The National Lung Health Education Program: roots, mission, future directions.
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The National Lung Health Education Program (NLHEP), founded in 1997, is a national health care initiative to promote early diagnosis of chronic obstructive pulmonary disease and related disorders. NLHEP creates and provides lung health publications for laypeople and health professionals and develops and conducts workshops for health care professionals, to promote clinician expertise in office spirometry and spirogram interpretation, and to increase everyone's awareness of the effects of smoking and the availability of smoking-cessation programs, support systems, and treatments. The American Association for Respiratory Care (AARC) has been a NLHEP partner from the beginning, and now those 2 organizations are adding another dimension to their partnership: AARC is going to take over all NLHEP administrative functions. (+info)
Wisconsin Collaborative for Healthcare Quality (WCHQ): lessons learned.
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The Wisconsin Collaborative for Healthcare Quality demonstrated that seven hospitals, six multi-specialty physician groups, four health plans and nine employers from across the state can agree upon goals and work collaboratively to achieve them. Together they created: A public/private partnership to define common measures of health care quality that make sense to purchasers/consumers. A report that allows all health care providers to compare data against the measures reported, and evaluate their own performances. A tool that enables purchasers to educate their employees in making informed decisions in choosing and interacting with health care providers. A forward-looking approach for determining what effective, resonable health care will be in the future. The Collaborative has become a learning organization, expanding its capacity to create the quality improvement results to which its participants aspire. (+info)
Separating financing from provision: evidence from 10 years of partnership with health cooperatives in Costa Rica.
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OBJECTIVE: This article examines the impact of contracting health care provision to health care cooperatives in Costa Rica. METHODOLOGY: The article uses a panel dataset on health care outputs in traditional clinics and cooperatives in Costa Rica from 1990-99. RESULTS: Controlling for community socioeconomic characteristics, annual time trends and clinic complexity, the cooperatives conducted an average of 9.7-33.8% more general visits (95% confidence interval), 27.9-56.6% more dental visits, and 28.9-100% fewer specialist visits. Numbers of non-medical, emergency and first-time visits per capita were not different from the traditional public clinics. These results suggest that the cooperatives substituted generalist for specialist services and offered additional dental services, but did not turn away new patients, refuse emergency cases, or substitute nurses for doctors as care providers. Cooperatives authorized 30.4-60.5% fewer sick days (95% confidence interval), conducted 24.7-37.2% fewer lab exams, and gave out 26.7-38.3% fewer medications per visit than the traditional public clinics. Real total expenditure per capita in cooperatives was 14.7-58.9% lower than in traditional clinics. CONCLUSIONS: The findings suggest that cooperatives might, with an appropriate regulatory framework and incentives, be able to combine advantages of public and private approaches to health care service provision. Under certain conditions, they might be able to maintain accessibility, a sense of mission and efficiency in service provision. (+info)
A communitywide intervention to improve outcomes and reduce disability among injured workers in Washington State.
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One pressing challenge facing the U.S. health care system is the development of effective policies and clinical management strategies to address deficiencies in health care quality. In collaboration with researchers at the University of Washington, the Washington State Department of Labor and Industries has created a communitywide delivery system intervention to improve health outcomes and reduce disability among injured workers. This intervention is currently being tested in two sites in western and eastern Washington. So far, it appears to be possible to engage physicians and health care institutions in quality improvement initiatives and to form effective public-private partnerships for this purpose. Furthermore, collaborating with university researchers may help enhance the scientific rigor of the quality improvement initiative and create more opportunities for a successful evaluation. (+info)
Smoking cessation and prevention in women of reproductive age: resources and partnerships for physicians.
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The importance of smoking cessation and prevention as a women's issue is clear--physicians who interact with women of reproductive age are in an excellent position to influence women's decisions to quit smoking. This paper provides information on community resources physicians can offer to their patients to help support their cessation attempts and describes a new partnership opportunity that physicians can become involved with. (+info)
Has the leapfrog group had an impact on the health care market?
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A number of large employers and public purchasers founded the Leapfrog Group in 2000 in an attempt to consolidate the purchaser voice and engage consumers and clinicians in improving health care quality. Drawing on evidence-based medicine, Leapfrog publicly releases information about the extent to which hospitals are adopting three safety "leaps" with the theoretical capacity to prevent thousands of deaths. Although the group has grown rapidly and achieved national recognition, employer-based initiatives historically have struggled to create changes in health care. This paper examines the impact of the Leapfrog Group and its efforts to address the challenges of employer initiatives. (+info)
Making health equality a reality: the Bronx takes action.
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In response to growing evidence of racial and ethnic disparities in health, Bronx Health REACH, a coalition of health care providers and community and faith-based organizations, is engaged in an effort to identify and eliminate the root causes of health disparities in their Bronx neighborhood. The group has gained a community perspective on health disparities that it has developed into a seven-point advocacy agenda: universal health insurance, an end to segregation in health facilities based on insurance status, accountability for state uncompensated care funds, culturally competent care for all, greater health workforce diversity, an expansion of public health education, and environmental justice. (+info)
Exporting the Buyers Health Care Action Group purchasing model: lessons from other communities.
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When first implemented in Minneapolis and St. Paul, Minnesota, the Buyers Health Care Action Group's (BHCAG) purchasing approach received considerable attention as an employer-managed, consumer-driven health care model embodying many of the principles of managed competition. First BHCAG and, later, a for-profit management company attempted to export this model to other communities. Their efforts were met with resistance from local hospitals and, in many cases, apathy by employers who were expected to be supportive. This experience underscores several difficulties that appear to be inherent in implementing purchasing models based on competing care systems. It also, once again, suggests caution in drawing lessons from community-level experiments in purchasing health care. (+info)