Biomedical subjects

S Penner

Publications and source records attributed to S Penner.

6 recordsLinked to original sources

PubMed1997

The role of private-for-profit managed behavioral health in the public sector.

Managed behavioral health, once largely confined to private sector employees, has been growing rapidly in the public sector. Throughout the country, behavioral health services, particularly for Medicaid enrollees, are coming under the management of private-for-profit firms. The authors discuss these developments, and the controversies that have come about as a result. Several public/private models of managed behavioral health services are identified.

California↗

PubMed1993

A specialized mental health plan for persons with severe mental illness under managed competition.

Many concerns have been raised about the special problems of providing care for severely mentally ill persons in a reformed health care system based on managed competition. The authors describe what will likely be basic features of the reformed system and discuss potential problems in serving this population. The authors recommend the development of special mental health maintenance organizations (MHMOs) that would serve only persons with severe mental illness. The MHMO would emphasize case management in the community and would provide a fixed point of responsibility for clinical care of these patients. Two methods of reimbursing MHMOs are proposed. Each region's health insurance purchasing cooperative (HIPC) could reimburse the MHMO on a capitated risk-adjusted basis. Alternatively, HIPCs could require the general health plan to operate or contract for MHMOs. In each case, the HIPC would provide quality-of-care oversight and assign a team to act as a gatekeeper for referrals to the MHMO.

Competitive Medical Plans↗

PubMed1990

Excess insured health care costs from tobacco-using employees in a large group plan.

Health insurance costs from tobacco have been estimated from tobacco's contribution to annual or lifetime costs for heart disease, emphysema, and selected cancers. Because health plans seldom identify tobacco users, there are few published studies that compare users with nonusers. This study gathered data on paid claims from a large group's indemnity plan (4108 users, 16,723 nonusers) from Jan 1 to Nov 30, 1988. Tobacco users had more admissions per 1000 (124 v 76), days per 1000 (800 v 381), a longer average length of stay (6.47 v 5.03 days), higher average outpatient payments ($122 v $75), and higher average insured payments ($1,145 v $762). Tobacco use is correlated with other high-risk behaviors; thus, cost and utilization differences are not solely due to its effects. Nevertheless, tobacco users add to employer costs for health insurance as well as for absenteeism, workers' compensation, and life insurance. Employers may use these data to reduce costs by not hiring tobacco users, adding surcharges for their health insurance, and strongly encouraging cessation. Issues of equity are discussed in terms of coerciveness and intrusiveness.

Costs and Cost Analysis↗

PubMed1984

Application of theory of signal detection to dichotic listening.

Listener performance during dichotic listening to CV nonsense syllables was assessed with a Yes/No target-monitoring task that provides both hit and false alarm information. The ear advantage was described by a metric, P(C)maxRE - P(C)maxLE, that is relatively insensitive to a listener's criterion or bias toward "yes" or "no" responses. One half of the listeners in two experiments had a significant right-ear advantage. The potential influence of listener criterion on measures of the ear advantage in conventional dichotic listening experiments is discussed.

Adult↗

PubMed1978

Biochemical characteristics of Haemophilus influenzae in relationship to source of isolation and antibiotic resistance.

Based on a limited number of biochemical properties, a system for biotyping Haemophilus influenzae (M. Kilian, Acta Pathol. Microbiol, Scand. Sect. B82:835-842, 1976) was used to analyze the relationship of biotype to source of infection and antibiotic resistance for 600 clinical strains. The distribution of biotypes from bacteremic patients was significantly different (P less than 0.001) from the distribution of biotypes from nonbacteremic patients. Although there appeared to be a correlation between biotype and source of isolation, no single biotype correlated with a specific clinical syndrome in bacteremic patients. The frequency of resistance to antibiotics (ampicillin, tetracycline, chloramphenicol, and kanamycin), which was known to be at least in part plasmid mediated, was determined. Of the 600 isolates, 43 were resistant to at least one antibiotic (30 were ampicillin resistant, 11 were tetracycline resistant, 1 was ampicillin-tetracycline resistant, and 1 was tetracycline-chloramphenicol resistant). Of these 43 resistant isolates, 42 were either biotype I or II. This distribution of biotypes among antibiotic-resustant isolates was significantly different from the overall distribution of biotypes (P is less than 0.001).

Adolescent↗

PubMedDate not supplied

Population-based guidelines for performance measurement: a preliminary report.

This paper describes the development of--and early efforts to validate--guidelines that indicate average amounts of service expected to be used by a population of patients with a given disorder who are served by a comprehensive mental health system. These guidelines address expected service use by individuals in 55 diagnostic groups. The purpose of these guidelines is to provide a gauge for evaluating the amounts of service being delivered by managed care organizations. Three population-based guidelines (for attention-deficit/hyperactivity disorder, major depressive disorder, and schizophrenia) are compared to actual amounts of service delivered to enrollees in large behavioral health care systems.

Community Health Planning↗