to the technical guideline OHSAS 18001:1999 and the UNI and INAIL "Guidelines for a health and safety management system at workplace". So far, the following operations had been implemented: Setting up of a specific Commission within the Risk Management Committee; Identification and appointment of Departmental Representatives of HSMS; Carrying out of a training course addressed to Workers Representatives for Safety and Departmental Representatives of HSMS; Development of an Integrated Informative System for Prevention and Safety; Auditors qualification; Inspection of the Occupational Health Unit and the Prevention and Safety Service: reporting of critical situations and monitoring solutions adopted. Short term objectives are: Self-evaluation through check-lists of each department; Sharing of the Improvement Plan among the departments of the hospital; Planning of Health and Safety training activities in the framework of the Hospital Training Plan; Safety audit.

  19. Emergency planning and management in health care: priority research topics.

    Science.gov (United States)

    Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

    2014-06-01

    Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

  20. Assessing elders using the functional health pattern assessment model.

    Science.gov (United States)

    Beyea, S; Matzo, M

    1989-01-01

    The impact of older Americans on the health care system requires we increase our students' awareness of their unique needs. The authors discuss strategies to develop skills using Gordon's Functional Health Patterns Assessment for assessing older clients.

  1. Comparison of provider and plan-based targeting strategies for disease management.

    Science.gov (United States)

    Annis, Ann M; Holtrop, Jodi Summers; Tao, Min; Chang, Hsiu-Ching; Luo, Zhehui

    2015-05-01

    We aimed to describe and contrast the targeting methods and engagement outcomes for health plan-delivered disease management with those of a provider-delivered care management program. Health plan epidemiologists partnered with university health services researchers to conduct a quasi-experimental, mixed-methods study of a 2-year pilot. We used semi-structured interviews to assess the characteristics of program-targeting strategies, and calculated target and engagement rates from clinical encounter data. Five physician organizations (POs) with 51 participating practices implemented care management. Health plan member lists were sent monthly to the practices to accept patients, and then the practices sent back data reports regarding targeting and engagement in care management. Among patients accepted by the POs, we compared those who were targeted and engaged by POs with those who met health plan targeting criteria. The health plan's targeting process combined claims algorithms and employer group preferences to identify candidates for disease management; on the other hand, several different factors influenced PO practices' targeting approaches, including clinical and personal knowledge of the patients, health assessment information, and availability of disease-relevant programs. Practices targeted a higher percentage of patients for care management than the health plan (38% vs 16%), where only 7% of these patients met the targeting criteria of both. Practices engaged a higher percentage of their targeted patients than the health plan (50% vs 13%). The health plan's claims-driven targeting approach and the clinically based strategies of practices both provide advantages; an optimal model may be to combine the strengths of each approach to maximize benefits in care management.

  2. The changing roles of community nurses: the case of health plan nurses in Israel.

    Science.gov (United States)

    Nissanholtz-Gannot, Rachel; Rosen, Bruce; Hirschfeld, Miriam

    2017-12-23

    In Israel, approximately one-third of the country's nurses work in community settings - primarily as salaried employees in Israel's four non-profit health plans. Many health system leaders believe that the roles of health plan nurses have changed significantly in recent years due to a mix of universal developments (such as population aging and academization of the profession) and Israel-specific changes (such as the introduction of extensive quality monitoring in primary care). The main objectives of the study were to identify recent changes in the roles of health plan nurses and their current areas of activity. It also explored the experience of front-line nurses with regard to autonomy, work satisfaction, and barriers to further role development. The study integrated interviews and surveys of nurses and other professionals conducted across 4 years. Data generated from earlier study components were used to guide questions and focus for later components. In 2013, in-depth interviews were held with 55 senior nursing and medical professionals supplemented by interviews in mid-2017 with the head nurses in the four health plans. In addition, a national survey was conducted in 2014-5 among a representative sample of 1019 community nurses who work for the health plans and who are engaged in direct patient care. Six hundred ninety-two nurses responded to the survey, yielding a response rate of 69%. The survey sample consisted of an equal number of nurses from each health plan, and the observations were weighted accordingly. Senior professionals identified general themes associated with a shift in nursing roles, including a transition from reactive to initiated work, increased specialization, and a shifting of tasks from hospitals to community settings. They identified the current main areas of activity in the health plans as being: routine care, chronic care, health promotion, quality monitoring and improvement, specialized care (such as wound care), and home care. In

  3. Assessment and treatment of planning skills in adolescents