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At least 847 records · Page 47Linked to original sources
PubMed1996

Managed competition with prefunding: the solution for long-term care?

Managed competition with prefunding could be a useful approach to long-term care. One version, described here, has two main components: First, people would be required to save over their working lives to cover a portion of the expected cost of a minimum required level of long-term-care insurance. Second, people would begin purchasing long-term-care insurance around the time of retirement from one of a number of competing insurers, under a system of managed competition. Potentially large social gains would arise from improving insurance arrangements, distributing long-term-care costs more equitably across and within generations, and eliminating many of the distortions inherent in the current Medicaid program.

Humans↗
PubMedDate not supplied

[A mortality study of recipients of compensation for asbestosis in Italy (1980-1990)].

The cause-specific mortality experience of a cohort inclusive of all subjects compensated for asbestosis in Italy (altogether 3417 persons--2776 men and 641 women), was studied from 31.12.1979 through 30.6.1990. Forty-eight subjects, corresponding to 1.4% of the cohort, were lost to follow-up, while it was not possible to ascertain the cause of death of 78 subjects, corresponding to 6.9% of the deceased. Observed mortality was compared with expected figures, derived from the Italian population mortality rates. The study showed significant increases in mortality from all causes (SMR 153, 1134 obs), respiratory disease (SMR 388, 218 obs), all neoplasms (SMR 192, 438 obs), namely lung (SMR 289, 190 obs), pleura (SMR 2745, 34 obs), peritoneum (SMR 1372, 14 obs), intestine and rectum (SMR 186, 36 obs) and ovary (SMR 545, 6 obs). A significantly decreased mortality was observed for cardiovascular disease (SMR 85, 266 obs), diabetes (SMR 37, 8 obs) and disease of the nervous system (SMR 29, 3 obs). The increase in neoplasms of lung, pleura and peritoneum was significant in both genders, while the increase in intestinal neoplasms was significant among women but not among men. Exposure in the manufacture of asbestos-cement products, the shipbuilding and textile industries accounted for most of the observed mortality excess.

Asbestosis↗
PubMed1997

Managed health care and orofacial pain.

Dental and insurance communities must find common ground to manage orofacial pain effectively. By screening patients with orofacial pain for earlier referral, the incidence of improper medical utilization and the potential for chronic pain may be reduced.

Cost Control↗
PubMed1997

Just say no.

Explore the source record for details and available documents.

Fees and Charges↗
PubMedDate not supplied

Medicare spending for elderly beneficiaries who need long-term care.

To better understand how elderly people with long-term care needs might be affected by Medicare's greater reliance on risk plans, we examine Medicare spending for this population using data from the Medicare Current Beneficiary Survey. Medicare spending for elderly people with functional limitations is substantially greater than for other beneficiaries, but highly variable. Medicare spends more, however, for community residents with moderate to severe functional limitations than for nursing home residents with similar degrees of limitation. These results raise concerns about the incentives of Medicare risk plans in caring for enrollees with long-term care needs.

Activities of Daily Living↗
PubMed1997

Digit-sucking: a review of the literature, clinical observations and treatment recommendations.

Prolonged digit-sucking habits can have a negative impact on dental, speech, physical and emotional development. Children can be helped to eliminate their sucking habits quickly, without coercion, and in a positive way. Admittedly, most of my data is based purely on clinical observation. However, clinical observation is the basis for classical scientific investigation. I welcome this investigation; it is long overdue. Much of the literature available to parents appears to take a rather cavalier attitude with regard to the dental consequences of sucking habits. Parents are frequently left with the impression that no harm is done to the teeth. This perspective is based on the assumption that most children stop the sucking behavior before permanent teeth erupt into the mouth. Therefore, any dental malocclusion in the primary teeth will often be transitional or will spontaneously self-correct. However, as demonstrated by Kelly, et al (1973), millions of children do not discontinue their sucking habits before permanent teeth erupt. In addition, stress levels in today's world are probably significantly greater than when this study was done. Because stress is a powerful stimulus for the sucking activity, it is highly probable that if a similar study were done today, it would produce a substantially greater number of individuals with prolonged sucking habits. The active pursuit of insurance benefits for the Certified Orofacial Myologist providing therapy for the elimination of these habits will be germane to prevention. Research is needed to accomplish this goal including: investigation of the incidence of prolonged digit-sucking habits; the impact of these habits on the entire stomatognathic system, speech development and emotional health; efficacy of treatment (including psychological response) both through the utilization of habit appliances and motivational therapy. The Certified Orofacial Myologist provides many valuable therapeutic programs to enhance dental and speech development. In the words of our president, Marge Snow at the 25th Anniversary of the founding of The International Association of Orofacial Myology, "we are morally and ethically challenged with making this treatment available to everyone". Roberta Pierce (1988) in her paper, "Treatment For The Young Child" wrote, "The overall goal is to create as normal an environment as possible so as to facilitate normal growth and development." The early elimination of digit-sucking habits is one of the most important therapeutic services offered by the Certified Orofacial Myologist because it provides the most benefit toward prevention and the well-being of the whole person. Treatment after the pathology is fully developed is invasive, not cost-effective and does not provide as good a clinical result. Little mouths deserve a big chance to grow healthy and straight.

Child↗
PubMed1998

Child care beliefs and practices of Hispanic mothers.

Even though Hispanics are the fastest growing minority in the United States, they face difficulties in accessing the health care system because of perceived health care needs, culture, income, language and lack of health insurance benefits. As a result, children of Hispanic parents suffering from such ailments as viral and bacterial infections, upper respiratory infections and gastroenteritis may not be treated at all or may be treated in the home. It is unclear as to how much a role traditional, cultural practices continue to play in their health care and how long medical treatment may be delayed. The purposes of this exploratory pilot study were to examine the types of cultural health care provided by Mexican-American mothers to their ill children at home, the extent of the child's illness and the time frame involved that determined the mother's need to seek medical attention. The mothers' use of lay healers and/or folk remedies prior to seeking medical attention for their child was also investigated. Implications and recommendations for culturally-relevant and culturally-competent care, and sensitive health education are presented.

Adult↗