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Sample records for prepaid health plan

  1. The Adoption of Prepaid Tuition and Savings Plans in the American States: An Event History Analysis

    Science.gov (United States)

    Doyle, William R.; McLendon, Michael K.; Hearn, James C.

    2010-01-01

    The past two decades have been a period of far-reaching policy experimentation in state financing of higher education. Between 1986 and 1999, 21 states adopted prepaid college tuition plans. Thirty-one states adopted some form of college savings plan. Both kinds of policies were designed to enhance the affordability of higher education during a…

  2. The Adoption of Prepaid Tuition and Savings Plans in the American States: An Event History Analysis

    Science.gov (United States)

    Doyle, William R.; McLendon, Michael K.; Hearn, James C.

    2010-01-01

    The past two decades have been a period of far-reaching policy experimentation in state financing of higher education. Between 1986 and 1999, 21 states adopted prepaid college tuition plans. Thirty-one states adopted some form of college savings plan. Both kinds of policies were designed to enhance the affordability of higher education during a…

  3. Individual and social concerns in American surgical education: paying patients, prepaid health insurance, Medicare and Medicaid.

    Science.gov (United States)

    O'Shea, John S

    2010-05-01

    The education of the U.S. surgeon was traditionally based on a system in which surgeons-in-training cared for a population of largely indigent patients in a setting of graded responsibility. To ensure an ethically appropriate bargain, senior surgeons served as mentors, assumed ultimate responsibility for the patient, and supervised the surgical care of the ward patient by the surgical trainee. During the 20th century, changes in health care financing challenged this comfortable accommodation between charity care and medical education. As others have also written, the introduction of prepaid health insurance plans such as Blue Cross/Blue Shield in the early third of the century, the rapid expansion of employment-based health benefits during World War II, and the enactment of the Medicare and Medicaid legislation under Titles XVIII and XIX of the Social Security Act all contributed to a dramatic reduction in hospital ward (i.e., service) populations. The tension between education and patient care remains incompletely resolved; the proper balance between supervision and graded responsibility for the resident is ultimately worked out on an individual basis. Newer issues facing U.S. surgical education, including the justifiable demand for greater transparency, are likely to upset this suspended truce and lead to renewed discussions about such fundamental concepts as the definition of the resident and the role of the patient in the education of future surgeons.

  4. A Dental School Sponsored, Pre-Paid Dental Plan for College Students.

    Science.gov (United States)

    Friedman, Paula K,

    1992-01-01

    Boston University (Massachusetts) developed and marketed a dental care plan to three colleges and universities in the Boston area. After 5 academic years of operation, the dental program has 16 institutional affiliates, increased its patient pool by almost 1,500, generated substantial revenue, and exposed dental students to an alternative dental…

  5. Biased selection in Twin Cities health plans.

    Science.gov (United States)

    Dowd, B; Feldman, R

    1985-01-01

    The data in Tables 1 through 4 show significant differences in the enrollment of higher health-related financial risk individuals and their families among health plans. FFS enrollees are older and exhibit more chronic illness on average. IPAs enroll a greater proportion of females than do PGP or FFS plans. PGPs and IPAs do not differ significantly in the age and chronic illness of their enrollees, but IPAs enroll a significantly greater proportion of females than do PGPs. The age difference between FFS and prepaid plans appears to be greater for long-term enrollees. The same pattern is true of chronic illness, but the results are often not statistically significant. We do not have time-series data, however, and cannot conclude that future comparisons among long-term enrollees will remains as they are now. In any care our data do not support the hypothesis that biased selection is a short-term problem that will be corrected as the population in prepaid plans ages. Our data contain a cross-section of environments for health plans in firms: long- and short-term offerings, long- and short-term enrollees, high and low out-of-pocket premium costs, etc. Our strongest results are the simplest: across all plans and environments there are significant differences in enrollee characteristics. These differences would not be inefficient if all groups paid actuarially fair premiums. However, mandatory offering and community-rating allow prepaid plans to enroll a younger population with less chronic illness and to maintain an information asymmetry that prevents employers and employees from determining--either prior to or following enrollment--the relationship of the prepaid plan's premium to its marginal cost.

  6. 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 ...

  7. Application of Intelligent Agents in Wireless Prepaid Energy Meter

    Directory of Open Access Journals (Sweden)

    Suresh Sankaranarayanan

    2016-03-01

    Full Text Available Prepaid meter (PM is getting very popular especially in developing countries. There are many advantages to use prepaid meter as opposed to postpaid meter both to the utility provider and to the consumer. Brunei has adopted PM but it is not intelligent and not wireless enabled. Reading meters and topping up balance are still done manually. Utility provider does not have information on the usage statistics and has only limited functionalities in the grid control. So accordingly an intelligent agent based wireless prepaid energy meter been developed using JADE-LEAP Agent development kit allowing agent from utility provider to query wireless energy meter for energy values for every household. These statistics can be used for statistical computation of the power consumed and for policy and future planning. Agent from consumers’ mobile devices can query the energy meter to study the power consumed and for topping up the balance. When the meter reaches the threshold, agent at energy meter would also send messages to alert consumers for topping up through mobile handset and failing to do so will lead to power being cut automatically

  8. LONG RANGE HEALTH PLANNING

    Directory of Open Access Journals (Sweden)

    ST. Motameni

    1974-03-01

    Full Text Available In the past, health planning in Iran has been carried out in the context of short-range economic plans. Although this mechanism has helped a great deal in the achievement of certain health plans however, the said scheme has been short in meeting the health objectives on a comprehensive basis. Most often, the heath programs have lost their values to the priority and cost effectiveness of economic plans. A brief review of heath planning in the past shows that the second development plan has been devoted to the establishment of new hospitals on a scattered pattern. The development of a coordinated hospital and health center system has been accepted and partly implemented during the third plan period. In the fourth plan the whole direction has changed towards the de­velopment of private hospitals on profit making basis, and now the fifth plan calls for the regionalized hospital system. Thus, one can say that the past twenty years have been spent to the experimentation of different schemes with­out a real long-range goal. In the past decade the World Health Organization has ventured in the development of health planning principles, but most of the efforts have been devoted to the short-range planning. The long-range health planning is not only a new look to the prin­ciples of planning, but a thorough examination of the time factor in health planning.

  9. 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

  10. City health development planning.

    Science.gov (United States)

    Green, Geoff; Acres, John; Price, Charles; Tsouros, Agis

    2009-11-01

    The objective of this evaluation was to review the evolution and process of city health development planning (CHDP) in municipalities participating in the Healthy Cities Network organized by the European Region of the World Health Organization. The concept of CHDP combines elements from three theoretical domains: (a) health development, (b) city governance and (c) urban planning. The setting was the 56 cities which participated in Phase III (1998-2002) of the Network. Evidence was gathered from documents either held in WHO archives or made available from Network cities and from interviews with city representatives. CHDPs were the centrepiece of Phase III, evolving from city health plans developed in Phase II. They are strategic documents giving direction to municipalities and partner agencies. Analysis revealed three types of CHDP, reflecting the realpolitik of each city. For many cities, the process of CHDP was as important as the plan itself.

  11. 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.

  12. 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...

  13. 26 CFR 49.4251-4 - Prepaid telephone cards.

    Science.gov (United States)

    2010-04-01

    ..., sells 1,000 cards it calls prepaid telephone cards to R, a convenience store owner, for $7,000. C..., R is a transferee reseller. Because R's customers will purchase other than for resale, they will be holders. Each card sold by R provides its holder, R's customer, with a fixed amount of...

  14. Perancangan Sistem Informasi Prepaid di Perusahaan Makanan Siap Saji XYZ

    Directory of Open Access Journals (Sweden)

    J. Rolles Herwin Sihombing

    2015-06-01

    Full Text Available Prepaid System becomes a new trend in the Indonesia retail industry, particularly in the Food and Beverage (F&B sector. Many companies are trying to develop their own prepaid system, however they still lack of skills and knowledge regarding this system. This condition might not enable them to deliver the prepaid system to customers properly if they insist to develop their own system. However, this does not happen to company XYZ, the biggest fast food restaurant in Indonesia. Company XYZ, which collaborates with the local partner, implements their own prepaid system in their company. This local partner has already had years of experience in the payment industry, developing payment system that adapts to the latest technology and supports the company's business. A system that is integrated with the point-of-sales and website would absolutely help customer and cashier in doing the transaction process. Integrated data is very useful for the finance and accounting departments of Company XYZ providing annual financial report to the shareholders.

  15. An Analysis of Section 529 College Savings and Prepaid Tuition Plans. A Report Prepared by the Department of Treasury for the White House Task Force on Middle Class Working Families

    Science.gov (United States)

    US Department of the Treasury, 2009

    2009-01-01

    Making college education more affordable is a central goal of the Obama Administration and has been a focus of Vice-President Biden's Taskforce on the Middle Class. To that end, the Task Force asked U.S. Treasury Department to prepare this report on how to make Section 529 college savings plans a more effective and reliable tool for families to…

  16. Health Plans - Trend Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page contains several useful trend and competition indicators. Certain files will be updated monthly while others will be updated quarterly. The files are the...

  17. Health Plan Finder Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act requires that HHS establish a mechanism, including an internet website, through which a resident of, or small business in, any State may...

  18. Survey of health planning proposals.

    Science.gov (United States)

    Krakauer, R S

    1994-02-01

    It is important that physicians participate in the debate and planning process that will ultimately guide how we reform the way health care is financed and delivered in the United States. Herein is offered a perspective on the problem, one which is not necessarily appreciated by health planners. While we deliver the best quality of care in the world to most of our population, our system has been severely criticized because we fail to provide for access to a substantial minority of our population. Additionally, the cost of the product is considerably greater than that in comparable countries. Attempts to control costs without diminishing quality have introduced expensive complexities into our system without any real success in cutting costs. Several proposals have been advanced to address the issues of cost and access. One of these is a single payer system, common in Europe and Canada, whereby a single agent or group of agents finances all health care through universal rules and means. A system operating in Hawaii is a simple employer mandate to provide health insurance. A uniquely American plan is the Jackson Hole Plan or Managed Competition (now called "Managed Cooperation"). This system is currently popular among national health planners, and involves a defined minimum managed health plan offered by various groups of providers to employees and individuals through health plan purchasing cooperatives. This plan is interesting, but has not been implemented in any jurisdiction, and it is not certain it would accomplish its goals in practice since it is difficult to predict behavior of all parties to such a system.

  19. 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.

  20. Urban planning and health equity.

    Science.gov (United States)

    Northridge, Mary Evelyn; Freeman, Lance

    2011-06-01

    Although the fields of urban planning and public health share a common origin in the efforts of reformers to tame the ravages of early industrialization in the 19th century, the 2 disciplines parted ways in the early 20th century as planners increasingly focused on the built environment while public health professionals narrowed in on biomedical causes of disease and disability. Among the unfortunate results of this divergence was a tendency to discount the public health implications of planning decisions. Given increasingly complex urban environments and grave health disparities in cities worldwide, urban planners and public health professionals have once again become convinced of the need for inclusive approaches to improve population health and achieve health equity. To make substantive progress, intersectoral collaboration utilizing ecological and systems science perspectives will be crucial as the solutions lie well beyond the control of any single authority. Grounded in the social determinants of health, and with a renewed sense of interconnectedness, dedicated and talented people in government agencies and communities who recognize that our future depends on cultivating local change and evaluating the results can come to grips with the enormous challenge that lies ahead to create more equitable, sustainable, and healthier cities worldwide.

  1. 7 CFR 1717.158 - Mergers with borrowers who prepaid RUS loans.

    Science.gov (United States)

    2010-01-01

    ... has prepaid RUS debt at a discount pursuant to 7 CFR part 1786, and whose eligibility for future RUS... 7 Agriculture 11 2010-01-01 2010-01-01 false Mergers with borrowers who prepaid RUS loans. 1717.158 Section 1717.158 Agriculture Regulations of the Department of Agriculture (Continued)...

  2. Pre-paid envelopes commemorating the 2013 Open Days

    CERN Multimedia

    2013-01-01

    The post office on CERN's Prévessin site is still selling pre-paid envelopes commemorating the 2013 Open Days. Hurry while stocks last!   The special envelopes, which are valid in France for non-priority letters weighing up to 20 grams, are ideal for your Christmas and New Year correspondence. A set of ten envelopes, each featuring a different image, costs € 8.70 or 10 CHF. The post office is located in Building 866 on the Prévessin site and is open Mondays to Thursdays from 9.30 a.m. to 12.30 p.m.

  3. Voice over internet protocol with prepaid calling card solutions

    Science.gov (United States)

    Gunadi, Tri

    2001-07-01

    The VoIP technology is growing up rapidly, it has big network impact on PT Telkom Indonesia, the bigger telecommunication operator in Indonesia. Telkom has adopted VoIP and one other technology, Intelligent Network (IN). We develop those technologies together in one service product, called Internet Prepaid Calling Card (IPCC). IPCC is becoming new breakthrough for the Indonesia telecommunication services especially on VoIP and Prepaid Calling Card solutions. Network architecture of Indonesia telecommunication consists of three layer, Local, Tandem and Trunck Exchange layer. Network development researches for IPCC architecture are focus on network overlay hierarchy, Internet and PSTN. With this design hierarchy the goal of Interworking PSTN, VoIP and IN calling card, become reality. Overlay design for IPCC is not on Trunck Exchange, this is the new architecture, these overlay on Tandem and Local Exchange, to make the faster call processing. The nodes added: Gateway (GW) and Card Management Center (CMC) The GW do interfacing between PSTN and Internet Network used ISDN-PRA and Ethernet. The other functions are making bridge on circuit (PSTN) with packet (VoIP) based and real time billing process. The CMC used for data storage, pin validation, report activation, tariff system, directory number and all the administration transaction. With two nodes added the IPCC service offered to the market.

  4. [Evaluation model for municipal health planning management].

    Science.gov (United States)

    Berretta, Isabel Quint; Lacerda, Josimari Telino de; Calvo, Maria Cristina Marino

    2011-11-01

    This article presents an evaluation model for municipal health planning management. The basis was a methodological study using the health planning theoretical framework to construct the evaluation matrix, in addition to an understanding of the organization and functioning designed by the Planning System of the Unified National Health System (PlanejaSUS) and definition of responsibilities for the municipal level under the Health Management Pact. The indicators and measures were validated using the consensus technique with specialists in planning and evaluation. The applicability was tested in 271 municipalities (counties) in the State of Santa Catarina, Brazil, based on population size. The proposed model features two evaluative dimensions which reflect the municipal health administrator's commitment to planning: the guarantee of resources and the internal and external relations needed for developing the activities. The data were analyzed using indicators, sub-dimensions, and dimensions. The study concludes that the model is feasible and appropriate for evaluating municipal performance in health planning management.

  5. Health plan choice in the Netherlands: restrictive health plans preferred by young and healthy individuals.

    NARCIS (Netherlands)

    Bes, R.E.; Curfs, E.C.; Groenewegen, P.P.; Jong, J.D. de

    2017-01-01

    In a health care system based on managed competition, health insurers negotiate on quality and price with care providers and are allowed to offer restrictive health plans. It is crucial that enrolees who need care choose restrictive health plans, as otherwise health insurers cannot channel patients

  6. 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.

  7. 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.

  8. A public health hazard mitigation planning process.

    Science.gov (United States)

    Griffith, Jennifer M; Kay Carpender, S; Crouch, Jill Artzberger; Quiram, Barbara J

    2014-01-01

    The Texas A&M Health Science Center School of Rural Public Health, a member of the Training and Education Collaborative System Preparedness and Emergency Response Learning Center (TECS-PERLC), has long-standing partnerships with 2 Health Service Regions (Regions) in Texas. TECS-PERLC was contracted by these Regions to address 2 challenges identified in meeting requirements outlined by the Risk-Based Funding Project. First, within Metropolitan Statistical Areas, there is not a formal authoritative structure. Second, preexisting tools and processes did not adequately satisfy requirements to assess public health, medical, and mental health needs and link mitigation strategies to the Public Health Preparedness Capabilities, which provide guidance to prepare for, respond to, and recover from public health incidents. TECS-PERLC, with its partners, developed a framework to interpret and apply results from the Texas Public Health Risk Assessment Tool (TxPHRAT). The 3-phase community engagement-based TxPHRAT Mitigation Planning Process (Mitigation Planning Process) and associated tools facilitated the development of mitigation plans. Tools included (1) profiles interpreting TxPHRAT results and identifying, ranking, and prioritizing hazards and capability gaps; (2) a catalog of intervention strategies and activities linked to hazards and capabilities; and (3) a template to plan, evaluate, and report mitigation planning efforts. The Mitigation Planning Process provided a framework for Regions to successfully address all funding requirements. TECS-PERLC developed more than 60 profiles, cataloged and linked 195 intervention strategies, and developed a template resulting in 20 submitted mitigation plans. A public health-focused, community engagement-based mitigation planning process was developed by TECS-PERLC and successfully implemented by the Regions. The outcomes met all requirements and reinforce the effectiveness of academic practice partnerships and importance of

  9. Course Plan for Women's Health.

    Science.gov (United States)

    Whitaker, Linda A.

    In view of women's misconceptions about their bodies, their sexuality, their mental health, and the health care system, this three-credit evening community college course on women's health needs and concerns was designed. Course objectives include recording and analyzing the effects of nutrition, sleep, exercise, and stress on various body…

  10. How to choose a health plan

    Science.gov (United States)

    ... also may need to do some paperwork for tax purposes. How to Compare Health Plans Employers and ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  11. Health Insurance: Understanding Your Health Plan's Rules

    Science.gov (United States)

    ... NewsYour Health ResourcesHealthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, ... NewsYour Health ResourcesHealthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, ...

  12. UMTRA Project environmental, health, and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    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 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 S concerns will be addressed by special contract conditions in RAC subcontracts. 2 tabs.

  13. Management of behavioral health provider networks in private health plans.

    Science.gov (United States)

    Garnick, Deborah W; Horgan, Constance M; Reif, Sharon; Merrick, Elizabeth L; Hodgkin, Dominic

    2008-01-01

    We explored the techniques used by private health plans or by their contracted managed behavioral healthcare organizations (MBHOs) to maintain networks of behavioral health providers. In particular, we focused on differences by health plans' product types (health maintenance organization, point-of-service plan, or preferred provider organization) and contracting arrangements (MBHO contracts, comprehensive contracts, or no contracts). More than 94% of products selected providers using credentialing standards, particular specialists, or geographic coverage. To retain providers viewed as high quality, 54% offer reduced administrative burden and 44% higher fees. Only 16% reported steerage to a core group of highest-quality providers and few reported an annual bonus or guaranteed volume of referrals. Some standard activities are common, but some health plans are adopting other approaches to retain higher-quality providers.

  14. Health plan choice in the Netherlands: restrictive health plans preferred by young and healthy individuals.

    Science.gov (United States)

    Bes, Romy E; Curfs, Emile C; Groenewegen, Peter P; de Jong, Judith D

    2017-07-01

    In a health care system based on managed competition, health insurers negotiate on quality and price with care providers and are allowed to offer restrictive health plans. It is crucial that enrolees who need care choose restrictive health plans, as otherwise health insurers cannot channel patients to contracted providers and they will lose their bargaining power in negotiations with providers. We aim to explain enrolees' choice of a restrictive health plan in exchange for a lower premium. In 2014 an online survey with an experimental design was conducted on members of an access panel (response 78%; n=3,417). Results showed 37.4% of respondents willing to choose a restrictive health plan in exchange for a lower premium. This fell to 22% when the restrictive health plan also included a longer travelling time. Enrolees who choose a restrictive health plan are younger and healthier, or on lower incomes, than those preferring a non-restrictive one. This means that enrolees who use care will be unlikely to choose a restrictive health plan and, therefore, health insurers will not be able to channel them to contracted care providers. This undermines the goals of the health care system based on managed competition.

  15. Health Maintenance Organization (HMO) Plan

    Science.gov (United States)

    ... get about Medicare Lost/incorrect Medicare card Report fraud & abuse File a complaint Identity theft: protect yourself ... Medicare Covers Drug Coverage (Part D) Supplements & Other Insurance Claims & Appeals Manage Your Health Forms, Help & Resources ...

  16. A "Prepaid Package" for Obstetrics: Effect on Teaching and Patient Care in a University Hospital

    Science.gov (United States)

    Young, Philip E.

    1976-01-01

    The changing social milieu has removed the charity patient but not the need for a teaching population. The University Hospital's program is described, in which patients prepaid a fixed, single fee for all obstetrics-related care through the third post partum day. (LBH)

  17. A "Prepaid Package" for Obstetrics: Effect on Teaching and Patient Care in a University Hospital

    Science.gov (United States)

    Young, Philip E.

    1976-01-01

    The changing social milieu has removed the charity patient but not the need for a teaching population. The University Hospital's program is described, in which patients prepaid a fixed, single fee for all obstetrics-related care through the third post partum day. (LBH)

  18. 76 FR 45403 - Bank Secrecy Act Regulations-Definitions and Other Regulations Relating to Prepaid Access

    Science.gov (United States)

    2011-07-29

    ..., such as coffee vendors or fast food restaurants, convenience was the reason for offering closed loop... as pharmacies, convenience stores, supermarkets, discount stores or any of a number of other types of..., as some commenters pointed out, prepaid access devices and vehicles may be sold in convenience...

  19. The Prediabetes Detection and Physical Activity Intervention Delivery (PRE-PAID) program.

    Science.gov (United States)

    Rowan, Chip P; Riddell, Michael C; Jamnik, Veronica K

    2013-12-01

    Inspired by increases in the prevalence and incidence of prediabetes, the Pre-diabetes Detection and Physical Activity Intervention Delivery Project (PRE-PAID) is a multiphasic program that identifies persons at high risk for developing type 2 diabetes, provides an opportunity for culturally appropriate, community-based physical activity and facilitates training of qualified exercise professionals on diabetes screening as well as prediabetes-specific training recommendations. This article provides an overview of the PRE-PAID project and includes some preliminary screening data, as well as lessons learned from the implementation of community-based physical activity programs that target specific, high-risk ethnicities. Recommendations and special considerations involving physical activity that targets persons with prediabetes also are discussed. A total of 691 individuals have undergone the PRE-PAID risk-identification process, which involves a brief questionnaire and point-of-care finger-prick hemoglobin A1C testing. The mean hemoglobin A1C level was 6.0±0.90% (mean ± standard deviation). Questionnaire scores showed that, on average, the individuals screened had 3 to 5 typical risk factors for type 2 diabetes, such as high body mass index, waist circumference, physical inactivity or family history of diabetes. Community-specific breakdowns of these results also are presented in this article. Sharing experiences from the PRE-PAID project can help formulate a framework for future prediabetes screening and physical activity interventions that are community based, target persons with prediabetes and are culturally appropriate.

  20. Pursuing the Anonymous User: Privacy Rights and Mandatory Registration of Prepaid Mobile Phones

    Science.gov (United States)

    Gow, Gordon A.; Parisi, Jennifer

    2008-01-01

    In recent years there has been concern among law enforcement and national security organizations about the use of "anonymous" prepaid mobile phone service and its purported role in supporting criminal and terrorist activities. As a result, a number of countries have implemented registration requirements for such service. Privacy rights advocates…

  1. Urban planning and public health at CDC.

    Science.gov (United States)

    Kochtitzky, Chris S; Frumkin, H; Rodriguez, R; Dannenberg, A L; Rayman, J; Rose, K; Gillig, R; Kanter, T

    2006-12-22

    Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and public health share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, public health most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and public health have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and public health. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept

  2. 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,

  3. 45 CFR 162.925 - Additional requirements for health plans.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Additional requirements for health plans. 162.925... requirements for health plans. (a) General rules. (1) If an entity requests a health plan to conduct a... payer). (c) Code sets. A health plan must meet each of the following requirements: (1) Accept and...

  4. 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 planning document requirements (HIT PAPD). 495.336 Section 495.336 Public Health CENTERS FOR MEDICARE... Medicaid Program § 495.336 Health information technology planning advance planning document...

  5. 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. ...

  6. 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. ...

  7. A Guide for Environmental Health Planning

    Science.gov (United States)

    Crawford, Gene M.

    1972-01-01

    Outlines objectives and resources to be assessed in a community environmental health plan. Considers: water; liquid waste disposal; housing maintenance; solid waste disposal; air pollution; food and food protection; rodent control; insect control; migrant labor camps; recreation sites; mobile homes - trailer parks; schools, institutions - public…

  8. Cash planning in community mental health agencies.

    Science.gov (United States)

    Williams, E

    1976-01-01

    Community mental health agencies often receive funds from a number of different sources with varying restrictions. Cash planning can help them manage these funds properly and avoid serious problems. The use of a projected cash flow statement may even help produce additional income for them.

  9. Information systems in neonatology and health planning.

    Science.gov (United States)

    Di Lallo, Domenico; Di Napoli, Anteo

    2011-10-01

    Improving the well-being of infants and children is an important public health goal. To reach this objective public health authorities need in-depth knowledge of perinatal statistics as well as the organization of perinatal care. These data must be based on the use of reliable information describing both individual and organizational factors and short and long term outcomes. Several perinatal information sources are available in Italy for analyses aimed at producing evidence for health planning purposes: the National birth registry, Infant mortality registry and Neonatal networks. We describe their structure and summarize some evidence derived from the experiences conducted in the Lazio region.

  10. Microcontroller Based Single Phase Digital Prepaid Energy Meter for Improved Metering and Billing System

    Directory of Open Access Journals (Sweden)

    Md. Mejbaul Haque

    2011-10-01

    Full Text Available This paper presents a single phase digital prepaid energy meter based on two microcontrollers and a single phase energy meter IC. This digital prepaid energy meter does not have any rotating parts. The energy consumption is calculated using the output pulses of the energy meter chip and the internal counter of microcontroller (ATmega32. A microcontroller (ATtiny13 is used as a smart card and the numbers of units recharged by the consumers are written in it. A relay system has been used which either isolates or establishes the connection between the electrical load and energy meter through the supply mains depending upon the units present in the smart card.Energy consumption (kWh, maximum demand (kW, total unit recharged (kWh and rest of the units (kWh are stored in the ATmega32 to ensure the accurate measurement even in the event of an electrical power outage that can be easily read from a 20×4 LCD. As soon as the supply is restored, energy meter restarts with the stored values. A single phase prepaid energy meter prototype has been implemented to provide measurement up to 40A load current and 230V line to neutral voltage.Necessary program for microcontrollers are written in c-language and compiled by Win-AVR libc compiler.

  11. 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.

  12. 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...

  13. 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

  14. A health plan prescription for health information technology.

    Science.gov (United States)

    Gingrich, Newt; Hasan, Malik

    2010-12-01

    The economic stimulus law of 2009 included incentive payments to encourage providers and hospitals to adopt and "meaningfully use" electronic health records. One resource was excluded from these regulations: patient data from the patient's health insurer, although health insurance companies tie together multiple sectors of the healthcare industry in a single patient-centered data form known as the claims history. They also have considerable experience with information technology (IT). As a result, they are uniquely positioned to move adoption of health IT systems forward. Health plan technologies should be included in the meaningful-use requirements. The result will be additional functionality, which in the end will improve quality, lower costs, and improve individual health.

  15. 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...

  16. 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...

  17. Multi-agent plan-execution health repair

    NARCIS (Netherlands)

    Jonge, Femke de; Roos, Nico; Herik, Jaap van den

    2006-01-01

    This paper presents a protocol for plan health repair in multi-agent plan execution. Plan health repair aims at avoiding conflicts that might arise due to disruptions in the execution of a plan. This can be achieved by adjusting the executions of tasks instead of replanning the tasks. For this

  18. Health-insurance products and plan options.

    Science.gov (United States)

    Youkstetter, W D

    1990-10-01

    Trends in health insurance are discussed, with emphasis on insurers' efforts to offer an array of cost-effective plans tailored to the needs of employers and subscribers. Health-insurance companies, responding to employers' demands to curtail the rising costs of premiums, now offer a variety of insurance products. While indemnity plans, health maintenance organizations (HMOs), and preferred-provider organizations (PPOs) remain as the three basic types of plans, insurers are combining these elements in different ways, creating dual- and triple-option plans that consist of indemnity insurance and an HMO, a PPO and an HMO, or other variations. Insurers offering multiple options may effect internal cost savings through shared personnel and administrative expenses. Four factors influence the development and marketing of insurance products: cost and volume of healthcare services, adverse selection, competition, and the profit incentive. Many of the insurance products have been developed in response to requests for maximum freedom of choice of provider; as an example, the fastest-growing HMO product in 1989 was the point-of-service HMO, which allows the subscriber to seek care from a provider who is not part of the HMO network. PPOs and exclusive-provider organizations (EPOs) are growing; these are often organized by hospitals or physician networks. Among the new trends in product-line development are "riders" for specialty services such as vision care and prescription drugs. As competition intensifies, marketing efforts are focusing on previously overlooked groups such as the small employer and certain ethnic communities. Cost and freedom of choice will remain important criteria in the selection of insurance products.(ABSTRACT TRUNCATED AT 250 WORDS)

  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. 42 CFR 457.805 - State plan requirement: Procedures to address substitution under group health plans.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false State plan requirement: Procedures to address substitution under group health plans. 457.805 Section 457.805 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS...

  1. How health plans promote health IT to improve behavioral health care.

    Science.gov (United States)

    Quinn, Amity E; Reif, Sharon; Evans, Brooke; Creedon, Timothy B; Stewart, Maureen T; Garnick, Deborah W; Horgan, Constance M

    2016-12-01

    Given the large numbers of providers and enrollees with which they interact, health plans can encourage the use of health information technology (IT) to advance behavioral health care. The manner and extent to which commercial health plans promote health IT to improve behavioral health care is unknown. This study aims to address that gap. Cross-sectional study. Data are from a nationally representative survey of commercial health plans regarding administrative and clinical dimensions of behavioral health services in 2010. Data are weighted to be representative of commercial managed care products in the United States (n = 8427; 88% response rate). Approaches within the domains of provider support, access to care, and assessment and treatment were investigated as examples of how health plans can promote health IT to improve behavioral health care delivery. Health plans were using health IT approaches in each domain. About a quarter of products offered financial support for electronic health records, but technical assistance was rare. Primary care providers could bill for e-mail contact with patients for behavioral health in about a quarter of products. Few products offered member-provider e-mail, and none offered online appointment scheduling. However, online referral systems and online provider directories were common, and nearly all offered an online self-assessment tool; most offered online counseling and online personalized responses to questions or problems. In 2010, commercial health plans encouraged the use of health IT strategies for behavioral health care. Health plans have an important role to play for increasing health IT as a tool for behavioral health care.

  2. Do postage stamps versus pre-paid envelopes increase responses to patient mail surveys? A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Campbell Malcolm

    2008-05-01

    Full Text Available Abstract Background Studies largely from the market research field suggest that the inclusion of a stamped addressed envelope, rather than a pre-paid business reply, increases the response rate to mail surveys. The evidence that this is also the case regarding patient mail surveys is limited. Methods The aim of this study is to investigate whether stamped addressed envelopes increase response rates to patient mail surveys compared to pre-paid business reply envelopes and compare the relative costs. A sample of 477 initial non-responders to a mail survey of patients attending breast clinics in Greater Manchester between 1/10/2002 – 31/7/2003 were entered into the trial: 239 were randomly allocated to receive a stamped envelope and 238 to receive a pre-paid envelope in with their reminder surveys. Overall cost and per item returned were calculated. Results The response to the stamped envelope group was 31.8% (95% CI: 25.9% – 37.7% compared to 26.9% (21.3% – 32.5% for the pre-paid group. The difference (4.9% 95% CI: -3.3% – 13.1% is not significant at α = 0.05 (χ2 = 1.39; 2 tailed test, d.f. = 1; P = 0.239. The stamped envelopes were cheaper in terms of cost per returned item (£1.20 than the pre-paid envelopes (£1.67. However if the set up cost for the licence to use the pre-paid service is excluded, the cost of the stamped envelopes is more expensive than pre-paid returns (£1.20 versus £0.73. Conclusion Compared with pre-paid business replies, stamped envelopes did not produce a statistically significant increase in response rate to this patient survey. However, the response gain of the stamped strategy (4.9% is similar to that demonstrated in a Cochrane review (5.3% of strategies to increase response to general mail surveys. Further studies and meta analyses of patient responses to mail surveys via stamped versus pre-paid envelopes are needed with sufficient power to detect response gains of this magnitude in a patient population.

  3. 77 FR 28883 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

    Science.gov (United States)

    2012-05-16

    ... HUMAN SERVICES Centers for Disease Control and Prevention Draft Public Health Action Plan--A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility AGENCY: Centers... requesting public comment on the draft National Public Health Action Plan for the Detection, Prevention,...

  4. 77 FR 38296 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

    Science.gov (United States)

    2012-06-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Draft Public Health Action Plan--A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility AGENCY: Centers... Federal Register requesting public comment on the draft National Public Health Action Plan for...

  5. Business plan for a health club

    OpenAIRE

    Castelo, Rui Miguel André

    2010-01-01

    Mestrado em Gestão de Empresas/MOO This business plan describes all the steps and needs to build a health club in Faro. The fitness industry worldwide has showed a growing trend that in Portugal has been presented with a growing rate of 7,5% (Correia, 2006). The market penetration rate is of 5,7%, which represents 3350 potencial clients in Faro, being at the moment distributed by the 12 existing competitors, 2850 persons. The questionnaire showed that people go to the gym to ge...

  6. 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…

  7. PREPAID TELECOM CUSTOMERS SEGMENTATION USING THE K-MEAN ALGORITHM

    Directory of Open Access Journals (Sweden)

    Marar Liviu Ioan

    2012-07-01

    Full Text Available The scope of relationship marketing is to retain customers and win their loyalty. This can be achieved if the companies’ products and services are developed and sold considering customers’ demands. Fulfilling customers’ demands, taken as the starting point of relationship marketing, can be obtained by acknowledging that the customers’ needs and wishes are heterogeneous. The segmentation of the customers’ base allows operators to overcome this because it illustrates the whole heterogeneous market as the sum of smaller homogeneous markets. The concept of segmentation relies on the high probability of persons grouped into segments based on common demands and behaviours to have a similar response to marketing strategies. This article focuses on the segmentation of a telecom customer base according to specific and noticeable criteria of a certain service. Although the segmentation concept is widely approached in professional literature, articles on the segmentation of a telecom customer base are very scarce, due to the strategic nature of this information. Market segmentation is carried out based on how customers spent their money on credit recharging, on making calls, on sending SMS and on Internet navigation. The method used for customer segmentation is the K-mean cluster analysis. To assess the internal cohesion of the clusters we employed the average sum of squares error indicator, and to determine the differences among the clusters we used the ANOVA and the post-hoc Tukey tests. The analyses revealed seven customer segments with different features and behaviours. The results enable the telecom company to conceive marketing strategies and planning which lead to better understanding of its customers’ needs and ultimately to a more efficient relationship with the subscribers and enhanced customer satisfaction. At the same time, the results enable the description and characterization of expenditure patterns

  8. Rethinking health planning: a framework for organising information to underpin collaborative health planning.

    Science.gov (United States)

    Gudes, Ori; Kendall, Elizabeth; Yigitcanlar, Tan; Pathak, Virendra; Baum, Scott

    2010-01-01

    The field of collaborative health planning faces significant challenges created by the narrow focus of the available information, the absence of a framework to organise that information and the lack of systems to make information accessible and guide decision-making. These challenges have been magnified by the rise of the 'healthy communities movement', resulting in more frequent calls for localised, collaborative and evidence-driven health related decision-making. This paper discusses the role of decision support systems as a mechanism to facilitate collaborative health decision-making. The paper presents a potential information management framework to underpin a health decision support system and describes the participatory process that is currently being used to create an online tool for health planners using geographic information systems. The need for a comprehensive information management framework to guide the process of planning for healthy communities has been emphasised. The paper also underlines the critical importance of the proposed framework not only in forcing planners to engage with the entire range of health determinants, but also in providing sufficient flexibility to allow exploration of the local setting-based determinants of health.

  9. Taxing cadillac health plans may produce Chevy results.

    Science.gov (United States)

    Gabel, Jon; Pickreign, Jeremy; McDevitt, Roland; Briggs, Thomas

    2010-01-01

    It's often assumed that high-cost health insurance plans--sometimes called "Cadillac" plans--provide rich benefits to plan subscribers. Health reform provisions that treat these plans like luxuries may be misguided. Only 3.7 percent of variation in the cost of family coverage can be explained by benefit design (actuarial value). Benefit design plus plan type (HMO, PPO, POS, or high-deductible plans) explains 6.1 percent of this variation. Industry type and medical costs in the region also play a role. Most variation in premiums, however, remains largely unexplained.

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

    Science.gov (United States)

    2011-08-03

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ58 Requirements for Group Health Plans and Health... Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human Services... with respect to group health plans and health insurance coverage offered in connection with a group...

  12. 76 FR 16038 - Proposed Collection; Comment Request for Prepaid Card Marketing Customer Survey, CS-10-251.

    Science.gov (United States)

    2011-03-22

    ..., IRS is hoping to leverage the theory and principles of social marketing. Social marketing principles and practices apply marketing principles to social programs. This data will provide the IRS with... Internal Revenue Service Proposed Collection; Comment Request for Prepaid Card Marketing Customer...

  13. Principles for Health System Capacity Planning: Insights for Healthcare Leaders.

    Science.gov (United States)

    Shaw, James; Wong, Ivy; Griffin, Bailey; Robertson, Michael; Bhatia, R Sacha

    2017-01-01

    Jurisdictions across Canada and around the world face the challenge of planning high-performing and sustainable health systems in response to growing healthcare demands. In this paper, we report on the process of developing principles for health system capacity planning by the Ministry of Health and Long-Term Care in Ontario. Integrating the results of a literature review on health system planning and a symposium with representatives from local health integration networks, we describe the following six principles in detail: (1) develop an aspirational vision, (2) establish clear leadership, (3) commit to stakeholder engagement, (4) engage patients and the public, (5) build analytics infrastructure and (6) revise policy when necessary.

  14. 75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-06-17

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage Rules... respect to group health plans and health insurance coverage offered in connection with a group health plan... temporary regulations provide guidance to employers, group health plans, and health insurance issuers...

  15. Prospecting for customers in the small employer market: the experience of Arizona Health Care Group.

    Science.gov (United States)

    Christianson, J B; Liu, C F; Schroeder, C M

    1994-01-01

    The findings of this study provide an interesting profile of the small employer "prospects" for prepaid health plans, where a prospect is defined as an employer that responds to a mass mailing effort with a request for information and further contact. About 60% of these prospects already have insurance, with 40% having group insurance. Therefore, a substantial portion of prospects are seeking to replace their existing health benefit package with a different one. Of those who do not offer existing insurance, the most common reason is that it is "too expensive" or the employer is "not profitable." A very small proportion do not offer insurance because they do not qualify for it due to medical underwriting considerations. Prospects tend to be larger than non-prospects in terms of sales, but employ lower wage employees, on average. About half of prospects are in service industries, a proportion typical of small employers in general. Somewhat surprisingly, most prospects have been in operation for over five years. They are not new firms attempting to establish their benefit packages. This is consistent with the findings on gross sales, suggesting that some maturity is necessary before an employer considers offering group health insurance as a benefit. The prepaid plans in this study also appeared to target established employers for their marketing efforts. In responding to questions about their attitudes towards health insurance, over one-quarter of prospects indicated that they would be unwilling to offer insurance at rates so low that they would not normally apply to the coverages offered by prepaid plans. Thus, although they were "prospects" by the study's definition, they were unlikely to eventually contract with prepaid plans. Those prospects that had offered insurance previously, but had discontinued it, tended to cite premium increases as the reason. This suggests that prospects among small employers are likely to be very price sensitive, and that further

  16. Role of Information in Consumer Selection of Health Plans

    OpenAIRE

    Sainfort, François; Booske, Bridget C.

    1996-01-01

    Considerable efforts are underway in the public and private sectors to increase the amount of information available to consumers when making health plan choices. The objective of this study was to examine the role of information in consumer health plan decisionmaking. A computer system was developed which provides different plan descriptions with the option of accessing varying types and levels of information. The system tracked the information search processes and recorded the hypothetical p...

  17. A survey of financial planning models for health care organizations.

    Science.gov (United States)

    Coleman, J R; Kaminsky, F C; McGee, F

    1978-01-01

    This paper describes "what if?" financial planning models developed for health care administrators and financial managers to study and evaluate the economic impact of changes in a health care organization's charge structure, operating policies, reimbursement plans, and services and resources. Models for inpatient and outpatient care systems are presented. The models are described in terms of input, output, and application. An assessment of the state of the art of financial planning and prospects for the future of what if?models are given.

  18. A Health Facility Planning Methodology for Army Troop Medical Clinics.

    Science.gov (United States)

    1981-04-01

    Herbert H. Hyman, Basic Health Planning Methods, (Germantown, Md: Aspen Systems Corp., 1978), p.14 . 16 17 1 3James A. Rice, " Interinstitutional Planning...another for collaboration throughout the developmental process in order for that project to come to fruition. In the final analysis, the planning...Space Needs." Hospitals 54 (December 16, 1980): 109-112. Rice, James A. " Interinstitutional Planning Process, Part 1. Free Standing Hospitals." Hospitals

  19. Identifying Health Maintenance Organization membership through self-report of health plan name: ascertainment and reliability.

    Science.gov (United States)

    Clements, Karen M; Cohen, Bruce B; Brawarsky, Phyllis; Brooks, Daniel R; Mucci, Lorelei A; Wood, Phillip A

    2006-01-01

    To evaluate the feasibility and reliability of (1) identifying Health Maintenance Organization (HMO) membership by ascertaining self-reported health plan name in a telephone survey and (2) using external information to determine whether the plan was an HMO. Respondents to the 1999-2001 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS) and the 1999 Massachusetts Colorectal Cancer (CRC) survey were asked to name their health plan. The authors used information from external sources to classify the plan as an HMO or a non-HMO. Test-retest reliability of reported plan name was examined overall, by demographic characteristics, and by health plan name. Reliability of HMO classification was tested with the kappa statistic. More than 88 percent of respondents with commercial health insurance provided their health plan name; 84 percent reported a plan that could be assigned as either an HMO or a non-HMO. The percentage whose HMO status could be assigned differed by demographic characteristics. Among those assigned, the distribution of specific HMOs among survey respondents was similar to the distribution reported by the Massachusetts Division of Insurance. In a subsample, 78 percent reported the same health plan during a follow-up interview. Agreement was higher for men, and differed according to the plan reported at the first time point. Kappa for HMO classification from health plan name was 0.87. Self-report of health plan name is a feasible and reliable method to ascertain health insurance information in a telephone interview.

  20. Financial performance of health plans in Medicaid managed care.

    Science.gov (United States)

    McCue, Mike

    2012-01-01

    This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly traded, and provider-sponsored. National Association of Insurance Commissioners (NAIC) financial data, coupled with selected state financial data, were analyzed for 170 Medicaid health plans for 2009. A mean test compared the mean values for medical loss, administrative cost, and operating margin ratios across these plan traits. Medicaid dominant plans are plans with 75 percent of their total enrollment in the Medicaid line of business. Plans that are Medicaid dominant and publicly traded incurred a lower medical loss ratio and higher administrative cost ratio than multi-product and non-publicly traded plans. Medicaid dominant plans also earned a higher operating profit margin. Plans offering commercial and Medicare products are operating at a loss for their Medicaid line of business. Health plans that do not specialize in Medicaid are losing money. Higher medical cost rather than administrative cost is the underlying reason for this financial loss. Since Medicaid enrollees do not account for their primary book of business, these plans may not have invested in the medical management programs to reduce inappropriate emergency room use and avoid costly hospitalization.

  1. Service planning in the Victorian community health sector.

    Science.gov (United States)

    Roussy, Véronique; Livingstone, Charles

    2015-01-01

    Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne's outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.

  2. Design of SMS Prepaid Energy Meter for a Cashless Economy with Recharge Option and Bypass

    Directory of Open Access Journals (Sweden)

    Olawuni Adeolu

    2016-07-01

    Full Text Available With the current trend of Information Technology in our present time, the lot in our daily life is developing accordingly, and energy meters are no exception to this phenomenon. An intelligent GSM based prepaid energy meter is developed to be able to accurately calculate the amount of consumed energy by a certain building, display the remaining energy available from a pre-purchase of electricity, by which is done by the means of recharge through SMS service. The energy meter provide the utility company with regular status of the meter on a predefined interval, and also display a real time on the user’s account update, which contributes to the retrieval of the balance of the meter, as well as keeping log of the consumed energy and remaining electricity of each user by the means of SMS. It also provide utility company the ability to send updated consumption rates according to the Time of Day Tariff (TDF to the meter on pre-defined intervals The methodology used is embedded system with control system. The prepaid energy meter concept is shown by Proteus 8 software simulation. The major components are AVR microcontroller, Voltage and Current transformer, LCD, Relay and a load. Electricity has become one of the basic requirements for people and widely used for domestic, industrial and agricultural purposes. The software for this system was implemented with the use of embedded system code written onto the microcontroller. And the designed and implementation is an efficient way to collect billings for electricity consumptions, which further facilitate the recharge process of meters currently being used to the generalization and the acceptability in other to revolutionaries the entire metering system used in the 21st century.

  3. 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.

  4. Health Workforce Planning: An overview and suggested approach in Oman.

    Science.gov (United States)

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

    2015-02-01

    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.

  5. Health Workforce Planning: An overview and suggested approach in Oman

    Directory of Open Access Journals (Sweden)

    Abdulaziz Al-Sawai

    2015-01-01

    Full Text Available 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.

  6. Systems-Level Smoking Cessation Activities by Private Health Plans

    Directory of Open Access Journals (Sweden)

    Sharon Reif, PhD

    2011-01-01

    Full Text Available IntroductionThe US Public Health Service urges providers to screen patients for smoking and advise smokers to quit. Yet, these practices are not widely implemented in clinical practice. This study provides national estimates of systems-level strategies used by private health insurance plans to influence provider delivery of smoking cessation activities.MethodsData are from a nationally representative survey of health plans for benefit year 2003, across product types offered by insurers, including health maintenance organizations (HMOs, preferred provider organizations, and point-of-service products, regarding alcohol, tobacco, drug, and mental health services. Executive directors of 368 health plans responded to the administrative module (83% response rate. Medical directors of 347 of those health plans, representing 771 products, completed the clinical module in which health plan respondents were asked about screening for smoking, guideline distribution, and incentives for guideline adherence.ResultsOnly 9% of products require, and 12% verify, that primary care providers (PCPs screen for smoking. HMOs are more likely than other product types to require screening. Only 17% of products distribute smoking cessation guidelines to PCPs, and HMOs are more likely to do this. Feedback to PCPs was most frequently used to encourage guideline adherence; financial incentives were rarely used. Furthermore, health plans that did require screening often conducted other cessation activities.ConclusionFew private health plans have adopted techniques to encourage the use of smoking cessation activities by their providers. Increasing health plan involvement is necessary to reduce tobacco use and concomitant disease in the United States.

  7. Is health systems integration being advanced through Local Health District planning?

    Science.gov (United States)

    Saunders, Carla; Carter, David J

    2016-04-21

    Objective Delivering genuine integrated health care is one of three strategic directions in the New South Wales (NSW) Government State Health Plan: Towards 2021. This study investigated the current key health service plan of each NSW Local Health District (LHD) to evaluate the extent and nature of health systems integration strategies that are currently planned.Methods A scoping review was conducted to identify common key principles and practices for successful health systems integration to enable the development of an appraisal tool to content assess LHD strategic health service plans.Results The strategies that are planned for health systems integration across LHDs focus most often on improvements in coordination, health care access and care delivery for complex at-risk patients across the care continuum by both state- and commonwealth-funded systems, providers and agencies. The most common reasons given for integrated activities were to reduce avoidable hospitalisation, avoid inappropriate emergency department attendance and improve patient care.Conclusions Despite the importance of health systems integration and finding that all NSW LHDs have made some commitment towards integration in their current strategic health plans, this analysis suggests that health systems integration is in relatively early development across NSW.What is known about the topic? Effective approaches to managing complex chronic diseases have been found to involve health systems integration, which necessitates sound communication and connection between healthcare providers across community and hospital settings. Planning based on current health systems integration knowledge to ensure the efficient use of scarce resources is a responsibility of all health systems.What does this paper add? Appropriate planning and implementation of health systems integration is becoming an increasingly important expectation and requirement of effective health systems. The present study is the first of its

  8. Planning in Dutch health promotion practice: a comprehensive view.

    Science.gov (United States)

    Lezwijn, Jeanette; Wagemakers, Annemarie; Vaandrager, Lenneke; Koelen, Maria; van Woerkum, Cees

    2014-06-01

    Health promotion has a strong tradition of using planning models based on an a priori set of goals and processes defined by professionals. Those rational models only partly fit with today's view and practice of health promotion, where programmes can be considered as processes because they are guided by principles such as community participation and intersectoral collaboration. The aim of this paper is to provide a comprehensive view on approaches to planning in health promotion practice. To investigate these, Whittington's typology has been used. Whittington identifies four approaches to planning, i.e. classical, evolutionary, processual and systemic. In a retrospective multiple case study, we describe actual planning processes used in the development and implementation of a healthy ageing programme in three Dutch municipalities. These processes were described using data gathered by: interviews, participant observation and document analysis, and external auditing. Characteristics of the four planning approaches were used to interpret the data. The results show that, in practice, all forms of planning approaches were used, depending on the degree of complexity and dynamics of the context, the phase of the health promotion programme, and the time available. Our findings suggest that in the emergent practice of health promotion different approaches to planning are used. To make those planning approaches explicit and manageable for practice and science, discussion and reflection between stakeholders are essential.

  9. 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

  10. 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

  11. A model of succession planning for mental health nurse practitioners.

    Science.gov (United States)

    Hampel, Sally; Procter, Nicholas; Deuter, Kate

    2010-08-01

    This paper reviews current literature on succession planning for mental health nurse practitioners (NPs) and discusses a model of succession planning that is underpinned by principals of leadership development, workforce participation and client engagement. The paper identifies succession planning as a means of managing a present and future workforce, while simultaneously addressing individual and organizational learning and practice development needs. A discussion of the processes attendant upon sustainable succession planning - collegial support, career planning and development, information exchange, capacity building, and mentoring is framed within the potential interrelationships between existing NP, developing NP and service directors and/or team managers. Done effectively and in partnership with wider clinical services, succession planning has the potential to build NP leadership development and leadership transition more broadly within mental health services.

  12. The relationship between health plan performance measures and physician network overlap: implications for measuring plan quality.

    Science.gov (United States)

    Maeng, Daniel D; Scanlon, Dennis P; Chernew, Michael E; Gronniger, Tim; Wodchis, Walter P; McLaughlin, Catherine G

    2010-08-01

    To examine the extent to which health plan quality measures capture physician practice patterns rather than plan characteristics. We gathered and merged secondary data from the following four sources: a private firm that collected information on individual physicians and their health plan affiliations, The National Committee for Quality Assurance, InterStudy, and the Dartmouth Atlas. We constructed two measures of physician network overlap for all health plans in our sample and linked them to selected measures of plan performance. Two linear regression models were estimated to assess the relationship between the measures of physician network overlap and the plan performance measures. The results indicate that in the presence of a higher degree of provider network overlap, plan performance measures tend to converge to a lower level of quality. Standard health plan performance measures reflect physician practice patterns rather than plans' effort to improve quality. This implies that more provider-oriented measurement, such as would be possible with accountable care organizations or medical homes, may facilitate patient decision making and provide further incentives to improve performance.

  13. Principles of health infrastructure planning in less developed countries.

    Science.gov (United States)

    Unger, J P; Criel, B

    1995-01-01

    This article proposes a number of key principles for health infrastructure planning, based on a literature review on the one hand, and on a process of internal deduction on the other. The principles discussed are the following: an integrated health system; a thrifty planning of tiers within that health system; a specificity of tiers; a homogeneity of the tiers' structures; a minimum package of activities; a territorial responsibility and/or an explicit and discrete responsibility for a well-defined population; a necessary and sufficient population basis; a partial separation of administrative and public health planning bases; and, finally, rules for a geographical division and integration of non-governmental organizations. The definition of two strategies, primary health care and district health systems, is also revisited.

  14. Status report, The Public Health and Planning 101 project: strengthening collaborations between the public health and planning professions.

    Science.gov (United States)

    Mahendra, A; Vo, T; Einstoss, C; Weppler, J; Gillen, P; Ryan, L; Haley, K

    2017-01-01

    Land use planning is a complex field comprised of legislation, policies, processes and tools. A growing body of evidence supports the relationship between land use planning decisions, community design and health. The built environment has been shown to be associated with physical inactivity, obesity, cardiovascular disease, respiratory disease and mental illness. Consequently, there is a growing interest within public health to work with planners on land use planning initiatives such as official plans and transportation master plans. Two surveys were developed: one for public health professionals and the other for planning professionals (survey questions available upon request to the corresponding author). The surveys were pilot tested in two separate focus group sessions with public health and planning professionals. Focus group volunteers helped to validate the surveys by verifying survey questions, design and overall flow. In early 2012, 304 public health professionals and 301 planning professionals completed the two separate surveys, comprising the total survey respondents for each respective profession used to calculate proportions. The survey results represent a convenience sample and are not generalizable to the entire population of public health and planning professionals in Ontario. Results compare survey responses from both groups where appropriate. Most respondents worked either as public health staff (78%) or planners/senior planners (58%). A smaller percentage of public health and planning professionals worked either as managers (15% and 11%, respectively) or directors (5% and 9%, respectively). Health is associated with how communities are planned and built, and the services and resources provided within them. Inspired by the results of our survey and based on user feedback from the pilot tests, a free online training program entitled "Public Health and Planning 101: An Online Course for Public Health and Planning Professionals to Create Healthier

  15. 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.

  16. 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.

  17. Using scenario planning in public health: anticipating alternative futures.

    Science.gov (United States)

    Neiner, Jennifer A; Howze, Elizabeth H; Greaney, Mary L

    2004-01-01

    Scenario planning is a method for anticipating possible alternative futures. Used widely in business applications, it allows planners to anticipate problems, reevaluate assumptions, and reflect on consequences of those alternative futures. In this article, scenario planning is applied to public health, specifically to illustrate the four steps in scenario planning for public health using a health department's desire to address chronic disease prevention and control. An unhealthy diet and physical inactivity are considered to be key risk factors. The scenarios are presented in table format and are for illustration purposes only. Many other plausible scenarios could be constructed. Scenario planning allows stake-holders to define a desired, shared vision of the future, but more important, they can better prepare public health professionals to be successful in a constantly changing environment.

  18. Rocky Mountain Arsenal National Wildlife Refuge : Health and Safety Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Health and Safety Plan (HASP) applies to all U.S. Fish and Wildlife Service (Service) personnel including employees, graduate students, and volunteers on the...

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

    OpenAIRE

    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 influenc...

  20. Electronic health record project initiation and early planning in a community health center.

    Science.gov (United States)

    Cortelyou-Ward, Kendall; Noblin, Alice; Martin, Jeremy

    2011-01-01

    Community health centers exist to help their constituents become proactive in addressing their own health care needs and to improve the overall well-being of the community. However, they pose a different set of challenges when implementing an electronic health record system. This article applies 2 project management principles, initiation and early planning, to the electronic health record implementation in a community health center. Issues such as planning, financial considerations, and quality improvement are discussed.

  1. Optimal quality reporting in markets for health plans.

    Science.gov (United States)

    Glazer, Jacob; McGuire, Thomas G

    2006-03-01

    Quality reports about health plans and providers are becoming more prevalent in health care markets. This paper casts the decision about what information to report to consumers about health plans as a policy decision. In a market with adverse selection, complete information about quality leads to inefficient outcomes. In a Rothschild-Stiglitz model, we show that averaging quality information into a summary report can enforce pooling in health insurance, and by choice of the right weights in the averaged report, a payer or regulator can induce first-best quality choices. The optimal quality report is as powerful as optimal risk adjustment in correcting adverse selection inefficiencies.

  2. Participation in planning and evaluating mental health services: building capacity.

    Science.gov (United States)

    Restall, Gayle; Strutt, Carolyn

    2008-01-01

    The participation of people who use mental health services in service planning and evaluation has become increasingly important in recent years. Health planners and people who use services are seeking information about how to enable participation that is meaningful and impacts positively on service delivery. This qualitative study explored the perspectives of people who use mental health services on participation in mental health service planning and evaluation. Sixty-three people from diverse backgrounds participated in either a focus group or interview. Themes were extracted from the data and resulted in a conceptual framework that can be used to guide the development and evaluation of participation.

  3. Integrating reproductive health services into family planning programs.

    Science.gov (United States)

    1995-06-01

    A recent Population Council publication, Reproductive Health Approach to Family Planning, discusses integration of reproductive health into family planning programs in a series of edited presentations that Council staff and colleagues gave at a 1994 meeting of the US Agency for International Development (USAID) cooperating agencies. The presentations reflect the Council's view that family planning programs ought to help individuals achieve their own reproductive goals in a healthful manner. The report discusses four areas of reproductive health: reproductive tract infections (RTIs), including sexually transmitted diseases; prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. Christopher Elias (Senior Associate, Programs Division) argued that family planning programs ought to provide services that target RTIs, given that these illnesses afflict a significant proportion of reproductive-age women. The family planning community has an ethical responsibility to provide services to women who experience an unwanted pregnancy. They must have access to high-quality postabortion care, including family planning services. Professional midwives are ideally suited to serve as integrated reproductive health workers trained to combat the five major maternal killers: hemorrhage, sepsis, pregnancy-induced hypertension, obstructed labor, and unsafe abortion. This was demonstrated in a highly successful Life-Saving Skills for Midwives program undertaken in Ghana, Nigeria, and Uganda, and soon to start in Vietnam in conjunction with the Council's Safe Motherhood research program. Family planning services should be viewed as part of a comprehensive set of health services needed by postpartum women, which include appropriate contraception, maternal health checks, well-baby care, and information about breastfeeding, infant care, and nutrition. Family planning programs should incorporate breastfeeding counseling into their services. When

  4. Medicare health maintenance organization benefits packages and plan performance measures.

    Science.gov (United States)

    Cox, Don; Lanyi, Bettina; Strabic, Allison

    2002-01-01

    This article reports the results of an analysis of the relationship between supplemental benefits offered by Medicare+Choice (M+C) plans and their plan performance ratings. We examined two measures of plan performance: (1) plan ratings as reported in the Medicare Managed Care (MMC) Consumer Assessment of Health Care Study (CAHPS), and (2) disenrollment rates. The results of our analysis indicated that variations in plan supplemental offerings have little impact on enrollees' plan performance ratings--both overall ratings and access to care measures. Furthermore, disenrollment rates were found to be more sensitive to the availability of alternative M+C plans, either in general, or for specific benefits than to variations in benefit offerings.

  5. [Health professionals' opinion of the Catalan Health Plan. Basis for a reflexion on the future].

    Science.gov (United States)

    Brugulat, P; Séculi, E; Fusté, J; Juncà, S; Martínez, V; Medina, A; Mercader, M; Sánchez, E

    2003-01-01

    To know health professional's opinion of the Health Plan for Catalonia (Spain) in order to get news elements for the formulation and management of new plans. Combination of quantitative and qualitative methodologies. Postal survey to doctors and nurses (multistage randomised sample). 3.223 questionnaires were obtained (response rate: 34,1%). Interview to a selected sample of 41 health care professionals and managers. 78,8% (IC95%: 1,4) of health professionals are familiar with the Health Plan, and for most of them it is valued as important. 28,9% (IC95%: 1,7) of the professionals who know the Plan consider that it has repercussions in their daily work and 51,8% (IC95%: 1,9) declare that it doesn't have any repercussions. Different issues such as the planning process, the contents, the dissemination strategy, as well as a the poor impact on the health budget are critised. Differences by age group and sex, care setting and type of health professional are observed. The implication of health professionals in the discussion, formulation and implementation of the Health Plan proposals needs to be improved. It will be necessary to make progress in identifying health problems and needs, in setting priorities and in the allocation of resources. To increase the multisectorial involvement and to develop marketing strategies directed to politicians, managers and health professionals will also be needed in order to increase the impact of the Health Plan on both the Health System and the other sectors involved in health. The role to be played by the Health Plan in the health system must be redefined and this will lead to redesigning the planning process and the implementation of health strategies.

  6. Dyadic planning of health-behavior change after prostatectomy: a randomized-controlled planning intervention.

    Science.gov (United States)

    Burkert, Silke; Scholz, Urte; Gralla, Oliver; Roigas, Jan; Knoll, Nina

    2011-09-01

    In this study, we investigated the role of dyadic planning for health-behavior change. Dyadic planning refers to planning health-behavior change together with a partner. We assumed that dyadic planning would affect the implementation of regular pelvic-floor exercise (PFE), with other indicators of social exchange and self-regulation strategies serving as mediators. In a randomized-controlled trial at a German University Medical Center, 112 prostatectomy-patients with partners were randomly assigned to a dyadic PFE-planning condition or one of three active control conditions. Questionnaire data were assessed at multiple time points within six months post-surgery, measuring self-reported dyadic PFE-planning and pelvic-floor exercise as primary outcomes and social exchange (support, control) and a self-regulation strategy (action control) as mediating mechanisms. There were no specific intervention effects with regard to dyadic PFE-planning or pelvic-floor exercise, as two active control groups also showed increases in either of these variables. However, results suggested that patients instructed to plan dyadically still benefited from self-reported dyadic PFE-planning regarding pelvic-floor exercise. Cross-sectionally, received negative control from partners was negatively related with PFE only in control groups and individual action control mediated between self-reported dyadic PFE-planning and PFE for participants instructed to plan PFE dyadically. Longitudinally, action control mediated between self-reported dyadic PFE-planning and pelvic-floor exercise for all groups. Findings provide support for further investigation of dyadic planning in health-behavior change with short-term mediating effects of behavior-specific social exchange and long-term mediating effects of better self-regulation.

  7. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2011-08-03

    ...-AQ07 Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under... group health plans and health insurance coverage in the group and individual markets under provisions of... to group health plans and group health insurance issuers on August 1, 2011. ADDRESSES: Written...

  8. 75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

    Science.gov (United States)

    2010-11-17

    ... Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under... and Insurance Oversight, Department of Health and Human Services. ACTION: Amendment to interim final... regulations implementing the rules for group health plans and health insurance coverage in the group and...

  9. 76 FR 44491 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-07-26

    ...-AQ66 Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and... amendment to the interim final rules (76 FR 37208) entitled, ``Group Health Plans and Health Insurance... rule with request for comments entitled, ``Group Health Plans and Health Insurance Issuers: Rules...

  10. 75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

    Science.gov (United States)

    2010-05-13

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ45 Group Health Plans and Health Insurance Issuers Providing... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... health plans and health insurance coverage offered in connection with a group health plan under the...

  11. 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.

  12. Health and culture in urban planning.

    Science.gov (United States)

    Baba, S

    1994-01-01

    Rapid change, driven mainly by business and technology, has transformed our understanding of health and living conditions in recent decades. Experiments in urban development in Japan are bringing together technology, quality of life, culture and business to satisfy the needs of human health and well-being.

  13. Medicare and Rural Health

    Science.gov (United States)

    ... 1.9 million rural beneficiaries participated in Medicare Advantage (MA) and other prepaid plans, accounting for 13.4% of MA enrollees. While rural participation is not proportionate to urban participation, strong rural enrollment in ... Medicare Advantage – The ACA reduces the payments to companies providing ...

  14. Towards best practice in national health workforce planning.

    Science.gov (United States)

    McCarty, Maureen V; Fenech, Bethany J

    2013-09-02

    Health Workforce Australia (HWA) was established by the Council of Australian Governments through its 2008 National Partnership Agreement on Hospital and Health Workforce Reform, as the national agency to progress health workforce reform and address the challenges of providing a skilled, innovative and flexible health workforce in Australia. The Australian Health Ministers' Conference commissioned HWA to undertake a workforce planning exercise for doctors, nurses and midwives over a planning horizon to 2025. Health Workforce 2025 (HW 2025) was conducted in two phases: developing projections for the size and type of the health workforce (doctors, nurses and midwives) needed to meet future service requirements from 2012 to 2025; and modelling the training pipeline necessary to meet the size and type of this health workforce. HWA has used a number of key principles in developing HW 2025 to ensure the projections are robust and able to be applied nationally. HW 2025 is not a one-off project. Projections will be updated as new data become available, and methodology and assumptions underpinning the projections will be periodically reviewed. To also ensure the continued improvement of national health workforce planning, HWA is pursuing other areas for improvement, including better national data collections and improved estimation methodology for demand. Results of HW 2025 were presented to the Australian Health Ministers (through the Standing Council on Health) in April 2012.

  15. 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.

  16. The Impact of Health on Individual Retirement Plans

    DEFF Research Database (Denmark)

    Datta Gupta, Nabanita; Larsen, Mona

    2010-01-01

    of diagnosis matters, however. For men, the largest reduction in planned retirement age occurs for a diagnosis of lung disease while for women it occurs for musculo-skeletal disease. Except for cardiovascular disease, diagnosed disease is more influential in men's retirement planning than in women's. Our study......-reports of health conditions with diffuse symptoms to the study of labor market outcomes. On the other hand, self-reported cardiovascular disease such as high blood pressure does not appear to bias the estimated impact on planned retirement. Copyright (c) 2009 John Wiley & Sons, Ltd.......We reassess the impact of health on retirement plans of older workers using a unique survey-register match-up which allows comparing the retirement effects of potentially biased survey self-reports of health to those of unbiased register-based diagnostic measures. The aim is to investigate whether...

  17. Health Care Transition Planning among Adolescents with Autism Spectrum Disorder

    Science.gov (United States)

    Walsh, Casey; Jones, Barbara; Schonwald, Alison

    2017-01-01

    Improving the health care transition process for youth with autism spectrum disorder (ASD) is critically important. This study was designed to examine the overall national transition core outcome among youth with ASD and each of the component measures of health care transition planning. Fewer than 10% of youth with ASD meet the national transition…

  18. Planning parenthood: Health care providers' perspectives on pregnancy intention, readiness, and family planning.

    Science.gov (United States)

    Stevens, Lindsay M

    2015-08-01

    A major health care goal in the United States is increasing the proportion of pregnancies that are planned. While many studies examine family planning from the perspective of individual women or couples, few investigate the perceptions and practices of health care providers, who are gatekeepers to medicalized fertility control. In this paper, I draw on 24 in-depth interviews with providers to investigate how they interpret and enact the objective to "plan parenthood" and analyze their perspectives in the context of broader discourses about reproduction, family planning, and motherhood. Interviews reveal two central discourses: one defines pregnancy planning as an individual choice, that is as patients setting their own pregnancy intentions; the second incorporates normative expectations about what it means to be ready to have a baby that exclude poor, single, and young women. In the latter discourse, planning is a broader process of achieving middle-class life markers like a long-term relationship, a good job, and financial stability, before having children. Especially illuminating are cases where a patient's pregnancy intention and the normative expectations of "readiness" do not align. With these, I demonstrate that providers may prioritize normative notions of readiness over a patient's own intentions. I argue that these negotiations of intention and readiness reflect broader tensions in family planning and demonstrate that at times the seemingly neutral notion of "planned parenthood" can mask a source of stratification in reproductive health care.

  19. Real estate planning for population health.

    Science.gov (United States)

    McHugh, Margie

    2014-11-01

    Factors that health systems should consider when performing strategic assessments of their portfolios of ambulatory facilities include: Inventory. Location Facility condition. Service mix. Space use and capacity. Occupancy metrics. Strategic and economic opportunities.

  20. Physician workforce planning in an era of health care reform.

    Science.gov (United States)

    Grover, Atul; Niecko-Najjum, Lidia M

    2013-12-01

    Workforce planning in an era of health care reform is a challenge as both delivery systems and patient demographics change. Current workforce projections are based on a future health care system that is either an identified "ideal" or a modified version of the existing system. The desire to plan for such an "ideal system," however, may threaten access to necessary services if it does not come to fruition or is based on theoretical rather than empirical data.Historically, workforce planning that concentrated only on an "ideal system" has been centered on incorrect assumptions. Two examples of such failures presented in the 1980s when the Graduate Medical Education National Advisory Committee recommended a decrease in the physician workforce on the basis of predetermined "necessary and appropriate" services and in the 1990s, when planners expected managed care and health maintenance organizations to completely overhaul the existing health care system. Neither accounted for human behavior, demographic changes, and actual demand for health care services, leaving the nation ill-prepared to care for an aging population with chronic disease.In this article, the authors argue that workforce planning should begin with the current system and make adjustments based on empirical data that accurately reflect current trends. Actual health care use patterns will become evident as systemic changes are realized-or not-over time. No single approach will solve the looming physician shortage, but the danger of planning only for an ideal system is being unprepared for the actual needs of the population.

  1. 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.

  2. Who chooses a consumer-directed health plan?

    Science.gov (United States)

    Barry, Colleen L; Cullen, Mark R; Galusha, Deron; Slade, Martin D; Busch, Susan H

    2008-01-01

    Consumer-directed health plans (CDHPs) hold the promise of reining in health spending by giving consumers a greater stake in health care purchasing, yet little is known about employers' experience with these products. In examining the characteristics of those selecting a CDHP offered by one large employer, we found stronger evidence of selection than has been identified in prior research. Our findings suggest that in the context of plan choice, CDHPs may offer little opportunity to greatly lower employers' cost burden, and they highlight concerns about the potential for risk segmentation and the value of conferring preferential tax treatment to CDHPs.

  3. [Planning and instrumental rationality: an analysis of theoretical production in strategic health planning in the 1990s in Brazil].

    Science.gov (United States)

    Campos, R O

    2000-01-01

    This article analyzes recent theoretical production in Brazil on strategic health planning, focusing on instrumental logic. The approach centers on authors who have emphasized theoretical and methodological aspects of strategic planning. Emphasis is on the need to develop a new instrumentality capable of answering dilemmatic questions faced in health issues (professional health workers' efficacy/personal achievement) in order to recover the teleological planning action. The author provides a proposal that considers planning a modulator for the incorporation of technology by health institutions.

  4. 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.

  5. Expanding Medicare and employer plans to achieve universal health insurance.

    Science.gov (United States)

    Davis, K

    1991-05-15

    This article presents a proposal for expanding Medicare and employer-based health insurance plans to achieve universal health insurance. Under this proposed health care financing system, employees would provide basic health insurance coverage to workers and dependents, or pay a payroll tax contribution toward the cost of their coverage under Medicare. States would have the option of buying all Medicaid beneficiaries and other poor individuals into Medicare by paying the Medicare premiums and cost sharing. Other uninsured individuals would be automatically covered by Medicare. Employer plans would incorporate Medicare's provider payment methods. This proposal would result in incremental federal governmental outlays on the order of $25 billion annually. These new federal budgetary costs would be met through a combination of premiums, employer payroll tax, income tax, and general tax revenues. The principal advantage of this plan is that it draws on the strengths of the current system while simplifying the benefit and provider payment structure and instituting innovations to promote efficiency.

  6. Public engagement and the changing face of health system planning.

    Science.gov (United States)

    Grant, John; Sears, Nancy A; Born, Karen

    2008-01-01

    This paper examines the impact of the emerging citizens' assembly model of public engagement on health system planning and management. The characteristics that distinguish this model from more traditional approaches such as surveys and town hall meetings are elaborated using the case study of the recent Citizens' Regional Health Assembly. The paper concludes by suggesting the possibility of a new type of relationship between health system decision-makers, providers and the community.

  7. Health workforce planning in Europe: Creating learning country clusters.

    Science.gov (United States)

    Batenburg, Ronald

    2015-12-01

    In this article, the different dimensions and determinants of health workforce planning (HWF) are investigated to improve context-sensitivity and mutual learning among groups of countries with similar HWF characteristics. A novel approach to scoring countries according to their HFW characteristics and type of planning is introduced using data collected in 2012 by a large European Union project involving 35 European countries (the 'Matrix Study' [8]). HWF planning is measured in terms of three major dimensions: (1) data infrastructure to monitor the capacities and dynamics of health workforces, (2) the institutions involved in defining and implementing labour market regulations, and (3) the availability of models to estimate supply-demand gaps and to forecast imbalances. The result shows that the three dimensions of HWF planning are weakly interrelated, indicating that countries invest in HWF in different ways. Determinant analysis shows that countries with larger health labour markets, National Healthcare Service (NHS), mobility, and strong primary health care score higher on HWF planning dimensions than others. Consequently, the results suggest that clustering countries with similar conditions in terms of HWF planning is a way forward towards mutual and contextual learning.

  8. Price-Shopping in Consumer-Directed Health Plans.

    Science.gov (United States)

    Sood, Neeraj; Wagner, Zachary; Huckfeldt, Peter; Haviland, Amelia

    2013-01-01

    We use health insurance claims data from 63 large employers to estimate the extent of price shopping for nine common outpatient services in consumer-directed health plans (CDHPs) compared to traditional health plans. The main measures of price-shopping include: (1) the total price paid on the claim, (2) the share of claims from low and high cost providers and (3) the savings from price shopping relative to choosing prices randomly. All analyses control for individual and zip code level demographics and plan characteristics. We also estimate differences in price shopping within CDHPs depending on expected health care costs and whether the service was bought before or after reaching the deductible. For 8 out of 9 services analyzed, prices paid by CDHP and traditional plan enrollees did not differ significantly; CDHP enrollees paid 2.3% less for office visits. Similarly, office visits was the only service where CDHP enrollment resulted in a significantly larger share of claims from low cost providers and greater savings from price shopping relative to traditional plans. There was also no evidence that, within CDHP plans, consumers with lower expected medical expenses exhibited more price-shopping or that consumers exhibited more price-shopping before reaching the deductible.

  9. Health planning for remote petrochemical field operations

    Energy Technology Data Exchange (ETDEWEB)

    Krieger, G.R.; Balge, M.Z.

    1995-12-31

    Occupational/Public Health Services are becoming increasingly required in projects that involve the extended presence of expatriates in remote underdeveloped areas of the world. These ``expats`` are defined as individuals living and working in the environment who are not indigenous to the area. Under this definition, workers who are resistant to a ``local`` strain of malaria and then relocate to another geographic within the same country can also be considered as ``biologic expatriates`` since their resistance profile for certain tropical diseases is not reflective of their new environment. Unlike a major infrastructure project in the industrialized world, project planners in remote areas of the developing world should be expected to make significant long term medical and environmental commitments. US companies have extensive experience in the business of large-scale development projects, e.g. oil and gas pipelines and well field development; however, these projects represent major long-term in-country commitments with potentially large labor forces and substantial and sustained impacts on local health and safety resources. The initial structuring of health and safety programs will, therefore, have long-term ramifications on the project both during construction and ``routine`` operations since the multi-national companies are increasingly expected to develop and maintain self-sustaining health, safety and environmental programs.

  10. Defining "Rural" for Veterans' Health Care Planning

    Science.gov (United States)

    West, Alan N.; Lee, Richard E.; Shambaugh-Miller, Michael D.; Bair, Byron D.; Mueller, Keith J.; Lilly, Ryan S.; Kaboli, Peter J.; Hawthorne, Kara

    2010-01-01

    Purpose: The Veterans Health Administration (VHA) devised an algorithm to classify veterans as Urban, Rural, or Highly Rural residents. To understand the policy implications of the VHA scheme, we compared its categories to 3 Office of Management and Budget (OMB) and 4 Rural-Urban Commuting Area (RUCA) geographical categories. Method: Using…

  11. Pharmaceutical Education and Health Planning--Issues and Opportunities. The 1979 AACP Argus Commission Report.

    Science.gov (United States)

    And Others; Kinnard, William J., Jr.

    1979-01-01

    National and state programs that identify and incorporate the role of pharmacists into major health care plans are discussed. Local planning efforts and the development of databases for health care planning are also examined. (SF)

  12. Strategic Facilities Planning: A Focus On Health Care

    Directory of Open Access Journals (Sweden)

    Ellen D. Hoadley

    2011-01-01

    Full Text Available Turbulent market conditions have forced the health care sector to re-examine its business and operational practices.  Health care has become increasingly complex as decisions and planning are reframed in light of the current lagging economy, an increased demand for services, new global competition, and impending legislation reform.  The stress is felt most keenly within the nation’s hospitals and consortia of health care facilities.  Facility planning decisions are no exception.  Hospital administrators are abandoning the once commonplace rules governing aging infrastructure renovations.  Instead, administrators are basing decisions within their respective strategic context and are attempting to align buildings, services, personnel, and technology to an overall plan that looks at markets, operations, and finances as resources for competitive advantage.  This paper reviews the strategic facilities planning literature and applies those best practices which support this organizational alignment for health care.  An application in the mid-Atlantic demonstrates that hospital facilities, by design, need to support the current and future needs of health care delivery systems, while dated structures impede industry advances.  Health care infrastructure improvements must proactively address technological, regulatory, and financial changes facing the sector.

  13. Provider-owned health plans: El Dorado or Armageddon?

    Science.gov (United States)

    McCarthy, E J

    1999-11-01

    The development of provider-owned health plans continues to be an important strategy of integrated delivery systems (IDSs). While HMO enrollment growth has continued, reaching almost 70 million people, average health plan profit margins have declined from 8 percent in 1994 to less than 1 percent in 1997. About 56 percent of HMOs lost money in 1998. The ability to successfully develop and operate a provider-owned HMO is affected by conditions inherent to the managed care industry, the level of cooperation among IDS business, units, and local market conditions.

  14. 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

    ... Occupational Safety and Health Administration 29 CFR Part 1952 RIN 1218-AC78 Hawaii State Plan for Occupational Safety and Health; Proposed Modification of 18(e) Plan Approval AGENCY: Occupational Safety and Health...; request for written comments. SUMMARY: Hawaii administers an occupational safety and health state...

  15. Health Care Consumerism: Lessons My 401(k) Plan Taught Me.

    Science.gov (United States)

    Steinberg, Allen T

    2015-01-01

    Changes to the U.S. health care system are here. As we think about how individuals will pay for health care--while actively employed and while retired--our experiences with 401(k) plans provide some valuable lessons. In order to support employees in this new health care world--a challenge arguably more daunting than the 401(k) challenge we faced 20 years ago--some very different types of support are needed. Employers should consider providing their employees with the resources to manage health care changes.

  16. [Applicability of Children's Environment and Health Action Plan in Serbia].

    Science.gov (United States)

    Ilić, Miroslava Kristoforović

    2010-01-01

    The Children's Environment and Health Action Plan for Europe was adopted at the 4th Ministry Conference on Environment (the World Health Organization, 2004). It is focused on children health care against hazards originating from the human environment. In its conclusion, the need is expressed for the development of national plans in the field of Environmental and Children Health for European region by 2007. Mutual activities would be obligatory for each country and their realization should be the responsibility of Ministers of Health Care and Environmental Health. In our country, a draft version of this document was recently adopted, where the following priority regional goals are proposed: safe drinking water and adequate sanitation, injury prevention and adequate physical activity, clean indoor and outdoor air, the human environment without chemicals. Every segment has been explained in details through activities, expected results, indicators, sources of verification and the main participants in the project implementation. The end of the action plan period is proposed to be the year 2019. It is also followed by a defined set of indicators: exposure, activities and health status. The analyses of particular activities or data to be used have pointed to some drawbacks of this draft version, which can be overcome by respecting expert opinions.

  17. City planning and population health: a global challenge.

    Science.gov (United States)

    Giles-Corti, Billie; Vernez-Moudon, Anne; Reis, Rodrigo; Turrell, Gavin; Dannenberg, Andrew L; Badland, Hannah; Foster, Sarah; Lowe, Melanie; Sallis, James F; Stevenson, Mark; Owen, Neville

    2016-12-10

    Significant global health challenges are being confronted in the 21st century, prompting calls to rethink approaches to disease prevention. A key part of the solution is city planning that reduces non-communicable diseases and road trauma while also managing rapid urbanisation. This Series of papers considers the health impacts of city planning through transport mode choices. In this, the first paper, we identify eight integrated regional and local interventions that, when combined, encourage walking, cycling, and public transport use, while reducing private motor vehicle use. These interventions are destination accessibility, equitable distribution of employment across cities, managing demand by reducing the availability and increasing the cost of parking, designing pedestrian-friendly and cycling-friendly movement networks, achieving optimum levels of residential density, reducing distance to public transport, and enhancing the desirability of active travel modes (eg, creating safe attractive neighbourhoods and safe, affordable, and convenient public transport). Together, these interventions will create healthier and more sustainable compact cities that reduce the environmental, social, and behavioural risk factors that affect lifestyle choices, levels of traffic, environmental pollution, noise, and crime. The health sector, including health ministers, must lead in advocating for integrated multisector city planning that prioritises health, sustainability, and liveability outcomes, particularly in rapidly changing low-income and middle-income countries. We recommend establishing a set of indicators to benchmark and monitor progress towards achievement of more compact cities that promote health and reduce health inequities.

  18. 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

  19. Animal health and welfare planning in organic dairy cattle farms

    OpenAIRE

    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 ba...

  20. Integrated Marketing Communications Plan for Health Centre Rhein-Neckar

    OpenAIRE

    Stock, Katharina

    2017-01-01

    In today’s competitive environment, medical practices cannot do without advertising their services in order to attract and retain patients. Marketing in health care has become as essential as within any other industry. Therefore, this product-oriented thesis aims at creating an integrated marketing communications plan for the case company, Orthopaedic Health Centre Rhein-Neckar. The company’s objective is to increase sales generated by its diagnostic methods and treatment options for arthrosi...

  1. 75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-11-17

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage... provide guidance to employers, group health plans, and health insurance issuers providing group health... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar...

  2. How Do Private Health Plans Manage Specialty Behavioral Health Treatment Entry and Continuing Care?

    Science.gov (United States)

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

    2017-09-01

    This study examined private health plans' arrangements for accessing and continuing specialty behavioral health treatment in 2010 as federal health reforms were being implemented. These management practices have historically been stricter in behavioral health care than in general medical care; however, the Mental Health Parity and Addiction Equity Act of 2010 required parity in management policies. The data source was a nationally representative survey of private health plans' behavioral health treatment management approaches in 2010. Health plan executives were asked about activities for their plan's three products with highest enrollment (weighted N=8,427, 88% response rate). Prior authorization for outpatient behavioral health care was rarely required (4.7% of products), but 75% of products required authorization for ongoing care and over 90% required prior authorization for other levels of care. The most common medical necessity criteria were self-developed and American Society of Addiction Medicine criteria. Nearly all products had formal standards to limit waiting time for routine and urgent treatment, but almost 30% lacked such standards for detoxification services. A range of wait time-monitoring approaches was used. Health plans used a variety of methods to influence behavioral health treatment entry and continuing care. Few relied on prior authorization for outpatient care, but the use of other approaches to influence, manage, or facilitate access was common. Results provide a baseline for understanding the current management environment for specialty behavioral health care. Tracking health plans' approaches over time will be important to ensure that access to behavioral health care is not prohibitively restrictive.

  3. Changing workforce demographics necessitates succession planning in health care.

    Science.gov (United States)

    Collins, Sandra K; Collins, Kevin S

    2007-01-01

    Health care organizations continue to be plagued by labor shortage issues. Further complicating the already existing workforce challenges is an aging population poised to retire en masse within the next few years. With fewer cohorts in the age group of 25 to 44 years (Vital Speeches Day. 2004:71:23-27), a more mobile workforce (Grow Your Own Leaders: How to Identify, Develop, and Retain Leadership Talent, 2002), and an overall reduction in the number of individuals seeking employment in the health care field (J Healthc Manag. 2003:48:6-11), the industry could be faced with an unmanageable number of vacant positions throughout the organization. Bracing for the potential impact of these issues is crucial to the ongoing business continuity of health care organization. Many health care organizations have embraced succession planning to combat the potential labor famine. However, the health care industry as a whole seems to lag behind other industries in terms of succession planning efforts (Healthc Financ Manage. 2005;59:64-67). This article seeks to provide health care managers with a framework for improving the systematic preparation of the next generation of managers by analyzing the succession planning process. The proposition of these models is to initiate and simplify the gap reduction between theoretical concepts and future organizational application.

  4. 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.

  5. Financial planning and management of health programmes in India.

    Science.gov (United States)

    Handa, K L

    1981-01-01

    In this paper, the author deals with the financial planning and control of health programmes in India. The techniques of cost-effectiveness analysis and of performance budgeting are highly useful aids to management for implementation of monitoring and review of performance of the programmes are also essential for gauging the progress.

  6. Planning health care for patients with Graves’ orbitopathy

    NARCIS (Netherlands)

    Sasim, I.V.; Berendschot, T.T.J.M.; Isterdael, C. van; Mourits, M.P.

    2008-01-01

    Background: To describe disease parameters of patients with Graves’ orbitopathy in a tertiary referral center in order to plan health care resource allocations. To investigate whether the clinical activity and/or the severity of the disease can be used as a predictor of the duration of treatment. Me

  7. Sanitation Health Risk and Safety Planning in Urban Residential ...

    African Journals Online (AJOL)

    Sultan

    approach for sustainable management of urban environment. This was ... areas around major cities in developing countries. ... microbial analysis (Luiza et al, 2015). Health .... handling food remains a key cost effective and .... and solid waste systems are considered to be .... municipal sanitation planning system has not.

  8. Health workforce planning in Europe: creating learning country clusters.

    NARCIS (Netherlands)

    Batenburg, R.

    2015-01-01

    In this article, the different dimensions and determinants of health workforce planning (HWF) are investigated to improve context-sensitivity and mutual learning among groups of countries with similar HWF characteristics. A novel approach to scoring countries according to their HFW characteristics a

  9. Replacement-ready? Succession planning tops health care administrators' priorities.

    Science.gov (United States)

    Husting, P M; Alderman, M

    2001-09-01

    Nurses' increasing age coupled with health care's rapidly changing environment moves succession planning, originally only a business sector tool, to a top administrative priority. Through active support of your facility's executive leadership and a clear linkage to long range organization objectives, you can implement this progressive procedure.

  10. Strategic business planning and development for competitive health care systems.

    Science.gov (United States)

    Nauert, Roger C

    2005-01-01

    The health care industry has undergone enormous evolutionary changes in recent years. Competitive transitions have accelerated the compelling need for aggressive strategic business planning and dynamic system development. Success is driven by organizational commitments to farsighted market analyses, timely action, and effective management.

  11. 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

  12. NIF special equipment construction health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    Sawicki, R.H.

    1997-07-28

    The purpose of this plan is to identify how the construction and deployment activities of the National Ignition Facility (NIF) Special Equipment (SE) will be safely executed. This plan includes an identification of (1) the safety-related responsibilities of the SE people and their interaction with other organizations involved; (2) safety related requirements, policies, and documentation; (3) a list of the potential hazards unique to SE systems and the mechanisms that will be implemented to control them to acceptable levels; (4) a summary of Environmental Safety and Health (ES&H) training requirements; and (5) requirements of contractor safety plans that will be developed and used by all SE contractors participating in site activities. This plan is a subsidiary document to the NIF Construction Safety Program (CSP) and is intended to compliment the requirements stated therein with additional details specific to the safety needs of the SE construction-related activities. If a conflict arises between these two documents, the CSP will supersede. It is important to note that this plan does not list all of the potential hazards and their controls because the design and safety analysis process is still ongoing. Additional safety issues win be addressed in the Final Safety Analysis Report, Operational Safety Procedures (OSPs), and other plans and procedures as described in Section 3.0 of this plan.

  13. Health Care Procedure Considerations and Individualized Health Care Plans

    Science.gov (United States)

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

    Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

  14. 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.

  15. Managing patients with high-deductible health plans and health savings accounts.

    Science.gov (United States)

    Weaver, Catherine M

    2009-01-01

    High-deductible health plans and health savings accounts have many patients and providers mutually mystified. It is very important for providers and their staff to understand and manage these emerging products. If the current growth rate of enrollment in these plans continues, 25% of your patients will be presenting with this coverage in fewer than six years. Mishandling these products can cause unnecessary cash flow issues, but a little proactivity, education, and training now, will go a long way.

  16. Experience of the Checkerboard Area Health System in planning for rural health care.

    OpenAIRE

    1982-01-01

    The design of rural health care delivery systems often is based on concepts obtained from urban models. The implicit planning premises of successful urban models, however, may be inappropriate for many rural systems. An alternative model planned and implemented in the checkerboard region of rural northwest New Mexico has proved to be successful. This experience may be helpful to health care policymakers and planners confronted with environments that are not congruent with typical urban settin...

  17. [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.

  18. 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.

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

    DEFF Research Database (Denmark)

    Vaarst, Mette; Winckler, Christoph; Roderick, Stephen

    2011-01-01

    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...... seven countries. The process begins with gathering knowledge about the current status within a given herd as background for making decisions and planning future improvements as well as evaluating already implemented improvements. Respectful communication between the owner of the herd and other farmers...... countries, in collaboration with groups of organic farmers and organisations....

  20. 75 FR 27121 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Dependent...

    Science.gov (United States)

    2010-05-13

    ... Health Plans and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the... and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the Patient... implementing the requirements for group health plans and health insurance issuers in the group and individual...

  1. 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

    ... Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection...-AB68 Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a... Consumer Information and Insurance Oversight, Department of Health and Human Services. ACTION: Interim...

  2. 75 FR 43329 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal...

    Science.gov (United States)

    2010-07-23

    ... Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and External... CFR Part 147 RIN 0991-AB70 Interim Final Rules for Group Health Plans and Health Insurance Issuers... Administration, Department of Labor; Office of Consumer Information and Insurance Oversight, Department of Health...

  3. [planning And Instrumental Rationality: An Analysis Of Theoretical Production In Strategic Health Planning In The 1990s In Brazil].

    OpenAIRE

    Campos, R O

    2015-01-01

    This article analyzes recent theoretical production in Brazil on strategic health planning, focusing on instrumental logic. The approach centers on authors who have emphasized theoretical and methodological aspects of strategic planning. Emphasis is on the need to develop a new instrumentality capable of answering dilemmatic questions faced in health issues (professional health workers' efficacy/personal achievement) in order to recover the teleological planning action. The author provides a ...

  4. 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...... seven countries. The process begins with gathering knowledge about the current status within a given herd as background for making decisions and planning future improvements as well as evaluating already implemented improvements. Respectful communication between the owner of the herd and other farmers...

  5. Developing a promotion plan for health care marketing.

    Science.gov (United States)

    Hallums, A

    1994-07-01

    Promotion of a health care provider's services is essential for communication with its customers and consumers. It is relevant to an organization's marketing strategy and is an element of what is described as the marketing mix. This paper considers the relationship of promotion to the marketing of services and proposes a plan for the promotion of the organization as a whole which can also be applied to an individual service or specialty. Whilst specific reference is made to an National Health Service (NHS) Trust it is also relevant to a Directly Managed Unit.

  6. Operating plan for the Office of International Health Programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-01-01

    In this report unified ideas are presented about what the Office of International Health Programs does, what the individual contributions are, and how the organization connects to the Department of Energy. The planning efforts have focused on the office`s three areas of responsibility: Europe, Japan, and the Marshall Islands. Common to each technical program area are issues related to the following: health of populations exposed to radiation incidents and the associated medical aspects of exposure; dose reconstruction; training; and public involvement. Each of the program areas, its customers, and primary customer interests are described.

  7. NIF conventional facilities construction health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    Benjamin, D W

    1998-05-14

    The purpose of this Plan is to outline the minimum health and safety requirements to which all participating Lawrence Livermore National Laboratory (LLNL) and non-LLNL employees (excluding National Ignition Facility [NIF] specific contractors and subcontractors covered under the construction subcontract packages (e.g., CSP-9)-see Construction Safety Program for the National Ignition Facility [CSP] Section I.B. ''NIF Construction Contractors and Subcontractors'' for specifics) shall adhere to for preventing job-related injuries and illnesses during Conventional Facilities construction activities at the NIF Project. For the purpose of this Plan, the term ''LLNL and non-LLNL employees'' includes LLNL employees, LLNL Plant Operations staff and their contractors, supplemental labor, contract labor, labor-only contractors, vendors, DOE representatives, personnel matrixed/assigned from other National Laboratories, participating guests, and others such as visitors, students, consultants etc., performing on-site work or services in support of the NIF Project. Based upon an activity level determination explained in Section 1.2.18, in this document, these organizations or individuals may be required by site management to prepare their own NIF site-specific safety plan. LLNL employees will normally not be expected to prepare a site-specific safety plan. This Plan also outlines job-specific exposures and construction site safety activities with which LLNL and non-LLNL employees shall comply.

  8. Student specialty plans, clinical decision making, and health care reform.

    Science.gov (United States)

    Williams, Robert L; Romney, Crystal; Kano, Miria; Wright, Randy; Skipper, Betty; Getrich, Christina; Susman, Andrew L; Zyzanski, Stephen J

    2014-05-01

    Health care reform aims to increase evidence-based, cost-conscious, and patient-centered care. Family medicine is seen as central to these aims in part due to evidence of lower cost and comparable quality care compared with other specialties. We sought evidence that senior medical students planning family medicine residency differ from peers entering other fields in decision-making patterns relevant to these health care reform aims. We conducted a national, anonymous, internet-based survey of senior medical students. Students chose one of two equivalent management options for a set of patient vignettes based on preventive care, medication selection, or initial chronic disease management scenarios, representing in turn evidence-based care, cost-conscious care, and patient-centered care. We examined differences in student recommendations, comparing those planning to enter family medicine with all others using bivariate and weighted, multilevel, multivariable analyses. Among 4,656 surveys received from seniors at 84 participating medical schools, students entering family medicine were significantly more likely to recommend patient management options that were more cost conscious and more patient centered. We did not find a significant difference between the student groups in recommendations for evidence-based care vignettes. This study provides preliminary evidence suggesting that students planning to enter family medicine may already have clinical decision-making patterns that support health care reform goals to a greater extent than their peers. If confirmed by additional studies, this could have implications for medical school admission and training processes.

  9. Employer strategies to combat health care plan fraud.

    Science.gov (United States)

    Pflaum, B B; Rivers, J S

    1991-01-01

    Each year health care fraud drains millions of dollars from employer-sponsored health plans. Historically, employers have taken a rather tolerant view of fraud. As the pressure to manage health plan costs increases, however, many employers are beginning to see the detection and prosecution of fraud as an appropriate part of a cost management program. Fraud in medical insurance covers a wide range of activities in terms of cost and sophistication--from misrepresenting information on a claim, to billing for services never rendered, to falsifying the existence of an entire medical organization. To complicate matters, fraudulent activities can emanate from many, many sources. Perpetrators can include employees, dependents or associates of employees, providers and employees of providers--virtually anyone able to make a claim against a plan. This article addresses actions that employers can take to reduce losses from fraud. The first section suggests policy statements and administrative procedures and guidelines that can be used to discourage employee fraud. Section two addresses the most prevalent form of fraud--provider fraud. To combat provider fraud, employers should set corporate guidelines and should enlist the assistance of employees in identifying fraudulent provider activities. Section three suggests ways to improve fraud detection through the claims payment system--often the first line of defense against fraud. Finally, section four discusses the possibility of civil and criminal remedies and reviews the legal theories under which an increasing number of fraud cases have been prosecuted.

  10. Policy succession: the case for federal health planning in the 1990's.

    Science.gov (United States)

    Mueller, K J

    1993-01-01

    Direct federal involvement in local health planning ended in 1986 with the repeal of the Health Planning and Resources Development Act of 1974. This article argues that planning has remained an important element in state and local public health activities, and that it will re-emerge as a national effort. Theories of policy succession are used to derive conditions for policy renewal that are satisfied by the current policy environment for health planning. The need for planning is obvious when issues related to health care delivery in rural areas are considered, and there are strong advocates of the need for planning.

  11. Guidelines for Analysis of Health Sector Financing in Developing Countries. Volume 8: Health Sector Financing in Developing Countries. International Health Planning Methods Series.

    Science.gov (United States)

    Robertson, Robert L.; And Others

    Intended to assist Agency for International Development officers, advisors, and health officials in incorporating health planning into national plans for economic development, this eighth of ten manuals in the International Health Planning Methods series provides a methodology for conducting a study of health sector financing. It presents an…

  12. Planned health change in an emerging nation. Maternal/child health programme in the Peruvian Andes.

    Science.gov (United States)

    Levine, M A

    1990-04-01

    Professional skills developed in providing maternal and child care in the industrialised world can be applied to the provision of appropriate services to emerging nations. Understanding local mores and values, one can more effectively convey the essential elements of maintenance and promotion of health. By volunteering to work with a locally based relief organisation in Arequipa, Peru, I helped to facilitate cross-cultural planned health change in the maternal/child health programme.

  13. Examining the Value of Subsidies of Health Plans and Cost-Sharing for Prescription Drugs in the Health Insurance Marketplace.

    Science.gov (United States)

    Ngorsuraches, Surachat; Mort, Jane R

    2016-10-01

    The Affordable Care Act (ACA) initiated federally and state-run health insurance exchanges, or marketplaces, with health plans offering subsidies for plan members as well as coverage for essential health benefits, to help individuals, families, and small businesses find health plans that fit their specific needs. A recent study found that the value of these healthcare subsidies varied with the number of health plans in the different geographic rating areas, but that study only examined the premiums and the deductibles of those health plans. To examine the value of subsidies of health plans, including cost-sharing for prescription drugs in the health insurance marketplace. We have used publicly available health plan data from HealthCare.gov and from county population data obtained from the US Census Bureau in June 2015. The average-weighted premium; medical deductible; medical maximum out-of-pocket spending; and cost-sharing for generic drugs, preferred and nonpreferred brand-name drugs, and specialty drugs were calculated for the second lowest-cost silver plan in each geographic rating area. These were then compared across geographic areas with different numbers of plans to determine the value of the subsidies. We also compared the difference between the cost of the average silver plan and the second lowest-cost silver plan for each area to determine the cost to enrollees if they selected the average silver plan. The monetary value of the subsidies provided by health plans was lower in areas with a larger number of plans, because the second lowest-cost silver plans in these areas tended to have lower premiums and higher deductibles. For the most common type of cost-sharing for generic and for preferred brand-name drugs, plan enrollees would likely have a lower or similar copayment if they selected the average-cost silver plan instead of the second lowest-cost silver plan. However, they may end up paying approximately $8 less in copayment for nonpreferred branded

  14. 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.

  15. 76 FR 17419 - Federal Health IT Strategic Plan: 2011-2015 Open Comment Period

    Science.gov (United States)

    2011-03-29

    ... HUMAN SERVICES Federal Health IT Strategic Plan: 2011-2015 Open Comment Period AGENCY: Office of the... the Federal Health IT Strategic Plan (developed June 3, 2008) in consultation with other appropriate... the Federal Health IT Strategic Plan is open through Friday, April 22 at 11:59 p.m. (Eastern)....

  16. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns

    Directory of Open Access Journals (Sweden)

    Maziar Moradi-Lakeh

    2015-10-01

    Full Text Available In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP, was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016. It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME affiliated hospitals, reduce out-of-pocket (OOP payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers’ concerns (as powerful and influential stakeholders potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes should be addressed through proper revision(s while nontechnical concerns (which are derived from conflicting interests must be responded through clarification and providing transparent information. The

  17. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns.

    Science.gov (United States)

    Moradi-Lakeh, Maziar; Vosoogh-Moghaddam, Abbas

    2015-08-31

    In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP), was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016). It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME) affiliated hospitals, reduce out-of-pocket (OOP) payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs) of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers' concerns (as powerful and influential stakeholders) potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes) should be addressed through proper revision(s) while nontechnical concerns (which are derived from conflicting interests) must be responded through clarification and providing transparent information. The requirements of

  18. 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.

  19. [Regionalization in health: an instrument for jurisdictional planning].

    Science.gov (United States)

    Romero-Guerrero, X R; Perham-Zellmer, K A; Vázquez-Calderón, R H; Díaz-Gois, A; García-Martínez, F E; Gómez-Solís, R A; Montijo-Quevedo, R E; Aguirre-Garza, J S; Izquierdo-Avalos, M G; Hernández-Tezoquipa, I

    1992-01-01

    This study carried out the regionalization of Sanitary Jurisdiction No. III seated in Cuautla, Morelos, consisting of 16 of a total of 33 municipalities in the state of Morelos. This regionalization was carried out through the delination of areas sharing similar socioeconomical and demographic characteristics (SED). Subsequently, the major health hazards and the intraregional distribution of human health resources (physicians and nurses) and infrastructure services (institutional health centers) were identified for each region. The aim of this work was to devise an instrument for a better understanding of and approach to health problems at a juridictional level and to pave the way for health planning that would be congruent with regional characteristics and needs. Health sector efforts would be directed towards the promotion of preventive health care with greater efficiency and equity. In order to regionalize the jurisdiction, 17 SED indicators were studied in each of the 16 municipalities. Analysis was performed using the Principal Components Method (MCP) and an epidemiologic score. As a result, the sanitary jurisdiction was divided into three regions: Region I, with the best SED conditions, Region II, with moderate SED conditions and Region III with the lowest SED conditions. The results of this study show that there is an inverse relationship between the intraregional distribution of health resources with respect to the delineated regions and the health resources with respect to the delineated regions and the health needs and problems found in each one. Region III showed the worst SED conditions and the highest incidence of disease. It proved to be the region which had the greatest lack of material and human health resources, the latter having the lowest technical training level in all of the jurisdiction. In contrast. Region I had the best SED conditions and the lowest incidence of disease. It also had the highest number of material and human health resources

  20. 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

  1. 45 CFR 146.145 - Special rules relating to group health plans.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Special rules relating to group health plans. 146.145 Section 146.145 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO....145 Special rules relating to group health plans. (a) Group health plan—(1) Definition. A group...

  2. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation advance planning document requirements (HIT IAPD). 495.338 Section 495.338 Public Health CENTERS FOR... the Medicaid Program § 495.338 Health information technology implementation advance planning...

  3. Health financing in Africa: overview of a dialogue among high level policy makers

    Directory of Open Access Journals (Sweden)

    Sambo Luis

    2011-06-01

    Full Text Available Abstract Background Even though Africa has the highest disease burden compared with other regions, it has the lowest per capita spending on health. In 2007, 27 (51% out the 53 countries spent less than US$50 per person on health. Almost 30% of the total health expenditure came from governments, 50% from private sources (of which 71% was from out-of-pocket payments by households and 20% from donors. The purpose of this article is to reflect on the proceedings of the African Union Side Event on Health Financing in the African continent. Methods Methods employed in the session included presentations, panel discussion and open public discussion with ministers of health and finance from the African continent. Discussion The current unsatisfactory state of health financing was attributed to lack of clear vision and plan for health financing; lack of national health accounts and other evidence to guide development and implementation of national health financing policies and strategies; low investments in sectors that address social determinants of health; predominance of out-of-pocket spending; underdeveloped prepaid health financing mechanisms; large informal sectors vis-à-vis small formal sectors; and unpredictability and non-alignment of majority of donor funds with national health priorities. Countries need to develop and adopt a comprehensive national health policy and a costed strategic plan; a comprehensive evidence-based health financing strategy; allocate at least 15% of the national budget to health development; use GFATM and PEPFAR funds for health systems strengthening; strengthen intersectoral collaboration to address health determinants; advocate among donors to implement the Paris Declaration on Aid Effectiveness and its Accra Agenda for Action; ensure universal access to health services for pregnant women, lactating mothers and children aged under five years; strengthen financial management capacities; and develop prepaid health

  4. [National planning of health policy in Brazil: strategies and instruments in the 2000s].

    Science.gov (United States)

    Machado, Cristiani Vieira; Baptista, Tatiana Wargas de Faria; de Lima, Luciana Dias

    2010-08-01

    This paper discusses the national planning of health policy between 2003 and 2010, in the light of the development of state planning in Brazil and Lula's administration. Firstly an historical overview is presented of the key moments for national planning, regarding its effects on health care. The governmental context is then described with a review of the strategies and instruments in health planning over recent years. The methodology involved a bibliographic and documental review - including the Multi-year Plans, the National Health Plan, the Health Pact and the More Health program - considering their intention, contents and development processes. The results indicate that national health planning has been condensed in order to enable better direction of the policy. Two key moments in federal health planning were identified: between 2003 and 2006 a managerial and participative line was followed; between 2007 and 2010, the managerial line was kept allied to an effort to tie health policy to the development model. Despite the advances, health planning has displayed limitations, such as: restrictions in health financing, which has compromised the execution of the plans; failure to tackle structural problems in the health care system; and the fragile territorial organization.

  5. Administrative data for public health surveillance and planning.

    Science.gov (United States)

    Virnig, B A; McBean, M

    2001-01-01

    Electronically available administrative data are increasingly used by public health researchers and planners. The validity of the data source has been established, and its strengths and weaknesses relative to data abstracted from medical records and obtained via survey are documented. Administrative data are available from a variety of state, federal, and private sources and can, in many cases, be combined. As a tool for planning and surveillance, administrative data show great promise: They contain consistent elements, are available in a timely manner, and provide information about large numbers of individuals. Because they are available in an electronic format, they are relatively inexpensive to obtain and use. In the United States, however, there is no administrative data set covering the entire population. Although Medicare provides health care for an estimated 96% of the elderly, age 65 years and older, there is no comparable source for those under 65.

  6. Overcoming information asymmetry in consumer-directed health plans.

    Science.gov (United States)

    Retchin, Sheldon M

    2007-04-01

    Consumer-centric healthcare has been extolled as the centerpiece of a new model for managing both quality and price. However, information asymmetry in consumer-directed health plans (CDHPs) is a challenge that must be addressed. For CDHPs to work as intended and to gain acceptance, consumers need information regarding the quality and price of healthcare purchases. The federal government, particularly the Agency for Healthcare Research and Quality, could function as an official resource for information on performance and comparisons among facilities and providers. Because of workforce constraints among primary care physicians, a new group of healthcare professionals called "medical decision advisors" could be trained. Academic health centers would have to play a critical role in devising an appropriate curriculum, as well as designing a certification and credentialing process. However, with appropriate curricula and training, medical decision advisors could furnish information for consumers and aid in the complicated decisions they will face under CDHPs.

  7. Publication planning: an effective corporate strategy to influence health professionals.

    Science.gov (United States)

    2013-12-01

    Pharmaceutical companies integrate scientific publications into the communication strategies they employ to influence the practices of health professionals. In their"publication plan", pharmaceutical companies, or the communication agencies they hire, develop key messages to promote their drugs and then plan in advance how, when and where to disseminate them in medical journals or at conferences. Although their true intent is promotional, these messages must appear to be purely scientific, and are therefore disseminated as research articles, review articles, editorials, commentaries. Publication planning involves the use of "ghost" authors who work directly for pharmaceutical companies, but whose contribution is rarely acknowledged in the final published article. Key opinion leaders are recruited as the honorary authors of these articles, to which they have made little, if any, contribution. The criteria for authorship set by journals that publish primary research articles do not provide adequate protection against the practice of ghost and honorary authorship. Certain journals publishing primary research derive a large proportion of their revenue from selling reprints used by pharmaceutical companies to promote their drugs, especially by their sales representatives.

  8. 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.

  9. 76 FR 40457 - Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and...

    Science.gov (United States)

    2011-07-08

    ... the regulatory history, see the proposed rule entitled ``Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards,'' published... Insurance Portability and Accountability Act of 1996 (HIPAA) transactions: eligibility for a health plan and...

  10. 2015 Plan Selections by ZIP Code in the Health Insurance Marketplace

    Data.gov (United States)

    U.S. Department of Health & Human Services — The dataset here provides the total number of Qualified Health Plan selections by ZIP Code for 37 states for the second Health Insurance Marketplace open enrollment...

  11. Rebuilding the US Health Left

    Directory of Open Access Journals (Sweden)

    Victor W. Sidel, MD

    2010-02-01

    Full Text Available With this issue Social Medicine begins a series of invited papers on the topic: “Rebuilding the US Health Left.” In this editorial we will outline our vision for this series. We undertake this project aware that our good friend and mentor, Dr. Walter Lear, one of the leading health activists of the 20th century, lies critically ill. Walter was the creator and custodian of the US Health Left Archives, a collection that is now with the University of Pennsylvania library. The collection reminds us of the important role left health care workers played in US history throughout the 20th century. They advocated for a national health program (Committee on the Costs of Medical Care, Physicians Forum, Medical Care Section/APHA, HealthPAC, Physicians for a National Health Program, National Physicians Alliance, provided international solidarity (American Soviet Medical Society, international brigades during the Spanish Civil War, Central American Solidarity Movement, Committee to Help Chilean Health Workers, Doctors for Global Health, traced the connections between disease and social class (Sigerist Circle, Spirit of 1848, APHA, fought for workers’ health (Councils for Occupational Safety and Health; Occupational Health and Safety Section, APHA participated in anti-war movements (Medical Committee for Human Rights, Physicians for Social Responsibility, International Physicians for the Prevention of Nuclear War, created new models of health care delivery (Health Cooperatives, Prepaid Health Maintenance Organizations, Community Health Centers, National Health Service Corps, Free Clinics, were central to the struggle for women’s rights (Planned Parenthood, Physicians for Reproductive Choice and Health, supported the civil rights movement both in medicine and in the broader society (National Medical Association, Medical Committee for Human Rights, played key roles in the movement for gay rights (ACT-UP, Gay & Lesbian Medical Association, Lesbian, Gay

  12. 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.

  13. Managing patients with high-deductible health plans and health savings accounts: part 2.

    Science.gov (United States)

    Weaver, Catherine M

    2009-01-01

    High-deductible health plans and health savings accounts have many patients and providers mutually mystified. It is very important for providers and their staff to understand and manage these emerging products that are becoming more common. This article examines a case study of a family of four with these products. The case study shows the reader the number of moving parts as well as how quickly the patient liability can increase faster than the funds in the health savings account. Mishandling these products can cause unnecessary cash flow issues, but a little pro-activity, education, and training now will go a long way.

  14. Steps in planning and developing health communication campaigns: a comment on CDC's framework for health communication.

    Science.gov (United States)

    Donovan, R J

    1995-01-01

    This reviews the efforts of the Centers for Disease Control and Prevention to integrate effective health communication into its programs that are designed to change behaviors. Although the 10-step framework for developing and implementing the Centers' health communication programs is both practical and comprehensive, it is suggested that a reversal of steps 2 and 3 is a more logical sequence, is more consistent with the literature and, more importantly, could avoid misapplications of the framework by less experienced practitioners. Comment is also made on the dynamic nature of health communication planning and development, a point not made explicit in the Centers' framework. PMID:7631001

  15. 75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

    Science.gov (United States)

    2010-06-28

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ57 Requirements for Group Health Plans and Health Insurance..., Health care, Health insurance, Pensions, Reporting and recordkeeping requirements. Proposed Amendments to... U.S. Department of Health and Human Services are issuing substantially similar interim final...

  16. Planning for the Mercy Center for Breast Health.

    Science.gov (United States)

    Olivares, V Ed

    2002-01-01

    During the last months of 2000, administrators at the Mercy San Juan Medical Center in Carmichael, Calif., convened a steering committee to plan the Mercy Center for Breast Health. The Steering Committee was composed of the director of ancillary and support services, the oncology clinical nurse specialist, the RN manager of the oncology nursing unit, the RN surgery center manager, and me, the manager of imaging services. The committee was responsible for creating a new business with five specific objectives: to position the Center as a comprehensive diagnostic and resource center for women; to generate physician referrals to the Breast Center through various vehicles; to create awareness of the Breast Center's capabilities among area radiologists; to create awareness of the Breast Center among employees of six sister facilities; to create "brand awareness" for the Mercy Center for Breast Health among referring physicians and patients who could use competing centers in the area. The Steering Committee's charter was to design a center with a feminine touch and ambience and to provide a "one-stop shopping" experience for patients. A major component of the Breast Center is the Dianne Haselwood Resource Center, which provides patients with educational support and information. The Steering Committee brought its diverse experience and interests to bear on arranging for equipment acquisition, information and clerical systems, staffing, clinic office design, patient care and marketing. Planning the Mercy Center for Breast Health has been a positive challenge that brought together many elements of the organization and people from different departments and specialties to create a new business venture. Our charge now is to grow and to live up to our vision of offering complete breast diagnostic, education and support services in one location.

  17. 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

    ... plan enrollees. Based on prior work, there are several functional areas that the new instrument could...) the instrument is available in, evidence of cultural/cross group comparability, if any, instrument.... AHRQ determined that the CAHPS teams should develop a survey to obtain the consumers' perspective on...

  18. Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures

    OpenAIRE

    Richard J. Bloomer; Gunnels, Trint A; Schriefer, JohnHenry M.

    2015-01-01

    Background: We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF). This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan) or modified DF (i.e., restricted omnivorous; inclusive of ad libitu...

  19. An Integrated Work Force Planning Strategy For The Health Services 2009 - 2012

    OpenAIRE

    Department of Health and Children

    2009-01-01

    Workforce planning identifies the composition of the workforce required to deliver health service goals. It encompasses a range of human resource activities aimed at the short, medium and long-term. Workforce planning that is integrated with service and financial planning offers the best opportunity for linking human resource decisions to the strategic goals for the health services. Systems and structures are required to support and develop workforce planning activities

  20. A longitudinal perspective on health plan-provider risk contracting.

    Science.gov (United States)

    Hurley, Robert; Grossman, Joy; Lake, Timothy; Casalino, Lawrence

    2002-01-01

    During the past decade many health plans adopted risk-contracting arrangements that transferred substantial financial risk and care management responsibility to physician groups and hospital-sponsored integrated delivery systems. Risk transfer arrangements are now believed to be in steep decline, but there is little empirical evidence on this topic, particularly at the local-market level. Data from the Community Tracking Study were used to examine changes in risk contracting from 1996 to 2000. A decline in reliance on risk contracting is evident in nearly all markets. However, retrenchment in risk contracting has followed different patterns ranging from refinements in the scope of risk transfer to reduced use of risk arrangements to total rejection of risk-sharing arrangements. Modified risk-transfer agreements remain viable in several markets, but continued refinement in the nature and scope of risk sharing will be necessary.

  1. Planning the Marketing Activity in the Health Care Services

    Directory of Open Access Journals (Sweden)

    Violeta Radulescu

    2008-06-01

    Full Text Available The integration of marketing in the field of health care, starting with the 50’s, was accompanied by a series of controversies generated by the ethical and moral aspects that this type of services imply, as well as by the difficulty in determining exactly the demand, the unequal access to information of participants, the regulated mechanism for the establishment of prices and of rates and the intervention of the third party payer, the significant role of the state in ensuring the fair access of population to basic services, etc.The formulation of the marketing strategies, in the marketing planning process, starts from the generic strategy chosen by the organization according to its mission and objectives. As it has to adapt to the environment where it acts, to cope with the changes that appear, the organization must benefit from a perspective vision, all its actions must be subordinated to this vision in a whole marketing policy.

  2. Strategic planning and entrepreneurism in academic health centers.

    Science.gov (United States)

    Smith, C T

    1988-01-01

    This article examines the academic medical center as a mature component of the industry, whose complex mission can be reconciled with the public's changing needs in an era of cost containment through the use of increasingly businesslike strategic planning. New dimensions in academic health center missions (as a result of changing public mandates) emphasize the need to identify the most appropriate settings for both the delivery of patient care and physician education. Strategies to meet these new demands, reflecting a market-oriented approach, such as diversification through corporate reorganization and joint ventures are delineated. Legal, tax, and regulatory problems that develop as a result of not-for-profit hospital engagement in unrelated business activity are also reviewed.

  3. Current trends in health facility planning, design, and construction.

    Science.gov (United States)

    Beale, Craig; Kittredge, Frank D

    2014-01-01

    It is critical now more than ever for today's healthcare facilities to serve as more than just a backdrop to the care provided--they can, and should, be an integral part of that care. In addition to promoting efficacy, delighting the senses, and placing patients and families at ease, facilities need to be high-performing, sustainable, and healthy environments. Creating today's healthcare facilities requires breaking through barriers in unexpected ways, and it often requires looking outside the healthcare profession for guidance. In this article, we explore current trends in health facility planning, design, and construction. Our focus is on the buildings that serve as venues for the provision of healthcare services across the full continuum, from prevention to critical care. In particular, we discuss four current broad trends and conclude with thoughts on future developments.

  4. Increasing the impact of health plan report cards by addressing consumers' concerns.

    Science.gov (United States)

    Hibbard, J H; Harris-Kojetin, L; Mullin, P; Lubalin, J; Garfinkel, S

    2000-01-01

    Most plan report cards that compare the performance of health plans have framed the decision about plan choice as an opportunity to get better-quality care. This study uses a controlled experimental design to examine the effect of reframing the health plan choice decision to one that emphasizes protecting oneself from possible risk. The findings show that framing the health plan decision using a risk message has a consistent and significant positive impact on how consumers comprehend, value, and weight comparative performance information.

  5. 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

  6. A Joint Urban Planning and Public Health Framework: Contributions to Health Impact Assessment

    Science.gov (United States)

    Northridge, Mary E.; Sclar, Elliott

    2003-01-01

    A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public’s health. PMID:12511400

  7. Theoretical Foundation of Family Health Promotion—the Orientation of Family Planning Development in Urban Area

    Institute of Scientific and Technical Information of China (English)

    Er-sheng GAO; Jie YANG; Li-feng ZHOU; Mao-hua MIAO

    2006-01-01

    Objective To make a theoretical exploration of the function of family-based health promotion in family planning development.Methods Given the notion of reproductive health and the function of family in society,the author bring forward a new mode of family planning service, that was "healthy,happy household promotion" based on the principle of health education and health promotion.Results The mode of "healthy, happy household promotion" reflected the new F.P.service mode, and was the direction of family planning service. It might benefit both service provider and clients to make the family as the entrance point of quality care of reproductive health in communities, to develop health education and health promotion,and promote family health and family happiness.Conclusion Family health and family happiness should be the final goal of family planning.

  8. 75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

    Science.gov (United States)

    2010-07-19

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ58 Requirement for Group Health Plans and Health... Care Act (the Affordable Care Act) regarding preventive health services. The IRS is issuing the... Health and Human Services are issuing substantially similar interim final regulations with respect to...

  9. How can health ministries present persuasive investment plans for women's, children's and adolescents' health?

    Science.gov (United States)

    Anderson, Ian; Maliqi, Blerta; Axelson, Henrik; Ostergren, Mikael

    2016-06-01

    Most low- and middle-income countries face financing pressures if they are to adequately address the recommendations of the Global Strategy for Women's, Children's and Adolescent's Health. Negotiations between government ministries of health and finance are a key determinant of the level and effectiveness of public expenditure in the health sector. Yet ministries of health in low- and middle-income countries do not always have a good record in obtaining additional resources from key decision-making institutions. This is despite the strong evidence about the affordability and cost-effectiveness of many public health interventions and of the economic returns of investing in health. This article sets out 10 attributes of effective budget requests that can address the analytical needs and perspectives of ministries of finance and other financial decision-makers. We developed the list based on accepted economic principles, a literature review and a workshop in June 2015 involving government officials and other key stakeholders from low- and middle-income countries. The aim is to support ministries of health to present a more strategic and compelling plan for investments in the health of women, children and adolescents.

  10. Benefits of Water Safety Plans: microbiology, compliance, and public health.

    Science.gov (United States)

    Gunnarsdottir, Maria J; Gardarsson, Sigurdur M; Elliott, Mark; Sigmundsdottir, Gudrun; Bartram, Jamie

    2012-07-17

    The Water Safety Plan (WSP) methodology, which aims to enhance safety of drinking water supplies, has been recommended by the World Health Organization since 2004. WSPs are now used worldwide and are legally required in several countries. However, there is limited systematic evidence available demonstrating the effectiveness of WSPs on water quality and health. Iceland was one of the first countries to legislate the use of WSPs, enabling the analysis of more than a decade of data on impact of WSP. The objective was to determine the impact of WSP implementation on regulatory compliance, microbiological water quality, and incidence of clinical cases of diarrhea. Surveillance data on water quality and diarrhea were collected and analyzed. The results show that HPC (heterotrophic plate counts), representing microbiological growth in the water supply system, decreased statistically significant with fewer incidents of HPC exceeding 10 cfu per mL in samples following WSP implementation and noncompliance was also significantly reduced (p diarrhea was detected where a WSP was implemented, and, furthermore, the results indicate that population where WSP has been implemented is 14% less likely to develop clinical cases of diarrhea.

  11. Race, ethnicity, and language data collection by health plans: findings from 2010 AHIPF-RWJF survey.

    Science.gov (United States)

    Nerenz, David R; Carreón, Rita; Veselovskiy, German

    2013-11-01

    Previous national surveys have documented the increase in collection of race, ethnicity, and language (REL) data by health plans. The latest 2010 survey created an opportunity to examine recent trends and to determine whether the Patient Protection and Affordable Care Act (ACA) had an effect on plans' practices. A 51-item survey was sent to all health plans included in a national listing of plans (N = 250). The majority of responding plans collect data on members' REL. The frequency of race and ethnicity data collection was only slightly greater in 2010 than in 2008, 78.7% and 75% respectively. By 2010, 89.3% of health plans were collecting language data of their members, up from 74% in 2008 and 57.3% in 2003. Since 2008, collection and use of REL data continues gradually to increase among health plans, demonstrating the industry's commitment to address racial/ethnic gaps in care.

  12. Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example.

    NARCIS (Netherlands)

    Greuningen, M. van; Batenburg, R.S.; Velden, L.F.J. van der

    2012-01-01

    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

  13. Implementation of ways to effectively integrate health into local environmental planning

    DEFF Research Database (Denmark)

    Jakobsen, Mette Winge

    2015-01-01

    -2013) included testing of the implementation models, capacity building and expert consultation. The intervention was evaluated in 2012 and 2014 in relation to the most effective mechanisms in relation use of HIA tools, sustainable procedures for integrating a health concern and ensuring HiAP. Evaluation results...... showed that HIA tools were integrated into the local planning process as proactive planning tools. Systematic procedures and cross-sectoral collaboration were key factors in integrating a health concern in environmental planning, strengthened by frequent, accurate and timely communication, personal...... relationship and common language for health relevant for environmental planning. Also, early involvement increased ownership. Simple tools, improving existing planning processes and creating common language for health were key learnings to ensure effective implementation of a health concern in a local planning...

  14. APPLYING PREPAID CARD IN OBSTETRICAL PATIENTS’CHECK%预存卡在门诊产科围产期检查中的应用

    Institute of Scientific and Technical Information of China (English)

    韩琳; 刘惠娟; 吴卫荣

    2014-01-01

    With the development of economy,though the investment from Chinese government has been gradually increasing in medical and health services,the problem of“difficult in getting medical service”always exist in comprehensive hospitals.In China,this problem has the performance of many links in getting the medical services including registration,payment and check,in particular,long time for queuing. To solve this problem,there are the domestic hospitals who are exploring and improving the prepayment mode in outpatients service,though achieved some success,but it has not yet solved the recharging issue of medicare patients.With the help of information system in our hospital,we optimise the work flow in obstetric department,promote the application of prepaid card service pattern for outpatient service fees and ultimately improve patients’satisfaction.This pattern reduces the waiting times the patients spent in registration and paying queue, decreases the labour cost of hospital,and improves the diagnosis efficiency.This pattern has the role of being popularised to other hospitals outpatient services.%随着经济发展和国家对医疗卫生事业投入的逐步增加,但是病人在综合医院“看病难”的问题一直存在。在我国,看病难表现在挂号、付费和检查等就医环节多,尤其排队时间长。针对这一问题,国内也有医院对门诊预付费方式进行了探索和改进,虽然取得了一定成效,但是没有解决医保病人充值的问题。为解决这一问题,借助信息系统优化产科工作流程,推广应用门诊费用预存卡服务模式,最终提高了患者满意度,减少了病人挂号及收费排队等候时间,降低了人员成本,提高了诊疗效率。该模式对其他医院门诊具有推广作用。

  15. Family planning and sexual health organizations: management lessons for health system reform.

    Science.gov (United States)

    Ambegaokar, Maia; Lush, Louisiana

    2004-10-01

    Advocates of health system reform are calling for, among other things, decentralized, autonomous managerial and financial control, use of contracting and incentives, and a greater reliance on market mechanisms in the delivery of health services. The family planning and sexual health (FP&SH) sector already has experience of these. In this paper, we set forth three typical means of service provision within the FP&SH sector since the mid-1900s: independent not-for-profit providers, vertical government programmes and social marketing programmes. In each case, we present the context within which the service delivery mechanism evolved, the management techniques that characterize it and the lessons learned in FP&SH that are applicable to the wider debate about improving health sector management. We conclude that the FP&SH sector can provide both positive and negative lessons in the areas of autonomous management, use of incentives to providers and acceptors, balancing of centralization against decentralization, and employing private sector marketing and distribution techniques for delivering health services. This experience has not been adequately acknowledged in the debates about how to improve the quality and quantity of health services for the poor in developing countries. Health sector reform advocates and FP&SH advocates should collaborate within countries and regions to apply these management lessons.

  16. Knowledge and Attitude about Reproductive Health and Family Planning among Young Adults in Yemen

    Directory of Open Access Journals (Sweden)

    Muhammed S. A. Masood

    2017-01-01

    Full Text Available Background. The Yemeni government is focusing more attention on the needs of youth to ensure a healthy transition to adulthood. This is critical because adolescent population (ages 15–24 of 3.35 million will double in just 20 years. Young adults often lack basic knowledge about reproductive health and family planning. Objectives. To determine reproductive health and family planning knowledge and attitude among young adults aged 15 to 25+ years. Method. Sample study was taken from Marie Stopes International in Yemen which was conducted from March to July 2013 on the reproductive health age 15–49 years. Descriptive, bivariate, and multivariate analyses were employed. Results. Majority had heard about reproductive health and family planning and encouraged its methods. Television, relatives, and radio were major sources of information. Adults with higher education tend to have more awareness about health services. Knowledge about health services and family planning methods among older adults was significant, and adults in Belqees Club were more likely to have high empowerment scores for family planning methods. Conclusion. The level of knowledge about health services for reproductive health and family planning and its methods was low to moderate. The introduction of contraceptives remains a challenge in Yemen because the educational reproductive health is weak in Yemeni schools or health institutes or universities. Information about reproductive health and family planning should be provided to adolescents through medical schools curricula.

  17. The component alignment model: a new approach to health care information technology strategic planning.

    Science.gov (United States)

    Martin, J B; Wilkins, A S; Stawski, S K

    1998-08-01

    The evolving health care environment demands that health care organizations fully utilize information technologies (ITs). The effective deployment of IT requires the development and implementation of a comprehensive IT strategic plan. A number of approaches to health care IT strategic planning exist, but they are outdated or incomplete. The component alignment model (CAM) introduced here recognizes the complexity of today's health care environment, emphasizing continuous assessment and realignment of seven basic components: external environment, emerging ITs, organizational infrastructure, mission, IT infrastructure, business strategy, and IT strategy. The article provides a framework by which health care organizations can develop an effective IT strategic planning process.

  18. Florida's Prepaid College Tuition Program: Marketing a Pre-Need Service.

    Science.gov (United States)

    Gauff, Joseph F., Jr.

    1994-01-01

    A discussion of Florida's college tuition prepayment program describes the plan and its options and examines its marketing implications as a preneed service. It is concluded that the program makes saving for college easy, economical, and completely safe but requires rethinking of conventional marketing strategies and mix. (MSE)

  19. Florida's Prepaid College Tuition Program: Marketing a Pre-Need Service.

    Science.gov (United States)

    Gauff, Joseph F., Jr.

    1994-01-01

    A discussion of Florida's college tuition prepayment program describes the plan and its options and examines its marketing implications as a preneed service. It is concluded that the program makes saving for college easy, economical, and completely safe but requires rethinking of conventional marketing strategies and mix. (MSE)

  20. Applicability of children’s environment and health action plan in Serbia

    OpenAIRE

    Kristoforović-Ilić Miroslava

    2010-01-01

    The Children’s Environment and Health Action Plan for Europe was adopted at the 4th Ministry Conference on Environment (the World Health Organization, 2004). It is focused on children health care against hazards originating from the human environment. In its conclusion, the need is expressed for the development of national plans in the field of Environmental and Children Health for European region by 2007. Mutual activities would be obligatory for each country and their realization shou...

  1. Public health and urban planning: a powerful alliance to be enhanced in Italy.

    Science.gov (United States)

    D'Alessandro, D; Appolloni, L; Capasso, L

    2017-01-01

    Urban planning has played and still plays a key role in improving urban health and indoor health. The authors sketch out the historical evolution of the relationships between Public Health and urban planning, in particular to what happened in Italy during the past 150 years. The authors suggest some lines for further research, but also describe some interventions that could obtain practical results in terms of health gains for the population.

  2. 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.

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

    Science.gov (United States)

    Naccarella, Lucio; Wraighe, 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.

  4. 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

  5. Health care planning and education via gaming-simulation: a two-stage experiment.

    Science.gov (United States)

    Gagnon, J H; Greenblat, C S

    1977-01-01

    A two-stage process of gaming-simulation design was conducted: the first stage of design concerned national planning for hemophilia care; the second stage of design was for gaming-simulation concerning the problems of hemophilia patients and health care providers. The planning design was intended to be adaptable to large-scale planning for a variety of health care problems. The educational game was designed using data developed in designing the planning game. A broad range of policy-makers participated in the planning game.

  6. Integrating Health and Fairness into Duluth’s Comprehensive Plan

    Science.gov (United States)

    Cities of the Great Lakes are innovators in comprehensive ecosystem-focused urban planning. Beginning with the Plan of Chicago, comprehensive plans have been expressions of a community’s vision for the future, particularly regarding the use of waterfronts. Like Chicago in 1...

  7. A model linking clinical workforce skill mix planning to health and health care dynamics

    Directory of Open Access Journals (Sweden)

    McDonnell Geoff

    2010-04-01

    Full Text Available Abstract Background In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Methods Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. Results We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. Conclusion We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  8. Manager's leadership is the main skill for ambulatory health care plan success.

    Science.gov (United States)

    Marin, Gustavo Horacio; Silberman, Martin; Colombo, Maria Virginia; Ozaeta, Belen; Henen, Jaime

    2015-01-01

    To demonstrate effectiveness of ambulatory health care plan implementation among institutions and variables associated with the differences observed. Randomized selection of primary health care (PHC) centers was done. Leadership ability of the plan manager was explored. Univariate/bivariate analyses were performed to observe correlation between variables. Two groups of PHC centers were established according to the efficacy of plan implementation: high and low performance. Differences between groups were observed (592%-1023% more efficacy in controls and practices; P < .001). Leadership was responsible for the main differences observed. Leadership of manager for implementation of the health care plan was the major important variable to reach the best efficacy standards.

  9. Enablers and barriers to evidence based planning in the district health system in Uganda; perceptions of district health managers.

    Science.gov (United States)

    Henriksson, Dorcus Kiwanuka; Ayebare, Florence; Waiswa, Peter; Peterson, Stefan Swartling; Tumushabe, Elly K; Fredriksson, Mio

    2017-02-02

    The District Health System was endorsed as the key strategy to achieve 'Health for all' during the WHO organized inter-regional meeting in Harare in 1987. Many expectations were put upon the district health system, including planning. Although planning should be evidence based to prioritize activities, in Uganda it has been described as occurring more by chance than by choice. The role of planning is entrusted to the district health managers with support from the Ministry of Health and other stakeholders, but there is limited knowledge on the district health manager's capacity to carry out evidence-based planning. The aim of this study was to determine the barriers and enablers to evidence-based planning at the district level. This qualitative study collected data through key informant interviews with district managers from two purposefully selected districts in Uganda that have been implementing evidence-based planning. A deductive process of thematic analysis was used to classify responses within themes. There were considerable differences between the districts in regard to the barriers and enablers for evidence-based planning. Variations could be attributed to specific contextual and environmental differences such as human resource levels, date of establishment of the district, funding and the sociopolitical environment. The perceived lack of local decision space coupled with the perception that the politicians had all the power while having limited knowledge on evidence-based planning was considered an important barrier. There is a need to review the mandate of the district managers to make decisions in the planning process and the range of decision space available within the district health system. Given the important role elected officials play in a decentralized system a concerted effort should be made to increase their knowledge on evidence-based planning and the district health system as a whole.

  10. 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...

  11. 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…

  12. The Highland Park Environmental Health Plan: Evaluation and Recommendations for Improving the Urban Environment.

    Science.gov (United States)

    Michigan State Dept. of Commerce, Lansing. Community Planning Div.

    The Highland Park environmental health plan includes the following components: Legal and administrative and programmatic relationships, planning studies, residential environment, disease vector control, water and sewage systems, sanitation, air pollution, food protection, industrial and radiological health, and solid waste facilities. (JR)

  13. 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…

  14. The Highland Park Environmental Health Plan: Evaluation and Recommendations for Improving the Urban Environment.

    Science.gov (United States)

    Michigan State Dept. of Commerce, Lansing. Community Planning Div.

    The Highland Park environmental health plan includes the following components: Legal and administrative and programmatic relationships, planning studies, residential environment, disease vector control, water and sewage systems, sanitation, air pollution, food protection, industrial and radiological health, and solid waste facilities. (JR)

  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 ev

  16. 42 CFR 440.350 - Employer-sponsored insurance health plans.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may provide benchmark or benchmark-equivalent coverage by obtaining employer sponsored health plans (either alone...

  17. Development and evaluation of a new educational resource for farm-health planning.

    Science.gov (United States)

    Kerr, Annie J; Main, David C J

    2010-01-01

    Simple Templates for Everyday Planning and Support (STEPS) was created to illustrate the dynamic process of farm-health planning. Farm-health planning, also known as herd health or flock health planning, is a holistic, proactive management approach to animal health and welfare. This resource was used in a teaching seminar held for two groups of fourth-year veterinary students over a two-year period. Students answered a questionnaire before and after the teaching seminar that revealed that most participants believed the new resource had increased their knowledge of and ability to undertake farm-health planning. Students also completed one of four species-specific case examples that were evaluated by the first author. Most students (90.7%) included at least half of the essential farm-health planning factors in their case example submission. Twenty-six of these essential health planning factors were included by at least 80% of study participants. Six essential health planning factors received less than 20% of the student response rate. The traditional veterinary skills, which involve the management of individual animals, such as an assessment of the severity of lesions, were well represented in all of the case examples. However, the monitoring step of farm-health planning, such as the use of intervention levels, was the least well answered by the student population. In conclusion, the research study found that the STEPS seminar was successful in introducing many of the main principles of farm-health planning to two groups of fourth-year veterinary students.

  18. Considerations for planning and evaluating economic analyses of telemental health.

    Science.gov (United States)

    Luxton, David D

    2013-08-01

    The economic evaluation of telemental health (TMH) is necessary to inform ways to decrease the cost of delivering care, to improve access to care, and to make decisions about the allocation of resources. Previous reviews of telehealth economic analysis studies have concluded that there are significant methodological deficiencies and inconsistencies that limit the ability to make generalized conclusions about the costs and benefits of telehealth programs. Published economic evaluations specific to TMH are also limited. There are unique factors that influence costs in TMH that are necessary for those who are planning and evaluating economic analyses to consider. The purpose of this review is to summarize the main problems and limitations of published economic analyses, to discuss considerations specific to TMH, and to inform and encourage the economic evaluation of TMH in both the public and private sectors. The topics presented here include perspective of costs, direct and indirect costs, and technology, as well as research methodology considerations. The integration of economic analyses into effectiveness trials, the standardization of outcome measurement, and the development of TMH economic evaluation guidelines are recommended.

  19. Advancing Health Equity and Climate Change Solutions in California Through Integration of Public Health in Regional Planning

    OpenAIRE

    Gould, Solange M.

    2015-01-01

    Climate change is a significant public health danger, with a disproportionate impact on low-income and communities of color that threatens to increase health inequities. Many important social determinants of health are at stake in California climate change policy-making and planning, and the distribution of these will further impact health inequities. Not only are these communities the most vulnerable to future health impacts due to the cumulative impacts of unequal environmental exposures a...

  20. 77 FR 58488 - Hawaii State Plan for Occupational Safety and Health

    Science.gov (United States)

    2012-09-21

    ... Occupational Safety and Health Administration 29 CFR Part 1952 RIN 1218-AC78 Hawaii State Plan for Occupational Safety and Health AGENCY: Occupational Safety and Health Administration, Department of Labor. ACTION: Final rule. SUMMARY: This document announces the Occupational Safety and Health Administration's...

  1. Supporting Human Papillomavirus Vaccination in Adolescents: Perspectives From Commercial and Medicaid Health Plans.

    Science.gov (United States)

    Ng, Judy H; Sobel, Katherine; Roth, Lindsey; Byron, Sepheen C; Lindley, Megan C; Stokley, Shannon

    An estimated 79 million Americans are infected with human papillomavirus (HPV). Vaccination can reduce the burden of infection and HPV-associated cancers; yet, vaccination rates remain low. Little is known about why some health plans achieve higher vaccination rates. This study sought to identify strategies used by higher-performing health plans to support HPV vaccination. We used 2013 data from the Healthcare Effectiveness Data and Information Set (HEDIS) Human Papillomavirus Vaccine for Female Adolescents measure to identify high-performing plans. The measure examines the percentage of female adolescent plan members who received 3 doses of HPV vaccine by their 13th birthday. High performers were defined as the subset of commercial plans with the top 10 rates and the subset of Medicaid plans with the top 10 rates. An interview guide was developed to assess activities related to providing HPV vaccination. Interviews were conducted with selected plans and audio-recorded. Transcripts were reviewed independently by 2 interviewers and analyzed by hand to identify key themes. Staff members representing 10 plans agreed to be interviewed, representing a diversity of plan size (range, 5500 to >2.7 million members); plan type (about half were commercial, half were Medicaid plans); patient population, from predominantly white to predominantly nonwhite; and geographic region. Plans Participants highlighted multiple strategies that support HPV vaccination, particularly the "normalizing" of the vaccine. Plans' efforts highlighted patient and provider education, reminders, feedback loops, community collaborations, immunization registries, and use of medical home concepts-including team-driven efforts and coordination. There is an important need to improve the uptake of HPV vaccination. As health coverage expands to more organizations and individuals, it will be critical for health plans to consider the strategies implemented by higher-performing organizations. Although HPV

  2. 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.

  3. 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.

  4. 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.

  5. Telemedicine in the Malaysian Multimedia Super Corridor: towards personalized lifetime health plans.

    Science.gov (United States)

    Abidi, S S; Yusoff, Z

    1999-01-01

    The Malaysian Telemedicine initiative advocates a paradigm shift in healthcare delivery patterns by way of implementing a person-centred and wellness-focused healthcare system. This paper introduces the Malaysian Telemedicine vision, its functionality and associated operational conditions. In particular, we focus on the conceptualisation of one key Telemedicine component i.e. the Lifetime Health Plan (LHP) system--a distributed multimodule application for the periodic monitoring and generation of health-care advisories for all Malaysians. In line with the LHP project, we present an innovative healthcare delivery info-structure--LifePlan--that aims to provide life-long, pro-active, personalised, wellness-oriented healthcare services to assist individuals to manage and interpret their health needs. Functionally, LifePlan based healthcare services are delivered over the WWW, packaged as Personalised Lifetime Health Plans that allow individuals to both monitor their health status and to guide them in healthcare planning.

  6. Health care costs in the last four years of life for private health plan beneficiaries in Brazil.

    Science.gov (United States)

    Ferraz, Marcos Bosi; Miranda, Isaura Cristina; Padovan, Jorge; de Soárez, Patricia Coelho; Ciconellil, Rozana

    2008-08-01

    To examine health care use and expenditures by Brazilians covered by private health care plans in the last four years of life. Health plan provider enrollee files and death certificate data were used for 274 health plan beneficiaries who died in 1998, 1999, and 2000. Resources used for a beneficiary in the year of death and in the three years prior to death were identified. Descriptive statistical analyses were used for clinical and socio-demographic characteristics and to describe the costs. Of the 274 deaths included in this analysis, 92 occurred in 1998, 82 in 1999, and 100 in 2000. Most of the deceased were males (61.4%). Distribution in terms of type of health plan coverage (full versus hospitalization-only coverage) was similar among beneficiaries (53% had hospitalization only and 47% had full coverage). The total health plan expenditure in the last four years of life for the 274 decedents was US$ 26,300,283 (US$ 12,287,723 for beneficiaries with hospitalization-only and US$ 14,012,560 for those with full coverage). Expenditures increased progressively in the four years preceding death. About 70% of medical expenses for decedents in the four years of this analysis were incurred in the last year of life. Relatively large amounts of health care resources are used by Brazilian private health plan participants in their last year of life, suggesting that specific strategies are needed to optimize the allocation of medical care resources for these patients.

  7. Documentation of person-centred health plans for patients with acute coronary syndrome.

    Science.gov (United States)

    Jansson, Inger; Fors, Andreas; Ekman, Inger; Ulin, Kerstin

    2017-06-01

    Personalised care planning is argued for but there is a need to know more about what the plans actually contain. To describe the content of person-centred health, plans documented at three healthcare levels for patients with acute coronary syndrome. Patients with acute coronary syndrome aged under 75 years and admitted to two coronary care units at a university hospital were enrolled in the study. This retrospective descriptive study documented 89 person-centred health plans at three healthcare levels: hospital, outpatient and primary care. In total, 267 health plans were reviewed and a quantitative content analysis conducted. The health plans included commonly formulated goals, patients' own resources and support needed. The health plan goals were divided into three categories: lifestyle changes, illness management and relational activities. The most frequently reported goal for better health was increased physical activity, followed by social life/leisure activities and return to paid professional work. In order to reach the goals, patients identified three ways: own resources, family and social support and healthcare system, in total three categories. The most frequently reported own capability was self-motivation. Spouses and children were important sources of family and social support. The most frequently reported healthcare support was cardiac rehabilitation. In traditional care and treatment plans devised by health professionals, patient goals often comprise behavioural changes. When patients identify their own goals and resources with the help of professionals, they include maintaining social relations and being able to return to important activities such as work.

  8. 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.

  9. Designing evaluation plans for health promotion mHealth interventions: a case study of the Milk Man mobile app.

    Science.gov (United States)

    White, Becky K; Burns, Sharyn K; Giglia, Roslyn C; Scott, Jane A

    2016-10-26

    Evaluating complex health promotion interventions that use mobile apps requires comprehensive and adaptive evaluation plans. As mobile usage becomes increasingly sophisticated and personalised, broad evaluation plans are important in determining the impact and efficacy of a mobile health (mHealth) app. Evaluation should consider user feedback and outcome measures, as well as examine elements such as the robustness of the technology, the intervention principles and engagement strategies, and the interaction of the user with the technology. This paper introduces four mHealth evaluation models and tools and describes the evaluation plan that has been developed for Milk Man, a breastfeeding app targeting new and expectant fathers. Milk Man is a socially connected, gamified app that is being tested in a large Randomised Control Trial (RCT). While there is a need for mobile apps to be evaluated in adequately powered RCTs, trialling mobile apps over a long period of time presents challenges. Incorporating robust evaluation design will help ensure that technological performance, app intervention principles, as well as health and behavioural outcomes are measured. The detail and scope of the Milk Man app evaluation plan will ensure the findings add to the evidence base and have broad relevance to health promotion practitioners.So what? Evidence about the efficacy of mHealth interventions is an emerging area and appropriate evaluation skills are needed. This paper illustrates an evaluation planning approach for mHealth interventions that could be adapted for use by health promotion practitioners and researchers.

  10. In place of fear: aligning health care planning with system objectives to achieve financial sustainability.

    Science.gov (United States)

    Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie

    2015-04-01

    The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase.

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

    OpenAIRE

    Martha Akulume; 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...

  12. 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

  13. The Potential Linkage between Emergency Medical Services Systems and Health Systems Agencies to Civil Defense Related Health and Medical Care Plans and Operations.

    Science.gov (United States)

    1980-07-01

    Objective 10 B. Study Methodology 10 IV. E 7SS/HSA LINKAGE TO CIVIL DEFEN SE 13 V. HEALTH AND MEDICAL PLANNING FUNCIONS 31 A. Primarily Non-Health...Department Responsibilities 31 B. Primarily Health Department Responsibilities 41 VI. DISASTER MEDICAL PLANNING IN THE SAN FRANCISCO BAY AREA 62 VII...Agency B-i APPENDIX C - State Emergency Health Service Planning Functions: Potential Agency Input C-i APPENDIX D - San Francisco Bay Area Planning D

  14. [Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity].

    Science.gov (United States)

    Moyano-Santiago, Miguel A; Rivera-Lirio, Juana M

    2016-01-01

    To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. Implementing the Affordable Care Act: choosing an essential health benefits benchmark plan.

    Science.gov (United States)

    Corlette, Sabrina; Lucia, Kevin W; Levin, Max

    2013-03-01

    To improve the adequacy of private health insurance, the Affordable Care Act requires insurers to cover a minimum set of medical benefits, known as "essential health benefits." In implementing this requirement, states were asked to select a "benchmark plan" to serve as a reference point. This issue brief examines state action to select an essential health benefits benchmark plan and finds that 24 states and the District of Columbia selected a plan. All but five states will have a small-group plan as their benchmark. Each state, whether or not it made a benchmark selection, will have a set of essential health benefits that reflects local, employer-based health insurance coverage currently sold in the state. States adopted a variety of approaches to selecting a benchmark, including intergov­ernmental collaboration, stakeholder engagement, and research on benchmark options.

  16. [Communicative approach of Situational Strategic Planning at the local level: health and equity in Venezuela].

    Science.gov (United States)

    Heredia-Martínez, Henny Luz; Artmann, Elizabeth; Porto, Silvia Marta

    2010-06-01

    The article discusses the results of operationalizing Situational Strategic Planning adapted to the local level in health, considering the communicative approach and equity in a parish in Venezuela. Two innovative criteria were used: estimated health needs and analysis of the actors' potential for participation. The problems identified were compared to the corresponding article on rights in the Venezuelan Constitution. The study measured inequalities using health indicators associated with the selected problems; equity criteria were incorporated into the action proposals and communicative elements. Priority was assigned to the problem of "low case-resolving capacity in the health services network", and five critical points were selected for the action plan, which finally consisted of 6 operations and 21 actions. The article concludes that the combination of epidemiology and planning expands the situational explanation. Incorporation of the communicative approach and the equity dimension into Situational Strategic Planning allows empowering health management and helps decrease the gaps from inequality.

  17. Account planning: applying an advertising discipline to health communication and social marketing.

    Science.gov (United States)

    Mackert, Michael

    2012-01-01

    As health marketers seek new models to design campaigns, the advertising discipline of account planning offers an approach that can improve campaign development. The underlying principle of account planning is to bring the consumer perspective to all phases of campaign development, primarily through qualitative formative research. Account planners design the overall communication strategy and contribute to creative development of individual executions. The creative brief, a primary tool of account planning, is especially useful in conceptualizing campaigns. This report discusses the history and approach of account planning, followed by an example of account planning in the design of a social marketing campaign.

  18. Meeting the family planning needs of women living with HIV in US government global health programs.

    Science.gov (United States)

    Johnston, Beverly; Ligiero, Daniela; DeSilva, Shyami; Medley, Amy; Nightingale, Vienna; Sripipatana, Tabitha; Bachanas, Pamela; Abutu, Andrew; Brewinski-Isaacs, Margaret; Bathily, Fatoumata; Grillo, Michael; Bertz, Lilly; Mani, Nithya

    2013-10-01

    The integration of health programs, including HIV and voluntary family planning, is a priority for US government foreign assistance. One critical component of family planning and HIV integration that has significant positive health outcomes is ensuring that all women living with HIV have access to both a full range of contraceptives and safe pregnancy counseling. This article outlines the US government global health strategy to meet the family planning needs of women living with HIV based on three key principles: a focus on reproductive rights through voluntarism and informed choice, quality service provision through evidence-based programming, and development of partnerships.

  19. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Science.gov (United States)

    2010-01-01

    ... the enrollment, in accordance with this part, and without regard to age, race, sex, health status, or... the organization on account of the prohibited factors (age, race, sex, health status, or hazardous... plan. (3) Provide health benefits for each enrollee and covered family member wherever they may be. (4...

  20. Switching gains and health plan price elasticities: 20 years of managed competition reforms in The Netherlands

    NARCIS (Netherlands)

    R.C.H.M. Douven (Rudy); K. Katona (Katalin); T. Schut, F. (Frederik); V. Shestalova (Victoria)

    2017-01-01

    textabstractIn this paper we estimate health plan price elasticities and financial switching gains for consumers over a 20-year period in which managed competition was introduced in the Dutch health insurance market. The period is characterized by a major health insurance reform in 2006 to provide h

  1. Creating a Facebook marketing plan to a children's health magazine

    OpenAIRE

    Kuusisto, Nina

    2016-01-01

    This is a product-based thesis, whose objective is to discuss the process of planning a Fa-cebook marketing strategy from both theoretical and practical viewpoints. The product de-veloped is the planning and implementation of a Facebook marketing plan, which was exe-cuted as a 5-month-project to the commissioning company, Pisamat magazine. The project started in spring 2015 and finished in autumn 2015. The first chapter begins with a brief introduction to the project topic and objectives,...

  2. Succession planning in the Iranian health system: a case study of the Ministry of Health and Medical Education.

    Science.gov (United States)

    Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

    2014-05-30

    Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization.

  3. Health human resources planning and the production of health: development of an extended analytical framework for needs-based health human resources planning.

    Science.gov (United States)

    Birch, Stephen; Kephart, George; Murphy, Gail Tomblin; O'Brien-Pallas, Linda; Alder, Rob; MacKenzie, Adrian

    2009-11-01

    Health human resources planning is generally based on estimating the effects of demographic change on the supply of and requirements for healthcare services. In this article, we develop and apply an extended analytical framework that incorporates explicitly population health needs, levels of service to respond to health needs, and provider productivity as additional variables in determining the future requirements for the levels and mix of healthcare providers. Because the model derives requirements for providers directly from the requirements for services, it can be applied to a wide range of different provider types and practice structures including the public health workforce. By identifying the separate determinants of provider requirements, the analytical framework avoids the "illusions of necessity" that have generated continuous increases in provider requirements. Moreover, the framework enables policy makers to evaluate the basis of, and justification for, increases in the numbers of provider and increases in education and training programs as a method of increasing supply. A broad range of policy instruments is identified for responding to gaps between estimated future requirements for care and the estimated future capacity of the healthcare workforce.

  4. [Health workforce planning: brief historic route of Chilean policies].

    Science.gov (United States)

    Villarroel González, Sebastián Raúl

    2016-11-18

    Healthcare workers have been widely recognized as the mainstay of healthcare systems. Mostly incorporated as human resources into healthcare planning, their expression in the public policies of Chile and Latin America has undergone changes in compliance with the socio-economic and economic development of the countries in the region as well as changes in their healthcare systems. This article offers a historical review of healthcare human resources planning in Chile from a government-level standpoint; thus, enabling the characterization of a path that has added tools from the economic sciences to the healthcare workers’ own diagnosis, promoting policy actions to improve planning and management at national level, although the results have been inconsistent. Today, the great interest by national and international entities in healthcare human resources constitutes a growing concern about current problems, asymmetries, and expected results-- all of which increase the complexity of healthcare staffing and human resources planning.

  5. 76 FR 22899 - Federal Health IT Strategic Plan: 2011-2015 Open Comment Period Extended Until Friday, May 6

    Science.gov (United States)

    2011-04-25

    ... HUMAN SERVICES Federal Health IT Strategic Plan: 2011-2015 Open Comment Period Extended Until Friday...: Notice. SUMMARY: The Federal Health IT Strategic Plan: 2011-2015 (``the Plan'') ] was posted on the ONC... considered, you must submit your comment via the Federal Health IT Buzz Blog:...

  6. 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.

  7. Medicare Drug, Health Plan, Medigap, and Compare Databases

    Data.gov (United States)

    U.S. Department of Health & Human Services — This functionality is primarily used by health policy researchers and the media. The data provided in the tables come from the data that is displayed in the Tool and...

  8. 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

  9. Health sector operational planning and budgeting processes in Kenya—“never the twain shall meet”

    Science.gov (United States)

    Molyneux, Sassy; Goodman, Catherine

    2015-01-01

    Summary Operational planning is considered an important tool for translating government policies and strategic objectives into day‐to‐day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top‐down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local‐level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. PMID:25783862

  10. Health sector operational planning and budgeting processes in Kenya-"never the twain shall meet".

    Science.gov (United States)

    Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine

    2016-07-01

    Operational planning is considered an important tool for translating government policies and strategic objectives into day-to-day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top-down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local-level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

  11. Low level of attention to health inequalities in prevention planning activities of the Italian Regions.

    Science.gov (United States)

    De Vito, Corrado; Massimi, Azzurra; Di Thiene, Domitilla; Rosso, Annalisa; D'Andrea, Elvira; Vacchio, Maria Rosaria; Villari, Paolo; Marzuillo, Carolina

    2016-02-19

    Health promotion and prevention activities should tackle health inequalities to reduce disparities in health among disadvantaged populations. This study aimed to assess the extent to which the Italian Regions considered health inequalities during the planning of prevention activities, to detect geographical differences and to identify the possible determinants of differences in attention to health inequalities. The 19 Regional Prevention Plans (RPPs) developed by Italian Regions within the National Prevention Plan (NPP) 2010-2013 were assessed using a specific tool to address the level of attention to health inequalities. Univariate and multivariate analyses were performed to identify regional characteristics associated with a higher level of attention to health inequalities. Of the 702 projects included in the 19 RPPs, only 56 (8.0 %) specifically addressed issues related to health inequalities. The results of the multivariate analysis showed that a higher level of attention was associated with the macroarea of intervention 'prevention in high-risk groups', with the higher quality of the Strategic Plan Section of the RPP and with the higher percentage of migrants in the Region in 2010. Moreover, projects that addressed the topic of health inequalities were more likely to be developed in the Northern Regions, in Regions with a lower level of 'linking social capital' and with a Higher Regional Health Care Expenditure (RHCE) as a percentage of Regional Gross Domestic Product (RGDP) in 2010. The level of attention to health inequalities in the regional planning process of prevention activities 2010-2013 in Italy is low. The results of this study supported the new round of prevention planning in Italy, and highlight the urgent need to increase the number of policies and interventions able to reduce health inequalities.

  12. Human Health Risk Assessment Strategic Research Action Plan 2012-2016

    Science.gov (United States)

    This document outlines the strategic plan for EPA’s Human Health Risk Assessment research efforts, and how they support and are integrated into the overall research portfolio of the Agency’s Office of Research and Development.

  13. [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.

  14. 41 CFR 60-300.25 - 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. 60-300.25 Section 60-300.25 Public Contracts and Property Management..., life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  15. 41 CFR 60-250.25 - 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. 60-250.25 Section 60-250.25 Public Contracts and Property Management..., life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  16. Guided reflection: a participatory evaluation and planning process to promote recovery in mental health services agencies.

    Science.gov (United States)

    Jacobson, Nora; Greenley, Dianne; Breedlove, Lynn; Roschke, Ruth; Koberstein, Jen

    2003-01-01

    This brief report describes a participatory evaluation and planning process--a "guided reflection"--that mental health services agencies can use to examine the state of recovery awareness and implementation in their organizations. The process revolves around structured small group discussions, identification of agency strengths and weaknesses, and the formation of an agency "recovery action team" to set priorities and plan for change.

  17. 20 CFR 1002.163 - What types of health plans are covered by USERRA?

    Science.gov (United States)

    2010-04-01

    ... by USERRA? (a) USERRA defines a health plan to include an insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or arrangement under which the employee's.... (c) USERRA covers multiemployer plans maintained pursuant to one or more collective bargaining...

  18. The Drive towards Sustainable Health Systems Needs an Alignment: Where are the Innovations in Health Systems Planning?

    Science.gov (United States)

    Murphy, Gail Tomblin; Birch, Stephen; MacKenzie, Adrian; Rigby, Janet; Purkis, Mary Ellen

    2017-01-01

    Clarifying the healthcare innovation agenda is critical in order to advance the impact of system innovations. As part of this agenda-setting it is important to address the four conditions within which innovations can enhance system sustainability: 1) the innovation agenda reflects and is aligned with healthcare objectives and policy; 2) planning methodologies for services, workforce and funding are aligned with healthcare objectives and policy; 3) innovations in services are accommodated in systems through innovations in policy, planning and funding; and 4) innovations are systematically monitored and evaluated. In order to illustrate these conditions, the authors present a case study of an evaluation of one Canadian Health Authority's efforts to transform healthcare delivery. This case study reveals that aligning innovations in policy, planning, funding and health services is critical to transforming health systems and that, in the absence of such alignment, sustainable health systems are difficult to achieve.

  19. Succession planning for local health department top executives: reducing risk to communities.

    Science.gov (United States)

    Schmalzried, Hans; Fallon, L Fleming

    2007-06-01

    This study assessed the degree to which local health departments (LHDs) are preparing to replace retiring top executives. Questionnaires were sent to all 134 local health departments in Ohio. It is typical of many states in terms of the organization of LHDs. Ninety-two LHD top executives responded. The questionnaire addressed aspects of departmental succession planning and demographic parameters of their departments. Approximately half (51.7%) of responding LHD top executives rated having succession plans as being important. Overall, local boards of health are not very concerned about actually having a succession plan. One in four (27.6%) local health departments reported that they have succession plans. Half of those were grooming a successor. Succession planning is not a high priority among the majority of LHDs, despite the fact that 43.7% of top executives reported planning to leave their current position within six years. Experienced and continuous LHD leadership is important for strong responses to public health crises like major disease outbreaks and natural disasters. Having a succession plan in place that identifies how leadership voids are filled can help minimize risks to populations in an emergency.

  20. Increasing response rates in a survey of Medicaid enrollees: the effect of a prepaid monetary incentive and mixed modes (mail and telephone).

    Science.gov (United States)

    Beebe, Timothy J; Davern, Michael E; McAlpine, Donna D; Call, Kathleen Thiede; Rockwood, Todd H

    2005-04-01

    We sought to evaluate the effect of pairing a mixed-mode mail and telephone methodology with a prepaid US 2.00 dollars cash incentive on response rates in a survey of Medicaid enrollees stratified by race and ethnicity. Sampling was conducted in 2 stages. The first stage consisted of a simple random sample (SRS) of Medicaid enrollees. In the second stage, American Indian, African American, Latino, Hmong, and Somali enrollees were randomly sampled. A total of 8412 enrollees were assigned randomly to receive a mail survey with no incentive or a US 2.00 dollars bill. The response rate within the SRS after the mail portion was 54% in the incentive group and 45% in the nonincentive group. Response rates increased considerably with telephone follow-ups. The incentive SRS response rate increased to 69%, and the nonincentive response rate increased to 64%. Differences between incentive conditions are more pronounced after the first mailing (P effects on response rates and cost across the different racial and ethnic strata, except for Latino enrollees. A mixed-mode mail and telephone methodology is effective for increasing response rates in a Medicaid population overall and within different racial and ethnic groupings. The effectiveness of this strategy can be enhanced, in terms of response rate and cost, by including a US 2.00 dollars prepaid incentive.

  1. Implementation of ways to effectively integrate health into local environmental planning

    DEFF Research Database (Denmark)

    Jakobsen, Mette Winge

    2015-01-01

    Health impact assessment (HIA) is an approach to ensure sustainable policymaking and development in relation to health. Despite increased interest only few actual HIAs have been carried out in Denmark. In 2011, the Danish Ministry of Health financed the Danish Healthy Cities Network project HIA...... process. Also, proactive approach instead of reactive is preferred. Key messages HIA is useful to improve existing planning procedures together with systematic cross-sectoral collaboration in the planning process to ensure health in all policies HIA is not directly applicable for effectively integrating...

  2. The massacre of MASSCARE. Dukakis' health-insurance plan and why it was defeated.

    Science.gov (United States)

    Danielson, D A; Abrams, S

    1987-12-01

    The authors critique the health-insurance plan proposed by Governor Michael Dukakis, and recount the uproar that followed its introduction into the Massachusetts legislature this past fall. With Dukakis having emerged as a leading contender for the Democratic presidential nomination, and with much hope for fundamental reform of our nation's health-care system hinging on the outcome of this year's elections, the plan, and its fate, may well provide a taste of things to come.

  3. Channelling Edwin Chadwick: beyond utopian thinking in urban planning policy and health.

    Science.gov (United States)

    Corbett, Stephen J

    2007-01-01

    Health impact assessment is advanced as a formal means to assess the direct and indirect health impacts of urban planning decisions and processes. It is, however, an intrinsically passive policy device. A more comprehensive and practical policy framework or architecture, reminiscent of that devised by Edwin Chadwick and the sanitary reform movement in 19th Century England, will be necessary to reorient the goals and practices of urban planning.

  4. Evidence Based Assessment of Public Health Planning: A Case Study of the 2014 Crisis in Ukraine

    Science.gov (United States)

    2015-06-12

    potential for morbidity and mortality from preventable disease or environmental injury. Challenges to planning for public health support each have an...organizations can help to prevent maximum possible death and disease , epidemics, and total destruction of the public health planning system. Understanding...disability- adjusted life years (DALYs), incidence or prevalence of disease , and others.5 Cholera rates are of interest because of the short incubation

  5. 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).

  6. Health sector planning led by management of recurrent expenditure: an agenda for action-research.

    Science.gov (United States)

    Segall, M

    1991-01-01

    Health services in developing countries face a crisis of recurrent costs. Far from being able to fund primary health care (PHC) developments, governments now have difficulty in keeping existing health services in operation. This article proposes an approach to the problem based on the proactive planning and management of recurrent health expenditure. The system addresses existing services as well as future plans and allows explicit trade-offs to be made in resource allocation. This may be termed 'recurrent-expenditureled planning'. The article describes a diagnostic health sector review, which incorporates a recurrent expenditure profile in four planes: by type of provider, source of finance, level of care and recipient population group. A fifth dimension of time trends for certain expenditure categories can be added. The steps of a strategic planning cycle for health services resources are then described, which allows health service strategies to be tested for broad economic feasibility. It also results in the establishment of resource targets that can act as benchmarks against which actual levels of funding can be compared. The targets help to maintain sectoral priorities in resource allocation even in times of economic constraint and to channel funds preferentially to localities and facilities in greatest need. The system calls for innovations in the methods of health planning and financial management in the health sector. Implementation will require health systems action-research at the country level. The essential purpose is to promote PHC policy-led resource allocation and use. No amount of planning can substitute for political action to realize 'health for all', but this system provides technical support to the political forces in favour of distributive PHC policies.

  7. 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.

  8. Functional fiefdom, poverty model or individualism? Development of intergovernmental relations in health planning.

    Science.gov (United States)

    Colby, D C

    1981-09-01

    The United States national government has the power under the National Health Planning and Development Act of 1974 to establish and exercise legal control over a system of Health System Agencies, State Health Planning and Development Agencies, and State Health Coordinating Councils. Although the national government appears to have the legal powers necessary to direct and control the health planning process, a federal system has difficulties in the implementation of planning which has centralized goals or direction. The states and regions have the potential power to weaken the strength of the national government. Three trends in the developing relationship between the national, state, and regional units in health planning are discussed. The first, the functional fiefdom, consists of self-perpetuating, narrow purpose agencies which are not responsible to local or state-wide elected officials. These are professional bureaucracies which create and reinforce cozy relationships with supportive interest groups. The second trend, the poverty model, includes the lack of control by local elected officials, a large role to nongovernmental actors, and a direct relationship between Washington and the regional planning agencies. The last trend appears to be an individualistic one with every unit fending for itself. A case study of Massachusetts along with supplemental materials from other states is presented to illustrate the trends.

  9. Strategies for community-based medication management services in value-based health plans.

    Science.gov (United States)

    Smith, Marie A; Spiggle, Susan; McConnell, Brody

    Health plans are moving away from a volume-driven payment structure toward value-driven and risk-based contracts. There is very limited information on commercial payers' perspectives on coverage of medication management services (MMS) in value-based alternative payment models. While some health plans have experience with Medicare Part D Medication Therapy Management (MTM) programs, this experience does not promote the integration of pharmacists as health care team members. The study objectives were to: (1) understand the evaluation process that health plan executives would use to determine benefit coverage for pharmacist-provided MMS in value-based health plans, (2) identify the facilitators and barriers that affect pharmacist-provided MTM services at the community pharmacy level, and (3) propose strategies for pharmacist-provided MMS in value-based health plans. This study used qualitative research methods that involved structured key informant interviews with commercial health plan executives and focus groups with community pharmacists who had experience providing MTM services. Health plan executives agreed conceptually that MMS could be a valuable program and recognized its potential. However, the most substantial barriers that health plan executives expressed were funding MMS in today's fee-for-service payment models; lack of physician infrastructure to implement and manage MMS; and difficulty in collecting timely, accurate data to execute and assess MMS programs. Community pharmacists identified the most serious barrier to altering health outcomes through MTM as the current lack of integration of MTM with a coordinated health care team. MTM services are conducted as a separate program by pharmacists who do not have access to patient health records, are time-constrained, and poorly incentivized. The findings can inform the development of successful strategies for pharmacist-provided MMS that align with emerging value-based health plans and alternative provider

  10. Performance evaluation: discussing technology for planning and managing health worforce.

    Science.gov (United States)

    Pierantoni, Celia Regina; França, Tania; Ney, Marcia Silveira; Monteiro, Valéria Oliveira; Varella, Thereza Christina; Santos, Maria Ruth Dos; Nascimento, Dayane

    2011-12-01

    This essay presents the outcome of reflections and analyses from examining the conceptual options inherent to the methodologies of employee performance appraisal (PA) and its possible application in the health area. It sets a conceptual discussion of the area, associating and integrating knowledge from different fields - health and public administration. It promotes an intersection between public health work management and personnel management strategies. It has the purpose to generate new analyses and studies that would allow for a new approach of the management practices for performance appraisals used in companies, adapting them to meet the specificities of the health sector.

  11. Are joint health plans effective for coordination of health services? An analysis based on theory and Danish pre-reform results

    Directory of Open Access Journals (Sweden)

    Martin Strandberg-Larsen

    2007-10-01

    Full Text Available Background: Since 1994 formal health plans have been used for coordination of health care services between the regional and local level in Denmark. From 2007 a substantial reform has changed the administrative boundaries of the system and a new tool for coordination has been introduced. Purpose: To assess the use of the pre-reform health plans as a tool for strengthening coordination, quality and preventive efforts between the regional and local level of health care. Methods: A survey addressed to: all counties (n=15, all municipalities (n=271 and a randomised selected sample of general practitioners (n=700. Results: The stakeholders at the administrative level agree that health plans have not been effective as a tool for coordination. The development of health plans are dominated by the regional level. At the functional level 27 percent of the general practitioners are not familiar with health plans. Among those familiar with health plans 61 percent report that health plans influence their work to only a lesser degree or not at all. Conclusion: Joint health planning is needed to achieve coordination of care. Efforts must be made to overcome barriers hampering efficient whole system planning. Active policies emphasising the necessity of health planning, despite involved cost, are warranted to insure delivery of care that benefits the health of the population.

  12. Developing a composite weighted quality metric to reflect the total benefit conferred by a health plan.

    Science.gov (United States)

    Taskler, Glen B; Braithwaite, R Scott

    2015-03-01

    To improve individual health quality measures, which are associated with varying degrees of health benefit, and composite quality metrics, which weight individual measures identically. We developed a health-weighted composite quality measure reflecting the total health benefit conferred by a health plan annually, using preventive care as a test case. Using national disease prevalence, we simulated a hypothetical insurance panel of individuals aged 25 to 84 years. For each individual, we estimated the gain in life expectancy associated with 1 year of health system exposure to encourage adherence to major preventive care guidelines, controlling for patient characteristics (age, race, gender, comorbidity) and variation in individual adherence rates. This personalized gain in life expectancy was used to proxy for the amount of health benefit conferred by a health plan annually to its members, and formed weights in our health-weighted composite quality measure. We aggregated health benefits across the health insurance membership panel to analyze total health system performance. Our composite quality metric gave the highest weights to health plans that succeeded in implementing tobacco cessation and weight loss. One year of compliance with these goals was associated with 2 to 10 times as much health benefit as compliance with easier-to-follow preventive care services, such as mammography, aspirin, and antihypertensives. For example, for women aged 55 to 64 years, successful interventions to encourage weight loss were associated with 2.1 times the health benefit of blood pressure reduction and 3.9 times the health benefit of increasing adherence with screening mammography. A single health-weighted quality metric may inform measurement of total health system performance.

  13. Challenges in Patient Discharge Planning in the Health System of Iran: A Qualitative Study.

    Science.gov (United States)

    Gholizadeh, Masumeh; Delgoshaei, Bahram; Gorji, Hasan Abulghasem; Torani, Sogand; Janati, Ali

    2015-10-26

    One of the main factors relating to quality of hospitals is effective discharge planning. Discharge planning promotes the quality of inpatient care and reduces unplanned hospital readmission. The current study investigated the challenges of discharge planning observed in the health system of Iran. This qualitative research was conducted using a thematic and framework analyses to identify the challenges under each themes defined by the World Health Organization (WHO), to understand barriers in developing an effective discharge planning system in Iran health system. The data was collected from detailed semi-structured interviews and sessions of focus group discussions. This study involved 51 participants including health policy makers, hospital and health managers, faculty members, nurses, practitioners, community medicine specialists and other professionals of the Ministry of Health and Medical Education (MOHME). To reduce the bias and to increase the credibility of the study, evaluation criteria from Lincoln and Guba were used. All interviews and FGDs were recorded and transcribed, then analyzed by the software MAXQDA-11 and also manually. According to the WHO health systems framework, challenges of effective hospital discharge planning were divided into six areas, leadership/governance, service delivery, information, financing, health workforce, and medical production(themes), in which there were 5,3,2,2,3,1 subthemes respectively. It is evident from the findings of this study that changes in the perspective of policy makers, health staff and managers, strengthening of systematic approach, and establishment of required infrastructures are essential for successful implementation of effective discharge planning in health systems in Iran.

  14. 77 FR 72721 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-12-06

    ... Internal Revenue Service 26 CFR Parts 40, 46, and 602 RIN 1545-BK59 Fees on Health Insurance Policies and... issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to...-3970 (regarding health insurance policies). SUPPLEMENTARY INFORMATION: Paperwork Reduction Act The...

  15. [Regulation of radiotherapy and chemotherapy services by health plan organizations in Brazil].

    Science.gov (United States)

    Lima, Sheyla Maria Lemos; Portela, Margareth Crisóstomo; Ugá, Maria Alicia Domíngues; de Vasconcellos, Maurício Teixeira Leite

    2014-01-01

    This paper characterizes regulatory procedures applied by private health plan operators on their outpatient radiotherapy and chemotherapy services, especially via contracts, and outlines the health care providers’ perception on regulation. The study relied on primary data, taking into consideration 638 hospitals and outpatient health care units with the services in question. A stratified random sample was selected, resulting in the inclusion of 54 units that are representative of the population, excluding hospitals that only provide radiotherapy. Private chemotherapy services are largely funded by health insurance plans (75.0%), while radiotherapy services are predominantly covered by the public health system (49.0%). Contracts are not applied by third part payers, in their potential, as regulatory and health care coordination instruments. The mechanisms of regulation applied by third part payers are centered on services use control and administrative aspects. It is recognized the need of adjustments for a health care quality focus, and contracts may contribute in this sense.

  16. 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

  17. Public Health Planning for Vulnerable Populations and Pandemic Influenza

    Science.gov (United States)

    2008-12-01

    or “ bird flu,” health authorities worldwide have anticipated that another great pandemic could be imminent. The threat posed to the United States...privacy or separation but do not require skilled or continuous health care support from facility staff. Communicable diseases like chicken pox or

  18. Using Uncertain Climate and Development Information in Health Adaptation Planning.

    Science.gov (United States)

    Ebi, Kristie L; Hess, Jeremy J; Isaksen, Tania Busch

    2016-03-01

    To aid health adaptation decision-making, there are increasing efforts to provide climate projections at finer temporal and spatial scales. Relying solely on projected climate changes for longer-term decisions makes the implicit assumption that sources of vulnerability other than climate change will remain the same, which is not very probable. Over longer time horizons, this approach likely over estimates the extent to which climate change could alter the magnitude and pattern of health outcomes, introducing systematic bias into health management decisions. To balance this potential bias, decision-makers also need projections of other drivers of health outcomes that are, like climate change, recognized determinants of some disease burdens. Incorporating projections via an iterative process that allows for regular updates based on new knowledge and experience has the potential to improve the utility of fine-scale climate projections in health system adaptation to climate change.

  19. Application of the PRECEDE-PROCEED Planning Model in Designing an Oral Health Strategy.

    Science.gov (United States)

    Binkley, Catherine J; Johnson, Knowlton W

    2013-11-01

    Although the poor oral health of adults with intellectual and developmental disabilities (IDD) constitutes a significant health disparity in the United States, few interventions to date have produced lasting results. Moreover, there is minimal application of planning models to inform and design a theory-based strategy that has the potential to be effective and sustainable in this population. The PRECEDE-PROCEED planning model is being used to design and evaluate an oral health strategy for adults with IDD. The PRECEDE component involves assessing social, epidemiological, behavioral, environmental, educational, and ecological factors that informed the development of an intervention with underlying social cognitive theory assumptions. The PROCEED component consists of pilot-testing and evaluating the implementation of the strategy, its impact on mediators and outcomes of the population under study. A The PRECEDE assessment and strategy design results are presented including a conceptual framework and oral health strategy that are linked to social cognitive theory and Health Action Process Approach. We have developed a strategy consisting of a planned actions, capacity building, environmental adaptations, and caregiver reinforcement within group homes. The strategy is designed to increase caregiver self-efficacy, outcome expectancies, and behavioral capability, and also to create environmental influences that will lead to improved self-care behavior of the adult with IDD. It is anticipated that this strategy will improve the oral health and quality of life, including respiratory health, of individuals with IDD. The planned PROCEED component of the planning model includes a description of an in-process pilot study to refine the oral health strategy, along with a future randomized controlled clinical trial to demonstrate its effectiveness. The application of the PRECEDE-PROCEED planning model presented here demonstrates the feasibility of this planning model for

  20. Planning for, implementing and assessing the impact of health promotion and behaviour change interventions: a way forward for health psychologists.

    Science.gov (United States)

    Wallace, L M; Brown, K E; Hilton, S

    2014-01-01

    Researchers in the field of health psychology have increasingly been involved in translating a body of knowledge about psychological factors associated with health-relevant behaviours, into the development and evaluation of interventions that seek to apply that knowledge. In this paper we argue that a changing economic and political climate, and the strong behavioural contribution to disease morbidity and mortality in developed nations, requires health psychologists to plan more rigorously for, and communicate more effectively, about how health promotion, social cognition and behaviour change interventions will have impact and be increasingly embedded into health services or health promotion activity. We explain academic and wider socio-economic uses of 'impact' in health services research. We describe the relationship between impact and dissemination, and impact as distinct from, but often used interchangeably with the terms 'implementation', 'knowledge transfer' and 'knowledge translation' (KT). The evidence for establishing impact is emergent. We therefore draw on a number of impact planning and KT frameworks, with reference to two self- management interventions, to describe a framework that we hope will support health psychologists in embedding impact planning and execution in research. We illustrate this further in an on-line annexe with reference to one of our own interventions, Mums-and-MS (see Supplemental Material).

  1. Scenario planning: a tool for academic health sciences libraries.

    Science.gov (United States)

    Ludwig, Logan; Giesecke, Joan; Walton, Linda

    2010-03-01

    Review the International Campaign to Revitalise Academic Medicine (ICRAM) Future Scenarios as a potential starting point for developing scenarios to envisage plausible futures for health sciences libraries. At an educational workshop, 15 groups, each composed of four to seven Association of Academic Health Sciences Libraries (AAHSL) directors and AAHSL/NLM Fellows, created plausible stories using the five ICRAM scenarios. Participants created 15 plausible stories regarding roles played by health sciences librarians, how libraries are used and their physical properties in response to technology, scholarly communication, learning environments and health care economic changes. Libraries are affected by many forces, including economic pressures, curriculum and changes in technology, health care delivery and scholarly communications business models. The future is likely to contain ICRAM scenario elements, although not all, and each, if they come to pass, will impact health sciences libraries. The AAHSL groups identified common features in their scenarios to learn lessons for now. The hope is that other groups find the scenarios useful in thinking about academic health science library futures.

  2. 基于GPRS的非接触式IC卡蒸汽预付费终端设计%Design of Steam Prepaid Terminal Based on GPRS and Contactless IC Card

    Institute of Scientific and Technical Information of China (English)

    郭宗方

    2016-01-01

    以MSP430为控制核心,射频卡作为预付费载体,设计蒸汽预付费终端,具有人机交互功能,通过GPRS与上位机通信。终端可采集温度、压力、流量实现对饱和或过热蒸汽的流量补偿。介绍了蒸汽预付费系统总体结构,蒸汽预付费终端的功能、设计方案、硬件电路和软件流程。调试结果表明,蒸汽预付费终端工作稳定可靠,数据安全性高,实时性强,操作简单,界面友好。%Steam prepaid terminal takes MSP430 control er as the core of control,RF card as the prepaid carrier,commu-nicating with upper computer through GPRS.The terminal col ect temperature,pressure and flow at the same time realize the flow compensation of saturated steam or superheated steam,it provides human-computer interaction function.Giving a brief introduction of steam prepaid system overal structure,then mainly introduces the functions of steam prepaid terminal,designs scheme,hardware circuit,and some software processes.

  3. Policy and evidence in Canadian health human resources planning.

    Science.gov (United States)

    Wilson, C Ruth

    2013-01-01

    The health human resources supply in Canada swings reactively between over- and under-supply. There are numerous policy actors in this arena, each of whom could contribute to good data collection and an agreed-on process for decision-making. This could form the basis for evidence-informed policy. Absent these tools for pan-Canadian health human resources policy development, smaller health jurisdictions are experimenting with quality improvement initiatives which, when properly evaluated, can discover useful methods of aligning patient and community needs with healthcare resources.

  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. 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

  6. 77 FR 22949 - Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier...

    Science.gov (United States)

    2012-04-17

    ...-- Institutional. NCPDP D.0 and Version 1.2 Health care claims--Retail pharmacy drug. ASC X12 837 P and NCPDP D.0... Version 1.2 Coordination of Benefits-- Retail pharmacy drug. ASC X12 837 D Coordination of Benefits... institutional. NCPDP D.0 Eligibility for a health plan (request and response)--Retail pharmacy drugs. ASC X12...

  7. 77 FR 70619 - Incentives for Nondiscriminatory Wellness Programs in Group Health Plans

    Science.gov (United States)

    2012-11-26

    ..., high blood pressure, abnormal body mass index, or high glucose level) and provides a reward to... eight health factors are health status, medical condition (including both physical and mental illnesses... biometric screenings, or meeting targets for exercise). As outlined in the 2006 regulations,\\7\\ plans and...

  8. Integrated Environment and Safety and Health Management System (ISMS) Implementation Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    MITCHELL, R.L.

    2000-01-10

    The Integrated Environment, Safety and Health Management System (ISMS) Implementation Project Plan serves as the project document to guide the Fluor Hanford, Inc (FHI) and Major Subcontractor (MSC) participants through the steps necessary to complete the integration of environment, safety, and health into management and work practices at all levels.

  9. What health plans do people prefer? : The trade-off between premium and provider choice

    NARCIS (Netherlands)

    Determann, Domino; Lambooij, Mattijs S; de Bekker-Grob, Esther W; Hayen, Arthur P; Varkevisser, Marco; Schut, Frederik T; Wit, G Ardine de

    2016-01-01

    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

  10. Emergency Planning Guidelines for Campus Health Services: An All-Hazards Approach

    Science.gov (United States)

    Journal of American College Health, 2011

    2011-01-01

    This document, written collaboratively by members of ACHA's Emerging Public Health Threats and Emergency Response Coalition and Campus Safety and Violence Coalition, is designed to assist members of the college health community in planning for emergencies using an all-hazards approach. Its perspective is both macro and micro, beginning with a…

  11. Simulation modelling for resource allocation and planning in the health sector.

    Science.gov (United States)

    Lehaney, B; Hlupic, V

    1995-12-01

    This paper provides a review of the use of simulation for resource planning in the health sector. Case examples of simulation in health are provided, and the modelling problems are explored. The successes and failures of simulation modelling in this context are examined, and an approach for improving the processes, and outcomes, by the use of soft systems methodology, is suggested.

  12. [Russian Federation implementation of WHO global efforts plan on workers health care].

    Science.gov (United States)

    Izmerov, N F; Bukhtiyarov, I V; Prokopenko, L V; Shigan, E E

    2015-01-01

    The article deals with problems of implementing global WHO efforts plan on workers health care, Target program of World Labor Organization on work and occupational environment safety "For safe labor", some WLO conventions. The authors justify priority directions of governmental policy on health care for working population in Russia.

  13. Communicating Nursing Care Using the Health Level Seven Consolidated Clinical Document Architecture Release 2 Care Plan.

    Science.gov (United States)

    Matney, Susan A; Dolin, Gay; Buhl, Lindy; Sheide, Amy

    2016-03-01

    A care plan provides a patient, family, or community picture and outlines the care to be provided. The Health Level Seven Consolidated Clinical Document Architecture (C-CDA) Release 2 Care Plan Document is used to structure care plan data when sharing the care plan between systems and/or settings. The American Nurses Association has recommended the use of two terminologies, Logical Observation Identifiers Names and Codes (LOINC) for assessments and outcomes and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) for problems, procedures (interventions), outcomes, and observation findings within the C-CDA. This article describes C-CDA, introduces LOINC and SNOMED CT, discusses how the C-CDA Care Plan aligns with the nursing process, and illustrates how nursing care data can be structured and encoded within a C-CDA Care Plan.

  14. Urban Planning, Downstream Petroleum Industry and Human Health

    African Journals Online (AJOL)

    DELL

    space, congestion, squalor, pollution and attendant environmental and health challenges. A glaring ... petrol station controls and regulations if the nation is to avert mass mortality in the near future. ..... International Cooperation in National.

  15. Improving Heat Health Resilience through Urban Infrastructure Planning and Design

    Science.gov (United States)

    This webinar will explore ways in which public health and environmental agencies can collaborate to reduce the heat island effect, increase resilience to extreme heat events, and help each other further their respective missions.

  16. Index of Access: a new innovative and dynamic tool for rural health service and workforce planning.

    Science.gov (United States)

    McGrail, Matthew R; Russell, Deborah J; Humphreys, John S

    2016-08-19

    Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning.Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations.Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions.Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities.What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making.What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is

  17. [Ethical issues in a market dispute between clinical laboratories and a health plan: case report].

    Science.gov (United States)

    Pinheiro, Malone Santos; de Brito, Ana Maria Guedes; Jeraldo, Verônica de Lourdes Sierpe; Pinheiro, Kariny Souza

    2011-01-01

    In Brazil the private health plans appear as an alternative to the public health assistance. This segment suffered great intensification in the seventies and eighties, culminating in the entry of large insurance company in the scenario of supplementary medicine. Quickly, the service providers associated with these insurance companies, consolidating them in the market and triggering a relationship of dependency. This article analyzed, in the form of a case report, a marketing dispute between clinical laboratories and a health plan, emphasizing the moral and ethical aspects involved in this episode.

  18. Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures

    Directory of Open Access Journals (Sweden)

    Richard J. Bloomer

    2015-07-01

    Full Text Available Background: We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF. This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan or modified DF (i.e., restricted omnivorous; inclusive of ad libitum meat and skim milk consumption, with those following an unrestricted vegan diet plan. Methods: 35 subjects (six men; 29 women; 33 ± 2 years; range: 18–67 years completed a 21-day diet plan. Subjects reported to the lab for pre- (day 1 and post-intervention testing (day 22 in a 10 h fasted state. Blood samples were collected and assayed for complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite. Heart rate and blood pressure were measured and body composition was determined via dual energy X-ray absorptiometry. Subjects’ self-reported compliance, mental and physical health, and satiety in relation to the dietary modification were recorded. Results: No interaction effects were noted for our outcome measures (p > 0.05. However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the unrestricted vegan plan. A small (2 mmHg reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the unrestricted vegan group. An approximate 20

  19. Comparison of a Restricted and Unrestricted Vegan Diet Plan with a Restricted Omnivorous Diet Plan on Health-Specific Measures.

    Science.gov (United States)

    Bloomer, Richard J; Gunnels, Trint A; Schriefer, JohnHenry M

    2015-07-14

    We have previously noted beneficial health outcomes when individuals follow a dietary restriction plan in accordance with the Daniel Fast (DF). This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional DF (i.e., restricted vegan) or modified DF (i.e., restricted omnivorous; inclusive of ad libitum meat and skim milk consumption), with those following an unrestricted vegan diet plan. 35 subjects (six men; 29 women; 33 ± 2 years; range: 18-67 years) completed a 21-day diet plan. Subjects reported to the lab for pre- (day 1) and post-intervention testing (day 22) in a 10 h fasted state. Blood samples were collected and assayed for complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite). Heart rate and blood pressure were measured and body composition was determined via dual energy X-ray absorptiometry. Subjects' self-reported compliance, mental and physical health, and satiety in relation to the dietary modification were recorded. No interaction effects were noted for our outcome measures (p > 0.05). However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the unrestricted vegan plan. A small (2 mmHg) reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the unrestricted vegan group. An approximate 20% reduction was noted in total and LDL cholesterol

  20. 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

    2016-08-19

    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.

  1. 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.

  2. Health behavior segmentation and campaign planning to reduce cardiovascular disease risk among Hispanics.

    Science.gov (United States)

    Williams, J E; Flora, J A

    1995-02-01

    Using the social marketing principle of audience segmentation, a Hispanic audience was disaggregated to examine heterogeneous behaviors and lifestyles that could guide planning for public information campaigns designed to reduce cardiovascular disease (CVD) risk. Signal detection analysis resulted in six mutually exclusive subgroups, based on self-reported behavioral changes to improve health. Subgroups differed significantly in communication, behavioral, psychological, and demographic dimensions, indicating they may require unique campaign planning strategies. To determine whether subgroups were meaningful relative to external health-related criteria, they were compared as to health knowledge and status on cardiovascular disease risk factors. The results showed significant differences among audience subgroups in plasma high-density lipoprotein levels and hypertensive status. Results are discussed in terms of their implications for campaign planning and the need for public health campaigns to diversify strategies when targeting Hispanic audiences.

  3. Strategic plan for geriatrics and extended care in the veterans health administration: background, plan, and progress to date.

    Science.gov (United States)

    Shay, Kenneth; Hyduke, Barbara; Burris, James F

    2013-04-01

    The leaders of Geriatrics and Extended Care (GEC) in the Veterans Health Administration (VHA) undertook a strategic planning process that led to approval in 2009 of a multidisciplinary, evidence-guided strategic plan. This article reviews the four goals contained in that plan and describes VHA's progress in addressing them. The goals included transforming the healthcare system to a veteran-centric approach, achieving universal access to a panel of services, ensuring that the Veterans Affair's (VA) healthcare workforce was adequately prepared to manage the needs of the growing elderly veteran population, and integrating continuous improvement into all care enhancements. There has been substantial progress in addressing all four goals. All VHA health care has undergone an extensive transformation to patient-centered care, has enriched the services it can offer caregivers of dependent veterans, and has instituted models to better integrate VA and non-VA cares and services. A range of successful models of geriatric care described in the professional literature has been adapted to VA environments to gauge suitability for broader implementation. An executive-level task force developed a three-pronged approach for enhancing the VA's geriatric workforce. The VHA's performance measurement approaches increasingly include incentives to enhance the quality of management of vulnerable elderly adults in primary care. The GEC strategic plan was intended to serve as a road map for keeping VHA aligned with an ambitious but important long-term vision for GEC services. Although no discrete set of resources was appropriated for fulfillment of the plan's recommendations, this initial report reflects substantial progress in addressing most of its goals. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  4. 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

  5. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    Directory of Open Access Journals (Sweden)

    Andrew J Barnes

    Full Text Available The Affordable Care Act's marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool--plan recommendations--in improving marketplace decisions.Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia.We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended.Primary data were gathered using an online choice experiment and questionnaire.Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made.As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers' decisions.

  6. Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012

    Science.gov (United States)

    Kohatsu, Neal D.; Paciotti, Brian M.; Byrne, Jennifer V.; Kizer, Kenneth W.

    2015-01-01

    Introduction Prevention is the most cost-effective approach to promote population health, yet little is known about the delivery of health promotion interventions in the nation’s largest Medicaid program, Medi-Cal. The purpose of this study was to inventory health promotion interventions delivered through Medi-Cal Managed Care Plans; identify attributes of the interventions that plans judged to have the greatest impact on their members; and determine the extent to which the plans refer members to community assistance programs and sponsor health-promoting community activities. Methods The lead health educator from each managed care plan was asked to complete a 190-item online survey in January 2013; 20 of 21 managed care plans responded. Survey data on the health promotion interventions with the greatest impact were grouped according to intervention attributes and measures of effectiveness; quantitative data were analyzed using descriptive statistics. Results Health promotion interventions judged to have the greatest impact on Medi-Cal members were delivered in various ways; educational materials, one-on-one education, and group classes were delivered most frequently. Behavior change, knowledge gain, and improved disease management were cited most often as measures of effectiveness. Across all interventions, median educational hours were limited (2.4 h), and median Medi-Cal member participation was low (265 members per intervention). Most interventions with greatest impact (120 of 137 [88%]) focused on tertiary prevention. There were mixed results in referring members to community assistance programs and investing in community activities. Conclusion Managed care plans have many opportunities to more effectively deliver health promotion interventions. Establishing measurable, evidence-based, consensus standards for such programs could facilitate improved delivery of these services. PMID:26564012

  7. Discharge planning in mental health care: an integrative review of the literature.

    Science.gov (United States)

    Nurjannah, Intansari; Mills, Jane; Usher, Kim; Park, Tanya

    2014-05-01

    To identify the evidence base related to discharge planning in the context of acute and community mental healthcare service provision to ascertain the need for future research. Discharge planning is an important activity when preparing consumers to transition from hospital to home. The efficiency of discharge planning for consumers living with a mental health issue can influence both the number of future readmissions to acute-care facilities and their quality of life at home. An integrative review of the peer-reviewed literature. This review uses specific search terms and a 21-year time frame to search two key nursing databases CINAHL (Cinahl Information Systems, Glendale, CA, USA) and PSYCHINFO (American Psychological Association, Washington, DC, USA) for research reports investigating the substantive area of enquiry. Hand searches of reference lists and author searches were also conducted. Nineteen peer-reviewed journal articles met the inclusion criteria for this review. Research findings about discharge planning for people living with a mental health issue identify the importance of communication between health professionals, consumers and their families to maximise the effectiveness of this process. The complexity of consumer's healthcare needs influences the discharge planning process and impacts on aftercare compliance and readmission rates. There is a limited amount of research findings relating to differences between health professionals and families' perceptions of the level of information required for effective discharge planning, and the appropriate level of involvement of individuals living with a mental health issue in their own discharge planning. Results from this integrative review will inform future research related to this topic. Discharge planning for consumers living with a mental health issue involves many stakeholders who have different expectations regarding the type of information required and the necessary level of involvement of people

  8. Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework

    DEFF Research Database (Denmark)

    Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San;

    2010-01-01

    In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania....... The objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees....

  9. Outcomes of Planned Home Visits of Intern Public Health Nurses: An Example from Turkey.

    Science.gov (United States)

    Ozkan, Ozlem; Ozdemir, Saadet

    This study aimed at evaluating the outcomes of planned home visits of intern public health nurses enrolled to a school of health over 8 educational years. The descriptive research consisted of 181 families (N = 745 individuals) who received primary services through the planned home visits undertaken by 431 intern public health nurses at Kocaeli province in Turkey. The data were collected from Family Nursing Process Records and Family Health Achievement Forms. Both of these data collection forms were classified according to North American Nursing Diagnosis Association (NANDA) Taxonomy II. Intern public health nurses provided primary health services to 181 families (N = 745 persons) with a total of 8771 planned home visits undertaken over 802 days and 14.874 student/practice days. A total of 1539 nursing diagnoses were identified and 1677 achievements about these diagnoses were reported. Nursing diagnosis per family and per individual turned out to be 8.50 and 2.1, respectively, and achievements were 9.3 per family and 2.3 per individual. Among the nursing diagnosis domains, health promotion (20.3%), safety/protection (16.8%), and activity/rest (16.0%) were the top 3 domains identified. The most common diagnoses turned out to be ineffective health maintenance (47.4%) in health promotion domain and risk for trauma (18.2%) in safety/protection domain. The achievements were reported most in health promotion (37.9%), activity/rest (17.6%), and safety/protection (9.6%), respectively. Planned and continuous home visits by intern public health nurses resulted in positive health achievements in families, especially for women and children. Copyright © 2016. Published by Elsevier Inc.

  10. Department of Energy Environment, Safety and Health Management Plan. Fiscal year 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-01-01

    This report describes efforts by the Department of Energy (DOE) to effectively plan for environment, safety and health activities that protect the environment, workers and the public from harm. This document, which covers fiscal year 1996, reflects planning by operating contractors and Program Offices in early 1994, updated to be consistent with the President`s FY 1996 budget submittal to Congress, and subsequent Department of Energy Program refinements. Prior to 1992, only a small number of facilities had a structured process for identifying environment, safety and health (ES and H) needs, reporting the costs (in both direct and indirect budgets) of ES and H requirements, prioritizing and allocating available resources, and efficiently communicating this information to DOE. Planned costs for ES and H activities were usually developed as an afterthought to program budgets. There was no visible, consistently applied mechanism for determining the appropriate amount of resources that should be allocated to ES and H, or for assuring that significant ES and H vulnerabilities were planned to be funded. To address this issue, the Secretary (in November 1991) directed DOE to develop a Safety and Health Five-Year Plan to serve as a line management tool to delineate DOE-wide programs to reduce and manage safety and health risks, and to establish a consistent framework for risk-based resource planning and allocation.

  11. 76 FR 14402 - Draft Action Plan-A Public Health Action Plan To Combat Antimicrobial Resistance

    Science.gov (United States)

    2011-03-16

    ... resistance (AR) in recognition of the increasing importance of AR as a public health threat. The Task Force..., fungi, and parasites) and settings (human medicine, veterinary medicine, agriculture, animal production...

  12. 76 FR 21907 - Draft Action Plan-A Public Health Action Plan To Combat Antimicrobial Resistance

    Science.gov (United States)

    2011-04-19

    ... the increasing importance of AR as a public health threat. The Task Force is co-chaired by the Centers... spectrum of AR issues, addressing resistance in a wide range of pathogens (bacteria, viruses, fungi, and...

  13. Reproductive Health, Family Planning and HIV/AIDS

    DEFF Research Database (Denmark)

    Richey, Lisa Ann

    2010-01-01

    . It offers startling new insights into these issues by linking them to neo-liberal economic policies that have profoundly shaped health policies globally. This book is essential reading for students of gender studies, public health and demography, as well as policy-makers and activists.......Markets and Malthus: Population, Gender, and Health in Neo-liberal Times explores the ideas and institutions that were framed at the 1994 United Nations population conference in Cairo and traces their trajectories sixteen years down the line. Why were Third World feminists profoundly critical......, Tanzania, Uganda and across Africa to Argentina, Peru and throughout Latin America, as well as overarching themed essays. From the politics of abortion and immigration to rising levels of fundamentalist violence and sex selective abortions, the volume explores a range of issues from several vantage points...

  14. Proposals for the National Environmental Health Action Plan Propuestas para el Plan Nacional de Salud y Medio Ambiente

    Directory of Open Access Journals (Sweden)

    Estrella López Martín

    2008-12-01

    Full Text Available According to international strategies for environment and health, the spanish administration of Health and Environment launched in 2007 the necessary mechanisms for developing the National Plan for Health and Environment. The first step was an agreement with the Carlos III Health Institute for designing the basis on which to sus- tain the plan. The scientific committee established for that purpose has drafted a basis-report with the participation of a large group of experts. This work is an abstract of the proposals contained in that report. The proposals refer to the items considered as a priority in the European environment and health strategy, ie, cancer, endocrine disruption, neuro-developmental disorders and respiratory diseases and are organized around the major environmental risk factors for health: water, persistent toxic chemicals, electromagnetic fields, ionizing radiation, noise and climate change and extreme temperatures. To give consistency to the plan, the report identifies some essential measures to ensure its administrative, political, technical and financial feasibility. To give it coherence, the report point to some common priorities and methodological strategies. To give a shape to the plan, the report finally identifies programs to be implemented.De acuerdo con las estrategias internacionales en materia de salud y medio ambiente, los Ministerios de Sanidad y de Medio Ambiente pusieron en marcha en 2007 los mecanismos necesarios para la elaboración del Plan Nacional de Salud y Medio Ambiente. El primer paso ha sido la firma de un acuerdo de encomienda de gestión con el Instituto de Salud Carlos III para que éste diseñara las bases sobre las que sustentar el plan. El comité científico creado al efecto ha redactado un informe de bases para lo que ha contado con el concurso de un nutrido grupo de expertos. Las propuestas que se recogen en el informe constituyen el contenido del presente trabajo. Las propuestas hacen

  15. 42 CFR 51c.303 - Project elements.

    Science.gov (United States)

    2010-10-01

    ... grant funds for the operation of a prepaid health care plan also must provide: (1) A marketing and enrollment plan, including market analysis, marketing strategy, and enrollment growth projections. (2) A plan...

  16. Reproductive Health, Family Planning and HIV/AIDS

    DEFF Research Database (Denmark)

    Richey, Lisa Ann

    2010-01-01

    Markets and Malthus: Population, Gender, and Health in Neo-liberal Times explores the ideas and institutions that were framed at the 1994 United Nations population conference in Cairo and traces their trajectories sixteen years down the line. Why were Third World feminists profoundly critical of ...

  17. Beyond Planning: The Implementation of a Worksite Health Promotional Scheme

    Directory of Open Access Journals (Sweden)

    Thor Christian Bjørnstad

    2012-06-01

    Full Text Available The aim of this article is to provide insight into how the presence of diverging organizational logics influences the outcome of worksite health promotion projects. The study is based on a one-year qualitative single-case study of the implementation of a health promotional physical exercise program in a transnational transport and logistics company based in Norway. While the program that was implemented was based on dominant logics in Norway, i.e., the emphasis on worker participation and influence, the organizational logics of the transport company defined company–worker relationships in other terms. We found that the logic of a highly specialized work organization that combined strict work distribution with a set of narrowly defined work tasks contradicted the logic that underpinned the health promotional program, and that this contradiction is an important reason why the initiative failed. We therefore conclude that in implementing health promotion projects at the workplace, there is a need to observe the relationship between logics related both to the project and to the organization.

  18. [Evaluation of the action plan for Roma people in health area].

    Science.gov (United States)

    Rodin, Urelija

    2010-12-01

    By virtue of the national program for Romanies and participation in the Decade of Roma Inclusion 2005-2015, Croatia has chosen its strategic standpoint toward programs of social inclusion of Romanies in four priority areas: housing, education, employment and health. The objectives of the Roma Action Plan (AP) for 2005-2015 in the health area focus on: * ensuring equal availability of health services through information about personal rights and health insurance options; * child health improvement and care, as well as mortality reduction; * raising health awareness and care in terms of safe motherhood, family planning and reproductive health; * financial support to schooling of Roma people in health professions In order to monitor the implementation of AP and measure the availability of health care and condition, certain indicators of the number and coverage of Romanies are crucial for each of the above objectives: indicators for the Roma informed about personal rights resulting from the mandatory health insurance; for Romanies who have health insurance; for vaccinated Romani children, for Romani newborns born in maternity hospitals, for prenatal and pregnancy health care in Romani women, for Romanies included in family planning, for the mortality rate and causes of death in Romanies, and for the Roma receiving scholarships for education in health professions. Most of these indicators are only obtainable through special studies, while routinely monitored indicators simply do not satisfy quantitative needs. Another problem is Romanies not stating their ethnic denomination. Consequently, routine Roma mortality and cause of death statistics are unreliable. At the state level, no specific indicators of implementation could be obtained for any of the above health objectives, while some were obtainable for specific units of local and self-government (Baranja, Medimurje and Primorje-Goranska County). According to the research, more than 50% of Romanies in Croatia are

  19. Health-related characteristics and preferred methods of receiving health education according to dominant language among Latinos Aged 25 to 64 in a large Northern California health plan

    Directory of Open Access Journals (Sweden)

    Iribarren Carlos

    2008-09-01

    Full Text Available Abstract Background Latinos are a fast growing segment of the U.S. health care population. Acculturation factors, including English fluency, result in an ethnic group heterogeneous with regard to SES, health practices, and health education needs. This study examined how demographic and health-related characteristics of Spanish-dominant (SD, Bilingual (BIL, and English-dominant (ED Latino men and women aged 25–64 differed among members of a large Northern California health plan. Methods This observational study was based on data from cohorts of 171 SD (requiring an interpreter, 181 BIL, and 734 ED Latinos aged 25–64 who responded to random sample health plan member surveys conducted 2005–2006. Language groups were compared separately by gender on education, income, behavioral health risks (smoking, obesity, exercise frequency, dietary practices, health beliefs, health status (overall health and emotional health, diabetes, hypertension, high cholesterol, heartburn/acid reflux, back pain, depression, computer and Internet access, and health education modality preferences. Results Compared with ED Latinos, higher percentages of the SD and BIL groups had very low educational attainment and low income. While groups were similar in prevalence of diabetes, hypertension, and high cholesterol, SD were less likely than ED Latinos to rate overall health and emotional well-being as good, very good, or excellent and more likely to report heartburn and back pain (women only. The groups were similar with regard to smoking and obesity, but among women, SD were more likely to be physically inactive than ED, and BIL were less likely than SD and ED groups to eat Conclusion There are important differences among Latinos of different English language proficiency with regard to education, income, health status, health behaviors, IT access, and health education modality preferences that ought to be considered when planning and implementing health programs for this

  20. Strategic planning as a tool for achieving alignment in academic health centers.

    Science.gov (United States)

    Higginbotham, Eve J; Church, Kathryn C

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare.

  1. Dutch healthcare reform: did it result in performance improvement of health plans? A comparison of consumer experiences over time

    Directory of Open Access Journals (Sweden)

    Rademakers Jany

    2009-09-01

    Full Text Available Abstract Background Many countries have introduced elements of managed competition in their healthcare system with the aim to accomplish more efficient and demand-driven health care. Simultaneously, generating and reporting of comparative healthcare information has become an important quality-improvement instrument. We examined whether the introduction of managed competition in the Dutch healthcare system along with public reporting of quality information was associated with performance improvement in health plans. Methods Experiences of consumers with their health plan were measured in four consecutive years (2005-2008 using the CQI® health plan instrument 'Experiences with Healthcare and Health Insurer'. Data were available of 13,819 respondents (response = 45% of 30 health plans in 2005, of 8,266 respondents (response = 39% of 32 health plans in 2006, of 8,088 respondents (response = 34% of 32 health plans in 2007, and of 7,183 respondents (response = 31% of 32 health plans in 2008. We performed multilevel regression analyses with three levels: respondent, health plan and year of measurement. Per year and per quality aspect, we estimated health plan means while adjusting for consumers' age, education and self-reported health status. We tested for linear and quadratic time effects using chi-squares. Results The overall performance of health plans increased significantly from 2005 to 2008 on four quality aspects. For three other aspects, we found that the overall performance first declined and then increased from 2006 to 2008, but the performance in 2008 was not better than in 2005. The overall performance of health plans did not improve more often for quality aspects that were identified as important areas of improvement in the first year of measurement. On six out of seven aspects, the performance of health plans that scored below average in 2005 increased more than the performance of health plans that scored average and/or above average in

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

    Science.gov (United States)

    Aspinall, Erinn E; Chew, Katherine; Watson, Linda; Parker, Mary

    2009-10-01

    What is the best approach for implementing a statewide electronic health library (eHL) to serve all health professionals in Minnesota? The research took place at the University of Minnesota Health Sciences Libraries. 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. 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. 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.

  3. Use and abuse of the medical loss ratio to measure health plan performance.

    Science.gov (United States)

    Robinson, J C

    1997-01-01

    This paper examines the use and abuse of the medical loss ratio in the contemporary health care system and health policy debate. It begins with a survey of the ways in which the medical loss ratio has been interpreted to be something it is not, such as a measure of quality or efficiency. It then analyzes key organizational features of the emerging health care system that complicate measures of financial performance, including integration between payers and providers, diversification of payers across multiple products and distribution channels, and geographic expansion across metropolitan and state lines. These issues are illustrated using medical loss ratios from a range of nonprofit and for-profit health plans. The paper then sketches a strategy for improving the public's understanding of health plan performance as an alternative to continued reliance on the flawed medical loss ratio. This strategy incorporates data on structure and process, service quality, and financial performance.

  4. Phase II -- Photovoltaics for Utility Scale Applications (PVUSA): Safety and health action plan

    Energy Technology Data Exchange (ETDEWEB)

    Berg, K.

    1994-09-01

    To establish guidelines for the implementation and administration of an injury and illness prevention program for PVUSA and to assign specific responsibilities for the execution of the program. To provide a basic Safety and Health Action Plan (hereinafter referred to as Plan) that assists management, supervision, and project personnel in the recognition, evaluation, and control of hazardous activities and/or conditions within their respective areas of responsibility.

  5. Prepaid monetary incentives—Predictors of taking the money and completing the survey: Results from the International Tobacco Control (ITC) Four Country Survey

    Science.gov (United States)

    Mutti, Seema; Kennedy, Ryan David; Thompson, Mary E.; Fong, Geoffrey T.

    2015-01-01

    Prepaid monetary incentives are used to address declining response rates in random-digit-dial surveys. There is concern among researchers that some respondents will accept the prepayment but not complete the survey. There is little research to understand check cashing and survey completing behaviors among respondents who receive pre-payment. Data from the International Tobacco Control Four Country Study—a longitudinal survey of smokers in Canada, the US, the UK, and Australia, were used to examine the impact of prepayment (in the form of checks, approximately $10USD) on sample profile. Approximately 14% of respondents cashed their check, but did not complete the survey, while about 14% did not cash their checks, but completed the survey. Younger adults (Canada, US), those of minority status (US), and those who had been in the survey for only two waves or less (Canada, US) were more likely to cash their checks and not complete the survey. PMID:26778862

  6. Prepaid monetary incentives-Predictors of taking the money and completing the survey: Results from the International Tobacco Control (ITC) Four Country Survey.

    Science.gov (United States)

    Mutti, Seema; Kennedy, Ryan David; Thompson, Mary E; Fong, Geoffrey T

    2014-05-01

    Prepaid monetary incentives are used to address declining response rates in random-digit-dial surveys. There is concern among researchers that some respondents will accept the prepayment but not complete the survey. There is little research to understand check cashing and survey completing behaviors among respondents who receive pre-payment. Data from the International Tobacco Control Four Country Study-a longitudinal survey of smokers in Canada, the US, the UK, and Australia, were used to examine the impact of prepayment (in the form of checks, approximately $10USD) on sample profile. Approximately 14% of respondents cashed their check, but did not complete the survey, while about 14% did not cash their checks, but completed the survey. Younger adults (Canada, US), those of minority status (US), and those who had been in the survey for only two waves or less (Canada, US) were more likely to cash their checks and not complete the survey.

  7. 77 FR 47573 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-08-09

    ... Internal Revenue Service 26 CFR Parts 40 and 46 RIN 1545-BK59 Fees on Health Insurance Policies and Self... Patient Protection and Affordable Care Act on issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust Fund...

  8. 76 FR 72980 - Occupational Safety and Health State Plans; Extension of the Office of Management and Budget's...

    Science.gov (United States)

    2011-11-28

    ... Occupational Safety and Health Administration Occupational Safety and Health State Plans; Extension of the... AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Request for public comments... and program regarding State Plans for the development and enforcement of state occupational safety...

  9. Identifying Factors Influencing the Establishment of a Health System Reform Plan in Iran's Public Hospitals

    Directory of Open Access Journals (Sweden)

    Rasul Fani khiavi

    2016-09-01

    Full Text Available In today's world, health views have found a wider perspective in which non-medical expectations are particularly catered to. The health system reform plan seeks to improve society's health, decrease treatment costs, and increase patient satisfaction. This study investigated factors affecting the successful establishment of a health system reform plan. A mixed qualitative – quantitative approach was applied to conduct to explore influential factors associated with the establishment of a health system reform plan in Iran's public hospitals. The health systems and approaches to improving them in other countries have been studied. A Likert-based five-point questionnaire was the measurement instrument, and its content validity based on content validity ratio (CVR was 0.87. The construct validity, calculated using the factorial analysis and Kaiser Mayer Olkin (KMO techniques, was 0.964, which is a high level and suggests a correlation between the scale items. To complete the questionnaire, 185 experts, specialists, and executives of Iran’s health reform plan were selected using the Purposive Stratified Non Random Sampling and snowball methods. The data was then analyzed using exploratory factorial analysis and SPSS and LISREL software applications. The results of this research imply the existence of a pattern with a significant and direct relationship between the identified independent variables and the dependent variable of the establishment of a health system reform plan. The most important indices of establishing a health system reform plan, in the order of priority, were political support; suitable proportion and coverage of services presented in the society; management of resources; existence of necessary infrastructures; commitment of senior managers; constant planning, monitoring, and evaluation; and presentation of feedback to the plan's executives, intrasector/extrasector cooperation, and the plan’s guiding committee. Considering the

  10. 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.

  11. Internal marketing within a health care organization: developing an implementation plan.

    Science.gov (United States)

    Hallums, A

    1994-05-01

    This paper discusses how the concept of internal marketing can be applied within a health care organization. In order to achieve a market orientation an organization must identify the needs and wants of its customers and how these may change in the future. In order to achieve this, internal marketing is a necessary step to the implementation of the organizations marketing strategy. An outline plan for the introduction of an internal marketing programme within an acute hospital trust is proposed. The plan identifies those individuals and departments who should be involved in the planning and implementation of the programme. The benefits of internal marketing to the Trust are also considered.

  12. Development of a business plan for women's health services, using Malcolm Baldrige Performance Excellence Criteria.

    Science.gov (United States)

    Caramanica, L; Maxwell, S; Curry, S

    2000-06-01

    A new process for business planning at Hartford Hospital was needed to achieve critical business results. This article describes the Hospital's use of the Malcolm Baldrige Performance Excellence Criteria as a way to standardize and improve business planning. Women's Health Services is one of Hartford Hospital's "centers for excellence" and one of the first to use these criteria to improve its service. Staff learned how to build their business plan upon a set of core values and concepts such as customer-driven quality, leadership that sets high expectations, continuous improvement and learning, valuing employees, faster response to market demands, management by fact, and a long-range view of the future.

  13. [The relationship between hospitals and health plans organizations in the scope of ANS Health Insurance Qualification Program].

    Science.gov (United States)

    Escrivão Junior, Alvaro; Koyama, Marcos Fumio

    2007-01-01

    In Brazilian health insurance sector, the fee-for-service model still remains the major payment method for health services, and predominates in the relationship between hospitals and private health insurance companies. After the creation of Health Insurance Qualification Program (HIQP), which focuses on the quality of the assistance given to consumers, the health insurance companies will be evaluated by health care performance indicators, established by this program. The present study discusses the impact of this pattern on the relationship between health insurance companies and hospitals, by analyzing data from interviews carried through with 18 health insurance managers, regarding the use - in hospital management - of performance indicators compatible to those adopted by HIQP. According to the managers perception, only three hospitals use this sort of indicators, two of them which are hospitals managed by the health insurance companies. The alignment of interests between health plans organizations and health care providers, at the HIQP proposed template, will imply changes in payment models between these market players, towards the inclusion of performance and quality of assistance given to users by providers, as components of wage determination.

  14. Educational Planning for Establishing a Health-Promoting Workplace (HPW).

    Science.gov (United States)

    Russell, Sally S

    2015-01-01

    The Academy of Medical-Surgical Nurses (AMSN) has had an ongoing series of articles related to Healthy Practice Environments. The AMSN website (www.amsn.org) also has a number of articles and documents about initiatives that AMSN has undertaken to promote healthy practice environments in health care settings. This articles will focus on the educational work necessary for nurses who desire to increase the healthiness of their workplace. The work is not easy, but the end result could be one that leaves a lasting legacy for those who work in that environment.

  15. Work plan, health and safety plan, and quality assurance project plan for hazardous waste removal at the CTF K-1654B underground collection tank

    Energy Technology Data Exchange (ETDEWEB)

    Panter, M.S.; Burman, S.N.; Landguth, D.C.; Uziel, M.S.

    1991-10-01

    The Central Training Facility (CTF), located on Bear Creek Road approximately two miles south of the K-25 Site, is utilized for training security personnel at Martin Marietta Energy Systems, Inc., Oak Ridge, Tennessee. At the request of the CTF staff, this plan has been developed for the removal of the waste contents in the facility's 500-gal septic tank and associated distribution box. The septic tank and distribution box were historically located beneath the K-1654B trailer and adjacent to the K-1654A Indoor Firing Range. Recently, however, the K-1654B trailer was removed to accommodate the objectives of this work plan as well as future construction activities planned at CTF. The purpose of this plan is to develop and assign responsibilities, establish personnel protection requirements and mandatory safety procedures, and provide for contingencies that may arise while operations are being conducted by ORNL/MAD at the CTF K-1654B underground collection tank site. This document addresses requirements of 29 CFR 1910.120, Final Rule, with respect to aspects of health and safety applicable to an underground collection tank waste removal.

  16. Work plan, health and safety plan, and quality assurance project plan for hazardous waste removal at the CTF K-1654B underground collection tank

    Energy Technology Data Exchange (ETDEWEB)

    Panter, M.S.; Burman, S.N.; Landguth, D.C.; Uziel, M.S.

    1991-10-01

    The Central Training Facility (CTF), located on Bear Creek Road approximately two miles south of the K-25 Site, is utilized for training security personnel at Martin Marietta Energy Systems, Inc., Oak Ridge, Tennessee. At the request of the CTF staff, this plan has been developed for the removal of the waste contents in the facility`s 500-gal septic tank and associated distribution box. The septic tank and distribution box were historically located beneath the K-1654B trailer and adjacent to the K-1654A Indoor Firing Range. Recently, however, the K-1654B trailer was removed to accommodate the objectives of this work plan as well as future construction activities planned at CTF. The purpose of this plan is to develop and assign responsibilities, establish personnel protection requirements and mandatory safety procedures, and provide for contingencies that may arise while operations are being conducted by ORNL/MAD at the CTF K-1654B underground collection tank site. This document addresses requirements of 29 CFR 1910.120, Final Rule, with respect to aspects of health and safety applicable to an underground collection tank waste removal.

  17. Financial planning of continuing education for health professions.

    Science.gov (United States)

    Bennett, N L; Schimmel, R J

    1981-02-01

    With the increase in continuing education programs being developed for more health professionals, more information for decision making is essential. A study was conducted to define costs of continuing education programming and to examine the productivity of the professional staff. Sixty-one programs were developed and offered in a semi-rural setting over a four-year period. Of the programs analyzed, 39.4% were interdisciplinary programs, 26.2% were allied health programs, 21.3% were nursing programs, and 13.1% were miscellaneous programs. During the four-year period, there were 4,528 participants. A total of 27,835 instructional units were generated. The direct program expenses totalled $47,411, with a cost per instructional unit of $1.70. To determine the total cost of programming, the supporting staff salaries were allocated to the programs and added to the direct program expenses. Staff salaries were allocated in three ways: by program, by participant, or by instructional unit. Based on the allocations, the average total cost per program was $3,488; the average total cost per participant was $47; and the average total cost per instructional unit was $7.65. Staff productivity figures were derived by comparing the numbers of programs offered to the full-time equivalency staff for a given period. Professional staff productivity was found to be equivalent to approximately seven programs per year with about 500 participants.

  18. 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.

    2016-01-01

    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. PMID:27110801

  19. Nurse migration and health workforce planning: Ireland as illustrative of international challenges.

    Science.gov (United States)

    Humphries, Niamh; Brugha, Ruairi; McGee, Hannah

    2012-09-01

    Ireland began actively recruiting nurses internationally in 2000. Between 2000 and 2010, 35% of new recruits into the health system were non-EU migrant nurses. Ireland is more heavily reliant upon international nurse recruitment than the UK, New Zealand or Australia. This paper draws on in-depth interviews (N=21) conducted in 2007 with non-EU migrant nurses working in Ireland, a quantitative survey of non-EU migrant nurses (N=337) conducted in 2009 and in-depth interviews conducted with key stakeholders (N=12) in late 2009/early 2010. Available primary and secondary data indicate a fresh challenge for health workforce planning in Ireland as immigration slows and nurses (both non-EU and Irish trained) consider emigration. Successful international nurse recruitment campaigns obviated the need for health workforce planning in the short-term, however the assumption that international nurse recruitment had 'solved' the nursing shortage was short-lived and the current presumption that nurse migration (both emigration and immigration) will always 'work' for Ireland over-plays the reliability of migration as a health workforce planning tool. This article analyses Ireland's experience of international nurse recruitment 2000-2010, providing a case study which is illustrative of health workforce planning challenges faced internationally.

  20. Validity of Health Plan and Birth Certificate Data for Pregnancy Research

    Science.gov (United States)

    Andrade, Susan E.; Scott, Pamela E.; Davis, Robert L.; Li, De-Kun; Getahun, Darios; Cheetham, T. Craig; Raebel, Marsha A.; Toh, Sengwee; Dublin, Sascha; Pawloski, Pamala A.; Hammad, Tarek A.; Beaton, Sarah J.; Smith, David H.; Dashevsky, Inna; Haffenreffer, Katherine; Cooper, William O.

    2012-01-01

    Purpose To evaluate the validity of health plan and birth certificate data for pregnancy research. Methods A retrospective study was conducted using administrative and claims data from 11 U.S. health plans, and corresponding birth certificate data from state health departments. Diagnoses, drug dispensings, and procedure codes were used to identify infant outcomes (cardiac defects, anencephaly, preterm birth, and neonatal intensive care unit [NICU] admission) and maternal diagnoses (asthma and systemic lupus erythematosus [SLE]) recorded in the health plan data for live born deliveries between January 2001 and December 2007. A random sample of medical charts (n = 802) was abstracted for infants and mothers identified with the specified outcomes. Information on newborn, maternal, and paternal characteristics (gestational age at birth, birth weight, previous pregnancies and live births, race/ethnicity) was also abstracted and compared to birth certificate data. Positive predictive values (PPVs) were calculated with documentation in the medical chart serving as the gold standard. Results PPVs were 71% for cardiac defects, 37% for anencephaly, 87% for preterm birth, and 92% for NICU admission. PPVs for algorithms to identify maternal diagnoses of asthma and SLE were ≥ 93%. Our findings indicated considerable agreement (PPVs > 90%) between birth certificate and medical record data for measures related to birth weight, gestational age, prior obstetrical history, and race/ethnicity. Conclusions Health plan and birth certificate data can be useful to accurately identify some infant outcomes, maternal diagnoses, and newborn, maternal, and paternal characteristics. Other outcomes and variables may require medical record review for validation. PMID:22753079

  1. Overcoming Health System Challenges for Women and Children Living With HIV Through the Global Plan.

    Science.gov (United States)

    Modi, Surbhi; Callahan, Tegan; Rodrigues, Jessica; Kajoka, Mwikemo D; Dale, Helen M; Langa, Judite O; Urso, Marilena; Nchephe, Matsepeli I; Bongdene, Helene; Romano, Sostena; Broyles, Laura N

    2017-05-01

    To meet the ambitious targets set by the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan), the initial 22 priority countries quickly developed innovative approaches for overcoming long-standing health systems challenges and providing HIV testing and treatment to pregnant and breastfeeding women and their infants. The Global Plan spurred programs for prevention of mother-to-child HIV transmission to integrate HIV-related care and treatment into broader maternal, newborn, and child health services; expand the effectiveness of the health workforce through task sharing; extend health services into communities; strengthen supply chain and commodity management systems; reduce diagnostic and laboratory hurdles; and strengthen strategic supervision and mentorship. The article reviews the ongoing challenges for prevention of mother-to-child HIV transmission programs as they continue to strive for elimination of vertical transmission of HIV infection in the post-Global Plan era. Although progress has been rapid, health systems still face important challenges, particularly follow-up and diagnosis of HIV-exposed infants, continuity of care, and the promotion of services that are respectful and client centered.

  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. The effectiveness of planned health education given to climacteric women on menopausal symptoms, menopausal attitude and health behaviors

    Directory of Open Access Journals (Sweden)

    Gülbu Tortumluoğlu

    2006-11-01

    Full Text Available Objective: The research was made to assign the effect of planned health education given to climacteric women on menopausal symptoms, menopausal attitude and health behaviors. Methods: The research was carried between January 2002-February 2003 in the district of Abdurrahman Gazi Primary Health department which lies in the borders of metropolitan municipality of Erzurum. 2761 climacteric women between the age of 40-60 formed the population of the research. In sample selection, because of knowing the frequency of event and the number of individuals in the population; the formula of, n=N . t2 . pq / y2 .(N-1 + t2 . pq was used and samples are assigned as 337. Afterresearch problem had been assigned on 337 women, the research was made control group with pretest-posttest of quasi experimental design on 100 women who were selected proper to the aim of the research, 50 of which was experiment, the rest was control group. But 87 women 44 of which was control, 434 of which was experiment group completed the research. Results: According to the research results, after planned health education given by the researcher, decrease in common menopausal symptoms and increase in point averages of menopausal attitude (t=4.697, p=.000 and health promotion life style behaviors (t=7.127, p=.000 were determined. Conclusion: After planned health education given to the women in climacteric period, positive health behaviors can be developed so as to make women live a more peaceful life. According to these result, it can be suggested to health professionals to mind education programs about climacteric period.

  4. Oak Ridge National Laboratory Health and Safety Long-Range Plan: Fiscal years 1989--1995

    Energy Technology Data Exchange (ETDEWEB)

    1989-06-01

    The health and safety of its personnel is the first concern of ORNL and its management. The ORNL Health and Safety Program has the responsibility for ensuring the health and safety of all individuals assigned to ORNL activities. This document outlines the principal aspects of the ORNL Health and Safety Long-Range Plan and provides a framework for management use in the future development of the health and safety program. Each section of this document is dedicated to one of the health and safety functions (i.e., health physics, industrial hygiene, occupational medicine, industrial safety, nuclear criticality safety, nuclear facility safety, transportation safety, fire protection, and emergency preparedness). Each section includes functional mission and objectives, program requirements and status, a summary of program needs, and program data and funding summary. Highlights of FY 1988 are included.

  5. [Use of an index of social welfare for health planning at a municipal level].

    Science.gov (United States)

    Ochoa-Díaz López, H; Sánchez-Pérez, H J; Martínez-Guzmán, L A

    1996-01-01

    This paper analyzes the relationship between a living standards index for small areas based on census data and information on morbidity and health care utilization. The information was gathered through a health interview survey of a random sample of 1 238 households from rural areas of Tlaxcala, Mexico. The population from localities with lower living standards showed significantly higher prevalences of morbidity and worse self-reported health status measures, as compared to localities with higher living standards. On the contrary, higher living standards were related with a greater utilization of health services. The approach proved to be useful in discriminating localities and areas of high and low prevalence of morbidity and utilization of health care services, which in turn could be used to identify those areas where needs are greatest. The implications of the results for health planning and resource allocation (based on population health needs and underlying social conditions) at the local level are discussed.

  6. Choosing the 'best' plan in a health insurance exchange: actuarial value tells only part of the story.

    Science.gov (United States)

    Lore, Ryan; Gabel, Jon R; McDevitt, Roland; Slover, Michael

    2012-08-01

    In the health insurance exchanges that will come online in 2014, consumers will be able to compare health plans with respect to actuarial value, or the percentage of health care costs that a plan would pay for a standard population. This analysis illustrates the out-of-pocket costs that might result from plans with various plan designs and actuarial values. We find that average out-of-pocket expense declines as actuarial values rise, but two plans with similar actuarial values can produce very different outcomes for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies. Actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person.

  7. Management of Newer Medications for Attention-Deficit Hyperactivity Disorder In Commercial Health Plans

    Science.gov (United States)

    Hodgkin, Dominic; Horgan, Constance M.; Quinn, Amity E.; Merrick, Elizabeth; Stewart, Maureen T.; Leslie, Laurel K.

    2014-01-01

    Purpose In the US, many individuals with attention deficit hyperactivity disorder (ADHD) pay for their medications using private health insurance coverage. As in other drug classes, private insurers are actively seeking to influence utilization and costs, particularly for newer and costlier medications. The approaches that insurers use may have important effects on patients’ access to medications. This paper examines approaches (e.g., copayments, prior authorization, and step therapy) that commercial health plans are employing to manage newer medications used to treat ADHD and changes in approaches since 2003. Methods Data are from a nationally representative survey of commercial health plans in 60 market areas regarding alcohol, drug abuse and mental health services in 2010. Responses were obtained from 389 plans (89% response rate), reporting on 925 insurance products. For each of six branded ADHD medications, respondents were asked whether the plan covered the medication and if so, on what copayment tier each medication was placed, and whether it was subject to prior authorization or step therapy. Measures of management approach were constructed for each medication and for the group of medications. Bivariate and multivariate analyses were used to test for association of the management approach with various health plan characteristics. Findings There was considerable variation across these 6 medications in how tightly they were managed by health plans, with newer medications being subject to more stringent management. The proportion of insurance products relying solely on copay tiering to manage novel ADHD medications appears to have decreased since 2003. Less than half of insurance products (43%) managed these 6 medications solely by use of Tier 3/4 placement, and most of the remainder (48%) used other restrictions (with or without Tier 3/4 placement). The average insurance product restricted access to at least 3 of the 6 brand-only medications examined

  8. The demonstration projects: creating the capacity for nursing health human resource planning in Ontario's healthcare organizations.

    Science.gov (United States)

    Burkoski, Vanessa; Tepper, Joshua

    2010-05-01

    Timely access to healthcare services requires the right number, mix and distribution of appropriately educated nurses, physicians and other healthcare professionals. In Ontario, as in several other jurisdictions, changing demographics, patterns of health service utilization and an aging workforce have created challenges related to the supply of nurses available now and in the future to deliver quality patient care. From 2006 to 2009, the Nursing Secretariat (NS) of Ontario's Ministry of Health and Long-Term Care (the ministry) undertook a progressive and comprehensive approach to address the issue of nursing supply across the province through the introduction of 17 Nursing Health Human Resources Demonstration Projects (demonstration projects). The demonstration projects initiative has led to the creation of a unique collection of best practices, tools and resources aimed at improving organizational planning capacity. Evaluation of the initiative generated recommendations that may guide the ministry toward policy and program development to foster improved nursing health human resource planning capacity in Ontario healthcare organizations.

  9. A public health academic-practice partnership to develop capacity for exercise evaluation and improvement planning.

    Science.gov (United States)

    Wright, Kate S; Thomas, Michael W; Durham, Dennis P; Jackson, Lillie M; Porth, Leslie L; Buxton, Mark

    2010-01-01

    In December 2006, Congress passed the Pandemic and All-Hazards Preparedness Act to improve the nation's public health preparedness and response capabilities. It includes the role of Centers for Public Health Preparedness (CPHPs) to establish a competency-based core curriculum and perform evaluation of impact on newly developed materials. The Heartland Center for Public Health Preparedness (HCPHP) at the Saint Louis University School of Public Health is part of the Centers for Disease Control and Prevention national CPHP network and is engaged with state and regional partners in workforce development, preparedness planning, evaluation, and multi-year exercise and training cycles. This includes development, implementation, and evaluation of the HCPHP Exercise Evaluation Training Program to improve the competence and capacity for exercise evaluation and improvement planning. This program is designed to enhance quality improvement and performance measurement capabilities to identify increase of workforce competence over time (maturity).

  10. Self-esteem, stress and self-rated health in family planning clinic patients

    Directory of Open Access Journals (Sweden)

    Young Rodney

    2004-06-01

    Full Text Available Abstract Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Results Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11, but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively. Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332. Conclusions Among younger low-income women, addressing low self-esteem might improve health status.

  11. Self-esteem, stress and self-rated health in family planning clinic patients.

    Science.gov (United States)

    Rohrer, James E; Young, Rodney

    2004-06-03

    The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11), but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively). Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were.19 and.22, respectively with corresponding p-values equal to.0043 and.0332). Among younger low-income women, addressing low self-esteem might improve health status.

  12. Feasibility of a SinglePayer Health Plan Model for the State of Maine

    OpenAIRE

    Deborah Chollet; Glen Mays; January Angeles; RolMcDevitt; Ryan Lore

    2002-01-01

    Reports on the estimates produced by an interactive policy microsimulation model developed to help study the feasibility of a single-payer plan that would cover all Maine citizens and guarantee savings of 5 percent relative to existing health care costs. Notes that such a system appears to be economically feasible for Maine. Although the system would increase total health care spending, the increase would decline over time as savings were realized through global budgeting, reduced administrat...

  13. Feasibility of a Single-Payer Health Plan Model for the State of Maine.

    OpenAIRE

    Deborah Chollet; Glen Mays; January Angeles; Roland McDevitt; Ryan Lore

    2002-01-01

    Reports on the estimates produced by an interactive policy microsimulation model developed to help study the feasibility of a single-payer plan that would cover all Maine citizens and guarantee savings of 5 percent relative to existing health care costs. Notes that such a system appears to be economically feasible for Maine. Although the system would increase total health care spending, the increase would decline over time as savings were realized through global budgeting, reduced administrat...

  14. Development of animal health and welfare planning in organic dairy farming in Europe

    OpenAIRE

    2008-01-01

    Good animal health and welfare is an explicit goal of organic livestock farming, and will need continuous development and adjustment on the farms. Furthermore, the very different conditions in different regions of Europe calls for models that can be integrated into local practice and be relevant for each type of farming context. A European project with participants from seven countries have been established with the aim of developing principles for animal health and welfare planning in organi...

  15. The use of programme planning and social marketing models by a state public health agency: a case study.

    Science.gov (United States)

    Kohr, J M; Strack, R W; Newton-Ward, M; Cooke, C H

    2008-03-01

    To investigate the use of planning models and social marketing planning principles within a state's central public health agency as a means for informing improved planning practices. Qualitative semi-structured interviews were conducted with 30 key programme planners in selected division branches, and a quantitative survey was distributed to 63 individuals responsible for programme planning in 12 programme-related branches. Employees who have an appreciation of and support for structured programme planning and social marketing may be considered the 'low hanging fruit' or 'early adopters'. On the other hand, employees that do not support or understand either of the two concepts have other barriers to using social marketing when planning programmes. A framework describing the observed factors involved in programme planning on an individual, interpersonal and organizational level is presented. Understanding the individual and structural barriers and facilitators of structured programme planning and social marketing is critical to increase the planning capacity within public health agencies.

  16. Self-Efficacy, Planning, and Drink Driving: Applying the Health Action Process Approach.

    Science.gov (United States)

    Wilson, Hollie; Sheehan, Mary; Palk, Gavan; Watson, Angela

    2016-05-19

    This study examines the constructs from the health action process approach (HAPA) theoretical model (Schwarzer, 1992) on future drink driving avoidance by first time drink driving offenders. This research presents an advance in health related theory by the novel application of the health model to predict risk avoidance. Baseline interviews were conducted with 198 first time drink driving offenders at the time of court appearance, and offenders were followed up 6-8 months following the offense date. The key outcome variables used in 3 stages were behavioral expectation, planning, and self-reported avoidance of drink driving at follow-up. Bivariate and multivariate analyses were conducted for each stage. High task self-efficacy and female gender were significantly related to having no behavioral expectation of future drink driving. High maintenance self-efficacy was significantly related to high levels of planning to avoid future drink driving. Those with higher planning scores at baseline had significantly higher odds of reporting that they had avoided drink driving at follow up. Planning plays an important role in drink driving rehabilitation and should be a focus of early intervention programs aimed at reducing drink driving recidivism following a first offense. Self-efficacy is an important construct to consider for the behavior and could strengthen a planning focused intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. 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.

  18. On the importance of planned health education. Prevention of ski injury as an example.

    Science.gov (United States)

    Kok, G; Bouter, L M

    1990-01-01

    The planning of health education aimed at preventing sports injuries is often incomplete and not stated explicitly. In most instances, the evaluation is incomplete or nonexistent. We present a theoretical framework for planning and evaluating health education, illustrating the main points by using as an example the health education for downhill skiers. Systematic planning consists of analyzing the magnitude of the problem and the behavioral risk factors, studying behavior determinants, designing an optimal intervention, and implementing the intervention. The evaluation phase deals with the effects on these five levels (implementation, intervention, determinants, behavior, and incidence of injury). Some common pitfalls are mentioned and special attention is given to the study of determinants of behavior and to the design of the intervention. The importance of pretesting health education material and the community approach in educating sports participants is underlined. Health education, together with regulations and facilities, constitutes the health promotion strategy in the prevention of sports injuries. For most sports, there seems to be a strong need for further research on the etiology and determinants of behavior before effective prevention can be realized.

  19. SUSTAINABLE LAND USE PLANNING BASED ON ECOLOGICAL HEALTH --Case Study of Beiwenquan Town, Chongqing, China

    Institute of Scientific and Technical Information of China (English)

    SHAO Jin-gan; WEI Chao-fu; XIE De-ti

    2005-01-01

    This paper, taking Beiwenquan Town of Beibei, Chongqing as an example, assessed the impacts of land use on ecological health by comprehensive index method, and discussed methodological system of sustainable land use planning based on ecological health. Results indicated that: 1) From 1992 to 2002, land use changes focused on 12 patterns with the total conversion area of 92.11%, which were related to cultivated land, residential and industrial-mining area, and orchard land. Urbanization and economic reconstruction were the leading driving forces. 2) There was obvious difference of the areas ofecotypes driven by land use change in wide valley and mild slope between 1992 and 2002,while there were little or no difference in steep slope and very steep slope. 3) Both of the conditions of ecological health in 1992 and 2002 were sound, and the ecotypes focused on the types of health and sub-health. But, health ecosystem in 1992, with an area of 764.64ha, accounting for 38.51% of the total evaluation area, was better than that in 2002, with an area of 636.10ha, accounting for 34.19% of the total evaluation area. 4) The ecotypes involved into different ranges have already degenerated, due to humankind's disturbance, while the conditions of ecological health in the same ranges in 1992, regardless of stability and reconstruction, were better than that in 2002.5) The planning scenario based on ecological health was accorded with the practice condition of Beiwenquan Town: 388.29ha of cultivated land could meet the Beiwenquan demand of food and byproduct; 1045.26ha of forest land area, the Beiwenquan demand of ecological health; and 1004.73ha of the residential and industrial-mining area, the Beiwenquan building demand. 6) Sustainable land use planning based on ecological health had higher useful value, because it not only stood to ecological theory, but also satisfied the developmental demand of society and economy.

  20. 'Including health in systems responsible for urban planning': a realist policy analysis research programme.

    Science.gov (United States)

    Harris, Patrick; Friel, Sharon; Wilson, Andrew

    2015-07-23

    Realist methods are increasingly being used to investigate complex public health problems. Despite the extensive evidence base clarifying the built environment as a determinant of health, there is limited knowledge about how and why land-use planning systems take on health concerns. Further, the body of research related to the wider determinants of health suffers from not using political science knowledge to understand how to influence health policy development and systems. This 4-year funded programme of research investigates how the land-use planning system in New South Wales, Australia, incorporates health and health equity at multiple levels. The programme uses multiple qualitative methods to develop up to 15 case studies of different activities of the New South Wales land-use planning system. Comparison cases from other jurisdictions will be included where possible and useful. Data collection includes publicly available documentation and purposively sampled stakeholder interviews and focus groups of up to 100 participants across the cases. The units of analysis in each case are institutional structures (rules and mandates constraining and enabling actors), actors (the stakeholders, organisations and networks involved, including health-focused agencies), and ideas (policy content, information, and framing). Data analysis will focus on and develop propositions concerning the mechanisms and conditions within and across each case leading to inclusion or non-inclusion of health. Data will be refined using additional political science and sociological theory. Qualitative comparative analysis will compare cases to develop policy-relevant propositions about the necessary and sufficient conditions needed to include health issues. Ethics has been approved by Sydney University Human Research Ethics Committee (2014/802 and 2015/178). Given the nature of this research we will incorporate stakeholders, often as collaborators, throughout. We outline our research translation

  1. Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule.

    Science.gov (United States)

    2012-07-20

    This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.

  2. Use of a modified reproductive life plan to improve awareness of preconception health in women with chronic disease

    National Research Council Canada - National Science Library

    Mittal, Pooja; Dandekar, Aparna; Hessler, Danielle

    2014-01-01

    .... Preconception health results in improved reproductive outcomes. We designed an interventional study testing the use of a reproductive life plan to improve knowledge of preconception and contraception health in women with chronic diseases...

  3. The role of law in public health: the case of family planning in the Philippines.

    Science.gov (United States)

    Mello, Michelle Marie; Powlowski, Marcus; Nañagas, Juan M P; Bossert, Thomas

    2006-07-01

    Compared to neighboring countries, the Philippines has high fertility rates and a low prevalence of modern-method contraception use. The Philippine government faces political and cultural barriers to addressing family planning needs, but also legal barriers erected by its own policies. We conducted a review of laws and policies relating to family planning in the Philippines in order to examine how the law may facilitate or constrain service provision. The methodology consisted of three phases. First, we collected and analyzed laws and regulations relating to the delivery of family planning services. Second, we conducted a qualitative interview study. Third, we synthesized findings to formulate policy recommendations. We present a conceptual model for understanding the impact of law on public health and discuss findings in relation to the roles of health care provider regulation, drug regulation, tax law, trade policies, insurance law, and other laws on access to modern-method contraceptives.

  4. Suicide Ideation, Plan, and Attempt in the Mexican Adolescent Mental Health Survey

    Science.gov (United States)

    Borges, Guilherme; Benjet, Corina; Medina-Mora, Maria Elena; Orozco, Ricardo; Nock, Matthew

    2008-01-01

    The study examines data from the Mexican Adolescent Mental Health Survey to study the prevalence and risk factors for suicide ideation, plan, and attempt among Mexican adolescents. The results reveal patterns of the risk factors and suggest that intervention should focus on adolescents with mental disorders to effectively prevent suicides.

  5. 77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Science.gov (United States)

    2012-03-27

    ... Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Exchange Standards..., 156, and 157 RIN 0938-AQ67 Patient Protection and Affordable Care Act; Establishment of Exchanges and... collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for...

  6. 76 FR 41865 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans

    Science.gov (United States)

    2011-07-15

    ... Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Proposed Rule #0... Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010...-152), referred to collectively as the Affordable Care Act. The Exchanges will provide...

  7. Increasing maternal age at first pregnancy planning: Health outcomes and associated costs

    NARCIS (Netherlands)

    M. Tromp (Miranda); A.C. Ravelli (Anita); J.B. Reitsma (Johannes); G.J. Bonsel (Gouke); B.W.J. Mol (Ben)

    2011-01-01

    textabstractObjectives: To describe the consequences in terms of health outcomes, care and associated healthcare costs for three hypothetical cohorts of women planning their first pregnancy at a fixed, different age. Design: Decision model based on data from perinatal registries and the literature.

  8. European variation in health workforce planning: do we need best practices or situational solutions?

    NARCIS (Netherlands)

    Batenburg, R.

    2013-01-01

    Context:The feasibility study report published by Matrix Insight in 2012, is probably the first empirical and systematic comparison of health workforce planning systems in all European countries. As such, the report provides important data and information to explore what differences and similarities

  9. Workforce Planning for the Community Services and Health Industry. Occasional Paper

    Science.gov (United States)

    Karmel, Tom; Blomberg, Davinia

    2009-01-01

    This paper aims to provide a picture of the occupations in the community services and health industry, and how the workforce obtains the required skills. The authors argue that planning for the industry should concentrate on occupations specific to the industry and those which require high skill levels. Findings suggest that the qualification…

  10. European variation in health workforce planning: do we need best practices or situational solutions?

    NARCIS (Netherlands)

    Batenburg, R.

    2013-01-01

    Context:The feasibility study report published by Matrix Insight in 2012, is probably the first empirical and systematic comparison of health workforce planning systems in all European countries. As such, the report provides important data and information to explore what differences and similarities

  11. 77 FR 54663 - Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier...

    Science.gov (United States)

    2012-09-05

    ... with the organization, disclose them to any entity that needs the NPIs to identify the prescribers in... serve as an other entity identifier (OEID), or an identifier for entities that are not health plans... disclose a National Provider Identifier (NPI). Lastly, this final rule changes the compliance date for the...

  12. Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework

    DEFF Research Database (Denmark)

    Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San

    2010-01-01

    In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania...

  13. Determinants of Quality of Family Planning Counseling among Private Health Facilities in Lagos.

    Science.gov (United States)

    Johnson, Doug; Ugaz, Jorge

    2016-09-01

    We use a unique dataset that includes an objective measure of the quality of family planning counseling from 927 private health facilities in Lagos State, Nigeria, to determine which variables at the facility and provider levels are most closely correlated with the quality of family planning counseling. Our data on quality come from mystery client surveys in which the clients posed as women seeking family planning counseling. We find that quality is strongly associated with the cadre of provider, with doctors delivering substantially higher-quality counselling than nurses. Doctors not only outperform nurses overall, but also perform better on each category of quality and spend nearly three minutes longer on average counseling the mystery client. Location, fees charged for the service, and facility type are also strongly correlated with quality. The degree to which a facility specializes in family planning and facility size are only weakly predictive of quality.

  14. Forensic focused treatment planning: a new standard for forensic mental health systems.

    Science.gov (United States)

    Schaufenbil, Robert J; Kornbluh, Rebecca; Stahl, Stephen M; Warburton, Katherine D

    2015-06-01

    Almost no literature addresses treatment planning for the forensic psychiatric patient. In the absence of such guidance, recovery-oriented multifocal treatment planning has been imported into forensic mental health systems from community psychiatric settings, despite the fact that conditions of admission and discharge are vastly different for forensic psychiatry inpatients. We propose that instead of focusing on recovery, forensic treatment planning should prioritize forensic outcomes, such as restoration of trial competence or mitigation of violence risk, as the first steps in a continuum of care that eventually leads to the patient's ability to resolve forensic issues and return to the community for recovery-oriented care. Here we offer a model for treatment planning in the forensic setting.

  15. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

    Directory of Open Access Journals (Sweden)

    Bakhtiar Piroozi

    2016-07-01

    Full Text Available Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results: The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion: The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of

  16. Revitalizing communities together: the shared values, goals, and work of education, urban planning, and public health.

    Science.gov (United States)

    Cohen, Alison Klebanoff; Schuchter, Joseph W

    2013-04-01

    Inequities in education, the urban environment, and health co-exist and mutually reinforce each other. Educators, planners, and public health practitioners share commitments to place-based, participatory, youth-focused, and equitable work. They also have shared goals of building community resilience, social capital, and civic engagement. Interdisciplinary programs that embody these shared values and work towards these shared goals are emerging, including school-based health centers, full-service community schools, community health centers, Promise Neighborhoods, and Choice Neighborhoods. The intersection of these three fields represents an opportunity to intervene on social determinants of health. More collaborative research and practice across public health, education, and planning should build from the shared values identified to continue to address these common goals.

  17. Integrating oral health into Haiti's National Health Plan: from disaster relief to sustainable development.

    Science.gov (United States)

    Estupiñán-Day, Saskia; Lafontant, Christina; Acuña, Maria Cecilia

    2011-11-01

    In 2010, Haiti suffered three devastating national emergencies: a 7.0 magnitude earthquake that killed over 200 000 and injured 300 000; a cholera outbreak that challenged recovery efforts and caused more deaths; and Hurricane Tomas, which brought additional destruction. In the aftermath, the Pan American Health Organization (PAHO) reoriented its technical cooperation to face the myriad of new challenges and needs. Efforts included support and technical assistance to the Ministry of Health and Population of Haiti and coordination of actions by the United Nations Health Cluster. This Special Report focuses specifically on the PAHO Regional Oral Health Program's call to action in Haiti and the institutional partnerships that were developed to leverage resources for oral health during this critical time and beyond. To date, achievements include working with Haiti's private sector, dental schools, public health associations, and other stakeholders, via the Oral Health of Haiti (OHOH) Coalition. The OHOH aims to meet the immediate needs of the dental community and to rebuild the oral health component of the health system; to provide dental materials and supplies to oral health sites in affected areas; and to ensure that the "Basic Package of Health Services" includes specific interventions for oral health care and services. The experience in Haiti serves as a reminder to the international community of how important linking immediate/short-term disaster-response to mid- and longterm strategies is to building a health system that provides timely access to health services, including oral health. Haiti's humanitarian crisis became an important time to rethink the country's health system and services in terms of the right to health and the concepts of citizenship, solidarity, and sustainable development.

  18. A Cluster Randomized Controlled Trial of the MyFamilyPlan Online Preconception Health Education Tool.

    Science.gov (United States)

    Batra, Priya; Mangione, Carol M; Cheng, Eric; Steers, W Neil; Nguyen, Tina A; Bell, Douglas; Kuo, Alice A; Gregory, Kimberly D

    2017-01-01

    To evaluate whether exposure to MyFamilyPlan-a web-based preconception health education module-changes the proportion of women discussing reproductive health with providers at well-woman visits. Cluster randomized controlled trial. One hundred thirty participants per arm distributed among 34 clusters (physicians) required to detect a 20% change in the primary outcome. Urban academic medical center (California). Eligible women were 18 to 45 years old, were English speaking, were nonpregnant, were able to access the Internet, and had an upcoming well-woman visit. E-mail and phone recruitment between September 2015 and May 2016; 292 enrollees randomized. Intervention participants completed the MyFamilyPlan module online 7 to 10 days before a scheduled well-woman visit; control participants reviewed standard online preconception health education materials. The primary outcome was self-reported discussion of reproductive health with the physician at the well-woman visit. Self-reported secondary outcomes were folic acid use, contraceptive method initiation/change, and self-efficacy score. Multilevel multivariate logistic regression. After adjusting for covariates and cluster, exposure to MyFamilyPlan was the only variable significantly associated with an increase in the proportion of women discussing reproductive health with providers (odds ratio: 1.97, 95% confidence interval: 1.22-3.19). Prespecified secondary outcomes were unaffected. MyFamilyPlan exposure was associated with a significant increase in the proportion of women who reported discussing reproductive health with providers and may promote preconception health awareness; more work is needed to affect associated behaviors.

  19. District health planning at a time of transition: a critical review and lessons learnt from the implementation of regional planning in Uganda.

    Science.gov (United States)

    Curtale, Filippo; Musila, Timothy; Opigo, Jimmy; Nantamu, Dyogo; Ezati, Isaac Alidria

    2016-05-01

    A quarter of a century after the Harare Declaration on Strengthening District Health Systems Based on Primary Health Care (1987) was conceived, district health teams (DHTs) are facing a markedly changed situation. Rapid population growth, urbanization, a rapidly developing private sector, and the increasing role of vertical programs and global initiatives have marginalized the planning process and weakened the entire district health system (DHS). The Ugandan Ministry of Health (MoH) responded to these challenges by beginning a review of district planning: a key action point of the Harare Declaration. The first step was a critical review of relevant literature, then central and district health staff were engaged with to provide their input in developing the new strategy. Through a field experiment started in 2012-13, and still underway, the MoH is developing an innovative regional approach to health planning, which aims to encompass the complexity of the new context of health care provision and coordinate all new actors (private health providers, projects and local government staff from other sectors) operating in the health sector. A strategic revision of the planning process represents an opportunity to develop an appropriate 'Theory of Change', intended as a broader approach of thinking about the entire DHS and the relative role and functions of the DHT. Leadership and stewardship capacities of MoH staff, at central and peripheral level, must be strengthened and supported to achieve the expected changes and results.

  20. Evaluation of the Arizona health care cost-containment system

    OpenAIRE

    1985-01-01

    This article evaluates Arizona's alternative to the acute portion of Medicaid, the Arizona Health Care Cost-Containment System (AHCCCS), during its first 18 months of operation from October 1982 through March 1984. It focuses on the program's implementation and describes and evaluates the program's innovative features. The features of the program outlined in the original AHCCCS legislation included: Competitive bidding, prepaid capitation of providers, capitation of the State by the Health Ca...

  1. Family planning through child health: a case study of El Kef project in Tunisia.

    Science.gov (United States)

    Bouzidi, M; Jones, M

    1985-01-01

    In 1970, a Dutch medical team began work in the city of El Kef in Tunisia on a project designed to bring family planning into rural areas. The project aimed to persuade the rural people to use urban health centers, but this approach failed partly because of the remoteness of the communities and their reluctance to discuss personal matters with strangers. Funded by UNFPA, a new project began to recruit and train local girls as home health visitors or aides-familiales, an approach which became the central focus of the El Kef project. The International Planned Parenthood Federation (IPPF) took over the project and expanded it to include nutrition, health care, health education, family planning, disease prevention and domestic crafts. 4 goals were fixed for the project: total vaccination coverage for children; elimination of severe malnutrition; reduction of infant mortality; and use of family planning practice by at least 1/2 the women of childbearing age. An efficient recordkeeping system enabled the project to be carefully evaluated and provides much-needed data, showing where it has achieved its aims and where new efforts should be directed. The project resulted in large numbers of women receiving ante-natal advice, child care and family planning from their local health centers. 860 pregnant women were followed up during the 3-year study period. Some 57% of pregnant women went for advice; only 15% went for postnatal care, but 50% of the women under 50 attended child welfare sessions during the study period for weight checks, nutrition advice, vaccination and treatment for minor ailments. Over the 3 years, the number of contraceptive users more than trebled, from 14% to 54%. The IUD was the most popular method. The most successful aspect of the project was the emphasis on maternal and child health, and the home visits were the most motivating feature. Vaccination became more popular. A further aspect of the project was the training in home improvement skills, like

  2. 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.

  3. The facilitators’ point of view regarding the primary health care planning as a continuing education program

    Directory of Open Access Journals (Sweden)

    Kênia Lara Silva

    2012-09-01

    Full Text Available This is a qualitative study that aims at analyzing the Primary Health Care Strategic Planning in a continuing education process, as well as the professional’s formation to work as facilitators in it. Data was obtained through interviews with 11 nurses that had acted as the plan’s facilitators in a municipality within Belo Horizonte. The results indicate that the experience as facilitators allowed them to reflect on the work process and this practice contributed to the incorporation of new tools to the primary health care system. The participants reported the difficulties faced when conducting the experience and the gap in the professionals’ formation to act in the PHC and to put into practice the processes of continuing education on a day to day basis. In conclusion, the Planning represents an important continuing education strategy and it is significance to transform processes and practices in the primary health care service.

  4. 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…

  5. 48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Integration of environment, safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning...

  6. 48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Integration of environment... 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...

  7. National program for family planning and primary health care Pakistan: a SWOT analysis.

    Science.gov (United States)

    Wazir, Mohammad Salim; Shaikh, Babar Tasneem; Ahmed, Ashfaq

    2013-11-22

    The National Program for Family Planning and Primary Healthcare was launched in 1994. It is one of the largest community based programs in the world, providing primary healthcare services to about 80 million people, most of which is rural poor. The program has been instrumental in improving health related indicators of maternal and child health in the last two decades. SWOT analysis was used by making recourse to the structure and dynamics of the program as well as searching the literature. Strengths of the program include: comprehensive design of planning, implementation and supervision mechanisms aided by an MIS, selection and recruitments processes and evidence created through improving health impact indicators. Weaknesses identified are slow progress, poor integration of the program with health services at local levels including MIS, and de-motivational factors such as job insecurity and non-payment of salaries in time. Opportunities include further widening the coverage of services, its potential contribution to health system research, and its use in areas other than health like women empowerment and poverty alleviation. Threats the program may face are: political interference, lack of funds, social threats and implications for professional malpractices. Strengthening of the program will necessitate a strong political commitment, sustained funding and a just remuneration to this bare foot doctor of Pakistan, the Lady Health Worker.

  8. Environmental Risks to Public Health in the United Arab Emirates: A Quantitative Assessment and Strategic Plan

    Science.gov (United States)

    Farah, Zeinab S.

    2012-01-01

    Background: Environmental risks to health in the United Arab Emirates (UAE) have shifted rapidly from infectious to noninfectious diseases as the nation has developed at an unprecedented rate. In response to public concerns over newly emerging environmental risks, the Environment Agency–Abu Dhabi commissioned a multidisciplinary environmental health strategic planning project. Objectives: In order to develop the environmental health strategic plan, we sought to quantify the illnesses and premature deaths in the UAE attributable to 14 environmental pollutant categories, prioritize these 14 risk factors, and identify interventions. Methods: We estimated the disease burden imposed by each risk factor using an attributable fraction approach, and we prioritized the risks using an empirically tested stakeholder engagement process. We then engaged government personnel, scientists, and other stakeholders to identify interventions. Results: The UAE’s environmental disease burden is low by global standards. Ambient air pollution is the leading contributor to premature mortality [~ 650 annual deaths; 95% confidence interval (CI): 140, 1,400]. Risk factors leading to > 10,000 annual health care facility visits included occupational exposures, indoor air pollution, drinking water contamination, seafood contamination, and ambient air pollution. Among the 14 risks considered, on average, outdoor air pollution was ranked by the stakeholders as the highest priority (mean rank, 1.4; interquartile range, 1–2) and indoor air pollution as the second-highest priority (mean rank 3.3; interquartile range, 2–4). The resulting strategic plan identified 216 potential interventions for reducing environmental risks to health. Conclusions: The strategic planning exercise described here provides a framework for systematically deciding how to invest public funds to maximize expected returns in environmental health, where returns are measured in terms of reductions in a population

  9. Couples' notions about preconception health: implications for framing social marketing plans.

    Science.gov (United States)

    Lewis, Megan A; Mitchell, Elizabeth W; Levis, Denise M; Isenberg, Karen; Kish-Doto, Julia

    2013-01-01

    To understand couples' notions of preconception health (PCH) and to inform the development of social marketing plans focused on PCH. APPROACH/DESIGN: We used a social marketing perspective to understand how couples considered PCH as a product, its potential price, how it should be promoted, and in what type of places it should be promoted. These variables are typically referred to as the four social marketing P's. Telephone interviews with couples recruited from a national database. A total of 58 couples (116 individuals) were segmented by five couple segments based on pregnancy planning intention and current parental status in which the wife or partner was 18 to 44 years of age. The five segments were combined into three categories: couples who were planning pregnancies, couples who were not planning pregnancies, or couples who were recent parents (interconception). Couple-based structured interviews lasting approximately 45 to 60 minutes were conducted via telephone. Questions inquired about couples' experience with PCH and the four social marketing P's. Commonalities existed across the four social marketing P's for the different couple segments. Notable couple-related themes that emerged included the importance of couple communication, support, and relationship quality. PCH was more relevant for couples planning a pregnancy, but nonplanning couples understood the benefits of PCH and related behaviors. Couples may be an important target audience when considering social marketing approaches for PCH. Many couples perceived the relevance of the issue to important aspects of their lives, such as health, family, and their relationships.

  10. Work plan and health and safety plan for Building 3019B underground storage tank at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Burman, S.N.; Brown, K.S.; Landguth, D.C.

    1992-08-01

    As part of the Underground Storage Tank Program at the Department of Energy's Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee, this Health and Safety Plan has been developed for removal of the 110-gal leaded fuel underground storage tank (UST) located in the Building 3019B area at ORNL This Health and Safety Plan was developed by the Measurement Applications and Development Group of the Health and Safety Research Division at ORNL The major components of the plan follow: (1) A project description that gives the scope and objectives of the 110-gal tank removal project and assigns responsibilities, in addition to providing emergency information for situations occurring during field operations; (2) a health and safety plan in Sect. 15 for the Building 3019B UST activities, which describes general site hazards and particular hazards associated with specific tasks, personnel protection requirements and mandatory safety procedures; and (3) discussion of the proper form completion and reporting requirements during removal of the UST. This document addresses Occupational Safety and Health Administration (OSHA) requirements in 29 CFR 1910.120 with respect to all aspects of health and safety involved in a UST removal. In addition, the plan follows the Environmental Protection Agency (EPA) QAMS 005/80 (1980) format with the inclusion of the health and safety section (Sect. 15).

  11. Work plan and health and safety plan for Building 3019B underground storage tank at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Burman, S.N.; Brown, K.S.; Landguth, D.C.

    1992-08-01

    As part of the Underground Storage Tank Program at the Department of Energy`s Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee, this Health and Safety Plan has been developed for removal of the 110-gal leaded fuel underground storage tank (UST) located in the Building 3019B area at ORNL This Health and Safety Plan was developed by the Measurement Applications and Development Group of the Health and Safety Research Division at ORNL The major components of the plan follow: (1) A project description that gives the scope and objectives of the 110-gal tank removal project and assigns responsibilities, in addition to providing emergency information for situations occurring during field operations; (2) a health and safety plan in Sect. 15 for the Building 3019B UST activities, which describes general site hazards and particular hazards associated with specific tasks, personnel protection requirements and mandatory safety procedures; and (3) discussion of the proper form completion and reporting requirements during removal of the UST. This document addresses Occupational Safety and Health Administration (OSHA) requirements in 29 CFR 1910.120 with respect to all aspects of health and safety involved in a UST removal. In addition, the plan follows the Environmental Protection Agency (EPA) QAMS 005/80 (1980) format with the inclusion of the health and safety section (Sect. 15).

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

    Science.gov (United States)

    Beaulieu, Nancy Dean

    2004-01-01

    Over the last decade, managed-care companies have been consolidating on both a regional and national scale. More recently, nonprofit health plans have been converting to for-profit status, and this conversion has frequently occurred as a step to facilitate merger or acquisition with a for-profit company. Some industry observers attribute these managed-care marketplace trends to an industry shakeout resulting from increased competition in the sector. At the same time, these perceived competitive pressures have led to questions about the long-run viability of nonprofit health plans. Furthermore, some industry and government leaders believe that some nonprofits are already conducting themselves like for-profit health plans and question the state premium tax exemption ordinarily accorded to such plans. This paper examines related health policy issues through the lens of a case study of the proposed conversion of the CareFirst Blue Cross Blue Shield company to a for-profit public-stock company and its merger with the Wellpoint Corporation. Company executives and board members argued that CareFirst lacked access to sufficient capital and faced serious threats to its viability as a financially healthy nonprofit health care company. They also argued that CareFirst and its beneficiaries would benefit from merger through enhanced economies of scale and product-line extensions. Critics of the proposed conversion and merger raised concerns about the adverse impacts on access to care, coverage availability, quality of care, safety-net providers, and the cost of health insurance. Analyses demonstrate that CareFirst wields substantial market power in its local market, that it is unlikely to realize cost savings through expanded economies of scale, and that access to capital concerns are largely driven by the perceived need for further expansion through merger and acquisition. Although it is impossible to predict future changes in quality of care for CareFirst, analyses suggest

  13. Breckinridge Project, initial effort. Report VII, Volume 4. Safety and health plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    1982-01-01

    The Safety and Health Plan recognizes the potential hazards associated with the Project and has been developed specifically to respond to these risks in a positive manner. Prevention, the primary objective of the Plan, starts with building safety controls into the process design and continues through engineering, construction, start-up, and operation of the Project facilities and equipment. Compliance with applicable federal, state, and local health and safety laws, regulations, and codes throughout all Project phases is required and assured. The Plan requires that each major Project phase be thoroughly reviewed and analyzed to determine that those provisions required to assure the safety and health of all employees and the public, and to prevent property and equipment losses, have been provided. The Plan requires followup on those items or situations where corrective action needs were identified to assure that the action was taken and is effective. Emphasis is placed on loss prevention. Exhibit 1 provides a breakdown of Ashland Synthetic Fuels, Inc.'s (ASFI's) Loss Prevention Program. The Plan recognizes that the varied nature of the work is such as to require the services of skilled, trained, and responsible personnel who are aware of the hazards and know that the work can be done safely, if done correctly. Good operating practice is likewise safe operating practice. Training is provided to familiarize personnel with good operational practice, the general sequence of activities, reporting requirements, and above all, the concept that each step in the operating procedures must be successfully concluded before the following step can be safely initiated. The Plan provides for periodic review and evaluation of all safety and loss prevention activities at the plant and departmental levels.

  14. Advance Care Planning Documentation Practices and Accessibility in the Electronic Health Record: Implications for Patient Safety.

    Science.gov (United States)

    Walker, Evan; McMahan, Ryan; Barnes, Deborah; Katen, Mary; Lamas, Daniela; Sudore, Rebecca

    2017-09-21

    Documenting patients' advance care planning wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about advance care planning documentation practices in the electronic health record. Describe advance care planning documentation practices and the accessibility of documented discussions in the electronic health record. Participants were primary care patients at the San Francisco VA Medical Center, were ≥60 years old, and had ≥2 chronic/serious health conditions. In this cross-sectional study, we assessed the prevalence of advance care planning documentation, including any legal forms/orders and discussions in the prior five years. We also determined accessibility of discussions (i.e., accessible centralized posting vs. inaccessible free-text in progress notes). The mean age of 414 participants was 71 years (SD ±8), 9% were women, 43% were non-white, and 51% had documented advance care planning including 149 (36%) with forms/orders and 138 (33%) with discussions. Seventy-four participants (50%) with forms/orders lacked accompanying explanatory documentation. Most (55%) discussions were not easily accessible, including 70% of those documenting changes in treatment preferences from prior forms/orders. Half of chronically ill, older participants had documented advance care planning, including one third with documented discussions. However, half of the patients with completed legal forms/orders had no accompanying documented explanatory discussions, and the majority of documented discussions were not easily accessible, even when wishes had changed. Ensuring that patients' preferences are documented and easily accessible is an important patient safety and quality improvement target to ensure patients' wishes are honored. Copyright © 2017. Published by Elsevier Inc.

  15. Health and Safety Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee. Environmental Restoration Program

    Energy Technology Data Exchange (ETDEWEB)

    Van Hoesen, S.D.; Clark, C. Jr.; Burman, S.N. [Oak Ridge National Lab., TN (United States); Manis, L.W.; Barre, W.L. [Analysas Corp., Oak Ridge, TN (United States)

    1993-12-01

    The Martin Marietta Energy Systems, Inc. (Energy Systems), policy is to provide a safe and healthful workplace for all employees and subcontractors. The accomplishment of this policy requires that operations at Waste Area Grouping (WAG) 6 at the Department of Energy (DOE) Oak Ridge National Laboratory are guided by an overall plan and consistent proactive approach to safety and health (S&H) issues. The plan is written to utilize past experience and best management practices to minimize hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water This plan explains additional site-specific health and safety requirements such as Site Specific Hazards Evaluation Addendums (SSHEAs) to the Site Safety and Health Plan which should be used in concert with this plan and existing established procedures.

  16. Urban and transport planning, environmental exposures and health-new concepts, methods and tools to improve health in cities.

    Science.gov (United States)

    Nieuwenhuijsen, Mark J

    2016-03-08

    The majority of people live in cities and urbanization is continuing worldwide. Cities have long been known to be society's predominant engine of innovation and wealth creation, yet they are also a main source of pollution and disease. We conducted a review around the topic urban and transport planning, environmental exposures and health and describe the findings. Within cities there is considerable variation in the levels of environmental exposures such as air pollution, noise, temperature and green space. Emerging evidence suggests that urban and transport planning indicators such as road network, distance to major roads, and traffic density, household density, industry and natural and green space explain a large proportion of the variability. Personal behavior including mobility adds further variability to personal exposures, determines variability in green space and UV exposure, and can provide increased levels of physical activity. Air pollution, noise and temperature have been associated with adverse health effects including increased morbidity and premature mortality, UV and green space with both positive and negative health effects and physical activity with many health benefits. In many cities there is still scope for further improvement in environmental quality through targeted policies. Making cities 'green and healthy' goes far beyond simply reducing CO2 emissions. Environmental factors are highly modifiable, and environmental interventions at the community level, such as urban and transport planning, have been shown to be promising and more cost effective than interventions at the individual level. However, the urban environment is a complex interlinked system. Decision-makers need not only better data on the complexity of factors in environmental and developmental processes affecting human health, but also enhanced understanding of the linkages to be able to know at which level to target their actions. New research tools, methods and paradigms such as

  17. A community-based participatory planning process and multilevel intervention design: toward eliminating cardiovascular health inequities.

    Science.gov (United States)

    Schulz, Amy J; Israel, Barbara A; Coombe, Chris M; Gaines, Causandra; Reyes, Angela G; Rowe, Zachary; Sand, Sharon L; Strong, Larkin L; Weir, Sheryl

    2011-11-01

    The elimination of persistent health inequities requires the engagement of multiple perspectives, resources, and skills. Community-based participatory research (CBPR) is one approach to developing action strategies that promote health equity by addressing contextual as well as individual-level factors, and that can contribute to addressing more fundamental factors linked to health inequity. Yet many questions remain about how to implement participatory processes that engage local insights and expertise, are informed by the existing public health knowledge base, and build support across multiple sectors to implement solutions. This article describes a CBPR approach used to conduct a community assessment and action planning process, culminating in development of a multilevel intervention to address inequalities in cardiovascular disease in Detroit, Michigan. The authors consider implications for future efforts to engage communities in developing strategies toward eliminating health inequities.

  18. Dialectical thinking and health behaviors: the effects of theory of planned behavior.

    Science.gov (United States)

    Jiang, Feng; Lu, Su; Hou, Yubo; Yue, Xiaodong

    2013-01-01

    The primary purpose of this study was to investigate whether the theory of planned behavior (TPB) mediated the relationship between dialectical thinking and health behaviors. A sample of 285 undergraduates was tested with a dialectical thinking styles scale, health promoting lifestyle profiles, and TPB questionnaires. Structural equation modeling was used for data analysis. Results indicated that all the three dimensions of thinking styles (belief in the connection, acceptance of change, and acceptance of contradiction) exerted significant effects on TPB constructs. Specifically, the connection and the change dimensions had positive effects on health behaviors mediated by TPB, whereas the contradiction dimension had a negative effect. Model 2 showed a satisfactory fit, demonstrating the influential pathways between dialectical thinking and health behaviors. Implications in issues of health promotion and future research are discussed.

  19. The Ghana community-based health planning and services initiative for scaling up service delivery innovation.

    Science.gov (United States)

    Nyonator, Frank K; Awoonor-Williams, J Koku; Phillips, James F; Jones, Tanya C; Miller, Robert A

    2005-01-01

    Research projects demonstrating ways to improve health services often fail to have an impact on what national health programmes actually do. An approach to evidence-based policy development has been launched in Ghana which bridges the gap between research and programme implementation. After nearly two decades of national debate and investigation into appropriate strategies for service delivery at the periphery, the Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. Over a 2-year period, 104 out of the 110 districts in Ghana started CHPS. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces. Evidence from the national monitoring and evaluation programme provides insights into CHPS' success and identifies constraints on future progress.

  20. Chronic Kidney Disease: A Public Health Problem That Needs a Public Health Action Plan

    Directory of Open Access Journals (Sweden)

    Anton C. Schoolwerth, MD, MSHA

    2006-03-01

    Full Text Available For a health problem or condition to be considered a public health issue, four criteria must be met: 1 the health condition must place a large burden on society, a burden that is getting larger despite existing control efforts; 2 the burden must be distributed unfairly (i.e., certain segments of the population are unequally affected; 3 there must be evidence that upstream preventive strategies could substantially reduce the burden of the condition; and 4 such preventive strategies are not yet in place. Chronic kidney disease meets these criteria for a public health issue. Therefore, as a complement to clinical approaches to controlling it, a broad and coordinated public health approach will be necessary to meet the burgeoning health, economic, and societal challenges of chronic kidney disease.

  1. Managing biotechnology in a network-model health plan: a U.S. private payer perspective.

    Science.gov (United States)

    Watkins, John B; Choudhury, Sanchita Roy; Wong, Ed; Sullivan, Sean D

    2006-01-01

    Emerging biotechnology poses challenges to payers, including access, coverage, reimbursement, patient selection, and affordability. Premera Blue Cross, a private regional health plan, developed an integrated cross-functional approach to managing biologics, built around a robust formulary process that is fast, flexible, fair, and transparent to stakeholders. Results are monitored by cost and use reporting from merged pharmacy and medical claims. Utilization management and case management strategies will integrate with specialty pharmacy programs to improve outcomes and cost-effectiveness. Creative approaches to provider reimbursement can align providers' incentives with those of the plan. Redesign of member benefits can also encourage appropriate use of biotechnology.

  2. Strategic plan of the Canadian Institutes of Health Research Institute of Nutrition, Metabolism, and Diabetes

    Science.gov (United States)

    Sherman, Philip M; Makarchuk, Mary-Jo; Belanger, Paul; Roberts, Eve A

    2011-01-01

    The present document provides the new and updated strategic plan for the Institute of Nutrition, Metabolism, and Diabetes (INMD) of the Canadian Institutes of Health Research. This plan provides an overarching map for the strategic activities of the INMD during the five years from 2010 to 2014. These strategic priorities will guide the way that the INMD uses its resources over this period of time, and will provide opportunities to build new partnerships and strategic alliances that enhance and leverage the capacity to fund targeted research initiatives. PMID:22059161

  3. Strategic Plan of the Canadian Institutes of Health Research Institute of Nutrition, Metabolism, and Diabetes

    Directory of Open Access Journals (Sweden)

    Philip M Sherman

    2011-01-01

    Full Text Available The present document provides the new and updated strategic plan for the Institute of Nutrition, Metabolism, and Diabetes (INMD of the Canadian Institutes of Health Research. This plan provides an overarching map for the strategic activities of the INMD during the five years from 2010 to 2014. These strategic priorities will guide the way that the INMD uses its resources over this period of time, and will provide opportunities to build new partnerships and strategic alliances that enhance and leverage the capacity to fund targeted research initiatives.

  4. Managing health and welfare plans instead of letting them manage you.

    Science.gov (United States)

    Havlin, L; Laspisa, E K

    1997-01-01

    The explosive growth and change in the health care provider industry is presenting a considerable challenge to employers that manage these benefits for their employees. Corporate mergers, supportive federal and state legislation expanding benefit availability and access to new consumer markets are a few of the forces changing the shape of the industry. Furthermore, participants are more knowledgeable about their benefit plans and are more vocal about their needs. The authors discuss these challenges and possible solutions for the employer that is attempting to determine how plan delivery and management needs can be served in a way that supports business environment and strategy.

  5. 我国预付卡反洗钱监管模式研究%The Study on the Supervision Pattern of Pre-paid Cards Anti-money laundering

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    预付卡能够减少现金使用、为公众支付结算提供方便,但由于持卡消费的匿名性、便利性特征,也给违法犯罪分子提供了可乘之机。随着预付卡市场的快速发展,利用预付卡非实名、流通领域广、现金替代性强等特性,将其作为转移资金替代工具的现象有所抬头。本文就如何加强预付卡反洗钱监管进行了探讨,并提出相关政策建议。%Pre-paid cards can reduce the usage of cash and facilitate public settlement. But the characteristics of anonymity of card holders and convenience provide chances for criminals. With the rapid development of the pre-paid card market, pre-paid cards have been used to transfer fimds. The paper discusses how to strengthen the supervision on pre-paid cards anti.-money laundering, and puts forward relevant policy suggestions.

  6. Human resource development: the management, planning and training of health personnel.

    Science.gov (United States)

    Simmonds, S

    1989-09-01

    The morale of health personnel is fast becoming the major factor affecting both the sustainability and the quality of health care world-wide. Low morale mirrors problems ranging from declining balance of payments allocation to GNP, and a lack of support for the health system from the very top down to the rigid application of national pay, grading and career structures, and the stress of not being able to do the job properly. While many of these and other problems have been voiced again and again in the press and in the academic literature, much of the work on health manpower development has focused on the planning and production of personnel. This has been with the aim of producing specific categories of better-trained health workers with relevant qualifications, resulting in a heavy emphasis on a quantitative output. In this paper it is argued that the management of health personnel, the qualitative aspect of staff development, has been relatively neglected. Unless and until the management of human resource development receives the attention it needs, seeds of discontent, disillusion and dissatisfaction will ultimately lead to national health services losing their competitiveness as employers. The sustainability and quality of health programmes will then be in even greater jeopardy than they are at present. The planning, production and management components of health manpower development have developed haphazardly as verticle activities. A new term such as 'human resource development; the management of health personnel' might help ensure the concept of an integrated process contingent on economic, political, organizational and other important circumstances.

  7. Developing a mental health care plan in a low resource setting: the theory of change approach.

    Science.gov (United States)

    Hailemariam, Maji; Fekadu, Abebaw; Selamu, Medhin; Alem, Atalay; Medhin, Girmay; Giorgis, Tedla Wolde; DeSilva, Mary; Breuer, Erica

    2015-09-28

    Scaling up mental healthcare through integration into primary care remains the main strategy to address the extensive unmet mental health need in low-income countries. For integrated care to achieve its goal, a clear understanding of the organisational processes that can promote and hinder the integration and delivery of mental health care is essential. Theory of Change (ToC), a method employed in the planning, implementation and evaluation of complex community initiatives, is an innovative approach that has the potential to assist in the development of a comprehensive mental health care plan (MHCP), which can inform the delivery of integrated care. We used the ToC approach to develop a MHCP in a rural district in Ethiopia. The work was part of a cross-country study, the Programme for Improving Mental Health Care (PRIME) which focuses on developing evidence on the integration of mental health in to primary care. An iterative ToC development process was undertaken involving multiple workshops with stakeholders from diverse backgrounds that included representatives from the community, faith and traditional healers, community associations, non-governmental organisations, Zonal, Regional and Federal level government offices, higher education institutions, social work and mental health specialists (psychiatrists and psychiatric nurses). The objective of this study is to report the process of implementing the ToC approach in developing mental health care plan. A total of 46 persons participated in four ToC workshops. Four critical path dimensions were identified: community, health facility, administrative and higher level care organisation. The ToC participants were actively engaged in the process and the ToC encouraged strong commitment among participants. Key opportunities and barriers to implementation and how to overcome these were suggested. During the workshops, a map incorporating the key agreed outcomes and outcome indicators was developed and finalized later

  8. The Palau AHEC--academizing the public health work plan: capacity development and innovation in Micronesia.

    Science.gov (United States)

    Dever, Greg; Finau, Sitaleki; Kuartei, Stevenson; Durand, A Mark; Rykken, David; Yano, Victor; Untalan, Pedro; Withy, Kelley; Tellei, Patrick; Baravilala, Wame; Pierantozzi, Sandra; Tellei, Jullie

    2005-03-01

    The Palau Area Health Education Center (AHEC)--a program of the University of Hawaii's John A. Burns School of Medicine (JABSOM) and based at Palau Community College--was established in 2001 in response to the recommendations of the 1998 Institute of Medicine (IOM) report--Pacific Partnerships for Health--Charting a New Course for the 21st Century1. One of IOM's core recommendations was to promote the training of the primary health care workforce among the U.S.-Associated Pacific Islands. Since its inception in 2001, the Palau AHEC has coordinated overall 37 postgraduate and undergraduate courses in General Practice and Public Health taught by the University of Auckland Faculty of Medicine and Health Sciences and the Fiji School of Medicine's School of Public Health and Primary Care (SPH&PC) in Palau, Yap State, and the Republic of the Marshall Islands. Currently 139 physicians, nurses, health administrators, and environmental health workers are registered as active students in Palau (58), Yap State (22), and the RMI (59). Notably, the Palau AHEC and the SPH&PC have worked in an innovative partnership with the Palau Ministry of Health to operationalize the MOH's public health work plan to implement a comprehensive community health survey of all 4,376 households in Palau, interviewing 79% of the total population, to determine Palau's health indicators. To accomplish this, the SPH&PC developed and taught a curriculum for Palau physicians and public health nurses on how to design the survey, gather, and analyze data in order to develop and implement appropriately responsive intervention and treatment programs to address Palau's old and newer morbidities. In early FY2005, two other Micronesian AHECs--the Yap State and Commonwealth of the Northern Mariana Islands AHECs--were funded through JABSOM administered grants which will also address the primary care training needs of Micronesia's remote and isolated health workforce.

  9. Application of ecosystem health cost-effect analysis in eco-planning in Guangzhou City,China

    Institute of Scientific and Technical Information of China (English)

    GUO Xiurui; MAO Xianqiang; YANG Jurong; YANG Zhifeng

    2007-01-01

    Ecosystem health has been a focal point and research frontier of applied ecology in recent years,increasingly used in urban ecological studies.To quantify the effect of ecological improvement from eco-planning,an ecosystem health assessment method is used in eco-planning evaluation and decision support in the urban eco-planning research of Guangzhou City of China.Based on features of an urban ecosystem,five factors such as vigor,organizational structure,resilience,ability to maintain ecosystem service,and influence on people's health were selected to develop the assessment indicator system.Then.to evaluate the validity of planning measures,a cost-effect analysis of the different sce-narios on eco-planning was made,taking investment of the planned projects as the cost and ecosystem health state after implementing the scenarios as the effect.To establish priority of all the proposed planning schemes or countermeasures,variation of the ecosystem health state was evaluated when the investment of eco-environmental construction projects changes by±10%,±20% and±50%,respectively.Thus,the order of importance of eco-environment construction projects to the urban ecosystem health state Can be worked out,providing a reference for prioritizing the implementation of such urban eco-environmental projects.The study proved the trial value of an ecosystem health evaluation method in urban eco-planning research.

  10. The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Mental Health Financial Requirements among Commercial "Carve-In" Plans.

    Science.gov (United States)

    Friedman, Sarah A; Thalmayer, Amber G; Azocar, Francisca; Xu, Haiyong; Harwood, Jessica M; Ong, Michael K; Johnson, Laura Lambert; Ettner, Susan L

    2016-12-12

    Did mental health cost-sharing decrease following implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA)? Specialty mental health copayments, coinsurance, and deductibles, 2008-2013, were obtained from benefits databases for "carve-in" plans from a national commercial managed behavioral health organization. Bivariate and regression-adjusted analyses compare the probability of use and (conditional) level of cost-sharing pre- and postparity. An interaction term is added to compare differential levels of pre- and postparity cost-sharing changes for plans that were and were not already at parity pre-MHPAEA. Controlling for employer/plan characteristics, MHPAEA is associated with higher intermediate care copayments ($15.9) but lower outpatient ($2.6) copayments among in-network-only plans. Among plans with in- and out-of-network benefits, MHPAEA is associated with lower inpatient ($23.2) and outpatient ($2.5) copayments, but increases in inpatient and intermediate in-network and out-of-network coinsurance (about 1 percentage point). Among the few plans not at parity pre-MHPAEA, changes in use and level of cost-sharing associated with MHPAEA were more dramatic. Mixed evidence that MHPAEA led to more generous mental health benefits may stem from the finding that many plans were already at parity pre-MHPAEA. Future policy focus in mental health may shift to slowing growth in cost-sharing for all health services. © Health Research and Educational Trust.

  11. Restructuring family planning in the health service: the case of young people's clinics.

    Science.gov (United States)

    West, J

    1995-04-01

    A review of the experience of adolescent reproductive health clinics in Liverpool and Bristol highlights the potentially disruptive impact of new National Health Service (NHS) policies and competing professional interests on the attempt to provide integrated, high-quality services. In particular, responsiveness to client needs often collides with NHS demands for efficiency. UK health authorities accept, in principle, the need for separate, informal family planning centers for young people. The 34 Brook Advisory Centers, which deliver confidential contraceptive and counseling services to adolescents, face pressure to become population rather than client-based and to reduce time spent on individual sessions. Moreover, new NHS contracting arrangements have greatly increased the role of general practitioners (GPs) in contraceptive provision, with serious implications for family planning clinics. At present, about 70% of UK women obtain contraceptive and sexual health services from a GP. This encroachment has further increased the marginalization of family planning practitioners, the majority of whom are female, within the medical profession. Concerns have been expressed, however, that GPs are not able to offer the comprehensive services available in clinics and lack sufficient female staff.

  12. Situation analysis: assessing family planning and reproductive health services. Quality of care.

    Science.gov (United States)

    1997-01-01

    This issue of Population Briefs contains articles on researches conducted by the Population Council concerning the delivery of quality of care, contraceptive development, safe abortion, family planning, demography, and medical anthropology. The cover story focuses on a systematic data collection tool called Situation Analysis that helps managers in program evaluation. This tool has a handbook entitled "The Situation Analysis Approach to Assessing Family Planning and Reproductive Health Services" that contains all the information needed to conduct a Situation Analysis study. The second article reports about a new contraceptive method, the two-rod levonorgestrel, which was developed at the Population Council and was recently approved by the US Food and Drug Administration. The third article reports on a medical abortion procedure that was proven to be safe, effective, and acceptable to women in developing countries. Moreover, the fourth article presents initial findings of the Community Health and Family Planning Project conducted in Northern Ghana. The fifth article discusses the paper written by the Population Council demographer, Mark Montgomery entitled "Learning and lags in mortality perceptions". Finally, the sixth article deals with another paper that reports on women's health perceptions and reproductive health in the Middle East.

  13. [Government health planning in the state of Bahia, Brazil: political actors, social interaction and institutional learning].

    Science.gov (United States)

    Jesus, Washington Luiz Abreu de; Teixeira, Carmen Fontes

    2014-09-01

    This article analyzes the process of government planning in health in the state of Bahia in the 2007-2010 period based on the formulation of the State Health Plan. The benchmark adopted involved adaptation of the theoretical model of the cycle of public policy, including analysis of context, characterization of the actors involved, operations conducted in decision making and the strategic means used. The production of information was through the analysis of documents organized in institutional portfolios and records of the planning process in the organization studied. The analysis of results reveals that the political game included "concessions" and "negotiations" regarding changes in the management and organization of the health system, highlighting the discussion on the problems facing the state management of the Unified Health System (SUS) during the period, and the search for alternatives and solutions to these problems. It also reveals the institutional learning acquired, involving managers and technicians who broadened and reinforced their capacity to analyze and formulate proposals around the government agenda.

  14. Treatment planning in dentistry using an electronic health record: implications for undergraduate education.

    Science.gov (United States)

    Tokede, O; Walji, M; Ramoni, R; White, J M; Schoonheim-Klein, M; Kimmes, N S; Vaderhobli, R; Stark, P C; Patel, V L; Kalenderian, E

    2013-02-01

    Treatment planning, an essential component of clinical practice, has received little attention in the dental literature and there appears to be no consistent format being followed in the teaching and development of treatment plans within dental school curricula. No investigation, to our knowledge, has been carried out to explore the subject of treatment planning since the advent of electronic health record (EHR) use in dentistry. It is therefore important to examine the topic of treatment planning in the context of EHRs. This paper reports on how 25 predoctoral dental students from two U.S. schools performed when asked to complete diagnosis and treatment planning exercises for two clinical scenarios in an EHR. Three calibrated clinical teaching faculty scored diagnosis entry, diagnosis-treatment (procedure) pairing, and sequencing of treatment according to criteria taught in their curriculum. Scores were then converted to percent correct and reported as means (with standard deviations). Overall, the participants earned 48.2% of the possible points. Participants at School 2 earned a mean of 54.3% compared with participants at School 1, who earned 41.9%. Students fared better selecting the appropriate treatment (59.8%) compared with choosing the correct diagnoses (41.9%) but performed least favorably when organizing the sequence of their treatment plans (41.7%). Our results highlight the need to improve the current process by which treatment planning is taught and also to consider the impact of technology on the fundamental skills of diagnosis and treatment planning within the modern educational setting. © 2012 John Wiley & Sons A/S.

  15. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Science.gov (United States)

    2010-10-01

    ... hospital services must include short-term rehabilitation services and physical therapy, the provision of... hospitalization; (13) Whole blood and blood plasma; (14) Long-term physical therapy and rehabilitation; (15....101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

  16. 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

  17. Role of GIS in social sector planning: can developing countries benefit from the examples of primary health care (PHC) planning in Britain?

    Science.gov (United States)

    Ishfaq, Mohammad; Lodhi, Bilal Khan

    2012-04-01

    Social sector planning requires rational approaches where community needs are identified by referring to relative deprivation among localities and resources are allocated to address inequalities. Geographical information system (GIS) has been widely argued and used as a base for rational planning for equal resource allocation in social sectors around the globe. Devolution of primary health care is global strategy that needs pains taking efforts to implement it. GIS is one of the most important tools used around the world in decentralization process of primary health care. This paper examines the scope of GIS in social sector planning by concentration on primary health care delivery system in Pakistan. The work is based on example of the UK's decentralization process and further evidence from US. This paper argues that to achieve benefits of well informed decision making to meet the communities' needs GIS is an essential tool to support social sector planning and can be used without any difficulty in any environment. There is increasing trend in the use of Health Management Information System (HMIS) in Pakistan with ample internet connectivity which provides well established infrastructure in Pakistan to implement GIS for health care, however there is need for change in attitude towards empowering localities especially with reference to decentralization of decision making. This paper provides GIS as a tool for primary health care planning in Pakistan as a starting point in defining localities and preparing locality profiles for need identification that could help developing countries in implementing the change.

  18. Understanding experiences of and preferences for service user and carer involvement in physical health care discussions within mental health care planning.

    Science.gov (United States)

    Small, Nicola; Brooks, Helen; Grundy, Andrew; Pedley, Rebecca; Gibbons, Chris; Lovell, Karina; Bee, Penny

    2017-04-13

    People with severe mental illness suffer more physical comorbidity than the general population, which can require a tailored approach to physical health care discussions within mental health care planning. Although evidence pertaining to service user and carer involvement in mental health care planning is accumulating, current understanding of how physical health is prioritised within this framework is limited. Understanding stakeholder experiences of physical health discussions within mental health care planning, and the key domains that underpin this phenomena is essential to improve quality of care. Our study aimed to explore service user, carer and professional experiences of and preferences for service user and carer involvement in physical health discussions within mental health care planning, and develop a conceptual framework of effective user-led involvement in this aspect of service provision. Six focus groups and four telephone interviews were carried out with twelve service users, nine carers, three service users with a dual service user and carer role, and ten mental health professionals recruited from one mental health Trust in the United Kingdom. Data was analysed utilising a thematic approach, analysed separately for each stakeholder group, and combined to aid comparisons. No service users or carers recalled being explicitly involved in physical health discussions within mental health care planning. Six prerequisites for effective service user and carer involvement in physical care planning were identified. Three themes confirmed general mental health care planning requirements: tailoring a collaborative working relationship, maintaining a trusting relationship with a professional, and having access to and being able to edit a living document. Three themes were novel to feeling involved in physical health care planning discussions: valuing physical health equally with mental health; experiencing coordination of care between physical-mental health

  19. Barriers and opportunities for evidence-based health service planning: the example of developing a Decision Analytic Model to plan services for sexually transmitted infections in the UK

    Directory of Open Access Journals (Sweden)

    Aicken Catherine R H

    2012-07-01

    Full Text Available Abstract Background Decision Analytic Models (DAMs are established means of evidence-synthesis to differentiate between health interventions. They have mainly been used to inform clinical decisions and health technology assessment at the national level, yet could also inform local health service planning. For this, a DAM must take into account the needs of the local population, but also the needs of those planning its services. Drawing on our experiences from stakeholder consultations, where we presented the potential utility of a DAM for planning local health services for sexually transmitted infections (STIs in the UK, and the evidence it could use to inform decisions regarding different combinations of service provision, in terms of their costs, cost-effectiveness, and public health outcomes, we discuss the barriers perceived by stakeholders to the use of DAMs to inform service planning for local populations, including (1 a tension between individual and population perspectives; (2 reductionism; and (3 a lack of transparency regarding models, their assumptions, and the motivations of those generating models. Discussion Technological advances, including improvements in computing capability, are facilitating the development and use of models such as DAMs for health service planning. However, given the current scepticism among many stakeholders, encouraging informed critique and promoting trust in models to aid health service planning is vital, for example by making available and explicit the methods and assumptions underlying each model, associated limitations, and the process of validation. This can be achieved by consultation and training with the intended users, and by allowing access to the workings of the models, and their underlying assumptions (e.g. via the internet, to show how they actually work. Summary Constructive discussion and education will help build a consensus on the purposes of STI services, the need for service planning to

  20. Site health and safety plan/work plan for further characterization of waste drums at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Abston, J.P.; Burman, S.N.; Jones, D.L.

    1995-10-01

    The health and safety plan/work plan describes a strategy for characterizing the contents of 172 liquid waste and 33 solid waste drums. It also addresses the control measures that will be taken to (1) prevent or minimize any adverse impact on the environment or personnel safety and health and (2) meet standards that define acceptable management of hazardous and radioactive materials and wastes. When writing this document, the authors considered past experiences, recommendations, and best management practices to minimize possible hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or unplanned releases of hazardous or radioactive materials to air, soil, or surface water.

  1. Human Health Countermeasures (HHC) Element Management Plan: Human Research Program. Revision B

    Science.gov (United States)

    Norsk, Peter; Baumann, David

    2012-01-01

    NASA s Human Research Program (HRP) is an applied research and technology program within the Human Exploration and Operations Mission Directorate (HEOMD) that addresses human health and performance risk mitigation strategies in support of exploration missions. The HRP research and technology development is focused on the highest priority risks to crew health and safety with the goal of ensuring mission success and maintaining long-term crew health. Crew health and performance standards, defined by the NASA Chief Health and Medical Officer (CHMO), set the acceptable risk level for exploration missions. The HRP conducts research to inform these standards as well as provide deliverables, such as countermeasures, that ensure standards can be met to maximize human performance and mission success. The Human Health Countermeasures (HHC) Element was formed as part of the HRP to develop a scientifically-based, integrated approach to understanding and mitigating the health risks associated with human spaceflight. These health risks have been organized into four research portfolios that group similar or related risks. A fifth portfolio exists for managing technology developments and infrastructure projects. The HHC Element portfolios consist of: a) Vision and Cardiovascular; b) Exercise and Performance; c) Multisystem; d) Bone; and e) Technology and Infrastructure. The HHC identifies gaps associated with the health risks and plans human physiology research that will result in knowledge required to more fully understand risks and will result in validated countermeasures to mitigate risks.

  2. Suicide ideation, plans, and attempts among general practice patients with chronic health conditions in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Sarah Huertas

    2011-03-01

    Full Text Available Mildred Vera2,4, María L Reyes-Rabanillo1, Sarah Huertas3, Deborah Juarbe4, Coralee Pérez-Pedrogo4, Aracelis Huertas5, Marisol Peña61Veterans Affairs Caribbean Healthcare System, San Juan, Puerto Rico; 2Department of Health Services Administration, School of Public Health; 3Department of Psychiatry, School of Medicine; 4Center for Evaluation and Sociomedical Research, School of Public Health; 5School of Health Professions; 6Center for Preparedness in Public Health, School of Public Health, Medical Sciences Campus, University of Puerto Rico San Juan, Puerto Rico.Background: Little is known about suicidal ideation among general practice patients in Puerto Rico. In this study we examined the rates, severity, and correlates of suicidal ideation, plans, and attempts among general practice patients with chronic illnesses. This is important in targeting appropriate interventions and management approaches to minimize and prevent suicide.Methods: We screened patients with chronic physical conditions at general practices. Suicidal ideation was assessed with the suicidality module of the Mini International Neuropsychiatric Interview. Major depression was assessed with the Patient Health Questionnaire depression module. The relationship between sociodemographic factors, depression and suicidal ideation was examined with multiple logistic regression analysis. Among the subgroup that acknowledged suicidal ideation, we used multinomial logistic regression analysis to estimate simultaneously the multivariate associations of depression and sociodemographic factors with suicidality risk levels.Results: Of the 2068 patients screened, 15.4% acknowledged recent suicidal ideation. Among this group, 8.6% reported passive ideation, 3.7% active ideation without a plan, and 3.1% active ideation with a plan or attempt. According to multivariate logistic regression, suicidal ideation was higher among patients with moderately severe depression and severe depression than

  3. Business planning: can the health service move from strategy into action?

    Science.gov (United States)

    Bennett, A R

    1994-01-01

    Advances the case for the use of one particular business planning technique within a National Health Service Trust. At the present time, NHS trusts are required to write strategic direction statements. Evidence suggests that these documents provide an accurate account of past performance and present position of the trust, but do not express the future position intended to be achieved. These documents also tend to be lengthy and lack strategic focus, which means that they are not helpful to managers who want clear organizational goals and objectives to which to work. Attempts to address the difficulties associated with determining how existing skills and resources can be used as the platform for future growth strategies by using the Ansoff Matrix and SWOT Analysis planning tools, given the external changes in the marketplace. Also attempts to shed light on some of the important links between busines strategy and management development by extending planning theory into practice.

  4. Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

    OpenAIRE

    Shidhaye, R.; Shrivastava, S.; Murhar, V; Samudre, S; Ahuja, S.; R. Ramaswamy; Patel, V.

    2016-01-01

    BACKGROUND: The large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care.AIMS: To operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district.METHOD: Mixed methods were used including theory of change workshops, qualitative research to...

  5. Family planning and reproductive health supply stockouts: problems and remedies for faith-based health facilities in Africa

    Directory of Open Access Journals (Sweden)

    Amy M. Metzger

    2017-01-01

    Full Text Available Background and aims: Faith-based organizations (FBOs provide a substantial portion of the health care services in many African countries. FBO facilities do consider family planning and reproductive health services as essential to reducing maternal and child mortality, and to the growth of healthy families. Many health facilities, however, struggle to maintain adequate stocks of reproductive health (RH supplies because of the various RH supply chains and funding sources, which often operate separately from other medicines and supplies. The purpose of this study is to identify the types of supply chain systems used by African faith-based health facilities to acquire reproductive health products (clotrimazole, combined oral contraceptive pills, contraceptive implants, CycleBeads®, emergency contraception, Erythromycin, female condoms, injectable contraceptives, intra-uterine contraceptive devices, magnesium sulfate, male condoms, Methyldopa, Misoprostol, Nifedpine, Oxytocin, and Progestin-only pills, to describe their problems and challenges, and to identify possible corrective actions. Methods: Through email surveys, phone interviews, and on-site visits, we studied the supply chains of 46 faith-based health facilities in 13 African countries. Sixteen RH commodities, including contraceptives, were selected as indicators. Results: Of the 46 facilities surveyed, 55 percent faced stockouts of one or more products in the three months prior to the survey. Stockouts were less common for contraceptives than for other RH products. Significant strengths of the FBO supply chain included creativity in finding other sources of commodities in the face of stockouts, staff designated to monitor quality of the commodities, high capacity for storage, low incidence of expired products, few instances of poor quality, and strong financial sustainability mechanisms, often including patient fees. Weaknesses included unreliable commodity sources and power supplies, long

  6. Meeting health and family planning needs in Latin America and the Caribbean.

    Science.gov (United States)

    1995-06-01

    The operations research and technical assistance (OR/TA) project in The Population Council has concentrated on fertility and infant mortality issues in Latin American and the Caribbean for more than a decade through INOPAL. INOPAL is an acronym for Investigacion Operacional en Planificacion Familiar y Atencion Materno-Infantil para America Latina y el Caribe (Operations Research in Family Planning and Maternal-Child Health in Latin America and the Caribbean). In March 1995, the project entered its third phase, INOPAL III, with the renewal of its contract from the United States Agency for International Development (USAID). To facilitate communication between INOPAL, collaborating agencies, and USAID, INOPAL Director James Foreit moved from Peru to a Council office in Washington, D.C. INOPAL has six objectives: 1) to test the integration of family planning and reproductive health services; 2) to increase access to family planning; 3) to develop strategies to reach special populations; 4) to improve the sustainability of family planning programs; 5) to improve service quality; and 6) to institutionalize operations research capability in the region. INOPAL II conducted 61 subprojects in 12 countries in collaboration with 24 USAID cooperating agencies and other international organizations. The project established new services for postpartum women, adolescents, and rural women; improved program quality and financial sustainability; increased vasectomy promotion and the range of available contraceptives; and developed new modes of service delivery. A key finding of INOPAL II operations research was the importance of increasing cost-effectiveness to ensure program sustainability. INOPAL III will work toward all six objectives, with an emphasis on integrating reproductive health and family planning services. Operations research and technical assistance (OR/TA) subprojects will focus on the prevention and treatment of sexually transmitted diseases, perinatal and postpartum

  7. An HIT Solution for Clinical Care and Disaster Planning: How One health Center in Joplin, MO Survived a Tornado and Avoided a Health Information Disaster.

    Science.gov (United States)

    Shin, Peter; Jacobs, Feygele

    2012-01-01

    Since taking office, President Obama has made substantial investments in promoting the diffusion of health information technology (IT). The objective of the national health IT program is, generally, to enable health care providers to better manage patient care through secure use and sharing of health information. Through the use of technologies including electronic health records, providers can better maintain patient care information and facilitate communication, often improving care outcomes. The recent tornado in Joplin, MO highlights the importance of health information technology in the health center context, and illustrates the importance of secure electronic health information systems as a crucial element of disaster and business continuity planning. This article examines the experience of a community health center in the aftermath of the major tornado that swept through the American Midwest in the spring of 2011, and provides insight into the planning for disaster survival and recovery as it relates to patient records and health center data.

  8. Mapping Extreme Heat Vulnerability and Health Outcomes to inform the District of Columbia's Climate Adaptation Plan

    Science.gov (United States)

    Declet-Barreto, J.; Wilhelmi, O.; Goggans, A.

    2016-12-01

    In this collaborative engagement, scientists are partnering with the District of Columbia (DC) to develop an extreme heat vulnerability assessment. To do so, we map socio-demographic and built environment indicators of extreme heat vulnerability in Census Tracts in DC neighborhoods. In order to provide information useful for DC public health and urban planning practitioners, we aggregate the indicators into an index of extreme heat vulnerability. We compare the index against heat-related call data from DC's 911 system to better understand the socio-spatial distribution of extreme heat-related health outcomes. Our assessment can help inform the District's Climate Adaptation Plan as well as increase public engagement in reducing vulnerability to extreme heat.

  9. Supporting Fernald Site Closure with Integrated Health and Safety Plans as Documented Safety Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Kohler, S.; Brown, T.; Fisk, P.; Krach, F.; Klein, B.

    2004-03-01

    At the Fernald Closure Project (FCP) near Cincinnati, Ohio, environmental restoration activities are supported by Documented Safety Analyses (DSAs) that combine the required project-specific Health and Safety Plans, Safety Basis Requirements (SBRs), and Process Requirements (PRs) into single Integrated Health and Safety Plans (I-HASPs). These integrated DSAs employ Integrated Safety Management methodology in support of simplified restoration and remediation activities that, so far, have resulted in the decontamination and demolition (D&D) of over 200 structures, including eight major nuclear production plants. There is one of twelve nuclear facilities still remaining (Silos containing uranium ore residues) with its own safety basis documentation. This paper presents the status of the FCP's safety basis documentation program, illustrating that all of the former nuclear facilities and activities have now replaced. Basis of Interim Operations (BIOs) with I-HASPs as their safety basis during the closure process.

  10. [Health promotion policy and urban planning: joint efforts for the development of healthy cities].

    Science.gov (United States)

    Sperandio, Ana Maria Girotti; Francisco, Lauro Luiz; Mattos, Thiago Pedrosa

    2016-06-01

    The National Health Promotion Policy (PNPS) defines strategies for devising inter-sectoral public policies that ensure the development of healthy cities. Urban planning constitutes a tool to improve the quality of life and enhance health promotion. Using the studies and cooperation actions conducted by the Urban Research Laboratory (LABINUR/FEC-Unicamp) as a reference, this article describes relevant aspects of the PNPS that have an interface with urban planning policies in Brazil. An increase in interdisciplinary and inter-sectoral measures related to the new PNPS after the passing of Ordinance 2.446/14 was identified, which include: mobility and accessibility; safe development (sanitation, housing and transport); healthy eating with social inclusion and reduction of poverty (community vegetable gardens); corporal activities and physical exercise and the enhancement of urban spaces. The conclusion drawn is that social participation, inter-sectoral activities and the role of the university are important aspects for the promotion of healthy cities.

  11. Developing a health and safety plan for hazardous field work in remote areas.

    Science.gov (United States)

    Gochfeld, Michael; Volz, Conrad D; Burger, Joanna; Jewett, Stephen; Powers, Charles W; Friedlander, Barry

    2006-12-01

    Developing health and safety plans (HASPs) is a common feature of occupational safety and health for many workplaces. Formal HASPs are a requirement for hazardous waste work, requiring the anticipation and identification of hazards and embodying the training, equipping, and evaluation of workers. Aside from OSHA, there are relatively few manuals or examples and virtually no papers that provide practical guidance in what a HASP should cover or how to create and implement one. Moreover, existing guidance refers to spatially circumscribed worksites. This article details development of a HASP to cover field researchers and ship personnel conducting scientific research in a remote area of the world (Amchitka Island in the western Aleutians), hundreds of kilometers from the nearest emergency room. It required characterizing the kinds of work to be performed and anticipating the hazards that could be encountered. It illustrates the meshing of a general HASP with a ship safety plan, a dive safety plan, and specialized topics, including stop-work authority, rock climbing, firearms, vehicle safety, and communication strategy. Remote area operations are a growing challenge facing the profession. An expedition of this sort requires extensive planning and experienced safety personnel and cannot rely on luck to ensure the safe return of participants.

  12. Oral health workforce planning. Part 1: Data available in a sample of FDI member countries.

    Science.gov (United States)

    Yamalik, Nermin; Ensaldo-Carrasco, Eduardo; Bourgeois, Denis

    2013-12-01

    Workforce planning is a resource to measure and compare current versus future workforce. Organised dentistry needs to focus on the benefits and the determinants and various systems of workforce planning together with the challenges, new trends and threats. The aim of the study was to identify data sources from countries relating to a selection of oral health indicators in a sample of FDI member countries. The potential for differences between developed and developing countries was also examined. A cross-sectional survey study was carried out among FDI member countries classified in developed and developing countries between October 2011 and January/February 2012. A questionnaire was developed addressing the availability of 40 selected indicators distributed in four domains. Mann-Whitney U-tests to identify differences between developed and developing countries and chi-square tests for the degree of information regularly available were carried out. There is an important lack of information about indicators relevant to oral health between FDI participating countries regardless of their level of economic development. Although not significant, the availability of indicators for developing countries showed higher variability and minimum values of zero for all domains. Surveys were the source of information more frequently reported. Standardised and reliable methodologies are needed to gather information for successful workforce planning. It is of utmost importance to increase the awareness and understanding of the member National Dental Associations regarding the role, basic elements, benefits, challenges, models and critical elements of an ideal workforce planning system.

  13. OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA.

    Science.gov (United States)

    Ouma, S; Turyasima, M; Acca, H; Nabbale, F; Obita, K O; Rama, M; Adong, C C; Openy, A; Beatrice, M O; Odongo-Aginya, E I; Awor, S

    Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. To determine obstacles to family planning use among rural women in Northern Uganda. A descriptive cross-sectional analytical study. Atiak Health Centre IV, Amuru District, rural Northern Uganda. Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning programme. In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty.

  14. Designing HIGH-COST medicine: hospital surveys, health planning, and the paradox of progressive reform.

    Science.gov (United States)

    Perkins, Barbara Bridgman

    2010-02-01

    Inspired by social medicine, some progressive US health reforms have paradoxically reinforced a business model of high-cost medical delivery that does not match social needs. In analyzing the financial status of their areas' hospitals, for example, city-wide hospital surveys of the 1910s through 1930s sought to direct capital investments and, in so doing, control competition and markets. The 2 national health planning programs that ran from the mid-1960s to the mid-1980s continued similar strategies of economic organization and management, as did the so-called market reforms that followed. Consequently, these reforms promoted large, extremely specialized, capital-intensive institutions and systems at the expense of less complex (and less costly) primary and chronic care. The current capital crisis may expose the lack of sustainability of such a model and open up new ideas and new ways to build health care designed to meet people's health needs.

  15. Incidence and prevalence of acromegaly in a large US health plan database

    OpenAIRE

    Burton, Tanya; Le Nestour, Elisabeth; Neary, Maureen; Ludlam, William H.

    2016-01-01

    Purpose Incidence and prevalence estimates of acromegaly in the United States (US) are limited. Most existing reports are based on European data sources. The objective of this study was to estimate the annual incidence and prevalence of acromegaly in a large US managed care population, overall and stratified by age, sex, and geographic region, using data from 2008 to 2012. Methods Using administrative claims data, commercial health plan enrollees were identified with acromegaly if they had tw...

  16. A Project to Develop a Marketing Plan for Dwight David Eisenhower Health Service Region by Audit

    Science.gov (United States)

    1991-04-01

    1986), and Zikmund & D’Amico (1986). All four marketing scholars, including Kotler (1984), reference to Philip Kotler’s selected component format (see...motivate both negative and positive behavior in publics can be considered a critical factor in health care service delivery ( Kotler , & Clarke, 1987...monitoring of communicated information is the institution of a marketing plan within the organization ( Kotler & Clarke, 1987). MARKETING Within the

  17. Security and privacy preserving approaches in the eHealth clouds with disaster recovery plan.

    Science.gov (United States)

    Sahi, Aqeel; Lai, David; Li, Yan

    2016-11-01

    Cloud computing was introduced as an alternative storage and computing model in the health sector as well as other sectors to handle large amounts of data. Many healthcare companies have moved their electronic data to the cloud in order to reduce in-house storage, IT development and maintenance costs. However, storing the healthcare records in a third-party server may cause serious storage, security and privacy issues. Therefore, many approaches have been proposed to preserve security as well as privacy in cloud computing projects. Cryptographic-based approaches were presented as one of the best ways to ensure the security and privacy of healthcare data in the cloud. Nevertheless, the cryptographic-based approaches which are used to transfer health records safely remain vulnerable regarding security, privacy, or the lack of any disaster recovery strategy. In this paper, we review the related work on security and privacy preserving as well as disaster recovery in the eHealth cloud domain. Then we propose two approaches, the Security-Preserving approach and the Privacy-Preserving approach, and a disaster recovery plan. The Security-Preserving approach is a robust means of ensuring the security and integrity of Electronic Health Records, and the Privacy-Preserving approach is an efficient authentication approach which protects the privacy of Personal Health Records. Finally, we discuss how the integrated approaches and the disaster recovery plan can ensure the reliability and security of cloud projects.

  18. Pilot-testing an applied competency-based approach to health human resources planning.

    Science.gov (United States)

    Tomblin Murphy, Gail; MacKenzie, Adrian; Alder, Rob; Langley, Joanne; Hickey, Marjorie; Cook, Amanda

    2013-10-01

    A competency-based approach to health human resources (HHR) planning is one that explicitly considers the spectrum of knowledge, skills and judgement (competencies) required for the health workforce based on the health needs of the relevant population in some specific circumstances. Such an approach is of particular benefit to planners challenged to make optimal use of limited HHR as it allows them to move beyond simply estimating numbers of certain professionals required and plan instead according to the unique mix of competencies available from the existing health workforce. This kind of flexibility is particularly valuable in contexts where healthcare providers are in short supply generally (e.g. in many developing countries) or temporarily due to a surge in need (e.g. a pandemic or other disease outbreak). A pilot application of this approach using the context of an influenza pandemic in one health district of Nova Scotia, Canada, is described, and key competency gaps identified. The approach is also being applied using other conditions in other Canadian jurisdictions and in Zambia.

  19. Factors associated with health care professionals' choice of written asthma management plans.

    Science.gov (United States)

    Bibb, Sandra C; Norwood, Ricky; Meyer, John F

    2007-10-01

    The objective of this descriptive-comparative study was to determine what factors were associated with health care professionals' choice of written asthma management plans (WAMP) for health care practice. A convenience sample of medical and nursing students and practicing health care professionals was asked to choose the preferred WAMP and give a brief explanation for the choice on the questionnaire. Comparative groups were formed based on the WAMP choice. Independent sample chi2 and content analysis were used to analyze data. Ninety-five percent (n = 192) of all survey respondents (N = 202) preferred the highly readable Global Initiative for Asthma Sample Patient Asthma Management Plan, as compared to the Veterans Administration/Department of Defense (DoD) WAMP. Major themes as to why respondents preferred the Global Initiative for Asthma WAMP include "pictures," "readability," "user-friendliness," and "simplicity." Use of the current DoD/Veterans Health Administration WAMP within the DoD Military Health System may need to be re-evaluated.

  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. Project health and safety plan for the Gunite and Associated Tanks at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Abston, J.P.

    1997-04-01

    The Lockheed Martin Energy Systems, Inc. (Energy Systems) policy is to provide a safe and healthful workplace for all employees and subcontractors. The accomplishment of this policy requires that operations at the Gunite and Associated Tanks (GAAT) in the North and South Tank Farms (NTF and STF) at the Department of Energy (DOE) Oak Ridge National Laboratory are guided by an overall plan and consistent proactive approach to health and safety (H and S) issues. The policy and procedures in this plan apply to all GAAT operations in the NTF and STF. The provisions of this plan are to be carried out whenever activities identifies s part of the GAAT 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 in order to minimize hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to the air. This plan explains additional task-specific health and safety requirements such as the Site Safety and health Addendum and Activity Hazard Analysis, which should be used in concert with this plan and existing established procedures.

  2. HAZWOPER work plan and site safety and health plan for the Alpha characterization project at the solid waste storage area 4 bathtubbing trench at Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-01

    This work plan/site safety and health plan is for the alpha sampling project at the Solid Waste Storage Area 4 bathtubbing trench. The work will be conducted by the Oak Ridge National Laboratory (ORNL) Environmental Sciences Division and associated ORNL environmental, safety, and health support groups. This activity will fall under the scope of 29 CFR 1910.120, Hazardous Waste Operations and Emergency Response (HAZWOPER). The purpose of this document is to establish health and safety guidelines to be followed by all personnel involved in conducting work for this project. Work will be conducted in accordance with requirements as stipulated in the ORNL HAZWOPER Program Manual and applicable ORNL; Martin Marietta Energy Systems, Inc.; and U.S. Department of Energy policies and procedures. The levels of protection and the procedures specified in this plan are based on the best information available from historical data and preliminary evaluations of the area. Therefore, these recommendations represent the minimum health and safety requirements to be observed by all personnel engaged in this project. Unforeseeable site conditions or changes in scope of work may warrant a reassessment of the stated protection levels and controls. All adjustments to the plan must have prior approval by the safety and health disciplines signing the original plan.

  3. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    Science.gov (United States)

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph

    2010-11-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application.

  4. Impact of family planning health education on the knowledge and attitude among Yasoujian women.

    Science.gov (United States)

    Mahamed, Fariba; Parhizkar, Saadat; Raygan Shirazi, Alireza

    2012-02-29

    The aim of this study was to determine the effect of health education on the knowledge and attitude regarding family planning and contraception's method among the women who obligatory attended the Premarital Counseling Center in Yasouj city, Iran. An experimental study was carried out and a total of 200 women were selected for the study using convenience sampling method among women who attended in the health centre in order to utilize the necessary premarital actions. Respondents were divided by two experimental and control groups randomly. A pre-evaluation was done on the knowledge and attitude on family planning using a structured questionnaire. After which, the health education for experimental group was done within four educational sessions during 4 consecutive weeks and control group underwent traditional education method. Post evaluation was utilized for any changes regarding their knowledge and attitude among the respondents immediately after the intervention. Independent and paired t-test was used to evaluate the mean knowledge and attitude scores differences among both groups. RESULTS showed that there was a significant improvement in respondents' knowledge and attitude after educational program in experimental group (peducational method. In conclusion, the educational method is effective in increasing the knowledge and improving the attitude of women regarding family planning in Yasouj compared to current used educational method. Future educational programs need to incorporate the features that have been associated with successful interventions in the past, as well as including their own evaluation procedures.

  5. Validation of an Algorithm to Estimate Gestational Age in Electronic Health Plan Databases

    Science.gov (United States)

    Li, Qian; Andrade, Susan E.; Cooper, William O.; Davis, Robert L.; Dublin, Sascha; Hammad, Tarek A.; Pawloski, Pamala A.; Pinheiro, Simone P.; Raebel, Marsha A.; Scott, Pamela E.; Smith, David H.; Dashevsky, Inna; Haffenreffer, Katie; Johnson, Karin E.; Toh, Sengwee

    2013-01-01

    Purpose To validate an algorithm that uses delivery date and diagnosis codes to define gestational age at birth in electronic health plan databases. Methods Using data from 225,384 live born deliveries among women aged 15–45 years in 2001–2007 within 8 of the 11 health plans participating in the Medication Exposure in Pregnancy Risk Evaluation Program, we compared 1) the algorithm-derived gestational age versus the “gold-standard” gestational age obtained from the infant birth certificate files; and 2) the prenatal exposure status of two antidepressants (fluoxetine and sertraline) and two antibiotics (amoxicillin and azithromycin) as determined by the algorithm-derived versus the gold-standard gestational age. Results The mean algorithm-derived gestational age at birth was lower than the mean obtained from the birth certificate files among singleton deliveries (267.9 versus 273.5 days) but not among multiple-gestation deliveries (253.9 versus 252.6 days). The algorithm-derived prenatal exposure to the antidepressants had a sensitivity and a positive predictive value (PPV) of ≥95%, and a specificity and a negative predictive value (NPV) of almost 100%. Sensitivity and PPV were both ≥90%, and specificity and NPV were both >99% for the antibiotics. Conclusions A gestational age algorithm based upon electronic health plan data correctly classified medication exposure status in most live born deliveries, but misclassification may be higher for drugs typically used for short durations. PMID:23335117

  6. Estimating causal effects from family planning health communication campaigns using panel data: the "your health, your wealth" campaign in Egypt.

    Directory of Open Access Journals (Sweden)

    Paul L Hutchinson

    Full Text Available BACKGROUND: Health communication campaigns - involving mass media and interpersonal communication - have long been utilized by national family planning programs to create awareness about contraceptive methods, to shift social norms related to fertility control, and to promote specific behaviors, such as the use of condoms, injectable methods or permanent sterilization. However, demonstrating the effectiveness of these campaigns is often complicated because the infeasibility of experimental designs generally yields statistically non-equivalent samples of campaign-exposed and unexposed individuals. METHODS: Using data from a panel survey of reproductive age women in Egypt, we estimate the effects of the multimedia health communication campaign "Your Health, Your Wealth" ("Sahatek Sarwetek" on precursors to contraceptive use (e.g., spousal communication, birth spacing attitudes and on modern contraceptive use. Difference-in-differences and fixed effects estimators that exploit the panel nature of the data are employed to control for both observed and unobserved heterogeneity in the sample of women who self-report recall of the messages, thereby potentially improving upon methods that make no such controls or that rely solely on cross-sectional data. FINDINGS: All of the estimators find positive effects of the "Your Health, Your Wealth" campaign on reproductive health outcomes, though the magnitudes of those effects diverge, often considerably. Difference-in-differences estimators find that exposure to the campaign increases the likelihood of spousal discussions by 14.4 percentage points (pp. (SE= .039, p<0.001 but has no effect on contraceptive use. In contrast, the fixed effects, instrumental variables estimator, controlling for unobserved heterogeneity, finds a large, statistically significant effect on modern contraceptive use (27.4 pp., SE=0.135, p=0.043. CONCLUSIONS: The difficulties of evaluating family planning communication programs may

  7. Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit. Final regulations.

    Science.gov (United States)

    2015-12-18

    This document contains final regulations on the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, and the Department of Defense and Full-Year Continuing Appropriations Act, 2011. These final regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges, sometimes called Marketplaces) and claim the health insurance premium tax credit, and Exchanges that make qualified health plans available to individuals and employers.

  8. How the Reproductive Health Needs of Unmarried Youth Be Concerned in Quality Services in Family Planning/ Reproductive Health?

    Institute of Scientific and Technical Information of China (English)

    Nian CUI; Min-xiang LI; Xiao-wen TU

    2006-01-01

    Objective To understand the reproductive health needs of unmarried youth so as to provide them better quality services.Method Data were drawn from a baseline questionnaire survey of provision of reproductive health information and services for unmarried youth aged 16-20 years in rural areas of Chengdu, Southwest China in 2001-2002.Results The study comprised of 1 895 valid subjects. More than 70% subjects felt that the knowledge, information and services in relation to sexual and reproductive health provided by the society were rather insufficient. Near 95% thought that unmarried young people seeking sexual and reproductive health counseling and services were quite normal, although some of them had different misgivings. Their preferred services in reproductive health included: counseling in relation to sexual and reproductive health, how to cope with unexpected sex and unwanted pregnancy, how to select the appropriate contraceptives for unmarried youth, etc. About 2/3 subjects agreed to provide contraceptive services to unmarried youth actively by the society. And they thought the difficulties and obstacles in provision of contraceptive services for unmarried youth were in the following order: restriction of the traditional conceptions,shyness of unmarried youth in accept of such services, disapproval of parents/school teachers, and so forth.Conclusion To improve reproductive health status of unmarried youth and meet their needs is a challenge to quality service of family planning/reproductive health program in China. The related departments and service providers should pay attention to this matter and take the strategies and measures to provide appropriate, specific, friendly and accessibly services for unmarried young people.

  9. Profit-seeking, corporate control, and the trustworthiness of health care organizations: assessments of health plan performance by their affiliated physicians.

    Science.gov (United States)

    Schlesinger, Mark; Quon, Nicole; Wynia, Matthew; Cummins, Deborah; Gray, Bradford

    2005-06-01

    To compare the relative trustworthiness of nonprofit and for-profit health plans, using physician assessments to measure dimensions of plan performance that are difficult for consumers to evaluate. A nationally representative sample of 1,621 physicians who responded to a special topics module of the 1998 Socioeconomic Monitoring System Survey (SMS), fielded by the American Medical Association. Physicians assessed various aspects of their primary managed care plan, defined as the plan in which they had the largest number of patients. Plan ownership was measured as the interaction of tax-exempt status (nonprofit versus for-profit) and corporate control (single state versus multistate health plans). Two sets of regression models are estimated. The dependent variables in the regressions are five measures of performance related to plan trustworthiness: two related to deceptive practices and three to dimensions of quality that are largely hidden from enrollees. The first set (baseline) models relate plan ownership to trustworthy practices, controlling for other characteristics of the plan, the marketplace for health insurance, and the physician respondents. The second (interactive) set of models examines how the magnitude of ownership-related differences in trustworthiness varies with the market share of nonprofit plans in each community. The 1998 SMS was fielded between April and September of 1998 by Westat Inc. The average time required for a completed interview was approximately 30 minutes. The overall response rate was 52.2 percent. Compared with more local nonprofit plans, for-profit plans affiliated with multistate corporations are consistently reported by their affiliated physicians to engage in practices associated with reduced trustworthiness. Nonprofit plans affiliated with multistate corporations have more physician-reported practices associated with trustworthiness than do for-profit corporate plans on four of five outcomes, but appear less trustworthy than

  10. Factors that hinder community participation in developing and implementing comprehensive council health plans in Manyoni District, Tanzania

    Directory of Open Access Journals (Sweden)

    Emmanuel G. Kilewo

    2015-06-01

    Full Text Available Background: Decentralization of public health planning is proposed to facilitate public participation in health issues. Health Sector Reform in Tanzania places emphasis on the participation of lower level health facilities and community in health planning process. Despite availability of policies, guidelines, and community representative organs, actual implementation of decentralization strategies is poorly achieved. This study intended to find out factors that hinder community participation in developing and implementing Comprehensive Council Health Plan (CCHP. Materials and methods: A qualitative approach was conducted in this study with key informants from Health Facility Governing Committees (HFGC, Council Health Service Board (CHSB, and Council Health Management Team (CHMT. Data were collected using in-depth interviews. Data generated were analyzed for themes and patterns. Results: Factors that hindered community participation included lack of awareness on the CCHP among HFGC members, poor communication and information sharing between CHMT and HFGC, unstipulated roles and responsibilities of HFGC, lack of management capacity among HFGC members, and lack of financial resources for implementing HFGC activities. Conclusions: The identified challenges call for policy makers to revisit the decentralization by devolution policy by ensuring that local governance structures have adequate resources as well as autonomy to participate in planning and managing CCHP in general and health facility plans in particular.

  11. Family Planning Counseling in Your Pocket: A Mobile Job Aid for Community Health Workers in Tanzania.

    Science.gov (United States)

    Agarwal, Smisha; Lasway, Christine; L'Engle, Kelly; Homan, Rick; Layer, Erica; Ollis, Steve; Braun, Rebecca; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa

    2016-06-20

    To address low contraceptive use in Tanzania, a pilot intervention using a mobile job aid was developed to guide community health workers (CHWs) to deliver integrated counseling on family planning, HIV, and other sexually transmitted infections (STIs). In this article, we describe the process of developing the family planning algorithms and implementation of the mobile job aid, discuss how the job aid supported collection of real-time data for decision making, and present the cost of the overall system based on an evaluation of the pilot. The family planning algorithm was developed, beginning in June 2011, in partnership with the Tanzania Ministry of Health and Social Welfare based on a combination of evidence-based tools such as the Balanced Counseling Strategy Plus Toolkit. The pilot intervention and study was implemented with 25 CHWs in 3 wards in Ilala district in Dar es Salaam between January 2013 and July 2013. A total of 710 family planning users (455 continuing users and 255 new users) were registered and counseled using the mobile job aid over the 6-month intervention period. All users were screened for current pregnancy, questioned on partner support for contraceptive use, counseled on a range of contraceptives, and screened for HIV/STI risk. Most new and continuing family planning users chose pills and male condoms (59% and 73%, respectively). Pills and condoms were provided by the CHW at the community level. Referrals were made to the health facility for pregnancy confirmation, injectable contraceptives, long-acting reversible contraceptives and HIV/STI testing. Follow-up visits with clients were planned to confirm completion of the health facility referral. The financial cost of implementing this intervention with 25 CHWs and 3 supervisors are estimated to be US$26,000 for the first year. For subsequent years, the financial costs are estimated to be 73% lower at $7,100. Challenges such as limited client follow-up by CHWs and use of data by supervisors

  12. Reproductive health services for refugees by refugees in Guinea I: family planning

    Directory of Open Access Journals (Sweden)

    Newey Claire

    2008-10-01

    Full Text Available Abstract Background Comprehensive studies of family planning (FP in refugee camps are relatively uncommon. This paper examines gender and age differences in family planning knowledge, attitudes, and practices among Sierra Leonean and Liberian refugees living in Guinea. Methods In 1999, a cross-sectional survey was conducted of 889 reproductive-age men and women refugees from 48 camps served by the refugee-organised Reproductive Health Group (RHG. Sampling was multi-stage with data collected for socio-demographics, family planning, sexual health, and antenatal care. Statistics were calculated for selected indicators. Results Women knew more about FP, although men's education reduced this difference. RHG facilitators were the primary source of reproductive health information for all respondents. However, more men then women obtained information from non-health sources, such as friends and media. Approval of FP was high, significantly higher in women than in men (90% vs. 70%. However, more than 40% reported not having discussed FP with their partner. Perceived service quality was an important determinant in choosing where to get contraceptives. Contraceptive use in the camps served by RHG was much higher than typical for either refugees' country of origin or the host country (17% vs. 3.9 and 4.1% respectively, but the risk of unwanted pregnancy remained considerable (69%. Conclusion This refugee self-help model appeared largely effective and could be considered for reproductive health needs in similar settings. Having any formal education appeared a major determinant of FP knowledge for men, while this was less noticeable for women. Thus, FP communication strategies for refugees should consider gender-specific messages and channels.

  13. Reproductive health and family planning needs among HIV-infected women in Sub-Saharan Africa.

    Science.gov (United States)

    Sarnquist, Clea C; Rahangdale, Lisa; Maldonado, Yvonne

    2013-03-01

    Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa. Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion. Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.

  14. 77 FR 22691 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-04-17

    ... Internal Revenue Service 26 CFR Parts 40 and 46 RIN 1545-BK59 Fees on Health Insurance Policies and Self... Protection and Affordable Care Act on issuers of certain health insurance policies and plan sponsors of..., Rebecca L. Baxter at (202) 622-3970 (regarding health insurance policies) or R. Lisa Mojiri-Azad at (202...

  15. 78 FR 25909 - Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance...

    Science.gov (United States)

    2013-05-03

    ... Other Rules Regarding the Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS... relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care... coverage under a qualified health plan through an Affordable Insurance Exchange may receive a premium tax...

  16. Projection scenarios of body mass index (2013-2030) for Public Health Planning in Quebec.

    Science.gov (United States)

    Lo, Ernest; Hamel, Denis; Jen, Yun; Lamontagne, Patricia; Martel, Sylvie; Steensma, Colin; Blouin, Chantal; Steele, Russell

    2014-09-25

    Projection analyses can provide estimates of the future health burden of increasing BMI and represent a relevant and useful tool for public health planning. Our study presents long-term (2013-2030) projections of the prevalence and numbers of individuals by BMI category for adult men and women in Quebec. Three applications of projections to estimate outcomes more directly pertinent to public health planning, as well as an in-depth discussion of limits, are provided with the aim of encouraging greater use of projection analyses by public health officers. The weighted compositional regression method is applied to prevalence time series derived from sixteen cross-sectional survey cycles, for scenarios of linear change and deceleration. Estimation of the component of projected change potentially amenable to intervention, future health targets and the projected impact on type 2 diabetes, were done. Obesity prevalence in Quebec is projected to rise steadily from 2013 to 2030 in both men (from 18.0-19.4% to 22.2-30.4%) and women (from 15.5-16.3% to 18.2-22.4%). Corresponding projected numbers of obese individuals are (579,000-625,000 to 790,000-1,084,000) in men and (514,000-543,000 to 661,000-816,000) in women. These projected increases are found to be primarily an 'epidemiologic' rather than 'demographic' phenomenon and thus potentially amenable to public health intervention. Assessment of obesity targets for 2020 illustrates the necessity of using projected rather than current prevalence; for example a targeted 2% drop in obesity prevalence relative to 2013 translates into a 3.6-5.4% drop relative to 2020 projected levels. Type 2 diabetes is projected to increase from 6.9% to 9.2-10.1% in men and from 5.7% to 7.1-7.5% in women, from 2011-2012 to 2030. A substantial proportion of this change (25-44% for men, and 27-43% for women) is attributable to the changing BMI distribution. Obesity in Quebec is projected to increase and should therefore continue to be a public

  17. "Planning eye health services in Varamin district, Iran: a cross-sectional study".

    Science.gov (United States)

    Katibeh, Marzieh; Blanchet, Karl; Akbarian, Shadi; Hosseini, Sara; Ahmadieh, Hamid; Burton, Matthew J

    2015-04-03

    A recent survey of avoidable blindness in Varamin District, Iran, identified moderately high levels of visual impairment (10%) and blindness (1.5%) in people >50 years. This study aimed to define current provision, identify gaps and suggest practical solutions for improving eye health services in this area. The World Health Organization (WHO) framework for analyzing health systems has several key components: service delivery, health workforce, information system, medical products and technologies, financing, and governance. We used this structure to investigate the strengths and weaknesses of the eye health system in Varamin. All public and private eye care facilities and a random selection of primary health care (PHC) units were assessed using semi-structured researcher-administered questionnaires. Varamin has 16 ophthalmic clinics, including two secondary hospitals that provide cataract surgery. There were ten ophthalmologists (1:68,000 population), two ophthalmic nurses and five optometrists working in Varamin district. There were no eye care social or community workers, ophthalmic counsellors, low vision rehabilitation staff. Although the Vision 2020 target for ophthalmologists has been met, numbers of other eye care staff were insufficient. The majority of patients travel to Tehran for surgery. The recent survey identified cataract as the leading cause of blindness, despite the availability of surgical services in the district and high health insurance coverage. Poor awareness is a major barrier. No units had a written blindness prevention plan, formal referral pathways or sufficient eye health promotion activities. Only one of the PHC units referred people with diabetes for retinal examination. There is partial integration between eye care services and the general health system particularly for prevention of childhood blindness: chemo-prophylaxis for ophthalmia neonatorum, school vision tests, measles immunization and Vitamin A supplementation. This analysis

  18. Operationalizing universal health coverage in Nigeria through social health insurance

    Science.gov (United States)

    Okpani, Arnold Ikedichi; Abimbola, Seye

    2015-01-01

    Nigeria faces challenges that delay progress toward the attainment of the national government's declared goal of universal health coverage (UHC). One such challenge is system-wide inequities resulting from lack of financial protection for the health care needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care. In this paper, we draw on existing evidence to suggest steps toward reforming health care financing in Nigeria to achieve UHC through social health insurance. This article sets out to demonstrate that a viable path to UHC through expanding social health insurance exists in Nigeria. We argue that encouraging the states which are semi-autonomous federating units to setup and manage their own insurance schemes presents a unique opportunity for rapidly scaling up prepaid coverage for Nigerians. We show that Nigeria's federal structure which prescribes a sharing of responsibilities for health care among the three tiers of government presents serious challenges for significantly extending social insurance to uncovered groups. We recommend that rather than allowing this governance structure to impair progress toward UHC, it should be leveraged to accelerate the process by supporting the states to establish and manage their own insurance funds while encouraging integration with the National Health Insurance Scheme. PMID:26778879

  19. Operationalizing universal health coverage in Nigeria through social health insurance

    Directory of Open Access Journals (Sweden)

    Arnold Ikedichi Okpani

    2015-01-01

    Full Text Available Nigeria faces challenges that delay progress toward the attainment of the national government's declared goal of universal health coverage (UHC. One such challenge is system-wide inequities resulting from lack of financial protection for the health care needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care. In this paper, we draw on existing evidence to suggest steps toward reforming health care financing in Nigeria to achieve UHC through social health insurance. This article sets out to demonstrate that a viable path to UHC through expanding social health insurance exists in Nigeria. We argue that encouraging the states which are semi-autonomous federating units to setup and manage their own insurance schemes presents a unique opportunity for rapidly scaling up prepaid coverage for Nigerians. We show that Nigeria's federal structure which prescribes a sharing of responsibilities for health care among the three tiers of government presents serious challenges for significantly extending social insurance to uncovered groups. We recommend that rather than allowing this governance structure to impair progress toward UHC, it should be leveraged to accelerate the process by supporting the states to establish and manage their own insurance funds while encouraging integration with the National Health Insurance Scheme.

  20. Health and safety plan for operations performed for the Environmental Restoration Program. Task, OU 1-03 and OU 4-10 Track 2 investigations

    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.

  1. A marketing plan for health care in the financial district of San Francisco.

    Science.gov (United States)

    Evans, S

    1987-01-01

    The development of a corporate health marketing program for the Medical Pavilion was based on three assumptions. 1. Medical Pavilion will contribute positively to health care cost containment for employers by providing convenient, quality medical care which will help to reduce employee time lost from work due to physician visits, and through health screening, early diagnosis, and out-patient procedures, decrease unnecessary hospitalization. 2. The level of awareness among chief executive officers, benefits directors, corporate medical directors, and employees will be positively related to utilization of health services at the Medical Pavilion. 3. The Medical Pavilion will be organized on a private practice model; although special programs related to employer coverage and specific benefits may be considered separately. The recommended goals of the corporate health program of the Medical Pavilion were as follows: 1. To develop demographic profiles based on current utilization of medical services in a random sample to corporations in the Financial District. 2. To design a survey of corporate leadership to determine a needs assessment strategy for the development of preventive health services programs to be offered at the Medical Pavilion. 3. To select an advertising and public relations agency; and determine the marketing bridges, for the first year and the following five year period. 4. To evaluate effectiveness of the corporate health marketing plan referral data collected through the Management Information System to be established at the Medical Pavilion.

  2. [The role of the court system in regulating health insurance plans in Brazil].

    Science.gov (United States)

    Alves, Danielle Conte; Bahia, Ligia; Barroso, André Feijó

    2009-02-01

    Consumer complaints against private health insurance plans and companies in Brazil have become increasingly frequent in the country's 'supplementary' (non-public) health care sector, with numerous cases reaching the courts. The problem raised the need for regulation of this private market, which began in 1998, through Law no. 9.656. One of the challenges faced by the National Agency for Supplementary Health Care (ANS) is resistance to the legislation by health insurance companies, besides the fact that there are still some contracts not covered by this law. The objective of the current study was to analyze health insurance policyholders' appeals against court rulings for or against injunctions concerning coverage, in cases heard by the courts in Rio de Janeiro and São Paulo. The main data investigated were: court issuing the ruling; defendant; basis for the case; ruling by the Circuit Court and Court of Appeals; and the legal arguments. Based on the findings, the Brazilian court system still plays an important role in hearing and ruling on complaints by health insurance policyholders. The ANS has an important role in filling some gaps that have still not been solved in regulating the health insurance industry.

  3. Valued identities and deficit identities: Wellness Recovery Action Planning and self-management in mental health.

    Science.gov (United States)

    Scott, Anne; Wilson, Lynere

    2011-03-01

    Wellness Recovery Action Planning (WRAP) is a self-management programme for people with mental illnesses developed by a mental health consumer, and rooted in the values of the 'recovery' movement. The WRAP is noteworthy for its construction of a health identity which is individualised, responsibilized, and grounded in an 'at risk' subjectivity; success with this programme requires development of an intensely focused health lifestyle. We draw on Bourdieu and Giddens to argue that what is being developed is a 'reflexive health habitus', which is not equally accessible to all social groups, and is in tension with WRAP's recovery-orientated aims. However, it is understandable that such a programme developed in mental health, because people with mental illness are highly stigmatized as 'a risk' and viewed as in need of risk management. By developing their own form of self-monitoring 'at risk' identity, mental health consumers are, paradoxically, able to construct themselves as ideal health citizens and no longer a risk, thus re-entering the moral community. We conclude by suggesting some changes to WRAP practice. © 2011 Blackwell Publishing Ltd.

  4. Couples’ Notions About Preconception Health: Implications for Framing Social Marketing Plans

    Science.gov (United States)

    Lewis, Megan A.; Mitchell, Elizabeth W.; Levis, Denise M.; Isenberg, Karen; Kish-Doto, Julia

    2015-01-01

    Purpose To understand couples’ notions of preconception health (PCH) and to inform the development of social marketing plans focused on PCH. Approach/Design We used a social marketing perspective to understand how couples considered PCH as a product, its potential price, how it should be promoted, and in what type of places it should be promoted. These variables are typically referred to as the four social marketing P’s. Setting Telephone interviews with couples recruited from a national database. Participants A total of 58 couples (116 individuals) were segmented by five couple segments based on pregnancy planning intention and current parental status in which the wife or partner was 18 to 44 years of age. The five segments were combined into three categories: couples who were planning pregnancies, couples who were not planning pregnancies, or couples who were recent parents (interconception). Method Couple-based structured interviews lasting approximately 45 to 60 minutes were conducted via telephone. Questions inquired about couples’ experience with PCH and the four social marketing P’s. Results Commonalities existed across the four social marketing P’s for the different couple segments. Notable couple-related themes that emerged included the importance of couple communication, support, and relationship quality. PCH was more relevant for couples planning a pregnancy, but nonplanning couples understood the benefits of PCH and related behaviors. Conclusion Couples may be an important target audience when considering social marketing approaches for PCH. Many couples perceived the relevance of the issue to important aspects of their lives, such as health, family, and their relationships. PMID:23286659

  5. The problem involving OPMEs and the health plans contracts: outline and analysis of the issue

    Directory of Open Access Journals (Sweden)

    MARTINS, Paulo Roberto do Nascimento

    2016-06-01

    Full Text Available This paper has as its scope to introduce and analyze some of most polemic issues involving the indications of OPMEs within the health plans contracts. During the text, are exhibited normative elements related to this context, as well as some judicial decisions concerning this matter, aiming to defend, with reasonable grounds, that the indication of the patient’s doctor, when choosing prostheses and orthoses, cannot be taken as the unique nor necessarily the best opinion, given the existence of other interests, beyond the patient’s health, that are often in stake as well. At the end, it is explained that, in light of the currently existing regulation in Brazil, in the context of the supplementary health system, to the patient’s doctor is given the authority only to indicate the characteristics of the materials needed, leaving it to the health plans Operators the choice of the brand and the manufacturer. As long as the courts deny these rules, this serious problem will not be solved.

  6. Herd health planning: farmers' perceptions in relation to lameness and mastitis.

    Science.gov (United States)

    Bell, N J; Main, D C J; Whay, H R; Knowles, T G; Bell, M J; Webster, A J F

    2006-11-18

    Between December 2002 and December 2003, the herd health planning activities on 61 dairy farms in the uk were compared with several measures of lameness and mastitis. Lameness had been reported as a problem in 53 of the herds directly by the farm and in the other eight by the nominating local veterinary practice; 54 of the farms also reported having a mastitis problem. Fifty-three (87 per cent) of the farms had some form of written herd health plan, of which 21 (40 per cent) had been in place for 12 months or less. All the farms were recording mastitis in some way, although 38 (62 per cent) of the farmers did not review these records and only four retained the results of a comprehensive record review. Farms defined as having a high incidence of mastitis were more likely to be reviewing their health records, but farms defined as having a high prevalence of lameness in a sentinel group of early lactation heifers were less likely to be reviewing their health records.

  7. Preconception health: awareness, planning, and communication among a sample of US men and women.

    Science.gov (United States)

    Mitchell, Elizabeth W; Levis, Denise M; Prue, Christine E

    2012-01-01

    It is important to educate both men and women about preconception health (PCH), but limited research exists in this area. This paper examines men's and women's awareness of exposure to PCH information and of specific PCH behaviors, PCH planning, and PCH discussions with their partners. Data from Porter Novelli's 2007 Healthstyles survey were used. Women and men of reproductive age were included in the analysis (n = 2,736) to understand their awareness, planning, and conversations around PCH. Only 27.9% of women and men reported consistently using an effective birth control method. The majority of men (52%) and women (43%) were unaware of any exposure to PCH messages; few received information from their health care provider. Women were more aware than men of specific pre-pregnancy health behaviors. Women in the sample reported having more PCH conversations with their partners than did men. PCH education should focus on both women and men. Communication about PCH is lacking, both between couples and among men and women and their health care providers. PCH education might benefit from brand development so that consumers know what to ask for and providers know what to deliver.

  8. Effects of a consumer driven health plan on pharmaceutical spending and utilization.

    Science.gov (United States)

    Parente, Stephen T; Feldman, Roger; Chen, Song

    2008-10-01

    To compare pharmaceutical spending and utilization in a consumer driven health plan (CDHP) with a three-tier pharmacy benefit design, and to examine whether the CDHP creates incentives to reduce pharmaceutical spending and utilization for chronically ill patients, generic or brand name drugs, and mail-order drugs. Retrospective insurance claims analysis from a large employer that introduced a CDHP in 2001 in addition to a point of service (POS) plan and a preferred provider organization (PPO), both of which used a three-tier pharmacy benefit. Difference-in-differences regression models were estimated for drug spending and utilization. Control variables included the employee's income, age, and gender, number of covered lives per contract, election of flexible spending account, health status, concurrent health shock, cohort, and time trend. Results. CDHP pharmaceutical expenditures were lower than those in the POS cohort in 1 year without differences in the use of brand name drugs. We find limited evidence of less drug consumption by CDHP enrollees with chronic illnesses, and some evidence of less generic drug use and more mail-order drug use among CDHP members. The CDHP is cost-neutral or cost-saving to both the employer and the employee compared with three-tier benefits with no differences in brand name drug use. © Health Research and Educational Trust.

  9. [Health impact assessment methodology for urban planning projects in Andalusia (Spain)].

    Science.gov (United States)

    Moya-Ruano, Luis A; Candau-Bejarano, Ana; Rodríguez-Rasero, Francisco J; Ruiz-Fernández, Josefa; Vela-Ríos, José

    To describe the tool developed in Andalusia (Spain) to conduct an analysis and prospective assessment of health impacts from urban planning projects as well as the process followed to design it. On the one hand, direct and indirect relationships between urban setting and health were identified in light of the best scientific evidence available; and, on the other hand, methods and tools in impact assessment were reviewed. After the design of the tool, it was tested via both internal and external validation processes (meetings, workshops and interviews with key informants). The tool consists of seven phases, structured in two stages. A first descriptive stage shows how to obtain information about goals, objectives and general points pertaining the project and also to characterise the potentially affected population. The second one indicates, in several phases, how to identify and sort out potential impacts from the project using different supporting tools. Both in the testing phase and through its implementation since the entry into force of Andalusian Decree 169/2014 (16 June 2015) and forced all urban planning projects to be subjected to an Health Impact Assessment, this methodology has proved responsive, identifying major potential health impacts from the measures included in those projects. However, the tool has been shaped as a living tool and will be adapted in line with the experience acquired in its use. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  10. Diabetes health information technology innovation to improve quality of life for health plan members in urban safety net.

    Science.gov (United States)

    Ratanawongsa, Neda; Handley, Margaret A; Sarkar, Urmimala; Quan, Judy; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

    2014-01-01

    Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support/health coaching intervention for English-, Spanish-, and Cantonese-speaking members from 4 publicly funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] = 0.29, P < .01) and 12-Item Short Form Health Survey physical scores (ES = 0.25, P = .03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. Automated telephone self-management is a strategy for improving patient-reported self-management and may also improve some outcomes.

  11. Emerging trends in cancer care: health plans' and pharmacy benefit managers' perspectives on changing care models.

    Science.gov (United States)

    Greenapple, Rhonda

    2012-07-01

    Cancer care in the United States is being transformed by a number of medical and economic trends, including rising drug costs, increasing availability of targeted therapies and oral oncolytic agents, healthcare reform legislation, changing reimbursement practices, a growing emphasis on comparative effectiveness research (CER), the emerging role of accountable care organizations (ACOs), and the increased role of personalization of cancer care. To examine the attitudes of health plan payers and pharmacy benefit managers (PBMs) toward recent changes in cancer care, current cost-management strategies, and anticipated changes in oncology practice during the next 5 years. An online survey with approximately 200 questions was conducted by Reimbursement Intelligence in 2011. The survey was completed by 24 medical directors and 31 pharmacy directors from US national and regional health plans and 8 PBMs. All respondents are part of a proprietary panel of managed care decision makers and are members of the Pharmacy and Therapeutics Committees of their respective plans, which together manage more than 150 million lives. Survey respondents received an honorarium for completing the survey. The survey included quantitative and qualitative questions about recent developments in oncology management, such as the impact on their plans or PBMs of healthcare reform, quality improvement initiatives, changes in reimbursement and financial incentives, use of targeted and oral oncolytics, and personalized medicine. Respondents were treated as 1 group, because there were no evident differences in responses between medical and pharmacy directors or PBMs. Overall, survey respondents expressed interest in monitoring and controlling the costs of cancer therapy, and they anticipated increased use of specialty pharmacy for oncology drugs. When clinical outcomes are similar for oral oncolytics and injectable treatments, 93% prefer the oral agents, which are covered under the specialty tier by 59

  12. Health financing in the African Region: 2000–2009 data analysis

    Science.gov (United States)

    2013-01-01

    Background In order to raise African countries probability of achieving the United Nations Millennium Development Goals by 2015, there is need to increase and more efficiently use domestic and external funding to strengthen health systems infrastructure in order to ensure universal access to quality health care. The objective of this paper is to examine the changes that have occurred in African countries on health financing, taking into account the main sources of funding over the period 2000 to 2009. Methods Our analysis is based on the National Health Accounts (NHA) data for the 46 countries of the WHO African Region. The data were obtained from the WHO World Health Statistics Report 2012. Data for Zimbabwe was not available. The analysis was done using Excel software. Results Between 2000 and 2009, number of countries spending less than 5% of their GDP on health decreased from 24 to 17; government spending on health as a percentage of total health expenditure increased in 31 countries and decreased in 13 countries; number of countries allocating at least 15% of national budgets on health increased from 2 to 4; number of countries partially financing health through social security increased from 19 to 21; number of countries where private spending was 50% and above of total health expenditure decreased from 29 (64%) to 23 (51%); over 70% of private expenditure on health came from household out-of-pocket payments (OOPS) in 32 (71%) countries and in 27 (60%) countries; number of countries with private prepaid plans increased from 29 to 31; number of countries financing more than 20% of their total health expenditure from external sources increased from 14 to 19; number of countries achieving the Commission for Macroeconomics and Health recommendation of spending at least US$34 per person per year increased from 11 to 29; number of countries achieving the International Taskforce on Innovative Financing recommendation of spending at least US$44 per person per year

  13. Health financing in the African Region: 2000-2009 data analysis.

    Science.gov (United States)

    Sambo, Luis Gomes; Kirigia, Joses Muthuri; Orem, Juliet Nabyonga

    2013-03-06

    In order to raise African countries probability of achieving the United Nations Millennium Development Goals by 2015, there is need to increase and more efficiently use domestic and external funding to strengthen health systems infrastructure in order to ensure universal access to quality health care. The objective of this paper is to examine the changes that have occurred in African countries on health financing, taking into account the main sources of funding over the period 2000 to 2009. Our analysis is based on the National Health Accounts (NHA) data for the 46 countries of the WHO African Region. The data were obtained from the WHO World Health Statistics Report 2012. Data for Zimbabwe was not available. The analysis was done using Excel software. Between 2000 and 2009, number of countries spending less than 5% of their GDP on health decreased from 24 to 17; government spending on health as a percentage of total health expenditure increased in 31 countries and decreased in 13 countries; number of countries allocating at least 15% of national budgets on health increased from 2 to 4; number of countries partially financing health through social security increased from 19 to 21; number of countries where private spending was 50% and above of total health expenditure decreased from 29 (64%) to 23 (51%); over 70% of private expenditure on health came from household out-of-pocket payments (OOPS) in 32 (71%) countries and in 27 (60%) countries; number of countries with private prepaid plans increased from 29 to 31; number of countries financing more than 20% of their total health expenditure from external sources increased from 14 to 19; number of countries achieving the Commission for Macroeconomics and Health recommendation of spending at least US$34 per person per year increased from 11 to 29; number of countries achieving the International Taskforce on Innovative Financing recommendation of spending at least US$44 per person per year increased from 11 to 24

  14. How does context influence collaborative decision-making for health services planning, delivery and evaluation?

    Science.gov (United States)

    Gagliardi, Anna R; Webster, Fiona; Brouwers, Melissa C; Baxter, Nancy N; Finelli, Antonio; Gallinger, Steven

    2014-11-19

    Collaboration among researchers (clinician, non-clinician) and decision makers (managers, policy-makers, clinicians), referred to as integrated knowledge translation (IKT), enhances the relevance and use of research, leading to improved decision-making, policies, practice, and health care outcomes. However IKT is not widely practiced due to numerous challenges. This research explored how context influenced IKT as a means of identifying how IKT could be strengthened. This research investigated IKT in three health services programs for colon cancer screening, prostate cancer diagnosis, and the treatment of pancreatic cancer. Qualitative methods were used to explore contextual factors that influenced how IKT occurred, and its impact. Data were collected between September 1, 2012 and May 15, 2013 from relevant documents, observation of meetings, and interviews with researchers and decision-makers, analyzed using qualitative methods, and integrated. Data were analyzed from 39 documents, observation of 6 meetings, and 36 interviews. IKT included interaction at meetings, joint undertaking of research, and development of guidelines. IKT was most prevalent in one program with leadership, clear goals, dedicated funding and other infrastructural resources, and an embedded researcher responsible for, and actively engaged in IKT. This program achieved a variety of social, research and health service outcomes despite mixed individual views about the value of IKT and the absence of a programmatic culture of IKT. Participants noted numerous challenges including lack of time and incentives, and recommendations to support IKT. A conceptual framework of factors that influence IKT and associated outcomes was generated, and can be used by others to plan or evaluate IKT. The findings can be applied by researchers, clinicians, managers or policy-makers to plan or improve collaborative decision-making for health services planning, delivery, evaluation or quality improvement. Further

  15. The impact of health system reform plan on the hospital\\'s performance indicators of Lorestan University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Reza Dadgar

    2017-10-01

    Conclusion: The health system  reform plan has been positive changes in indicators of hospital performance. Therefore, while considering the current trend of continuous improvement, the continuity of the project was advised based on the results of this study.

  16. Euro 2012 European Football Championship Finals: planning for a health legacy.

    Science.gov (United States)

    Smallwood, Catherine A H; Arbuthnott, Katherine G; Banczak-Mysiak, Barbara; Borodina, Mariya; Coutinho, Ana Paula; Payne-Hallström, Lara; Lipska, Elzbieta; Lyashko, Viktor; Miklasz, Miroslaw; Miskiewicz, Paulina; Nitzan, Dorit; Pokanevych, Igor; Posobkiewicz, Marek; Rockenschaub, Gerald; Sadkowska-Todys, Malgorzata; Sinelnik, Svetlana; Smiley, Daniel; Tomialoic, Rysard; Yurchenko, Volodimir; Memish, Ziad A; Heymann, David; Endericks, Tina; McCloskey, Brian; Zumla, Alimuddin; Barbeschi, Maurizio

    2014-06-14

    The revised international health regulations offer a framework that can be used by host countries to organise public health activities for mass gatherings. From June 8, to July 1, 2012, Poland and Ukraine jointly hosted the Union of European Football Associations European Football Championship Finals (Euro 2012). More than 8 million people from around the world congregated to watch the games. Host countries and international public health agencies planned extensively to assess and build capacity in the host countries and to develop effective strategies for dissemination of public health messages. The effectiveness of public health services was maximised through rapid sharing of information between parties, early use of networks of experienced individuals, and the momentum of existing national health programmes. Organisers of future mass gatherings for sporting events should share best practice and their experiences through the WHO International Observer Program. Research about behaviour of large crowds is needed for crowd management and the evidence base translated into practice. A framework to measure and evaluate the legacy of Euro 2012 is needed based on the experiences and the medium-term and long-term benefits of the tournament. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. 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…

  18. Federal employees health program experiences lack of competition in some areas, raising cost concerns for exchange plans.

    Science.gov (United States)

    McBride, Timothy D; Barker, Abigail R; Pollack, Lisa M; Kemper, Leah M; Mueller, Keith J

    2012-06-01

    The Affordable Care Act calls for creation of health insurance exchanges designed to provide private health insurance plan choices. The Federal Employees Health Benefits Program is a national model that to some extent resembles the planned exchanges. Both offer plans at the state level but are also overseen by the federal government. We examined the availability of plans and enrollment levels in the Federal Employees Health Benefits Program throughout the United States in 2010. We found that although plans were widely available, enrollment was concentrated in plans owned by just a few organizations, typically Blue Cross/Blue Shield plans. Enrollment was more concentrated in rural areas, which may reflect historical patterns of enrollment or lack of provider networks. Average biweekly premiums for an individual were lowest ($58.48) in counties where competition was extremely high, rising to $65.13 where competition was extremely low. To make certain that coverage sold through exchanges is affordable, policy makers may need to pay attention to areas where there is little plan competition and take steps through risk-adjustment policies or other measures to narrow differences in premiums and out-of-pocket expenses for consumers.

  19. TUESDAY: EPA Administrator to Discuss Historic Clean Power Plan to Cut U.S. Carbon Pollution and Protect Public Health

    Science.gov (United States)

    WASHINGTON - On Tuesday, August 11, EPA Administrator Gina McCarthy will be discussing the Clean Power Plan at the Resources for the Future (RFF) Leadership Forum. The Clean Power Plan will protect public health, spur clean energy investments and st

  20. 75 FR 33317 - Request for Information (RFI) on the National Institutes of Health Plan To Develop the Genetic...

    Science.gov (United States)

    2010-06-11

    ... Health Plan To Develop the Genetic Testing Registry ACTION: Notice. SUMMARY: The National Institutes of... on its plan to develop the Genetic Testing Registry (GTR); a centralized public resource that will provide information about the availability, scientific basis, and usefulness of genetic tests....