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At least 19 recordsLinked to original sources
PubMed1978

Health planning: progress, prospects, and issues.

The new Health Planning Act may have prescribed collection of too much data, too soon. There is no refuge in numbers from the social, professional, and political complexities of planning. A mechanistic criterion of "need" breaks down on close examination--we will have to recognize the effect of "availability." There is little or no experience in carrying out policies of selective contraction; modesty in claims and moderation in pursuit of goals are called for.

Delivery of Health Care↗
PubMed1978

Consumer-Choice Health plan (second of two parts). A national-health-insurance proposal based on regulated competition in the private sector.

Medical costs are straining public finances. Direct economic regulation will raise costs, retard beneficial innovation and be increasingly burdensome to physicians. As an alternative, I suggest that the government change financial incentives by creating a system of competing health plans in which physicians and consumers can benefit from using resources wisely. Main proposals consist of changed tax laws, Medicare and Medicaid to subsidize individual premium payments by an amount based on financial and predicted medical need, as well as subsidies usable only for premiums in qualified health insurance or delivery plans operating under rules that include periodic open enrollment, community rating by actuarial category, premium rating by market area and a limit on each person's out-of pocket costs. Also, efficient systems should be allowed to pass on the full savings to consumers. Finally, incremental changes should be made in the present system to alter it fundamentally, but gradually and voluntarily. Freedom of choice for consumers and physicians should be preserved.

Community Participation↗
PubMed1979

Comparing the medical utilization and expenditures of low income health plan enrollees with Medicaid recipients and with low income enrollees having Medicaid eligibility.

The study examines the medical care (hospital, physician, drug, diagnostic) utilization and expenditures of low income persons enrolled in a prepaid health plan with a matched group of Medicaid recipients. The study also examines the medical care utilization of low income persons enrolled in a prepaid health plan with a similar group of low income persons enrolled in the health plan but also eligible for Medicaid benefits. Utilization and population-at-risk data were obtained from the Kaiser-Permanente Medical Care Program of Portland, Oregon and from the State of Oregon Welfare Division. A hypothesis of lower hospital utilization by low income enrollees compared with Medicaid recipients was accepted. A hypothesis of higher ambulatory care utilization was accepted for diagnostic procedures and prescription use, but rejected for office visit utilization. An analysis of the findings appeared to implicate the Medicaid program for differences observed. The hypotheses of no significant differences in inpatient and ambulatory medical care utilization of low income health plan enrollees with and without Medicaid eligibility were generally rejected. Low income enrollees with concurrent Medicaid had consistently higher utilization rates for all services resulting in substantially higher medical care expenditures per person. The findings appear to contribute some useful information to planning or establishing policy for Medicaid Prepayment programs or other programs enrolling low income persons in prepaid health plans or HMOs.

Adolescent↗
PubMed1979

[Nursing in the National Health Plan of Honduras].

After summarizing the health situation in Honduras and describing the National Health Plan launched in 1973, the authors explain the changes that have come about in nursing, the difficulties that had to be surmounted to reach a new professional position, and the administrative decisions that had to be taken to devise a health policy. An account is given of the changes made in the training of nursing staff and in the functions that staff must perform in the planning, implementation, and evaluation of the coverage extensive program. The article high-lights the role of the Nursing Division in the Ministry of Public Health and Social Welfare and the levels of coordination established with the other technical divisions and institutions responsible for the health personnel training. In closing, the article points out that the nursing sector represents the keystone of the model for the delivery of services to attain the goal of health for all by the year 2000.

Education, Nursing↗