As of April 2002, KP Georgia provided care for 252 children and adults with SCD, or 0.04% of the membership. King JS. Health Affairs 21(3):169–181. Health Management Associates and Kaiser Commission on Medicaid and the Uninsured. The result of this interplay is that many governmental public health agencies have found themselves in a strained relationship with managed care organizations: on the one hand, encouraging their active partnership in an intersectoral public health system and, on the other, competing with them for revenues (Lumpkin et al., 1998). The health care delivery system has been criticized for its “culture of blame” in which culpability for failure has been attributed to the human elements of the system: People make errors; therefore people must change their behavior to reduce errors. Even the congressional authorizing committees for these activities are separate. Accessed October 6, 2002. The budget for fiscal year 2002. Those without health insurance or without insurance for particular types of services face serious, sometimes insurmountable barriers to necessary and appropriate care. Incomplete reporting may reflect a lack of understanding by some health care providers of the role of the governmental public health agencies in infectious disease monitoring and control. Cooper-Patrick L, Gallo JJ, Powe NR, Steinwachs DM, Eaton WW, Ford DE. Journal of the American Medical Association 265(3):374–379. The burgeoning knowledge base will require different educational approaches to use the continuously expanding evidence base, with an emphasis on continuing education and lifetime learning. Although the trend toward inclusion of clinical preventive services is positive, such benefits are still limited in scope and are not well correlated with evidence regarding the effectiveness of individual services. Health Affairs 19:65–75. You're looking at OpenBook, NAP.edu's online reading room since 1999. Summary of Findings: Privatization of Public Hospitals. Washington, DC: NACCHO. Baltimore, MD: Department of Health and Human Services. Increasing their numbers and assuring their viability can, to some degree, improve the availability of care. 1999. However, this valuable tool has not been well supported and, as noted earlier, suffers from issues of lack of timeliness and incomplete reporting, as well as complex or unclear reporting procedures and limited feedback from governmental public health agencies on how data are used (Baxter et al., 2000; Stagg Elliott, 2002). Mexican-American adults and children are more likely to have untreated decayed teeth than any other, BOX 5–7 Oral Health as a Component of Total Health. Leigh WA, Lillie-Blanton M, Martinez RM, Collins KS. systemic state or local deficiencies (e.g., a lack of mechanisms for follow-up, issues related to managed care contracting, and confusing program requirements) to barriers at the personal level (e.g., transportation and language) (GAO, 2001a; Strasz et al., 2002). This could significantly undermine the current. Physicians are proving more aggressive and successful in their negotiations with plans to decrease constraints, and to date, most employers have been willing to accept the higher costs that result. For individuals with Medicare, the following services are covered by Medicare Part B: Bone mass measurements for people at risk of losing bone mass, Colorectal cancer screening (people age 50 and older), Diabetes services (coverage of self-management training and glucose monitoring supplies) for people with diabetes, Mammogram screening (women age 40 and older), Prostate cancer screening (men age 50 and older), Vaccinations (flu, pneumococcal pneumonia, hepatitis B), Outpatient nutrition counseling by registered dietitians for patients with diabetes and some types of kidney disease. Low-income Hispanic children and adults are less likely to be eligible for Medicaid than other groups, so even the limited Medicaid benefits are unlikely to be available to them. Washington, DC: National Health Law Program. Unmet health needs of uninsured adults in the United States. Solanki G, Schauffler HH, Miller LS. For example, health care organiza. Archives of General Psychiatry 58:55–61. The American Hospital Association (AHA, 2001a) reports that from 1994 to 1999, the number of emergency departments in the nation decreased by 8.1 percent (see Table 5–3). Bloche MG. 2001. In the United States, more than 18 million people who use alcohol and nearly 5 million who use illicit drugs need substance abuse treatment (SAMHSA, 2001). Emergency department overcrowding: an action plan. The relentless focus on controlling costs over the past decade has squeezed a great deal of excess capacity out of the health care system, particularly the hospital system. American College of Clinical Engineering, in Clinical Engineering Handbook, 2004. However, payment systems are critical to encourage and sustain these network initiatives, and current reimbursement policies in public and private insurance are not designed to support population-focused care in a noncapitated system. Results from the National Comorbidity Survey. 2000; Young et al., 2000). Good. Surveys conducted over the past two decades show a consistent underestimation of the number of uninsured and of trends in insurance coverage over time (Blendon et al., 2001). Some studies indicate that, on average, minority physicians treat four to five times more minority patients than do white physicians, and studies of recent minority medical. Health-care costs jump at CalPERS: big premium increase may signal trend. The committee is concerned that the specific types of care that are important for population health—clinical preventive services, mental health care, treatment for substance abuse, and oral health care—are less available because of the current organization and financing of health care services. July. Los Angeles, CA: UCLA Center for Health Policy Research and KPMG Peat Marwick. For information technology to transform the health sector as it has banking and other forms of commerce that depend on the accurate, secure exchange of large amounts of information, action must be taken at the national level to develop the National Health Information Infrastructure (NHII) (NRC, 2000). AHA Workforce Survey Results. Washington, DC: The National Academies Press. generally weak. The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. About 40 million people (more than one in five) ages 18 to 64 are estimated to have a single mental disorder of any severity or both a mental and an addictive disorder in a given year (Regier et al., 1993; Kessler et al., 1994). Inequality in America: the contribution of health centers in reducing and eliminating disparities in access to care. Public health reporting flaws spell trouble: doctors complain about requirements that appear to lack follow-through. Key success factors include the development of shared vision; development of organizational governance models that reduce barriers to coordinated action; and developing capabilities to harness the energy and character of the large, diverse AHC enterprise to address substantial and largely unfamiliar organizational challenges. performed for self-limiting illnesses like diarrhea, there may be delays in recognizing a disease outbreak. Simplistic models of adverse events involving medical technology have been based on a dichotomy between “device failure” and “user error.” However, more sophisticated taxonomies have been developed that recognize numerous sources of error with the potential for complex interactions among them (ECRI, 1991). AHCPR (Agency for Health Care Policy and Research). SOURCE: Adapted from Olson et al. Chicago, IL: Hospital Research and Education Trust, American Hospital Association. Under the guidance of an external review panel, HRET and the Voluntary Hospital Association of America (VHA) Health Foundation reviewed the experiences of recipients of the Foster G. McGaw Prize3 from 1986 to 1998 and VHA Community Health Improvement Leadership Awards from 1996 to 1998.
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