Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Cost of Illness: The personal cost of acute or chronic disease. The cost to the patient may be an economic, social, or psychological cost or personal loss to self, family, or immediate community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, or QUALITY OF LIFE. It differs from HEALTH CARE COSTS, meaning the societal cost of providing services related to the delivery of health care, rather than personal impact on individuals.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Drug Costs: The amount that a health care institution or organization pays for its drugs. It is one component of the final price that is charged to the consumer (FEES, PHARMACEUTICAL or PRESCRIPTION FEES).Health Care Reform: Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Mental Health: The state wherein the person is well adjusted.Health: The state of the organism when it functions optimally without evidence of disease.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Health Planning: Planning for needed health and/or welfare services and facilities.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Health Services: Services for the diagnosis and treatment of disease and the maintenance of health.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.World Health: The concept pertaining to the health status of inhabitants of the world.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)Health Services Needs and Demand: Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.Cost Control: The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Public Health Administration: Management of public health organizations or agencies.Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Health Status Disparities: Variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically or similar measures.Health Care Rationing: Planning for the equitable allocation, apportionment, or distribution of available health resources.Delivery of Health Care, Integrated: A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.Mental Health Services: Organized services to provide mental health care.Cost Sharing: Provisions of an insurance policy that require the insured to pay some portion of covered expenses. Several forms of sharing are in use, e.g., deductibles, coinsurance, and copayments. Cost sharing does not refer to or include amounts paid in premiums for the coverage. (From Dictionary of Health Services Management, 2d ed)Public Health Practice: The activities and endeavors of the public health services in a community on any level.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Direct Service Costs: Costs which are directly identifiable with a particular service.Health Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.Rural Health: The status of health in rural populations.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Women's Health: The concept covering the physical and mental conditions of women.Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.Urban Health: The status of health in urban populations.Child Health Services: Organized services to provide health care for children.Health Literacy: Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.World Health Organization: A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples.Cost Allocation: The assignment, to each of several particular cost-centers, of an equitable proportion of the costs of activities that serve all of them. Cost-center usually refers to institutional departments or services.Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Health Facilities: Institutions which provide medical or health-related services.Community Health Planning: Planning that has the goals of improving health, improving accessibility to health services, and promoting efficiency in the provision of services and resources on a comprehensive basis for a whole community. (From Facts on File Dictionary of Health Care Management, 1988, p299)Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Regional Health Planning: Planning for health resources at a regional or multi-state level.Health Manpower: The availability of HEALTH PERSONNEL. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Health Benefit Plans, Employee: Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.Public Health Nursing: A nursing specialty concerned with promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences to develop local, regional, state, and national health policy and research. It is population-focused and community-oriented, aimed at health promotion and disease prevention through educational, diagnostic, and preventive programs.Maternal Health Services: Organized services to provide health care to expectant and nursing mothers.Electronic Health Records: Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.Employer Health Costs: That portion of total HEALTH CARE COSTS borne by an individual's or group's employing organization.Health Occupations: Professions or other business activities directed to the cure and prevention of disease. For occupations of medical personnel who are not physicians but who are working in the fields of medical technology, physical therapy, etc., ALLIED HEALTH OCCUPATIONS is available.Reproductive Health: The physical condition of human reproductive systems.Occupational Health Services: Health services for employees, usually provided by the employer at the place of work.Health Services for the Aged: Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.State Health Plans: State plans prepared by the State Health Planning and Development Agencies which are made up from plans submitted by the Health Systems Agencies and subject to review and revision by the Statewide Health Coordinating Council.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Health Services Administration: The organization and administration of health services dedicated to the delivery of health care.Great BritainPublic Health Informatics: The systematic application of information and computer sciences to public health practice, research, and learning.Politics: Activities concerned with governmental policies, functions, etc.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Health Plan Implementation: Those actions designed to carry out recommendations pertaining to health plans or programs.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.National Institutes of Health (U.S.): An operating division of the US Department of Health and Human Services. It is concerned with the overall planning, promoting, and administering of programs pertaining to health and medical research. Until 1995, it was an agency of the United States PUBLIC HEALTH SERVICE.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.Catchment Area (Health): A geographic area defined and served by a health program or institution.Quality-Adjusted Life Years: A measurement index derived from a modification of standard life-table procedures and designed to take account of the quality as well as the duration of survival. This index can be used in assessing the outcome of health care procedures or services. (BIOETHICS Thesaurus, 1994)Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Health Care Coalitions: Voluntary groups of people representing diverse interests in the community such as hospitals, businesses, physicians, and insurers, with the principal objective to improve health care cost effectiveness.Women's Health Services: Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.Poverty: A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.Reproductive Health Services: Health care services related to human REPRODUCTION and diseases of the reproductive system. Services are provided to both sexes and usually by physicians in the medical or the surgical specialties such as REPRODUCTIVE MEDICINE; ANDROLOGY; GYNECOLOGY; OBSTETRICS; and PERINATOLOGY.Health Services, Indigenous: Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Health Records, Personal: Longitudinal patient-maintained records of individual health history and tools that allow individual control of access.Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Family Health: The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members.Managed Care Programs: Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.Men's Health: The concept covering the physical and mental conditions of men.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Health Planning Guidelines: Recommendations for directing health planning functions and policies. These may be mandated by PL93-641 and issued by the Department of Health and Human Services for use by state and local planning agencies.Health Maintenance Organizations: Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)Financing, Government: Federal, state, or local government organized methods of financial assistance.Allied Health Personnel: Health care workers specially trained and licensed to assist and support the work of health professionals. Often used synonymously with paramedical personnel, the term generally refers to all health care workers who perform tasks which must otherwise be performed by a physician or other health professional.Population Surveillance: Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.Community Mental Health Services: Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.Health Planning Support: Financial resources provided for activities related to health planning and development.Social Justice: An interactive process whereby members of a community are concerned for the equality and rights of all.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Adolescent Health Services: Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures.Comprehensive Health Care: Providing for the full range of personal health services for diagnosis, treatment, follow-up and rehabilitation of patients.School Health Services: Preventive health services provided for students. It excludes college or university students.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Consumer Participation: Community or individual involvement in the decision-making process.Infant, Newborn: An infant during the first month after birth.Schools, Public Health: Educational institutions for individuals specializing in the field of public health.Healthcare Disparities: Differences in access to or availability of medical facilities and services.Insurance Coverage: Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)Rural Population: The inhabitants of rural areas or of small towns classified as rural.United States Dept. of Health and Human Services: A cabinet department in the Executive Branch of the United States Government concerned with administering those agencies and offices having programs pertaining to health and human services.State Medicine: A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Models, Economic: Statistical models of the production, distribution, and consumption of goods and services, as well as of financial considerations. For the application of statistics to the testing and quantifying of economic theories MODELS, ECONOMETRIC is available.Sex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Financing, Personal: Payment by individuals or their family for health care services which are not covered by a third-party payer, either insurance or medical assistance.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.Health Food: A non-medical term defined by the lay public as a food that has little or no preservatives, which has not undergone major processing, enrichment or refinement and which may be grown without pesticides. (from Segen, The Dictionary of Modern Medicine, 1992)Hospitalization: The confinement of a patient in a hospital.Health Fairs: Community health education events focused on prevention of disease and promotion of health through audiovisual exhibits.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Cooperative Behavior: The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)Health Communication: The transfer of information from experts in the medical and public health fields to patients and the public. The study and use of communication strategies to inform and influence individual and community decisions that enhance health.Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).Educational Status: Educational attainment or level of education of individuals.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.EnglandDental Health Services: Services designed to promote, maintain, or restore dental health.Social Class: A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Australia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions.Universal Coverage: Health insurance coverage for all persons in a state or country, rather than for some subset of the population. It may extend to the unemployed as well as to the employed; to aliens as well as to citizens; for pre-existing conditions as well as for current illnesses; for mental as well as for physical conditions.Prepaid Health Plans: Contracts between an insurer and a subscriber or a group of subscribers whereby a specified set of health benefits is provided in return for a periodic premium.Public Sector: The area of a nation's economy that is tax-supported and under government control.International Cooperation: The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest.United States Public Health Service: A constituent organization of the DEPARTMENT OF HEALTH AND HUMAN SERVICES concerned with protecting and improving the health of the nation.Organizational Objectives: The purposes, missions, and goals of an individual organization or its units, established through administrative processes. It includes an organization's long-range plans and administrative philosophy.Budgets: Detailed financial plans for carrying out specific activities for a certain period of time. They include proposed income and expenditures.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Government Agencies: Administrative units of government responsible for policy making and management of governmental activities.Employment: The state of being engaged in an activity or service for wages or salary.Organizational Case Studies: Descriptions and evaluations of specific health care organizations.Medicaid: Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.Residence Characteristics: Elements of residence that characterize a population. They are applicable in determining need for and utilization of health services.Interinstitutional Relations: The interactions between representatives of institutions, agencies, or organizations.Health Planning Councils: Organized groups serving in advisory capacities related to health planning activities.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.Health Transition: Demographic and epidemiologic changes that have occurred in the last five decades in many developing countries and that are characterized by major growth in the number and proportion of middle-aged and elderly persons and in the frequency of the diseases that occur in these age groups. The health transition is the result of efforts to improve maternal and child health via primary care and outreach services and such efforts have been responsible for a decrease in the birth rate; reduced maternal mortality; improved preventive services; reduced infant mortality, and the increased life expectancy that defines the transition. (From Ann Intern Med 1992 Mar 15;116(6):499-504)Efficiency, Organizational: The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.Occupational Health Nursing: The practice of nursing in the work environment.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Maternal-Child Health Centers: Facilities which administer the delivery of health care services to mothers and children.Medically Uninsured: Individuals or groups with no or inadequate health insurance coverage. Those falling into this category usually comprise three primary groups: the medically indigent (MEDICAL INDIGENCY); those whose clinical condition makes them medically uninsurable; and the working uninsured.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Fees and Charges: Amounts charged to the patient as payer for health care services.Financing, Organized: All organized methods of funding.Education, Public Health Professional: Education and training in PUBLIC HEALTH for the practice of the profession.Insurance, Health, Reimbursement: Payment by a third-party payer in a sum equal to the amount expended by a health care provider or facility for health services rendered to an insured or program beneficiary. (From Facts on File Dictionary of Health Care Management, 1988)History, 20th Century: Time period from 1901 through 2000 of the common era.Decision Making, Organizational: The process by which decisions are made in an institution or other organization.Social Determinants of Health: The circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics ( Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly.Holistic Health: Health as viewed from the perspective that humans and other organisms function as complete, integrated units rather than as aggregates of separate parts.BrazilSocial Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc.Efficiency: Ratio of output to effort, or the ratio of effort produced to energy expended.Stress, Psychological: Stress wherein emotional factors predominate.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.IndiaEthnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Models, Theoretical: Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment.State Government: The level of governmental organization and function below that of the national or country-wide government.Demography: Statistical interpretation and description of a population with reference to distribution, composition, or structure.Dental Health Surveys: A systematic collection of factual data pertaining to dental or oral health and disease in a human population within a given geographic area.Social Responsibility: The obligations and accountability assumed in carrying out actions or ideas on behalf of others.National Health Insurance, United States

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Medicare provides nearly universal health care coverage to the population over 65. However it does not pay for everything. ... one suggestion is that the elderly could pay a larger proportion of the costs of their healthcare. But exactly how much would ... aims to identify the portion of wealth Medicare beneficiaries spend on healthcare costs in the last five years of life. Their ... is under threat from a combination of spiraling healthcare costs and increased longevity. As the government attempts to reduce ...

*  Explainer: what is health rationing?

... a series which examines Australia's rising health costs and the tough decisions governments must make to rein them it. Any ... Rationing without information on the costs and benefits of health-care interventions can lead to waste, inefficiency and even ... Any mention of the "R" word in health care immediately brings to mind cuts to services and not being able to access care. It ... 2. Government bodies ration health care. Explicit rationing involves deliberation and judgements about the cost-effectiveness ...

*  Health-care costs: Debt talks boost Medicare reform plans -

But their health-care costs could rise under various Medicare reform plans. ... Health-care costs for seniors have been largely picked up by government. ... Health-care costs for seniors have been largely picked up by government. But their health-care costs could rise under various ... That can mean substantial health care tabs for some seniors.. Medicare households on average spent $4,620 on health care in ...

*  Healthcare Industry Can Learn From Other Sectors | HealthLeaders Media

... annual Health Care Cost Survey of the nation's 300 largest businesses projects that the average per-employee healthcare cost in ... annual Health Care Cost Survey of the nation's 300 largest businesses projects that the average per-employee healthcare cost in ... Actually, other sectors of the economy might be leading the healthcare sector when it comes to creative healthcare costs ... The healthcare sector-a notorious laggard in many worthy trends-is better protected from the risings costs of providing ...

*  Gastrointestinal bleeding in hospitalized children in the United States.

METHODS: Data were obtained from the Healthcare Cost and Utilizati.. ... A Survey on Health Status and Health Care Demands of Chinese Urban Elderly Residents. PPT Version , PDF Version ... METHODS: Data were obtained from the Healthcare Cost and Utilization Project Kids' Inpatient Database, Agency for Healthcare ...

*  Health Care: Costs

An additional listing of SHRM articles on health care costs not specifically related to health care reform may be found here.) ... Group Health Insurance Rates on the Rise for 2011. Employers Brace for Health Care Cost Increases, Remain Committed to ... State-Federal Review of Health Insurance Rate Increases Begins. Small Businesses Overpay for Health Insurance, Researchers Find ... Increased Health Care Cost Shifting Expected in 2011. ... Health Care Costs Health Care Reform Other Benefits LIKE SAVE ...

*  Health care costs - tribunedigital-chicagotribune

Romney, a master of vagueness, does not put a price tag on the health care he opposes or the bombers he desires. So we, the ... Do we want health insurance for truck drivers like Tobe, or do we want more playthings for the military? I've made my decision ... Millions of Americans, like Towe, are uninsured because they can't afford the high cost of premiums. The program, which is ...

*  Cost-effectiveness in Health Care | RAND

RAND researchers examine treatments, programs, drugs, and technologies in terms of their costs, their cost effectiveness, and ... One goal of health policy research is to improve cost effectiveness without compromising quality of care. ... Cost-effectiveness in Health Care. Featured. One goal of health policy research is to improve cost effectiveness without ... Small Ideas for Saving Big Health Care Dollars. Big proposals to rein in health care spending in the United States have ...

*  Infographic: Visualizing Health Care Costs

... of health care costs; how health care costs are putting pressure on US families; how the United States spends more per person ... Visualizing Health Care Costs. September's Visualizing Health Policy, a new monthly feature in JAMA, illustrates how health ... for health care than other countries; and how the cost of health insurance premiums has increased in the past decade for both ... The infographic, created by the Kaiser Family Foundation (KFF), shows how health care spending is unevenly distributed within ...

*  Finding Low-Cost Mental Health Care

Get tips on finding low-cost or free mental health care in this article for teens. ... If you need mental health care but don't think you can afford it, you're not alone. ... Finding Low-Cost Mental Health Care. Resources. Please Note: By clicking a link to any resource listed on this page, you will ... This website contains all the information you need to understand your health care. ...

*  Cut Your Health Care Costs

Robert Hendrick offers solutions to lower medical costs and advocates adopting a consumer mentality regarding health care. ... Cut Your Health Care Costs. Dr. Robert Hendrick offers solutions to lower medical costs and advocates adopting a consumer ...

*  House approves health care cost containment bill

Home , House approves health care cost containment bill. House approves health care cost containment bill. Matt Murphy ... and will place new costs on the system, Widmer said, "The House bill is a setback for health care consumers, the health care ... overhaul of the state's health care system on Tuesday when the House approved a bill aimed at reining in health care costs by ... Winslow said that the cost containment bill would only limit cost growth, but would do nothing to reduce the cost of health ...

*  Health Care Costs Continue to Rise - TheStreet

Health care reform and a weak economy lead to even more out of pocket expenses. ... Health Care Costs Continue to Rise. Health care reform and a weak economy lead to even more out of pocket expenses.. ... health care is more expensive than ever, and prices are rising fast. A new study says that not only are health care costs on ... the cost of health insurance just keeps going up faster than wages.". You can't blame rising costs strictly on health care ...

*  SHRM Research Spotlights Health Care Reform Strategies, Costs

Health Care Reform-Impact of Health Care Coverage and Costs, focuses on future health care coverage benefits and expected costs ... Increased Costs, Cost-Sharing Expected. A large majority of those surveyed (84 percent) expect their health care coverage costs ... For 2018, Expect Steeper Health Plan Premium Increases. Health Premiums Expected to Rise 5.5% in 2018, Driving Cost Management ... Health Care Reform-Challenges and Costs.. The research was conducted in May 2013, using a randomly selected sample of SHRM ...

*  Health Care Hikes Employment Costs | PLANSPONSOR

... cost index, a gauge of what employers pay in wages, salaries and benefits, increased by 1% in the third quarter of this year, ... Health Care Hikes Employment Costs. Benefits October 25, 2001. Health Care Hikes Employment Costs. October 25, 2001(PLANSPONSOR ... The Labor Department attributed the increase in benefit costs to hikes in health insurance premiums and noted that while the ... benefit costs rose by 1.6%, versus the 1.0% rise in the second quarter of the year ...

*  Health care: Hospitals cut costs with 'creepy' robots

Hospital administrators say the rolling electronic porters can help bring down the "absurd" costs of healthcare in America, the ... Hospitals cut costs with 'creepy' robots. Robert Ferris , @RobertoFerris Published 9:49 AM ET Thu, 12 Feb 2015 Updated 2:03 PM ...

*  Why Are Health Care Costs So High?

More and more Americans are becoming concerned with the rising costs of the U.S. health care system. While it is touted as ... According to one expert, health care costs won't slow down without consumers making "trade-offs," a big problem considering few ... The real way to drop medical costs is to look at pragmatic steps emphasizing care, not treatment, and personal responsibility. ... as well as the quality of care across the nation. And, no surprise, even though Americans want major health care reform, they ...

*  Reduce Readmissions to Lower Health Care Costs: ASQ Survey

Reducing hospital readmissions should be the top priority to help health care organizations lower costs, ... HURDLES TO HEALTH CARE COST-CUTTING. But health care organizations face serious hurdles as they try to implement these changes ... OPPORTUNITIES FOR HEALTH CARE BELT-TIGHTENING. When it comes to the best methods for cutting costs and reducing waste, experts ... A model of reimbursement that favors sick-care over health maintenance. 3. Affordable Care Act and its impact on how healthcare ...

*  Bruins left to lament bitter ending - ABC News

Trump fires back at McCain over health care bill Trump calls story 'hoax' as Facebook releases Russian-linked ads to Congress ... "It ended up costing us the series.". Tuukka should not bear the responsibility for this hugely disappointing loss. He put his ...

Pavement life-cycle cost analysis: In September 1998, the United States Department of Transportation (DoT) introduced risk analysis, a probabilistic approach to account for the uncertainty of the inputs of the cost/benefit evaluation of pavement projects, into its decision-making policies. The traditional (deterministic) approach did not consider the variability of inputs.Self-rated health: Self-rated health (also called Self-reported health, Self-assessed health, or perceived health) refers to both a single question such as “in general, would you say that you health is excellent, very good, good, fair, or poor?” and a survey questionnaire in which participants assess different dimensions of their own health.Public Health Act: Public Health Act is a stock short title used in the United Kingdom for legislation relating to public health.Global Health Delivery ProjectHealth policy: Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific health care goals within a society."World Health Organization.Rock 'n' Roll (Status Quo song)Lifestyle management programme: A lifestyle management programme (also referred to as a health promotion programme, health behaviour change programme, lifestyle improvement programme or wellness programme) is an intervention designed to promote positive lifestyle and behaviour change and is widely used in the field of health promotion.Halfdan T. MahlerContraceptive mandate (United States): A contraceptive mandate is a state or federal regulation or law that requires health insurers, or employers that provide their employees with health insurance, to cover some contraceptive costs in their health insurance plans. In 1978, the U.Behavior: Behavior or behaviour (see spelling differences) is the range of actions and [made by individuals, organism]s, [[systems, or artificial entities in conjunction with themselves or their environment, which includes the other systems or organisms around as well as the (inanimate) physical environment. It is the response of the system or organism to various stimuli or inputs, whether [or external], [[conscious or subconscious, overt or covert, and voluntary or involuntary.School health education: School Health Education see also: Health Promotion is the process of transferring health knowledge during a student's school years (K-12). Its uses are in general classified as Public Health Education and School Health Education.Behavior change (public health): Behavior change is a central objective in public health interventions,WHO 2002: World Health Report 2002 - Reducing Risks, Promoting Healthy Life Accessed Feb 2015 http://www.who.Incremental cost-effectiveness ratio: The incremental cost-effectiveness ratio (ICER) is a statistic used in cost-effectiveness analysis to summarise the cost-effectiveness of a health care intervention. It is defined by the difference in cost between two possible interventions, divided by the difference in their effect.Great Lakes Environmental Research Laboratory: right|300px|thumb|Great Lakes Environmental Research Laboratory logo.WHO collaborating centres in occupational health: The WHO collaborating centres in occupational health constitute a network of institutions put in place by the World Health Organization to extend availability of occupational health coverage in both developed and undeveloped countries.Network of WHO Collaborating Centres in occupational health.Aging (scheduling): In Operating systems, Aging is a scheduling technique used to avoid starvation. Fixed priority scheduling is a scheduling discipline, in which tasks queued for utilizing a system resource are assigned a priority each.National Collaborating Centre for Mental Health: The National Collaborating Centre for Mental Health (NCCMH) is one of several centres of the National Institute for Health and Care Excellence (NICE) tasked with developing guidance on the appropriate treatment and care of people with specific conditions within the National Health Service (NHS) in England and Wales. It was established in 2001.Comprehensive Rural Health Project: The Comprehensive Rural Health Project (CRHP) is a non profit, non-governmental organization located in Jamkhed, Ahmednagar District in the state of Maharashtra, India. The organization works with rural communities to provide community-based primary healthcare and improve the general standard of living through a variety of community-led development programs, including Women's Self-Help Groups, Farmers' Clubs, Adolescent Programs and Sanitation and Watershed Development Programs.Women's Health Initiative: The Women's Health Initiative (WHI) was initiated by the U.S.Resource leak: In computer science, a resource leak is a particular type of resource consumption by a computer program where the program does not release resources it has acquired. This condition is normally the result of a bug in a program.European Immunization Week: European Immunization Week (EIW) is an annual regional initiative, coordinated by the World Health Organization Regional Office for Europe (WHO/Europe), to promote immunization against vaccine-preventable diseases. EIW activities are carried out by participating WHO/Europe member states.Society for Education Action and Research in Community Health: Searching}}Healthy community design: Healthy community design is planning and designing communities that make it easier for people to live healthy lives. Healthy community design offers important benefits:Sharon Regional Health System: Sharon Regional Health System is a profit health care service provider based in Sharon, Pennsylvania. Its main hospital is located in Sharon; additionally, the health system operates schools of nursing and radiography; a comprehensive pain management center across the street from its main hospital; clinics in nearby Mercer, Greenville, Hermitage, and Brookfield, Ohio; and Sharon Regional Medical Park in Hermitage.Minati SenNortheast Community Health CentreDenplanMaternal Health Task ForceBasic Occupational Health Services: The Basic Occupational Health Services are an application of the primary health care principles in the sector of occupational health. Primary health care definition can be found in the World Health Organization Alma Ata declaration from the year 1978 as the “essential health care based on practical scientifically sound and socially accepted methods, (…) it is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work (…)”.National Cancer Research Institute: The National Cancer Research Institute (NCRI) is a UK-wide partnership between cancer research funders, which promotes collaboration in cancer research. Its member organizations work together to maximize the value and benefit of cancer research for the benefit of patients and the public.Essence (Electronic Surveillance System for the Early Notification of Community-based Epidemics): Essence is the United States Department of Defense's Electronic Surveillance System for the Early Notification of Community-based Epidemics. Essence's goal is to monitor health data as it becomes available and discover epidemics and similar health concerns before they move out of control.Opinion polling in the Philippine presidential election, 2010: Opinion polling (popularly known as surveys in the Philippines) for the 2010 Philippine presidential election is managed by two major polling firms: Social Weather Stations and Pulse Asia, and several minor polling firms. The polling firms conducted surveys both prior and after the deadline for filing of certificates of candidacies on December 1, 2009.Psychiatric interview: The psychiatric interview refers to the set of tools that a mental health worker (most times a psychiatrist or a psychologist but at times social workers or nurses) uses to complete a psychiatric assessment.Implementation research: Implementation research is the scientific study of methods to promote the uptake of research findings. Often research projects focus on small scale pilot studies or laboratory based experiments, and assume that findings can be generalised to roll out into a practice based domain with few changes.Time-trade-off: Time-Trade-Off (TTO) is a tool used in health economics to help determine the quality of life of a patient or group. The individual will be presented with a set of directions such as:Standard evaluation frameworkIntegrated catchment management: Integrated catchment management is a subset of environmental planning which approaches sustainable resource management from a catchment perspective, in contrast to a piecemeal approach that artificially separates land management from water management.Disease burden: Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity, or other indicators. It is often quantified in terms of quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs), both of which quantify the number of years lost due to disease (YLDs).Open Fuel Standard Coalition: The Open Fuel Standard Coalition is a bipartisan group in the United States actively working for passage of H.R.Poverty trap: A poverty trap is "any self-reinforcing mechanism which causes poverty to persist."Costas Azariadis and John Stachurski, "Poverty Traps," Handbook of Economic Growth, 2005, 326.Health management system: The health management system (HMS) is an evolutionary medicine regulative process proposed by Nicholas Humphrey reprinted fromMental disorder

(1/4244) Development of the physical therapy outpatient satisfaction survey (PTOPS).

BACKGROUND AND PURPOSE: The purposes of this 3-phase study were (1) to identify the underlying components of outpatient satisfaction in physical therapy and (2) to develop a test that would yield reliable and valid measurements of these components. SUBJECTS: Three samples, consisting of 177, 257, and 173 outpatients from 21 facilities, were used in phases 1, 2, and 3, respectively. METHODS AND RESULTS: In phase 1, principal component analyses (PCAs), reliability checks, and correlations with social desirability scales were used to reduce a pool of 98 items to 32 items. These analyses identified a 5-component model of outpatient satisfaction in physical therapy. The phase 2 PCA, with a revised pool of 48 items, indicated that 4 components rather than 5 components represented the best model and resulted in the 34-item Physical Therapy Outpatient Satisfaction Survey (PTOPS). Factor analyses conducted with phase 2 and phase 3 data supported this conclusion and provided evidence for the internal validity of the PTOPS scores. The 4-component scales were labeled "Enhancers," "Detractors," "Location," and "Cost." Responses from subsamples of phase 3 subjects provided evidence for validity of scores in that the PTOPS components of "Enhancers," "Detractors," and "Cost" appeared to differentiate overtly satisfied patients from overtly dissatisfied patients. "Location" and "Enhancer" scores discriminated subjects with excellent attendance at scheduled physical therapy sessions from those with poor attendance. CONCLUSION AND DISCUSSION: In this study, we identified components of outpatient satisfaction in physical therapy and used them to develop a test that would yield valid and reliable measurements of these components.  (+info)

(2/4244) Screening Mammography Program of British Columbia: pattern of use and health care system costs.

BACKGROUND: The use of mammography for screening asymptomatic women has increased dramatically in the past decade. This report describes the changes that have occurred in the use of bilateral mammography in British Columbia since the provincial breast cancer screening program began in 1988. METHODS: Using province-wide databases from both the breast cancer screening program and the provincial health insurance plan in BC, the authors determined the number and costs of bilateral mammography services for women aged 40 years or older between Apr. 1, 1986, and Mar. 31, 1997. Unilateral mammography was excluded because it is used for investigating symptomatic disease and screening abnormalities, and for follow-up of women who have undergone mastectomy for cancer. RESULTS: As the provincial breast cancer screening program expanded from 1 site in 1988 to 23 in 1997, it provided an increasing proportion of the bilateral mammographic examinations carried out each year in BC. In fiscal year 1996/97, 65% of bilateral mammographic examinations were performed through the screening program. The cost per examination within the screening program dropped as volume increased. Thirty percent more bilateral mammography examinations were done in 1996/97 than in 1991/92, but health care system expenditures for these services increased by only 4% during the same period. In calendar year 1996, 21% of new breast cancers were diagnosed as a result of a screening program visit. INTERPRETATION: Substantial increases in health care expenditures have been avoided by shifting bilateral mammography services to the provincial screening program, which has a lower cost per screening visit.  (+info)

(3/4244) The economic burden of asthma: direct and indirect costs in Switzerland.

Asthma mortality increased in Switzerland between 1980 and 1994. This study aimed to assess the economic burden of asthma in this country. Chart reviews were conducted for the last five patients seen for asthma in physician practices in 1996 and 1997. Direct expenditures and indirect costs for asthma-related morbidity were determined. A total of 589 patient charts were completely analysed, including 117 children's charts, obtained from 120 office-based physicians. The annual direct medical costs were CHF 1,778 and the mean annual indirect costs were CHF 1,019 per patient for all patients. The total estimated cost of asthma in Switzerland in 1997 was nearly CHF 1,252 million. Direct medical expenditures approached CHF 762 million, or 61% of the total. In 1997, the indirect costs for asthma were estimated to have exceeded CHF 490 million. Of these costs CHF 123 million (25%) was associated with morbidity and nearly CHF 368 million (75%) was associated with looking after asthmatic patients who had to be cared for at home. This study provides evidence that asthma is a major healthcare cost factor in Switzerland, amounting to approximately CHF 1,200 million per year. The data suggest that cost savings can be achieved by improving primary care for asthma in an ambulatory setting.  (+info)

(4/4244) The cost of obesity in Canada.

BACKGROUND: Almost one-third of adult Canadians are at increased risk of disability, disease and premature death because of being obese. In order to allocate limited health care resources rationally, it is necessary to elucidate the economic burden of obesity. OBJECTIVE: To estimate the direct costs related to the treatment of and research into obesity in Canada in 1997. METHODS: The prevalence of obesity (body mass index of 27 or greater) in Canada was determined using data from the National Population Health Survey, 1994-1995. Ten comorbidities of obesity were identified from the medical literature. A population attributable fraction (PAF) was calculated for each comorbidity with data from large cohort studies to determine the extent to which each comorbidity and its management costs were attributable to obesity. The direct cost of each comorbidity was determined using data from the Canadian Institute of Health Information (for direct expenditure categories) and from Health Canada (for the proportion of expenditure category attributable to the comorbidity). This prevalence-based approach identified the direct costs of hospital care, physician services, services of other health professionals, drugs, other health care and health research. For each comorbidity, the cost attributable to obesity was determined by multiplying the PAF by the total direct cost of the comorbidity. The overall impact of obesity was estimated as the sum of the PAF-weighted costs of treating the comorbidities. A sensitivity analysis was completed on both the estimated costs and the PAFs. RESULTS: The total direct cost of obesity in Canada in 1997 was estimated to be over $1.8 billion. This corresponded to 2.4% of the total health care expenditures for all diseases in Canada in 1997. The sensitivity analysis revealed that the total cost could be as high as $3.5 billion or as low as $829.4 million; this corresponded to 4.6% and 1.1% respectively of the total health care expenditures in 1997. When the contributions of the comorbidities to the total cost were considered, the 3 largest contributors were hypertension ($656.6 million), type 2 diabetes mellitus ($423.2 million) and coronary artery disease ($346.0 million). INTERPRETATION: A considerable proportion of health care dollars is devoted to the treatment and management of obesity-related comorbidities in Canada. Further research into the therapeutic benefits and cost-effectiveness of management strategies for obesity is required. It is anticipated that the prevention and treatment of obesity will have major positive effects on the overall cost of health care.  (+info)

(5/4244) The economic impact of Staphylococcus aureus infection in New York City hospitals.

We modeled estimates of the incidence, deaths, and direct medical costs of Staphylococcus aureus infections in hospitalized patients in the New York City metropolitan area in 1995 by using hospital discharge data collected by the New York State Department of Health and standard sources for the costs of health care. We also examined the relative impact of methicillin-resistant versus -sensitive strains of S. aureus and of community-acquired versus nosocomial infections. S. aureus-associated hospitalizations resulted in approximately twice the length of stay, deaths, and medical costs of typical hospitalizations; methicillin-resistant and -sensitive infections had similar direct medical costs, but resistant infections caused more deaths (21% versus 8%). Community-acquired and nosocomial infections had similar death rates, but community-acquired infections appeared to have increased direct medical costs per patient ($35,300 versus $28,800). The results of our study indicate that reducing the incidence of methicillin-resistant and -sensitive nosocomial infections would reduce the societal costs of S. aureus infection.  (+info)

(6/4244) Mixed signals: public policy and the future of health care R&D.

The incentives facing health care research and development (R&D) are influenced by the ambiguous signals sent by private and public insurance decisions affecting the use of, and payments for, existing technologies. Increasingly, that uncertainty is exacerbated by confusion over technologies' impact on health care costs, how costs are to be measured, and the social difficulty of determining medical "need" for purposes of insurance coverage. R&D executives appear to believe that "major" advances are more likely to win such coverage and thus to be profitable. The products that result, therefore, may make the current policy dilemma of cost containment versus service restriction more acute rather than less so. If the aim of policy is to cut costs, innovative remedies are necessary.  (+info)

(7/4244) Use of resources and costs of palliative care with parenteral fluids and analgesics in the home setting for patients with end-stage cancer.

BACKGROUND: In 1992 a home care technology project was started in which infusion therapy in the home setting was made available for patients with end-stage cancer. Beside aspects of feasibility and quality of life the resource utilization and costs of this transition was studied. PATIENTS AND METHODS: We conducted a cost evaluation study, to determine the actual cost of managing patients with endstage cancer who require parenteral administration of fluid or analgesics in the home setting. A total of 128 patients were prospectively followed, with a detailed analysis of some aspects in a sample of 24 patients. RESULTS: The cost for each patient was found to be between $250.00 and $300.00 per day, half of which are for hospital charges, even with this active home care technology program. One-third of the costs can be attributed to primary health care activities, in particular those of the district nurses. A hypothetical control group (n = 25) was constructed based on current practice and chart review. Patients in this group would have cost around $750.00 per day. With a median treatment period of 16 days this means a saving of $8000.00 per patient. CONCLUSION: Our data suggest that significant savings can be obtained by implementing programs transferring palliative care technology to the home setting.  (+info)

(8/4244) Breast cancer screening by mammography in Norway. Is it cost-effective?

BACKGROUND: Mammography screening is a promising method for improving prognosis in breast cancer. PATIENTS AND METHODS: In this economic analysis, data from the Norwegian Mammography Project (NMP), the National Health Administration (NMA) and the Norwegian Medical Association (NMA) were employed in a model for cost-effectiveness analysis. According to the annual report of the NMP for 1996, 60,147 women aged 50-69 years had been invited to a two-yearly mammographic screening programme 46,329 (77%) had been screened and 337 (0.7%) breast cancers had been revealed. The use of breast conserving surgery (BCS) was in this study estimated raised by 17% due to screening, the breast cancer mortality decreased by 30% and the number of life years saved per prevented breast cancer death was calculated 15 years. RESULTS: The cost per woman screened was calculated 75.4 Pounds, the cost per cancer detected 10.365 Pounds and the cost per life year (LY) saved 8.561 Pounds. A raised frequency of BCS, diagnosis and adjuvant chemotherapy brought two years forward, follow-up costs and costs/savings due to prevented breast cancer deaths were all included in the analysis. A sensitivity analysis documented mammography screening cost-effective in Norway when four to nine years are gained per prevented breast cancer death. CONCLUSION: Mammography screening in Norway looks cost-effective. Time has come to encourage national screening programmes.  (+info)


  • 1996 Benchmarks of Fairness for Health Care Reform - Oxford University Press. (
  • Most U.S. doctors believe that healthcare reform will increase use of public health insurance programs but will not reduce costs, according to results from a survey of 500 physicians by the Deloitte Center for Health Solutions. (
  • In addition, most of the survey respondents said they believe that healthcare reform will hurt their incomes and are pessimistic about the future of the medical profession. (
  • Doctors don't have a rosy view of the future of medicine: seven out of 10 surveyed said they think healthcare reform will make potential doctors reconsider entering the field of medicine. (
  • Healthcare reform is a hot topic right now. (
  • The World at Work and SHRM national conferences this year were full of sessions on healthcare reform. (
  • Most presentations emphasized that healthcare reform is a golden opportunity for HR to rise up as a strategic leader in a company. (
  • Why Is HR Hiding from Healthcare Reform? (
  • But, you have to be prepared to lead the conversations and understand the impact of healthcare reform on your business. (
  • Some of you are already learning what healthcare reform is and what impact it could have on your organization. (
  • The good news is that healthcare reform has helped HR by making employees aware of the value of their total rewards package. (


  • Since radiotherapy and hospitalization were the main total cost drivers, patients at more severe stages presented lower costs, probably because of the reduction in the number of therapeutic options. (


  • In terms of what changes the ACA likely would bring, physicians responded that in addition to increasing enrollment in Medicare and Medicaid, the law will mean that more people will seek care in emergency rooms because there won't be enough primary care physicians to treat newly insured patients. (
  • On the topic of salary, specialists said their pay should be 30% higher than what primary care specialists are paid, but primary care physicians don't think the pay difference should be that much. (

public health

  • and 2) the importance of public health reporting by covered entities to identify threats to the public and individuals. (
  • Accordingly, the rule 1) permits PHI disclosures without a written patient authorization for specified public health purposes to public health authorities legally authorized to collect and receive the information for such purposes, and 2) permits disclosures that are required by state and local public health or other laws. (
  • However, because the Privacy Rule affects the traditional ways PHI is used and exchanged among covered entities (e.g., doctors, hospitals, and health insurers), it can affect public health practice and research in multiple ways. (
  • To prevent misconceptions, understanding the Privacy Rule is important for public health practice. (
  • Also provided are sample letters that might prove useful in clarifying relationships involving public health and the Privacy Rule ( Appendix B ). (
  • A public health authority is broadly defined as including agencies or authorities of the United States, states, territories, political subdivisions of states or territories, American Indian tribes, or an individual or entity acting under a grant of authority from such agencies and responsible for public health matters as part of an official mandate. (
  • Public health authorities include federal public health agencies (e.g. (
  • and anyone performing public health functions under a grant of authority from a public health agency [45 CFR 164. (
  • Public health agencies often conduct their authorized public health activities with other entities by using different mechanisms (e.g., contracts and memoranda or letters of agreement). (
  • These other entities are public health authorities under the Privacy Rule with respect to the activities they conduct under a grant of authority from such a public health agency. (
  • A covered entity may disclose PHI to public health authorities and to these designated entities pursuant to the public health provisions of the Privacy Rule. (
  • The Privacy Rule permits covered entities to disclose PHI, without authorization, to public health authorities or other entities who are legally authorized to receive such reports for the purpose of preventing or controlling disease, injury, or disability. (
  • To protect the health of the public, public health authorities might need to obtain information related to the individuals affected by a disease. (
  • To receive PHI for public health purposes, public health authorities should be prepared to verify their status and identity as public health authorities under the Privacy Rule. (
  • 1 Mental health was a low priority on South Africa's public health agenda, the lack of an action plan being one of the shortcomings. (


  • Medical managers in 49 'designated' hospitals in KwaZulu-Natal (KZN) were surveyed on infrastructure, staffing, administrative requirements and mental health care user case load pertaining to the Act for the month of July 2009. (


  • The South African Mental Health Care Act (the Act) No. 17 of 2002 stipulated that regional and district hospitals be designated to admit, observe and treat mental health care users (MHCUs) for 72 hours before they are transferred to a psychiatric hospital. (
  • Historically, mental health services in KwaZulu-Natal (KZN) had been centred on a few large mental hospitals and stand-alone clinics. (
  • 50 (70.4%) of the district and regional hospitals have been designated to provide mental health services and admit involuntary and assisted MHCUs for 72-hour observations. (


  • As the 2009 council of the European Union conclusions on Alcohol and Health noted , there are a number of reasons to consider reviewing the impact of alcohol on older people in the European Union (EU) and what can be done about it [4, (


  • 3 To ensure adequate access and treatment for mental health care users (MHCUs), human, social and financial resources are necessary. (


  • As part of the European project VINTAGE, a systematic review of scientific literature was undertaken to document the evidence base on the impact of alcohol on the health and well-being of older people, and on effective policies and preventive approaches to face the problem in this steadily increasing segment of the population. (
  • First, much less is known about the health, social and economic impacts of alcohol use in older people compared to younger adults. (
  • Research suggests that older people might be more sensitive to alcohol's negative health effects compared to younger adults, which could mean that more harm results from equivalent amounts of consumption by older people. (
  • Media attention on this healthcare debate helps people be aware of what is at stake. (


  • 4 Internationally, 32% of 191 countries surveyed did not have a specified budget for mental health, 5 and 36% of countries spent less than 1% of their total health budgets on mental health. (
  • 10 In KZN, 0.03% of the total health budget is spent on mental health, a figure that has not increased in the last decade (personal communication, KZN Department of Health). (
  • A total of 85% of respondents said they felt that enrollment in Medicare and Medicaid would increase as a result of the Affordable Care Act (ACA), but just 27% said they thought the law would decrease healthcare costs. (
  • A total of 60% of respondents gave the U.S. healthcare system a grade of "C" or "D" overall, but they were split over whether the ACA is the way to fix the system (about 44% said the law is a good start, while another 44% said it's a step in the wrong direction, and 12% said they weren't sure). (


  • But, if you are an HR professional, you need to get educated and prepare to take the lead on your company's attempt to make sense of healthcare. (
  • Let's make it clear that the 7 percent raise in healthcare costs that the company absorbs, plus a 3 percent base salary raise, is really like an 10 percent raise overall. (


  • When asked about what is the main factor driving up healthcare costs, most doctors pegged "unhealthy lifestyles" of patients as the main culprit, followed by the fear of lawsuits leading to physicians practicing defensive medicine, followed by insurance company costs, hospital costs, and the cost of prescription drugs. (
  • Many workers have had to go without healthcare insurance because they were unemployed or have paid COBRA rates. (


  • The main cost drivers were radiotherapy and hospitalization. (


  • 6 Scarce resources, inequity of distribution and inefficiency of resource use characterise mental health services in low- and middle-income countries. (
  • Petersen expressed concern that de-institutionalisation and comprehensive integrated mental health care in South Africa were hampered by a lack of resources for mental health care as well as the inefficient use of existing mental health resources. (


  • The Mental Health Care Act No. 17 of 2002 (the Act) 8 introduced radical changes. (
  • The changes in healthcare are your opportunity to engage with your senior leaders on something where you're an expert and they need help. (


  • In one of the SHRM sessions I lead on compensation, one of the questions from the audience was, "How do you deal with the fact that your overall salary budget increase amount is 3 percent and healthcare is rising 7 percent? (


  • To describe the costs of treating lung, laryngeal and esophageal cancer among patients with histories of smoking. (