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Biomedical subjects

P V Stange

Publications and source records attributed to P V Stange.

7 recordsLinked to original sources
PubMed2000

Use of standing orders programs to increase adult vaccination rates.

The Advisory Committee on Immunization Practices recognizes the need for evidence-based policy to improve the delivery and receipt of immunization services recommended for adults (i.e., persons aged > or = 18 years). Two recent, systematic reviews of the health services research literature recommended standing orders programs as an effective organizational intervention to improve vaccination coverage rates among adults. This report briefly reviews the evidence on the effectiveness of standing orders programs, describes standards for program implementation, and recommends initiating these programs to improve immunization coverage in several traditional and nontraditional settings.

Adult↗
PubMed1998

Tuberculosis control in a changing health care system: model contract specifications for managed care organizations.

Increasingly, patients with tuberculosis are receiving clinical care in managed care organizations as a result of enrollment in Medicaid or Medicare, or coverage under privately purchased insurance policies or employee benefit plans. This represents a change from the system that has been in place for decades, where the clinical care and public health functions concerning treatment and control of tuberculosis occurred primarily in local health departments. The separation of individual patient care from the public health aspects of tuberculosis control has created challenges for managed care administrators, medical providers, and public health officials. To assist in the integration of the goals of managed care and public health with respect to the prevention and control of tuberculosis, we developed a set of model contract specifications for use by purchasers of managed care and by managed care organizations concerning the management of patients with tuberculosis and other related public health issues. These specifications can assist health officials in continuing their leadership roles by ensuring that managed care contracts address public health needs.

Contract Services↗
PubMed1998

Private sector health care organizations and essential public health services: potential effects on the practice of local public health.

This article focuses on the activities of eight private health care organizations undertaking public health and prevention activities. Few activities were motivated by or integrated into the business or operating strategy of the organizations and poor integration with the business strategy puts the long-term future of these activities in jeopardy. The lack of integrated activity can be attributed to: slow pace of managed care implementation; low penetrance of full-risk capitated reimbursement; and fragmented, competitive health care markets. Purchaser pressure, quality assurance requirements, community benefit standards, and government mandates are among the levers available to encourage such activities by the private sector.

Delivery of Health Care↗
PubMed1978

Predicting treatment costs and life expectancy for end-stage renal disease.

To estimate the cumulative 10-year direct medical costs and life expectancy associated with different methods of treatment for end-stage renal disease, we assessed predictively three treatment transition options. It is predicted that if 1000 patients shift from facility to home dialysis for each of 10 years, life expectancy of the cohort will not be reduced, but there will be a reduction of $241 million in total costs. The same number shifting from facility dialysis to cadaveric transplantation are predicted to have a $279 to $330 million reduction in total costs but a reduction of 7 to 17 per cent in life expectancy. Shifting from home dialysis to transplantation is predicted to reduce total costs by +103 to $142 million, and life expectancy by 10 to 20 per cent. As new program policies for treatment of end-stage renal disease are developed, their effect on both costs and life expectancy needs to be considered.

Cadaver↗