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At least 343 records · Page 19Linked to original sources
PubMed1988

Comparison of methods of analysis using data of the panel study of the Federal Institute for Population Research (BIB).

The author compares methods of analysis using data from a panel study of the Federal Republic of Germany's Institute for Population Research. "This does not only involve a comparison of the methods as such, but above all also a comparison of the results (of these methods), of their presentation and of the possibilities of interpreting them. The three programmes selected for this paper represent methods for...so-called multivariate analysis, in particular for the analysis of non-metric data as they are included in the panel study...." Data are for a sample of 1,868 women interviewed at least twice and concern women's educational status and the qualities of motherhood.

Developed Countries↗
PubMed1984

Health Maintenance Organizations and state DRG hospital cost control programs: the need for federal preemption.

The growth of Health Maintenance Organizations (HMOs) as alternatives to the conventional health care system is the result of HMOs' financial competitiveness and their ability to provide efficient health care without wasteful and costly medical procedures. An HMO's goal is to minimize the cost of providing responsible medical care. As a result, HMOs attempt to limit the length of stay of a patient in a hospital by providing alternatives to hospital care. They achieve a competitive advantage by utilizing less expensive methods of treatment. The emergence of diagnostically related group (DRG) regulatory systems threaten the viability of HMOs by eliminating their competitive advantage. State-adopted DRG systems require hospitals to charge a fixed rate to all patients with similar diagnoses. This eliminates the advantage an HMO might gain by reducing a patient's length of stay. The Author argues that since HMOs are federally supported, they should be exempt from any DRG system implemented by a state. Further, the Author argues that while federal law ostensibly eliminates the conflict between HMOs and the DRG systems, HMOs are still restrained from free negotiations with hospitals. Accordingly, the Author contends that courts should apply federal statutes that encourage HMOs, preempt state laws, and thus allow HMOs to negotiate freely with hospitals regarding the rates of payment for patients.

Costs and Cost Analysis↗
PubMed1992

Programs of safety surveillance and control of fishery products.

In the United States, fishery product safety at the federal level falls primarily under the authority of the Food and Drug Administration. However, other federal agencies play an important role. The Environmental Protection Agency is responsible for setting and recommending pesticide limits in seafood, and the National Marine Fisheries Service operates a voluntary inspection program. The Centers for Disease Control is responsible for the collection and evaluation of data characterizing the source of seafood-borne illness. Individual states also play a dominant role in the control of seafood-borne risk because of the important differences in consumption and contaminant levels across regions of the country. State public health, environmental protection, and resource management agencies have developed programs designed to mitigate that risk. Because of the complication and variability of the fishery industry, an effective safety system can be developed based on partnership among federal and state agencies, in which state governments retain the dominant role and the federal government develops and updates guidance programs and provides oversight. The international community has developed practices and protocols impacting the regulation of seafood safety in the United States. In view of developing trade agreements, the international community should address the criteria of setting equivalent contaminant levels and consider the option of establishing import contract criteria for fishery products.

Animals↗
PubMed1985

Medicare and Medicaid program; withholding the federal share of payments to recover Medicare or Medicaid overpayments--HCFA. Final rule.

These final regulations facilitate HCFA's recovery of Medicare and Medicaid overpayments. Some institutions or persons that participate (or have participated) in both programs have received a Medicare or Medicaid overpayment which cannot be recovered under that program. Under expanded statutory authority (Section 905 of Pub. L. 96-499 and section 2104 of Pub. L. 97-35), HCFA has authority to withhold the Federal share of Medicaid payments in order to recover Medicare overpayments and to withhold Medicare payments to recover Medicaid overpayments.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1983

New federalism and health policy.

The making of health policy in the United States is a complex process that involves the private and public sectors, including multiple levels of government. Five characteristics of the policy process are identified, which establish the means by which policies are formulated and which affect the nature of the policies that emerge. These characteristics include (1) the relationship of the government to the private sector; (2) the distribution of authority and responsibility within a federal system of government; (3) the relationship between policy formation and implementation; (4) a pluralistic ideology as the basis of politics; and (5) incrementalism as the strategy for reform. The article focuses on the impact on health policy of the distribution of authority and responsibility within the federal system, particularly the impact of new federalism policies as they emerged during the past decade. The effects of dual federalism, cooperative federalism, creative federalism, and new federalism are examined in relation to health policies. The article concludes with an examination of the challenge to long-established values and health policies posed by new federalism.

Government↗
PubMed2005

Introduction of direct-to-consumer advertising of prescription drugs in Canada: an opinion survey on regulatory policy.

BACKGROUND: Canada is strongly influenced by US cross-border direct-to-consumer advertising (DTCA) and has held consultations to discuss introduction of DTCA since 1996. This article describes a survey of Canadian drug policy experts carried out in 2001, during one such legislative review. The survey results are compared to more recent DTCA policy developments. METHODS: We recruited key informants on pharmaceutical policy to complete a faxed questionnaire that queried their opinions on DTCA information quality, effects on drug and health care use, and regulatory issues. Respondents were asked about the evidence they had used to back their opinions. Analysis was descriptive. RESULTS AND DISCUSSION: Of 79 identified potential participants, 60 (76%) participated, 40% of whom were from federal and provincial government; 3% were private insurers; 18%, 15%, and 8% were from health professional groups, consumer groups, and patient groups, respectively; 8% and 7% were from pharmaceutical and advertising industries, respectively. Opinions were highly polarized on the effects of DTCA on drug and health care use. Advertising and pharmaceutical industry respondents were generally positive, public sector, health professional and consumer groups generally negative. Over 80% believed DTCA leads to higher private and public drug costs and more frequent physician visits. Fewer judged billboards or television to be appropriate media for DTCA than magazines or the Internet, and most believed that children and adolescents should not be targeted. CONCLUSION: Given the polarization observed within this survey, we examined how DTCA policy has evolved in Canada since 2001. The federal government has legislative authority over DTCA, but bears few of the additional costs potentially incurred through policy change. These fall to the provinces, which provide an eroding patchwork of public coverage for prescription drugs in the face of rapidly increasing costs. No new federal legislation has been tabled since 2001. However, considerable shifts in administrative policy have occurred, all supportive of expanded advertising. Thus, the law continues to be restrictive but its application less so.

Advertising↗
PubMed1984

Hill-Burton program; medical facility construction and modernization; federal right of recovery and calculation of interest charges--HRSA. Notice.

On July 18, 1984, the President signed the Deficit Reduction Act of 1984. The law contains several provisions affecting medical facilities which are assisted under the Hill-Burton Program and which transfer ownership or control or cease to be used as medical facility. These provisions include authority to waive the Federal right of recovery and methods of calculating interest when recovery is not waived.

Financing, Government↗
PubMed2005

The impact of a brief tobacco-use cessation intervention in public health dental clinics.

BACKGROUND: Public health dental clinic patients use tobacco at disproportionately high rates. The purpose of this study was to evaluate a tobacco-use cessation program delivered via public health dental practitioners. METHODS: Two public health dental clinics participated in this quasiexperimental design study. First, all patients in one clinic who used tobacco (n = 178) received usual care. Next, the authors trained all practitioners to conduct a tobacco-use assessment and provide a brief cessation intervention. Subsequently, all patients in both clinics who used tobacco (N = 190) received the intervention. All enrolled patients had an income at or below the federal poverty level. The authors conducted follow-up assessments at six weeks and three and six months after enrollment. RESULTS: Differences in self-reported quitting by condition between participants in the two groups were significant across all endpoints. Patients in the intervention group were more likely to quit than those receiving usual care (15.5 versus 4.3 percent) and after 12 months (18.8 versus 4.6 percent). Controlling for enrollment differences between patients in the two groups (age, race/ethnicity, time to first cigarette after waking), the authors found that differences between groups were significant for quitting at three months (P < .05; odds ratio [OR] = 4.85; 95 percent confidence interval [CI] = 1.20, 19.60), and six months (P < . 01; OR = 5.25; 95 percent CI = 1.35, 20.36). CONCLUSIONS: The results of this study suggest the viability and effectiveness of delivering a tobacco intervention to low-income smokers via public dental practitioners. A randomized clinical trial is warranted. CLINICAL IMPLICATIONS: The potential reach of public health dental clinics is great. Because of the high percentage of tobacco-using patients in these clinics, the public health impact of a program such as the one reported here would be significant.

Adult↗
PubMed1994

Pesticide registration in the United States: overview and new directions.

This paper provides an overview of EPA's pesticide registration program and a discussion of recent activities. The registration of pesticides is the responsibility of the Office of Pesticide Programs, an office of the U.S. Environmental Protection Agency (EPA). EPA's pesticide regulatory authority derives from the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA) and the Federal Food, Drug and Cosmetic Act (FFDCA). FIFRA governs the registration or licensing of pesticide products including insecticides, herbicides, fungicides, rodenticides, disinfectants, plant growth regulators, and biological agents. FFDCA governs pesticide residue levels in food and feed crops. FIFRA gives EPA authority for registering pesticides to ensure that when used according to label directions, they will not pose unreasonable adverse effects to the environment. FIFRA requires EPA to balance the risks and benefits of a pesticide in deciding whether or not to grant a pesticide registration. In a typical year EPA reviews over 5000 registration submissions that vary from routine label amendments to the review of a new active ingredient. About 20 applications for registration of a new active ingredient are received each year. Registration for a new active ingredient requires a significant investment in time and money by the registrant. Data development for a major agricultural chemical can cost 10 million dollars or more and take several years to complete. EPA is embarking on a number of new initiatives in the registration program designed to reduce the use of chemical pesticides, limit the regulatory burden on lower risk and reduced risk products, and streamline the review process generally.

Agriculture↗
PubMed2006

Prevention and monitoring: tasks of the federal states in Germany.

Antimicrobial drugs in livestock farming are not used for therapeutic purposes, only, but also to conceal deficiencies in animal husbandry and management. Use of antibiotic drugs should be restricted by specific regulations, since some veterinarians seem to have an interest in increasing their income by treatment of diseases instead of performing health management. The above-mentioned requirements have been fulfilled by section 56 a (2) of German Pharmaceuticals Act, which regulates the usage and dispensary of pharmaceuticals according to the current standards of veterinary science. These current standards of veterinary science are described by common scientific positions and specific opinions of certain relevant committees. There is no single institutional committee available at present. Therefore, members of the German Federal Chamber of Veterinarians and members of the Committees of the German Federal States, which are responsible for the compliance with regulations and acts, defined a common position on current standards of veterinary science, concerning correct treatment with antibiotic drugs within a Working Group of the Federal States for Veterinary Pharmaceuticals (former ArgeVet, now AG TAM), the so-called "antibiotic guidelines". These antibiotic guidelines should help veterinary practitioners to use and prescribe those substances only, which are accurate for treatment of the diagnosed disease concerning the used class of antibiotic, amount, and duration of usage. The responsible authorities have to proof the prudent and proper use of antibiotic drugs in the range of their surveillance. The surveillance by the authorities is complicated, since the burden of proof of improper usage of antimicrobial drugs lies within the responsibility of the authorities. Prevention can primarily be conducted by informing the responsible veterinarians of the proper forms of treatment and by strict regulations for registration of pharmacologically active substances. Every additional label use and the usage of existing old registrations may undermine the surveillance of improper usage of pharmacologically active substances in livestock animals. The responsible authorities of the German Federal States, which may vary in their organization among the states, have to administrate the following duties: (1) Surveillance of manufacture and distribution of pharmaceuticals. (2) Inspection and control of proper usage of pharmaceuticals. Thus, the surveillance of distribution of veterinary pharmaceuticals has a broader range of requirements in comparison to surveillance of human pharmaceuticals. It is necessary to record and to control the amount of used drugs as well as their ways of distribution to perform a sufficient surveillance. The legal authorization was created by the 11th Amendment of the German Pharmaceuticals Act, but these specifications are still too imprecise to support the surveillance in the current process. Hence, the actual surveillance process is more focussed on usage and dispensary of pharmaceuticals and less focussed on manufacture and distribution. Therefore, the current surveillance with the aim to limit unnecessary usage of pharmacologically active substances according to the current legislation is limited. It is necessary to change legislation with regard to control of distribution of pharmaceuticals as well as integration of self-control of livestock owners for a sustainable increase of efficacy.

Animal Husbandry↗
PubMed2001

Welfare reform and "ineligibles": issue of constitutionality and recent court rulings.

In 1996 welfare legislation made lawful immigrants, with a few exemptions, categorically ineligible for most forms of public assistance. This legislation has led affected immigrants and their advocacy groups to file lawsuits to challenge the constitutionality of the Personal Responsibility and Work Opportunity Reconciliation Act. This article reviews recent court rulings that have upheld the act and examines court decisions in light of two constitutional principles (the Equal Protection and Supremacy clauses), which traditionally have been applied to the issue of aliens' eligibility for welfare benefits. The author finds inconsistent outcomes between federal and state legislation in the judicial review process. To resolve this inconsistency, the author suggests several policy changes in the distribution of welfare benefits concerning eligibility of lawful immigrants. The implications for social work practice are discussed.

Civil Rights↗