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PubMed1992

Patients comment on video-recorded consultations--the "good" GP and the "bad".

The aim of this study was to describe and understand patients' positive and negative experiences of General Practitioners (GPs). Forty-six consultations were videotaped in four primary health care centres in Sweden. Afterwards the patients commented on the recorded consultations. The comments were categorized and analyzed using an exploratory qualitative approach. An image of the "good" GP emerged that had two major characteristics: that of being a caring human; an individual who listens, understands, and is concerned. At the same time, the good GP acts like an ordinary person and treats the patient as an equal. The personal relationship with the GP also influenced the choice and course of medical interventions. For the patient, the manner in which an intervention is seen is linked to whether the GPs treats the patient with respect or not. A typical experience of a "bad" GP was that the GP appeared unreachable as a person. An example is when the patient feels that the GP was not taking his or her symptoms seriously. Another characteristic of the bad GP is failure to communicate to the patient his or her standpoint on issues raised during consultations.

Adult↗

PubMed2005

Homosexuality in TV situation comedies: characters and verbal comments.

A content analysis was conducted on 22 television situation comedies in order to determine the incidence of homosexual characters, their demographics (sex, age and race/ethnicity), and whether they verbally comment about sexual orientation. One episode of each program appearing in early October 2000 was video recorded and analyzed for its contents by trained coders. Only 2% of the 125 central characters were homosexual; thus, homosexuality is significantly under-represented in programs that adolescents and young adults watch compared to actual prevalence rates of homosexuality in North America (10-13%). All the homosexual characters were male and in the 20-35-year-old age group; this indicates that homosexual adolescent viewers have no peer role models with whom to identify. Homosexual characters made significantly more comments about sexual orientation than heterosexual characters. This suggests that television writers/producers present sexual orientation as a significant theme in the lives of homosexual characters.

Adolescent↗

PubMed1989

Constancy of individual exponents for inspired lung volume: a comment on Harver (1987).

In this paper we made two brief commentaries on Harver's (1987) experiment. The first comment is an observation on the growing area of respiratory psychophysics for which we prefer the name Behavioral Physiology. In the second comment it is suggested that the stable individual differences in the exponent of the psychophysical power law reported by Harver may be an artifact of the psychophysical method employed: category production.

Arousal↗

PubMed1991

Comparison of patients' and doctors' comments on video-recorded consultations.

To compare patient and doctor views of the consultation process, 46 consultations were videotaped in four primary health care centres. Twelve general practitioners and 46 patients participated. Later, the patients and the doctors (on different occasions) spontaneously commented on the recorded consultations. Qualitative methods were used for the analysis. The patients seemed to have a perspective oriented towards relationships, while the doctors were more oriented towards medical tasks. There was an association of power between the parties that implies a relationship of mutual dependency. The doctors depended on the patients to obtain the information they needed about the symptoms to be able to fulfil their professional task. The patients depended on the doctor to get their important needs satisfied; everything from a particular medicine to being treated as a human being. The major differences in the comments by the patients and the doctors reflected their different roles and the asymmetry in the relationship.

Adult↗

PubMed1990

Medicare program, fiscal year 1990; mid-year changes to the inpatient hospital prospective payment system--HCFA. Final rule with comment period.

This final rule with comment implements several provisions of the Omnibus Budget Reconciliation Act of 1989 that affect Medicare payment for inpatient hospitals and that, in general, take effect on April 1, 1990. This final rule also responds to comments received concerning the changes we made in 1989 in implementing provisions of the Medicare Catastrophic Coverage Act of 1988 concerning adjustments applicable to prospective payment hospitals and to the target amounts of hospitals and units excluded from the prospective payment system due to the elimination of the day limitation on covered inpatient hospital days. We are making additional changes in these provisions to take into account the Medicare Catastrophic Coverage Repeal Act of 1989, and changes in the law made by the Family Support Act of 1988, which clarified the criteria for adjusting target amounts and changed the date for implementing that provision.

Hospitals↗

PubMed1990

Medicare program; model fee schedule for physicians' services--HCFA. Notice with comment period.

This notice announces and invites comments on a model fee schedule for physicians' services that is required by section 6102 of the Omnibus Budget Reconciliation Act of 1989. The model fee schedule provides very preliminary estimates for some, but not all, services to illustrate the effects of the Medicare physician payment fee schedule that will begin to take effect in January 1992. In accordance with section 6102(f)(11), we are making the model fee schedule available to the public through publication of this notice. Any comments received from the public will be considered carefully, but not specifically addressed in a subsequent proposed rule.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1991

Medicaid program; state share of financial participation--HCFA. Withdrawal of interim final rule with comment.

On September 12, 1991, we published in the Federal Register an interim final rule with comment entitled "Medicaid Program; State Share of Financial Participation" (56 FR 46380). It dealt with the use of State taxes and provider donations as the State share of the costs of the Medicaid program. On October 31, 1991, we published a clarifying interim final rule with comment (56 FR 56132), which withdrew and cancelled the September 12, 1991, interim final rule. After further consideration, the Secretary has also decided to withdraw the October 31, 1991 interim final rule.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1994

Medicare program; uniform electronic cost reporting system for hospitals--HCFA. Final rule with comment period.

This final rule with comment period implements the provisions of section 4007(b) of the Omnibus Budget Reconciliation Act of 1987, as amended by section 411(b)(6) of the Medicare Catastrophic Coverage Act of 1988, which require the Secretary to place into effect a standardized electronic cost reporting system for all hospitals under the Medicare program. Under this final rule with comment period, all hospitals are required to submit their cost reports, for hospital cost reporting periods beginning on or after October 1, 1989, in a uniform electronic format. The Secretary may grant a delay or a waiver of this requirement where implementation could result in financial hardship for a hospital.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1995

Inappropriate patient sexual behaviour in physiotherapy practice: a qualitative analysis of questionnaire comments.

It has been reported that over 80% of physiotherapists and physiotherapy students have experienced inappropriate patient sexual behaviour (IPSB). This paper reports the results of a qualitative analysis of written comments respondents made to four open-ended questions that were part of a survey on IPSB. Quantitative analyses of the responses to the remainder of the questions have been reported previously. The objectives of this study were to determine the content required for educational programs and to explore the strategies and suggestions respondents have made relevant to IPSB. A questionnaire was sent to 118 physiotherapists and 87 physiotherapy students. Completed questionnaires were returned by over 70% in each group. The questions asking for comments on how respondents have learned to deal with IPSB and what information about IPSB is important for in-service and undergraduate education were coded into themes to characterize the responses. Respondents described their experiences with IPSB, identified the knowledge areas that they consider to be important, emphasized the importance of prevention, getting and giving support, the specific ways that they have learned to cope, and the skills to handle IPSB. This emphasized the importance of a comprehensive educational strategy to respond to IPSB.

Adult↗

PubMed1995

AICPA (American Institute of Certified Public Accountants) seeks comments on proposed accounting changes.

The American Institute of Certified Public Accountants has exposed for public comment a revised version of its accounting and auditing guide--Audits of Providers of Health Care Services. The guide covers accounting, auditing, and financial reporting in healthcare organizations and is being revised primarily to address the changing healthcare environment and changes mandated by the Financial Accounting Standards Board. This article provides an overview of some of the more significant proposed changes. The comment period ends August 14, 1995.

Accounting↗

PubMed1997

Medicare program; schedule of limits on home health agency costs per visit for cost reporting periods beginning on or after July 1, 1997--HCFA. Notice with comment period.

This notice sets fort a revised schedule of limits on home health agency costs that may be paid under the Medicare program for cost reporting periods beginning on or after July 1, 1997. These limits replace the per visit limits that were set forth in our July 1, 1996 notice with comment period (61 FR 34344). This notice also responds to comments on the July 1, 1996 notice.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1997

Content and format of labeling for human prescription drugs; pregnancy labeling; public hearing--FDA. Notice of public hearing; request for comments.

The Food and Drug Administration (FDA) is announcing a public hearing regarding requirements for the content and format of the pregnancy subsection of labeling for human prescription drugs. The public hearing will focus on the requirement that each drug product be classified in one of five pregnancy categories intended to aid clinicians and patients with decisions about drug therapy. Public comments and FDA's prelimintary review of the pregnancy category designations for marketed drugs suggest that the categories may be misleading and confusing, may not accurately reflect reproductive and developmental risk, and may be used inappropriately by clinicians in making decisions about drug therapy in pregnant women and women of childbearing potential and also in making decisions about how to respond to inadvertent fetal exposure. The hearing is intended to elicit comments on the practical utility, effects, and limitations of the current pregnancy labeling categories in order to help the agency identify the range of problems associated with the categories and to identify and evaluate options that might address identified problems, and to hear the views of groups most affected.

Drug Labeling↗

PubMed1992

Specific list for categorization of laboratory test systems, assays and examinations by complexity--PHS. Notice with comment period.

The Clinical Laboratory Improvement Amendments of 1988, Public Law 100-578, requires that the Secretary provide for the categorization of specific laboratory test systems, assays and examinations by level of complexity. 42 CFR 493.17, published in the Federal Register on February 28, 1992, established criteria for such categorization. It is the Department's intention to complete the categorization of all currently available clinical laboratory test systems, assays and examinations prior to the effective date of 42 CFR part 493. This notice announces the fourth of a series of lists containing specific clinical laboratory test systems, assays and examinations, categorized by complexity. This notice also includes deletions and corrections to the list of test systems, assays and examinations published on February 28, 1992. After publication and close of comment period on the published partial lists, a complete list of all laboratory test systems, assays and examinations, categorized by complexity, and responses to public comments received on the partial lists will be published in the form of a compilation of these Notices. Any clinical laboratory test system, assay or examination that is not on the compilation will be considered high complexity, until categorized otherwise as provided under 42 CFR 493.17. After publication of the compilation, applications will be taken to categorize (or re-categorize) other laboratory test systems, assays and examinations following the procedures delineated in 42 CFR 493.17(d). After the effective date of 42 CFR part 493, notices will be published periodically in the Federal Register to announce any additional test system, assay or examination that has been categorized (or re-categorized) during the preceding interval.

Clinical Laboratory Techniques↗

PubMed1995

CLIA program; categorization of tests and personnel modifications--HCFA. Final rule with comment period.

In this rule we are responding to some of the comments on categorization of tests and personnel requirements received in response to rules published on February 28, 1992 and January 19, 1993. (In a future rule, we will be responding to the remaining comments.) We are revising our regulations to: Allow dentists and midlevel practitioners to perform tests in the "physician-performed" microscopy (PPM) subcategory of moderate complexity procedures (we now call the subcategory "provider-performed"); include three additional tests in PPM; and expand provisions relating to general supervisor and high complexity testing personnel.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1998

Medicare program; schedule of limits on home health agency costs per visit for cost reporting periods beginning on or after October 1, 1997--HCFA. Notice with comment period.

This notice sets forth a revised schedule of limits on home health agency costs that may be paid under the Medicare program for cost reporting periods beginning on or after October 1, 1997. These limits replace the per visit limits that were set forth in our July 1, 1996 notice with comment period (61 FR 34344) and supersede those set forth in our July 1, 1997 notice with comment period (61 FR 35608). This notice also provides, in accordance with the Balanced Budget Act of 1997, that there be no changes in the home health per visit limits for cost reporting periods beginning on or after July 1, 1997 and before October 1, 1997 (that is, the cost limits set forth in our July 1, 1996 notice will apply to cost reporting periods beginning during this time period); that the establishment of the cost per visit limitations for cost reporting periods beginning on or after October 1, 1997 be based on 105 percent of the median of the labor-related and nonlabor per visit costs for freestanding home health agencies; that there be no updates in the home health costs limits (including no adjustments for changes in the wage index or other updates) for cost reporting periods beginning on or after July 1, 1994 and before July 1, 1996; and the wage index value that is applied to the labor portion of the per visit limitations be based on the geographic area in which the home health service is furnished.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1998

Medicare and Medicaid programs; surety bond and capitalization requirements for home health agencies--HCFA. Final rule with comment period.

The Balanced Budget Act of 1997-(BBA '97) requires each home health agency (HHA) to secure a surety bond in order to participate in the Medicare and Medicaid programs. This requirement applies to all participating Medicare and Medicaid HHAs, regardless of the date their participation began. This final rule with comment period requires that each HHA participating in Medicare must obtain from an acceptable authorized Surety a surety bond that is the greater of $50,000 or 15 percent of the annual amount paid to the HHA by the Medicare program, as reflected in the HHA's most recently accepted cost report. The BBA '97 also requires that provider agreements be amended to incorporate the surety bond requirement; this rule deems such agreements to be amended accordingly. The BBA '97 prohibits payment to a State for home health services under Medicaid unless the HHA has furnished the State with a surety bond that meets Medicare requirements. This final rule with comment period requires that, in order to participate in Medicaid, each HHA must obtain from an acceptable authorized Surety, a surety bond that is the greater of $50,000 or 15 percent of the annual Medicaid payments made to the HHA by the Medicaid agency for home health services for which Federal Financial Participation (FFP) is available. In addition to the surety bond requirement, an HHA entering the Medicare or Medicaid program on or after January 1, 1998 must demonstrate that it actually has available sufficient capital to start and operate the HHA for the first 3 months. Undercapitalized providers represent a threat to the quality of patient care.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1998

Medicare program; schedule of per-beneficiary limitations on home health agency costs for cost reporting periods beginning on or after October 1, 1997--HCFA. Final rule with comment period.

This final rule with comment period sets forth, in accordance with section 4602 of the Balanced Budget Act of 1997, a new schedule of limitations on home health agency costs that may be paid under the Medicare program for cost reporting periods beginning on or after October 1, 1997. These limitations are in addition to the per-visit limitations that were set forth in our January 2, 1998 notice with comment period.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1998

Federal universal service support mechanisms--FCC. Proposed rule; request for comments.

In this document, the Commission seeks comment on the Report and Proposed Plan of Reorganization (Plan) filed on July 1, 1998 by the Universal Service Administrative Company (USAC), the Schools and Libraries Corporation (SLC), and the Rural Health Care Corporation (RHCC). The Plan proposes a revised adminstrative structure of the federal universal service support mechanisms. RHCC filed a Separate Statement of the Rural Health Care Corporation and Request for Three Changes in the Plan, dissenting from certain provisions of the proposed Plan. In this document, the Commission also seeks comment on other issues regarding the administration of the federal universal service support mechanisms, including processes for Commission review of actions by USAC, SLC, and RHCC.

Decision Making, Organizational↗