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PubMed1987

Epidemiologic programs for computers and calculators. Inferences on odds ratios, relative risks, and risk differences based on standard regression programs.

Statistical analyses of the joint effects of several factors (covariates) on the risk of disease, death, or other dichotomous outcomes, are frequently based on a model that relates the effect of the covariates to some function of the probability of the outcome. The odds ratio, relative risk, and the difference in risks are among the simplest candidates for the outcome function. Each can be specified as a special case of the generalized linear model, but their use has been limited to researchers with access to specialized computer programs that are not yet generally available in standard computer packages. The purpose of this communication is to describe how to implement the maximum likelihood estimation procedures and hypothesis testing associated with the generalized linear model using any computer program that can perform weighted least squares analyses. The procedure is applied specifically to models for relative risks, risk differences, and odds ratios. The techniques are illustrated with SAS and SPSSx programs for data sets previously presented.

Computers↗

PubMedDate not supplied

A school reentry program for burned children. Part I: Development and implementation of a school reentry program.

Sustaining a burn injury is a devastating and painful experience. After acute concerns have been dealt with, continued support of the child and family is important in achieving a smooth return to normal activities. Reports from burned patients for whom physical therapy was a concern identified a need for physical therapy involvement in school reentry to facilitate a resumption of normal school routine. Physical therapy involvement in school reentry has been successful and rewarding with a reasonable commitment of manpower. Utilization of personnel in the administrative structure of state and local school systems promoted the acceptance of the program by local school personnel. Although this program is designed to meet the needs of burned children, the goals of the school reentry program may meet similar needs of children with other chronic illnesses.

Adolescent↗

PubMed1986

Dissemination of community health promotion programs: the Fargo-Moorhead Heart Health Program.

Dissemination often is the neglected phase of the development and distribution cycle. While attention has focused on developing and testing new health education and health promotion programs, relatively little effort has been placed on studying how the programs can be disseminated. This paper reviews the dissemination process, identifies factors critical to successful dissemination, uses examples from a community-based heart disease prevention study to illustrate how health promotion programs can be disseminated across a community, and suggests ways these methods might be applied to a community-based approach to adolescent drug use prevention.

Adolescent↗

PubMed1991

Who is served by programs for the homeless? Admission to a domiciliary care program for homeless veterans.

Demographic and clinical data are presented on 4,138 veterans assessed in the 20-site Department of Veterans Affairs (VA) Domiciliary Care for Homeless Veterans program during its first year of operation. More than two-thirds of the veterans who were screened had been hospitalized in VA medical centers during the year before assessment, and 34 percent were hospitalized at the time of assessment. Compared with veterans who were not admitted for residential treatment, veterans who were admitted were more likely to be previously involved in mental health treatment, literally homeless rather than at risk for homelessness, and without public financial support. Specialized service programs for the homeless such as the VA domiciliary care program may also be called on to play a broader role in the discharge and rehabilitative efforts of public mental health service systems.

Adult↗

PubMed1980

Effectiveness of a cephalosporin education program--a pharmacy education program.

In October, 1977, a cephalosporin drug-use review and an educational program were initiated to maximize savings in the pharmacy budget at UCSF and to revise the formulatory to include only one parenteral cephalosporin. The results of the drug-use review were presented to the Pharmacy and Therapeutics Committee where our proposal for an education campaign to encourage appropriate dosing of cefazolin was approved. An explanatory document comparing cephalosporin costs and equivalency was developed for hospital-wide distribution. Pharmacy staffs were informed of program objectives to coordinate education efforts. Physician education was undertaken via document and personal contact with pharmacy personnel. A drug-use review one month after institution of the cephalosporin education program showed marked changes in physician prescribing habits, with greater impact on services where pharmacists were members of the medical rounding team. A change to appropriate dosage prescribing of cefazolin resulted in significant cost savings to the pharmacy budget. These findings resulted in formulary revision to cefazolin as the single cephalosporin available at UCSF. Because cefazolin is available from more than one manufacturer, we were able to obtain a lower bid price the following year, thus realizing an additional cost savings.

California↗

PubMed1990

Attendance at health promotion programs: baseline predictors and program outcomes.

As part of a family cardiovascular health promotion project, 111 Mexican-American and 95 Anglo-American families with fifth- or sixth-grade children were assigned to either a primary prevention program involving 18 sessions or to a control condition. This article evaluates predictors of attendance at the year long sequence of sessions in the intervention group. In addition it considers the relationship between attendance and program outcomes. Low baseline scores on physical activity and cardiovascular fitness measures were associated with higher attendance for both children and adults. High initial health knowledge and self-motivation were also associated with attendance. Multiple regression analysis showed that adult attendance was significantly predicted by a model including completion of a three-day food record, low exercise, higher socioeconomic status, family adaptability, and self-motivation. Attendance was correlated with greater knowledge gains and larger reductions in blood pressure. The results indicate that motivated families who are in greater need of conditioning attended more sessions in a health promotion program.

Adult↗

PubMed1979

Program evaluation research: an experimental cost-effectiveness analysis of an armed robbery intervention program.

An armed robbery alarm system was implemented in 48 different stores in two separate geographical areas for 6 months and 12 months, respectively. The alarms were placed in the two separate areas at different times and all alarms were eventually removed. Thus, multiple baseline and reversal strategies were used to evaluate program impact. A device planted in a cash drawer was triggered whenever "bait" money was removed from the drawer sending an alarm signal directly to police cars and headquarters. On-scene apprehensions of armed robbers within target stores were greatly increased even though the armed robbery systems did not deter robbery incidents nor influence the court disposition of the cases. There was also no crime deterrence, crime displacement, or increased apprehensions in either the immediate neighborhoods of target stores or on a city-wide basis. The cost effectiveness of the program was calculated to be poor even though the program is being maintained because of the absence of an alternative robbery apprehension technology.

Cost-Benefit Analysis↗

PubMed1988

Differences in psychological need hierarchy between program completers and dropouts from a drug abuse treatment program.

Psychological need patterns among 116 drug addicts in treatment were measured with the Adjective Checklist. Compared to program completers, program dropouts had higher needs for autonomy and aggression and lower needs for deference, nurturance, and affiliation. This personality style may form the basis of dropping out, among certain types of addicts in certain types of programs, when faced with situational, environmental, or interactional stress. Results also suggest that we may be able to identify a personality pattern at risk for premature termination before the person experiences the impulse to leave.

Adult↗

PubMed1988

A comparison of motor performance of preschoolers enrolled in mental health programs and non-mental health programs.

Recognizing that the etiologies of some major mental illnesses may be in the physical domain, this study described and compared the motor performance of 27 preschool children enrolled in mental health programs with 27 children enrolled in Project Head Start, a non-mental health program. The two groups were matched for age, race, and sex. The Gross and Fine Motor scales of the Peabody Developmental Motor Scales were administered to all subjects. On both measures the children enrolled in mental health programs scored significantly lower than the children enrolled in Project Head Start. In addition their scores were more variable. The results of this study support other findings suggesting that developmental delays may be characteristic of children with emotional disturbances.

Child, Preschool↗

PubMed1990

Medicaid program; Medicaid eligibility quality control (MEQC) program requirements--HCFA. Final rule with comment period.

This rule revises the regulations governing the Medicaid eligibility quality control (MEQC) program to include more specific program requirements and to establish new timeframes for completing and reporting MEQC case findings to HCFA. The rule also establishes a performance-based threshold for States to meet before HCFA will consider good faith waiver requests of disallowance of Federal financial participation (FEP) in erroneous Medicaid payments and provides more definitive criteria for evaluating States' good faith efforts to meet the national standard error rate. In addition, the rule makes several technical changes and provides that a State may rebut its projected error rate only when it can present evidence that its projected error rate was based on erroneous data. These revisions will strengthen the basic MEQC program and provide flexibility and incentives to States to produce accurate Medicaid eligibility determinations.

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

PubMed1991

Medicaid program: Medicaid eligibility quality control program--HCFA. Response to comments on final rule.

This document responds to public comments received by the Department on a final rule issued on May 31, 1990, relating to the Department's decision not to publish regulations on the basis of the results of congressionally mandated studies of the quality control systems for the Aid to Families with Dependent Children (AFDC) program and the Medicaid program. The purpose of the studies, which were required by the Consolidated Omnibus Budget Reconciliation Act of 1985, was to examine how best to operate quality control systems in order to obtain information which would allow program managers to improve the quality of administration and provide reasonable data on which to base withholding Federal matching payments for excessive levels of erroneous State payments.

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

PubMed1992

Medicare program; recognition of the Community Health Accreditation Program standards for home care organizations--HCFA. Final notice.

This final notice recognizes accreditation by the Community Health Accreditation Program (CHAP), a subsidiary of the National League for Nursing (NLN), for home health agencies (HHAs) that wish to participate in the Medicare Program. As a result of this recognition, HHAs accredited by CHAP are deemed to meet the Medicare conditions of participation for HHAs to the extent described in this notice. This final notice sets forth certain specific requirements with which CHAP must comply to maintain Medicare recognition of its HHA accreditation program.

Accreditation↗

PubMed1992

LPTP's (Laboratory Proficiency Testing Program) educational assistance program (EAP)--a review.

The Educational Assistance Program (EAP) of the Laboratory Proficiency Testing Program (LPTP) in Ontario, Canada, provides at-the-bench in-service education to the technological staff in smaller, remote or rural hospital laboratories. This service is provided to laboratories which have either been identified by LPTP as experiencing problems or on direct request. The tutorials are conducted by experienced volunteer technologists. LPTP carries out mandatory testing and proficiency evaluation in Ontario. Funded by the Ministry of Health of Ontario, EAP is offered voluntarily and without charge as part of LPTP's educational component of external quality assessment. Preliminary post-tutorial proficiency testing results show improved performance and recipient evaluation forms express an enthusiastic response. Both support continuation of this unique program.

Clinical Competence↗

PubMed1993

Medicare and state health care programs: fraud and abuse; amendments to OIG exclusion and CMP authorities resulting from the Medicare and Medicaid Patient and Program Protection Act--Office of Inspector General (OIG), HHS. Final rule.

This document amends a technical error that appeared in the final rule, which amends the OIG exclusion and CMP authorities, published on January 29, 1992 designed to implement section 2 of the Medicare and Medicaid Patient and Program Protection Act, along with other conforming amendments. The final rule is designed to protect program beneficiaries from unfit health care practitioners, and otherwise improve the anti-fraud provisions of the Department's Medicare and State health care programs.

Fraud↗

PubMed1993

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); specialized treatment services; nonavailability statements; peer review organization program; supplemental care--DoD. Final rule.

This final rule: establishes a Specialized Treatment Services Program, under which CHAMPUS beneficiaries in need of certain highly specialized medical care will be referred to specially designated national or regional, military or civilian treatment facilities; revises a number of procedures applicable to the CHAMPUS Peer Review Organization program; and expands reliance on CHAMPUS payment rules and procedures for purposes of the supplemental care program, which applies to services provided by civilian providers to active duty members and certain other patients referred by military providers.

Economics, Medical↗

PubMed1994

Child support enforcement program: paternity establishment and revision of child support enforcement program and audit regulations--Office of Child Support Enforcement. Final rule.

This final rule contains provisions regarding both paternity establishment and the audit. The paternity establishment provisions implement the requirements of section 13721 of the Omnibus Budget Reconciliation Act of 1993 (OBRA '93) signed by the President on August 10, 1993, which amends title IV-D of the Social Security Act (the Act). These provisions require States to adopt procedures for a simple civil process for the voluntary acknowledgement of paternity, including early paternity establishment programs in hospitals. For paternity cases that remain contested, the statutory provisions require States to adopt a variety of procedures designed to streamline the paternity establishment process. These include the use of default orders, a presumption of paternity based on genetic test results, conditions for admission of genetic test results as evidence, and expedited decision-making processes for paternity cases in which title IV-D services are being provided. In addition, this final regulation amends the Child Support Enforcement program regulations governing the audit of State Child Support Enforcement (IV-D) programs and the imposition of financial penalties for failure to substantially comply with the requirements of title IV-D of the Act. This regulation specifies how audits will evaluate State compliance with the requirements set forth in title IV-D of the Act and Federal regulations, including requirements resulting from the Family Support Act of 1988 and section 13721 of OBRA '93. This final regulation also redefines substantial compliance to place greater focus on performance and streamlines Part 305 by removing unnecessary sections.

Child Welfare↗

PubMed1982

Refugee resettlement program and Cuban/Haitian entrant program: cash and medical assistance policies. Social Security Administration. Interim final rule.

This interim final regulation amends the refugee resettlement program regulations (45 CFR Part 400) and establishes new policies on cash and medical assistance available to refugees and Cuban and Haitian entrants who are ineligible for Aid to Families with Dependent Children (AFDC), Supplemental Security Income (SSI), adult assistance (OAA, AB, APTD, and AABD) in the Territories and medicaid. The Refugee Resettlement Program (RRP) provides Federal reimbursement to States for 100 percent of the costs of cash and medical assistance provided, during the first 36 months after entry into the United States, to such refugees in accordance with applicable program rules and requirements and the administrative costs of providing such assistance. Cash assistance provided to such refugees under the RRP is termed "refugee cash assistance" (RCA); and medical assistance provided to such refugees under the RRP is termed "refugee medical assistance" (RMA). This regulation permits 100 percent Federal reimbursement for RCA and RMA for an eligible refugee for the first 18 months that a refugee is in the United States. For a refugee who has been in the U.S. more than 18 months but less than 36 months, the regulation permits a State, at its option, to seek RRP reimbursement for the cost of General Assistance (GA) provided to such a refugee.

Cuba↗

PubMed1998

Medicare program; recognition of the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. for ambulatory surgical centers program-HCFA. Final notice.

This notice announces the approval of the American Association for the Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF) as an accreditation organization acknowledged by the Medicare program. We have found that AAAASF's standards for ambulatory surgical centers (ASCs) meet or exceed those established by the Medicare program. ASCs accredited by AAAASF will receive deemed status under the Medicare program.

Accreditation↗