SEARCH · PubMed Health

Results for “Policy--changes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources

PubMed1990

Public opinion on alcohol policies.

We conducted a survey of a probability sample of adult residents in the State of Michigan, assessed public support for various alcohol and drinking-driving policy changes, examined how opinions on various policies clustered, and compared Michigan results with national surveys on these issues. Results showed high levels of public support for raising alcohol excise taxes (82%), prohibiting concurrent sales of alcohol and gasoline (74%), administratively suspending drivers licenses of those over the legal alcohol limit (67%), limiting the numbers of alcohol outlets via government regulation (63%), and lowering the legal alcohol limit for drivers to .05 g/dl (55%). Support for these policies was found across all income and education categories, but was significantly lower among frequent heavy drinkers. Policies with lower levels of public support include liability of commercial servers and social hosts, and stricter limits on hours of alcohol sales. Results are clearly relevant to current policy debates, and point to the need for further research on how opinions concerning alcohol policies are interrelated.

Adolescent↗

PubMed1990

Provincial origin of first-time writers of the Canadian Dental Aptitude Test.

A brief summary of the current status of the Canadian Dental Aptitude Test (CDAT) is presented. The number of first-time writers of the CDAT is reported by the province of their preference as designated by the candidate on the test application form. Anomalies in the numbers taking the test are discussed and relationships with other provincial and regional parameters developed. It is clear that the effect of the policy change at the University of Toronto, where the CDAT is no longer required for admissions purposes, has had a major effect on the numbers taking the test and the information available about the demographics, quality and size of the Canadian dental school applicant pool. The regional and provincial differences highlighted include a relatively smaller applicant pool in British Columbia, Manitoba and the Atlantic Provinces in addition to a relatively limited educational opportunity for potential dental professionals in British Columbia, Ontario and the Atlantic Provinces.

Aptitude Tests↗

PubMed1989

Clinical biochemistry in Singapore.

During the period from 1982 to mid-1989, there has been very significant changes and improvement in the practice and application of clinical biochemistry in Singapore. This paper highlights recent developments in the repertoire of biochemical analyses, utilisation of laboratory tests, biochemical screening in preventive health care, handling and delivery of patient specimens, advances in analytical techniques, automation, computerisation, quality assurance, training of laboratory personnel, and professional activities. It also draws attention to the restructuring of the Singapore General Hospital and the government Department of Pathology which frees these government institutions from the constraints of the civil service so that they would be sufficiently flexible to respond readily to the changing needs and expectations of the patients and users of laboratory services. This is the most prominent event and policy change in the history of health care services in Singapore that is expected to result in more cost-effective utilisation of resources and greater improvement in the quality of health care.

Automation↗

PubMed1989

National survey of recent changes in hospital policies on pharmaceutical sales representatives' activities.

Data from a national survey of recent changes in hospital policies on the activities of pharmaceutical sales representatives (PSRs) are presented. Data were collected by means of a mail survey sent in October 1985 to pharmacy directors of 857 randomly selected hospitals. The questionnaire asked them to identify recent (since 1983) and anticipated changes in restrictions on policies concerning products that PSRs are permitted to detail and sample, persons with whom PSRs can have business contact, requirements for drug exhibits and displays, and areas where PSRs can detail products. Respondents also were asked to describe which PSR services they found to be most useful, which services they would like to see discontinued, and what new services they would like PSRs to provide. Data from 446 of 451 (52.2%) returned questionnaires were included in the analysis. For each of the four policy areas, approximately one fifth of the directors indicated that changes had been made during the previous two years, and nearly all of the changes involved increased restrictions. Half of the respondents reported that their hospitals planned to increase restrictions on products that PSRs would be permitted to detail or sample. The most common reason given for anticipated policy changes was a desire to improve control of the formulary. The directors viewed information about new products as the most useful PSR service, most directors wanted PSRs to discontinue sampling or excessive sampling, and most desired greater educational support from PSRs. From late 1983 to 1986, approximately 20% of hospitals had increased restrictions on the activities of PSRs, and many of the respondents anticipated further increases in restrictions.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Industry↗

PubMed1989

The first forty years: a personal view.

Discussed below are some of the great public health issues and trends of the period that has elapsed since the foundation of the World Health Organization. They were dominated by the new Malthusian nightmare, the tussle with malaria, the eradication of smallpox, the improved control of some other serious infections, the struggles for family planning, breast-feeding, immunization, and clean water, among other things, and above all, perhaps, by the decline of the doctor and the rise of the planner and manager. More recently there have been the policy changes affecting international health which came from the Declaration of Alma-Ata, and the emergence of primary health care.

Family Planning Services↗

PubMed1989

Bone scintigraphy in the evaluation of ejection injuries.

The Royal Air Force (RAF) experience on local back injury with all ejection seats is that 50% have vertebral fractures on radiographic examination, with or without symptoms. These aviators are placed under the care of an orthopedic specialist and restricted from flying duties for 3 months or more. About half of the remainder demonstrate positive bone scans. Until recently, RAF policy was to treat these individuals the same as those with radiographically defined fractures. The author recommends this group of pilots be examined by orthopedic surgeons, and reviewed annually to assess long-term sequelae. Meanwhile, if asymptomatic, they are allowed to return to flying duties. The RAF recently incorporated most of these recommendations into a policy change.

Aerospace Medicine↗

PubMed1989

Emergency room visit time: changes over a 16-year period.

A one-week time and motion study was conducted at a large urban hospital replicating a study performed in 1969 in the same hospital, allowing a longitudinal study of emergency room utilization to be reported. Despite a 36% increase in the number of emergency room patients over the 16-year period, the findings from both studies replicate many of the patterns previously reported. Over time, both length of stay and wait times to see physicians have increased, although the values are still well within the ranges found in the literature. As competition increases, hospitals and their emergency room managers will have to determine what constitutes acceptable visit and waiting times in order to compete effectively for emergency room "clientele." Studies such as this one serve as a foundation for hospitals to implement policy changes that will improve health care delivery, and, in fact, this institution has already implemented changes based on this study.

Adult↗

PubMed1978

Health care in early infancy.

The pattern of illness and of health care during the first 16 weeks of life in a cohort of 1210 infants was examined. Children from families in the lower social strata had a significantly increased risk of respiratory illness and gastrointestinal disturbance and received less routine well baby care than children from more socially advantaged backgrounds. A number of policy changes which might improve the distribution of health care resources are examined.

Child Health Services↗

PubMed1988

Dynamics and clinical implications of the nursing home-hospital interface.

Nursing homes and hospitals are dynamically interrelated, and there is much that the clinician can do to optimize patient transitions between institutions. This article approaches this topic in three sections: epidemiology of movement between hospitals and nursing homes, impacts of policy changes and financial incentives on patient transfers, and clinical strategies to reduce unnecessary hospitalizations of nursing home patients.

Aged↗

PubMed1987

Control of nosocomial tuberculosis in New Zealand: a window into hospital occupational health?

A survey of six New Zealand hospitals, each of which employs at least one respiratory physician, demonstrated lack of uniformity and several deficiencies in measures to prevent nosocomial tuberculosis. Preemployment screening measures in particular were frequently suboptimal. Suggested improvements include upgrading tuberculosis control policies at a national level, with input from hospital boards, clinicians, and the Department of Health. Future policy changes should be based upon local and national experience and this requires the auditing of hospital control measures. The number of health workers amongst new cases of tuberculosis should also be recorded and taken into account.

Cross Infection↗

PubMedDate not supplied

Perinatal toxicology and the law.

New perinatal toxicology research findings not only extend scientific knowledge but they also produce legal changes as they reach public domain. This article examines the interaction between perinatal drug research and the law. The reactivity of the law in assimilating research on exposure of the developing organism to a broad range of neurotoxins, including both licit and illicit drugs, is illustrated. Outcomes of some cases depend to a great extent upon legal concepts invoked rather than upon the scientific evidence involved. Proposed policy changes and their implications for scientists are discussed.

Abortion, Induced↗

PubMed1985

The extent of physician participation in Medicaid: a comparison of physician estimates and aggregated patient records.

This article compares two measures of the extent of physician participation in Medicaid programs. The first, which has been used in most research to date on the subject, is based on physician estimates of the proportion of their patients who are Medicaid patients. The second derives from encounter forms for a sample of visits to the interviewed physicians. The comparison shows that physicians in the sample tended to overestimate by 40 percent the extent of their Medicaid participation. Because the two measures are highly correlated, the analysis of the determinants of Medicaid participation was not affected by the measure used. However, since physicians tended to overstate the proportion of Medicaid patients in their practices, interview data should not be used to measure the amount of physician participation or to calculate elasticities for the effects of policy changes on the extent of participation.

Data Collection↗

PubMed1985

Cost-effective use of laboratory tests: a joint responsibility of clinicians and laboratorians.

The successful attempts to achieve cost savings through improving the effectiveness of test utilization have several things in common. First, if the laboratory is to improve test ordering, it must thoroughly understand the clinical questions behind the test requests. Working with the appropriate clinical experts, the laboratory must establish standards and guidelines for appropriate test use. Then procedures must be developed to review and monitor test utilization to determine compliance with the standards and guidelines. Cost-effective improvements in the use of laboratory tests may require modifying clinicians' test ordering behavior through strategies such as problem-oriented request forms and administrative policy changes, but also the clinical laboratory's testing procedures where appropriate. Because laboratory tests are important elements of medical practice, the cost-effective use of laboratory tests and services is clearly the joint responsibility of clinicians and the clinical laboratory.

Clinical Laboratory Techniques↗

PubMed1985

Tuberculosis control practices in major metropolitan health departments in the United States. 3. Standard of practice in 1984.

Twenty-eight metropolitan health departments in the United States reporting more than 200 cases annually were surveyed to determine the standard of practice in the control of pulmonary tuberculosis. The results were compared to previous surveys done in 1978 and 1980 to determine the impact of policy changes recommended by the American Thoracic Society, American College of Chest Physicians, and Centers for Disease Control and recent reports of innovative chemotherapeutic methods. A high degree of uniformity in chemoprophylaxis practices again was demonstrated. In contrast to our previous survey of 1980, most programs now use rifampin-containing regimens with short (less than 12 month) course chemotherapy as the primary initial treatment regimen for tuberculosis. Mean duration of treatment for tuberculosis decreased from 20.2 +/- 2.1 months in 1980 to 11.7 +/- 1.0 months in 1984. Intermittent chemotherapeutic regimens also were used more frequently in 1984. However, substantial variance from other recommended guidelines still is prevalent among the major metropolitan programs in the United States.

Adolescent↗

PubMed1978

External examinations for internal evaluation: the National Board Part I Test as a case.

The appropriateness of the Part I examination of the National Board of Medical Examiners to evaluate second-year curricular performance of students at Case Western Reserve School of Medicine was examined. Review of the June 1974 examination by 37 faculty members revealed that 85% of the items reflected the content of the second-year curriculum and that 60% could be answered from information provided in the second-year teaching. Two-thirds of the items were related to the content of the first-year curriculum, and half could be answered on the basis of first-year material. The school's faculty used the study data in making policy-changing decisions.

Curriculum↗

PubMed1983

Intravenous methylprednisolone at the time of renal transplantation.

Ninety-five consecutive transplants performed prior to the introduction of methylprednisolone bolus at transplantation were compared to 136 consecutive transplants performed after the policy change. No difference was found in the incidence of reversible or irreversible rejection in the two groups. The treated group were exposed to a higher total dose of steroid than the non-treated group. Routine bolus methylprednisolone therapy at transplantation is not recommended.

Adult↗

PubMed1975

Equal treatment and unequal benefits: the Medicare program.

This paper analyzes the distribution of Medicare benefits among elderly persons on the basis of income, race, and geographical location. It first presents available statistical evidence from Medicare on the distribution of benefits and the magnitude of differentials among these elderly. It then sorts out the contribution to differentials arising from differences in the availability of medical resources. prices of medical services, and other demographic factors. The importance of various Medicare program features on remaining differentials--such as the cost-sharing provisions of Medicare, reimbursement policies, and nondiscrimination enforcement procedures--are then investigated. The effect of health status on utilization of medical services by the elderly is also analyzed, and the distribution of Medicare benefits by income for elderly persons of similar health status is presented. The paper concludes with recommendations for reducing differentials in Medicare benefits and indicates those policy changes which would result in a distribution of benefits more closely related to health care needs of the elderly.

Aged↗

PubMed1989

Perinatal mortality in rural Tanzania.

Prolonged labour was the most frequent cause of perinatal death in a rural hospital in the south western highlands of Tanzania. After the introduction of an obstetric policy aiming to prevent prolonged labour by making use of the guidelines of the partogram, perinatal mortality was reduced from 71 to 39 per 1000 births. Baird's clinico-pathological classification is still considered a useful instrument for the discovery of avoidable factors in perinatal deaths. The concept of the partogram should be an integral part of the training of medical auxiliaries in the field of maternal and child health (MCH).

Delivery, Obstetric↗