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Biomedical subjects

M M Rogers

Publications and source records attributed to M M Rogers.

9 recordsLinked to original sources
PubMed1999

The Pregnancy Risk Assessment Monitoring System (PRAMS): methods and 1996 response rates from 11 states.

OBJECTIVES: To determine if the Pregnancy Risk Assessment Monitoring System (PRAMS) is a unique and valuable MCH data source and an effective mechanism for states to collect MCH data, and to assess if recent changes in it have improved efficiency and flexibility. METHODS: Each component of the PRAMS methodology is described: sampling and stratification, data collection, questionnaire, and data management and weighting. To assess effectiveness, we calculated response rates, contact rates, cooperation rates, refusal rates, and questionnaire completion rates. Logistic regression was used to examine the relationship between maternal and infant characteristics and the likelihood of response. Four criteria were defined to measure improvement in PRAMS functioning. RESULTS: Overall response rates for the 11 states in 1996 ranged from 66% to 80%. Cooperation rates were high (85-99%), with contact rates somewhat lower (73-87%). Response rates were higher for women who were older, White, married, had more education, were first-time mothers, and had a normal-birthweight infant. In all states, parity and education were the most consistent predictors of response, followed by marital status and race. Between 1988-1990 and 1996-1999, the number of states and areas participating in PRAMS increased from 6 to 23, response rates improved, and the time for a state to start data collection and to obtain a weighted dataset both decreased. CONCLUSIONS: PRAMS is a unique and valuable MCH data source. The mail/telephone methodology used in PRAMS is an effective means of reaching most women who have recently given birth in the 11 states examined; however, some population subgroups are not reached as well as others. The system has become more efficient and flexible over time and more states now participate.

Centers for Disease Control and Prevention, U.S.↗
PubMed1996

Impact of a social support program on teenage prenatal care use and pregnancy outcomes.

PURPOSE: This study evaluated the impact of a resource mothers program (RMP) on prenatal care use, low birth weight (LBW), and preterm birth (PTB). The intervention used paraprofessional women to provide social support to pregnant teenagers through home visiting. METHODS: Data were obtained by linking RMP, health department, and birth certificate data. Outcomes for primiparous teenagers were compared across two main study groups: a RMP group (n = 1,901) and a comparison group from counties in which the program was not offered (n = 4,613). Multiple logistic regression was used to estimate the effects of program participation with simultaneous adjustment for age, race, marital status, and previous pregnancies. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: Resource mothers program teenagers were more likely to initiate prenatal care early (OR = 1.48; CI = 1.32-1.66) and to receive adequate prenatal care (OR = 1.58; CI = 1.40-1.78) than teenagers in the other counties. The program had no significant effect on LBW, but unmarried teenagers in the RMP group were less likely to have a PTB than unmarried teenagers in the other counties with an OR of 0.81 (CI = 0.70-0.95). These findings were supported by analyses using a second comparison group. CONCLUSIONS: Given that PTB contributes heavily to infant mortality, the program's effect on PTB is promising.

Adolescent↗
PubMed1993

Helping physicians cope with RBRVS.

Hospital administrators have long recognized the importance of strong ties with medical staff. Implementation of the resource-based relative value scale (RBRVS) has disrupted the normal practice of physicians and has placed renewed stress upon the hospital-physician relationship. Hospital administrators can use their expertise to help physicians offset revenue losses incurred under this payment reform. Such an approach is logical and will benefit all parties involved, because it will enhance physician-facility relations and augment facility credibility. In this article, RBRVS is examined in terms of its impact on physicians, hospitals, and the relationship between the two. Financial management strategies are identified that can assist physicians to increase practice efficiency and cost containment to remedy potential revenue reductions caused by the implementation of RBRVS.

Fee Schedules↗
PubMed1993

Integrating capital budgeting techniques.

A.J. Hogan, in "Capital Expenditure Planning: The Value of Information to Hospitals," published in 1987 in Hospital and Health Services Administration, illustrated the value of information to the expenditure process. He noted that knowing what your competitors are up to, as well as where your facility stands in the market, can enable all concerned to make better judgments. One of the likely outcomes of good judgments is the efficient use of all resources. Unfortunately, Hogan's model draws on a non-existent computerized regional planning agency with the authority to approve or deny proposals. Integrated strategic financial planning also illustrates the value of information. In this case, information is readily available. The sources are the administrators: finance, accounting, marketing, and planning experts, doctors, nurses, statisticians, and epidemiologists. Each can make a unique contribution to the process, and together they can effectively guide the organization's capital budgeting programs. We have illustrated that there does exist a planning model that can work with the plurality of viewpoints in today's hospitals to produce the "most informed" decisions with known sensitivity to the decision criteria used.

Budgets↗
PubMed1993

The capital expenditure process for the health care supervisor.

Competition for health care capital dollars has increased as third-party and government reimbursement decreases, patient volume decreases, and alternative services increase. Given this rationing situation, it is more important than ever that the health care supervisor carefully document and present a capital expenditure request. This request should outline skillfully the benefits and costs of undertaking a new service or replacing an old asset. A supervisor who can quantify the costs and benefits of a project and utilize one of the four common capital budgeting techniques: payback period, net present value, profitability index, or internal rate of return, will certainly be taking a step in the right direction for ensuring a serious evaluation of his or her proposal. This article attempts to explain this process using both narrative and quantitative examples.

Budgets↗
PubMed1993

Healthcare for the homeless. A public health agency, a business, and a Catholic provider open a clinic.

In some communities, hospital emergency departments are the only places that provide healthcare services to homeless persons. In Dayton, OH, homeless persons have another option--the Samaritan: A Healthcare Clinic for the Homeless. The clinic is a collaborative venture involving the area's public health department, a Fortune 500 business, and a Catholic hospital. In 1991 Dayton's public health department, the Combined Health District (CHD) of Montgomery County, received an anonymous $50,000 donation to provide primary healthcare services to homeless persons. With the goal of generating a number of stakeholders to invest in the community (which would translate into additional volunteers and donations), CHD asked Good Samaritan Hospital, Dayton, if it would become a partner in launching the clinic. Good Samaritan agreed, seeing this as an opportunity to provide a much-needed community service and to fulfill its mission of providing care to the area's needy citizens. In addition, the project was consistent with the hospital's increased focus on primary care. Sponsors of the Samaritan: A Healthcare Clinic for the Homeless anticipate three outcomes resulting from this collaborative effort. First, the cost of healthcare for Dayton's citizens should decrease. Second, providing healthcare services to the homeless enhances the possibility of breaking the cycle of homelessness. Finally, it is critical that healthcare for the homeless become a community focus.

Catholicism↗
PubMedDate not supplied

Translating research into MCH service: comparison of a pilot project and a large-scale resource mothers program.

This study examines the process and effect of translating a pilot research project into a large-scale service program. In a pilot resource mothers program for pregnant teenagers, participants had fewer low birth weight infants than teenagers in the comparison group. In the corresponding large-scale service program, a similarly positive effect on low birth weight was not seen. In an effort to understand how these differences occurred, the evaluation methodologies and key characteristics that describe the background, infrastructure, components, and service providers of the two projects were compared. Important differences between the pilot project and the service program were seen in funding stability, diversity of staff, community versus health department ownership of the program, caseloads, and levels of training and supervision. It seems probable that these differences brought about changes in the intensity and character of the intervention from the pilot to the service program, leading to a reduction of the intervention's efficacy in reducing the number of low birth weight infants. The implications of these findings for researchers and program planners are discussed.

Adolescent↗