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Biomedical subjects

E Capilouto

Publications and source records attributed to E Capilouto.

16 recordsLinked to original sources
PubMed1998

Teaching and maintaining behavior management skills with nursing assistants in a nursing home.

This article describes a nursing staff training program in basic behavior management skills and a formal staff management system to encourage the application of these basic skills on the nursing unit. Behavioral skills training consists of a 5-hour in-service followed by three weeks of on-the-job training to ensure accurate application of behavior management skills. Following training, a staff management system is used to facilitate long-term use of the skills. Components of the staff management system include supervisory monitoring of the nursing assistants (NAs) by licensed practical nurses (LPNs), NA self-monitoring, verbal and written performance feedback, and incentives.

Alabama↗
PubMed1996

Reflections.

Explore the source record for details and available documents.

Academic Medical Centers↗
PubMed1995

Access to neonatal intensive care for low-birthweight infants: the role of maternal characteristics.

OBJECTIVES: This study assessed the impact of mother's race, insurance status, and use of prenatal care on very low birthweight infant delivery in or transfer to hospitals with neonatal intensive care units (ICUs). METHODS: Multivariate analysis of Alabama vital statistics records between 1988 and 1990 for infants weighing 500 to 1499 g was conducted, comparing hospital of birth and maternal and infant transfer status, and controlling for infant birthweight and for maternal pregnancy history and demographic characteristics. RESULTS: With other factors adjusted for, non-White mothers with early prenatal care were more likely than White mothers to deliver their very low birthweight infants in hospitals with neonatal ICUs without transfer. Among the mothers who presented first at hospitals without such facilities, those who had late prenatal care were less likely than those with early care to be transferred to hospitals with neonatal ICUs before delivery. Medicaid coverage increased the likelihood of antenatal transfer for White women. Likelihood of infant transfer was not associated with these maternal characteristics. CONCLUSIONS: Maternal race, prenatal care use, and insurance status may influence the likelihood that very low birthweight infants will have access to neonatal intensive care. Interventions to improve perinatal regionalization should address individual and system barriers to the timely referral of high-risk mothers.

Adolescent↗
PubMed1994

Health care reform: public views of problems and solutions.

Public opinion surveys have found growing discontent with the health care system. In response, major reform legislation has been introduced in Washington and in many statehouses as well. Nonetheless, very few, if any, state-level public opinion surveys examining health care have been conducted in the South. During November of 1991, a statewide survey of 1,250 Alabamians was conducted to collect information on a wide range of health care issues. The survey is perhaps the largest and most complete survey on health care issues ever conducted in a southern state. Major findings of the survey are as follows: (1) Two-thirds of Alabamians believe the health care system needs fundamental change or needs to be completely rebuilt; however, there is little consensus on the shape of this new health care system. (2) Over 50 percent of Alabamians believe that rising health care costs are the most important issue facing the country. Yet, only about one-third support managed-care mechanisms as a means of controlling personal health care costs. (3) Four of ten Alabamians believe access to care is a critical health care issue. Nonetheless, only 16 percent are willing to pay more than $100 in additional annual taxes to guarantee health care for everyone. This survey yields a set of conflicting conclusions. Policy makers and elected officials should be aware of these issues as they attempt to forge health care reform legislation.

Adult↗
PubMed1993

Consequences of alternative programs to cover the uninsured in central southern states.

The lack of health insurance represents a significant barrier to timely, preventive medical services. In addition, certain providers risk financial viability as their uncompensated care burdens worsen. These issues are particularly troublesome in southern states because the population is disproportionately represented by greater numbers of poor uninsured individuals. This study examines the consequences of three alternative proposals to reduce the number of uninsureds in five southern states. Program 1 raises the AFDC income eligibility threshold to the federal poverty level. Program 2 drops Medicaid categorical eligibility requirements in favor of a poverty-level income standard. Program 3 requires employers to insure all employees, and their dependents, who work 25 hours or more per week. Surprisingly, Program 1 produces a modest 16 percent reduction in the uninsured. Programs 2 and 3, however, reduce the uninsured population by 41 and 57 percent, respectively. Nonetheless, these last two programs reach very different income groups. Program 2 captures all the poor uninsureds whereas Program 3 includes 40 percent of this same population. From this analysis it is clear that a combination of these programs would be necessary to effectively cover the uninsured.

Aid to Families with Dependent Children↗
PubMed1993

Can a poor state afford not to expand Medicaid?

Some advocates of the uninsured support expansion of Medicaid programs, while others say that expansions are simply unaffordable, especially in poor states. State-level analyses of the costs and consequences of these expansion programs are infrequent. This study evaluates three programs to expand eligibility for Alabama's Medicaid program. The first two programs would raise the Aid to Families with Dependent Children (AFDC) eligibility threshold to 50 and 100 percent, respectively, of the federal poverty level. The third program, currently not available to the states without a federal waiver, would drop all categorical eligibility requirements and base eligibility solely on whether income is below the federal poverty level. Only 10.7 and 18.3 percent, respectively, of Alabama's uninsured would gain health care coverage under the first two programs. The third program would increase the proportion of Alabamians with health coverage to nearly 50 percent. For all of these programs, front-end state costs would be largely countered by federal funding and offsets, such as reductions in uncompensated hospital care and savings realized by former uninsureds from reductions in out-of-pocket expenditures for health services.

Adolescent↗
PubMed1992

How restrictive are Medicaid's categorical eligibility requirements? A look at nine Southern states.

Medicaid, as an existing program with federal matching dollars, remains attractive to state legislatures looking for a means to address the problems of the uninsured. However, the extent to which states can maximize coverage of the poor uninsured under Medicaid's present eligibility criteria is unknown. Surprisingly, this study of nine Southern states shows a modest 14.8% reduction in the uninsured population when the AFDC income eligibility threshold is moved up to the federal poverty level. This threshold is twice as high as the national mean and three times greater than the mean income eligibility threshold for the nine states that were the focus of this study. In sharp contrast, elimination of the categorical eligibility requirements under the same poverty-level threshold reduces the uninsured population by nearly 40%.

Eligibility Determination↗
PubMed1991

Access to appropriate dental care.

For this review, publications were considered in the context of a broad definition of access to dental care, including the ability to gain available, appropriate services as determined by personal, economic, cultural, geographic, and other factors. None of the studies fully integrated the multiple dimensions explicit in this definition. Nonetheless, it is clear that certain segments (ie, the poor and members of racial and ethnic minoritites) of the US population use dental services less frequently. When these people do use the system, they are less likely to receive preventive services and more likely to have a dental emergency. The availability of services to poor populations through Medicaid programs is compromised due to low provider participation, which is attributed to dissatisfaction with reimbursement rates and limitations in the breadth of covered services. Concerning the appropriateness of care, it is shown that practices with homogenous patient populations vary widely in the rates of the types of services provided.

Aged↗
PubMed1988

The dentist's role in access to dental care by Medicaid recipients.

This study uses a decision analytic approach to assess the dentist's role in access to care by Medicaid recipients. The question of whether a private dentist, when given the choice, will schedule a Medicaid or non-Medicaid patient is examined. The model considers factors frequently reported to influence dentist's decisions over whether to accept Medicaid recipients into their practices. Factors include reimbursement rates, probability of broken appointments, and likelihood of reimbursement. The model permits calculation of the expected benefits in dollars for comparable treatment of Medicaid and non-Medicaid patients. Under a variety of conditions, it is shown that the strategy to schedule a non-Medicaid patient dominates alternative strategies in which Medicaid recipients are scheduled. Policy implications of these results are discussed.

Costs and Cost Analysis↗
PubMedDate not supplied

Effects of tobacco excise taxes on the use of smokeless tobacco products in the USA.

Data from the September 1985 Current Population Survey are used to estimate the effects of tobacco excise taxes and state laws restricting smoking in public places on the likelihood of current use of cigarettes or smokeless tobacco (ST) products (moist snuff or chewing tobacco) among males in the USA. The results indicate that higher ST excise tax rates are associated with a reduced probability of ST use, whereas higher cigarette excise tax rates are associated with an increased probability of ST use, holding other factors constant. State laws restricting smoking have no apparent effect on ST use.

Adolescent↗