Report on the Department of Health and Human Services--Public Health Service, Health Care Financing Administration /

Also known as: The Grace report.

Availability of occupational health services for federal employees : results of a federal agency survey.

Shipping list no.: 86-742-P.

MEDLARS and health information policy.

Mode of access: Internet.

Rising health care costs : causes, implications, and strategies.

Includes bibliographical references.

Description of the pension provisions of the Tax Equity and Fiscal Responsibility Act of 1982 : scheduled for a hearing before the Subcommittee on Savings, Pensions, and Investment Policy of the Committee on Finance, United States Senate, April 11, 1983 /

"JCX-7-83."

Healing fractured lives : how three school-based projects approach violence prevention and mental health care.

Mode of access: Internet.

Risks of a growing balance of payments deficit : hearing before the Subcommittee on Economic Policy of the Committee on Banking, Housing, and Urban Affairs, United States Senate, One Hundred Seventh Congress, first session on the burgeoning balance of payments deficit which nearly doubled in the last few years, from $300 million in 1999 to an expected $500 billion in 2001, July 25, 2001.

"Printed for the use of the Committee on Banking, Housing, and Urban Affairs."

Productivity growth and efficiency measurements in fuzzy environments with an application to health care

Health care organizations must continuously improve their productivity to sustain long-term growth and profitability. Sustainable productivity performance is mostly assumed to be a natural outcome of successful health care management. Data envelopment analysis (DEA) is a popular mathematical programming method for comparing the inputs and outputs of a set of homogenous decision making units (DMUs) by evaluating their relative efficiency. The Malmquist productivity index (MPI) is widely used for productivity analysis by relying on constructing a best practice frontier and calculating the relative performance of a DMU for different time periods. The conventional DEA requires accurate and crisp data to calculate the MPI. However, the real-world data are often imprecise and vague. In this study, the authors propose a novel productivity measurement approach in fuzzy environments with MPI. An application of the proposed approach in health care is presented to demonstrate the simplicity and efficacy of the procedures and algorithms in a hospital efficiency study conducted for a State Office of Inspector General in the United States. © 2012, IGI Global.

Politics at the water's edge: The presidency, Congress, and the North Korea policy of the United States

For all their efforts to avoid a nuclear North Korea, the Clinton and Bush administrations failed to achieve this goal, the most important policy objective of the United States in its relations with North Korea for decades, mainly because of inconsistencies in U.S. policy. This dissertation seeks to explain why both administrations ultimately failed to prevent North Korea from going nuclear. It finds the origins of this failure in the implementation of different U.S. policy options toward North Korea during the Clinton and Bush administrations. To explain the lack of policy consistency, the dissertation investigates how the relations between the executive and the legislative branches and, more specifically, different government types—unified government and divided government—have affected U.S. policy toward North Korea. It particularly emphasizes the role of Congress and partisan politics in the making of U.S. policy toward North Korea. This study finds that divided government played a pivotal role. Partisan politics are also central to the explanation: politics did not stop at the water’s edge. A divided U.S. government produced more status quo policies toward North Korea than a unified U.S. government, while a unified government produced more active policies than a divided government. Moreover, a unified government with a Republican President produced more aggressive policies toward North Korea, whereas a unified government with a Democratic President produced more conciliatory policies. This study concludes that the different government types and intensified partisan politics were the main causes of the inconsistencies in the United States’ North Korea policy that led to a nuclear North Korea.

Low-income first time mothers: Effects on advanced practice nurse (APN) follow up telephone calls on maternal and infant health and health care charges

The United States has over 4 million births annually. Currently healthy women with non-complicated deliveries receive little to no routine postpartum support when discharged from the hospital. This is especially problematic if mothers are first time mothers, poor, have language barriers and little to no social support after giving birth. The purpose of this randomized clinical trial was to compare maternal and infant health outcomes, and health care charges between 2 groups of mothers and newborns. A control ( n = 69) group received routine posthospital discharge care. An intervention group (n = 70) received routine posthospital discharge care plus follow up telephone calls by advanced practice nurses (APNs) on days 3,7,14,21,28 and week 8. Both groups were followed for the first 8 weeks posthospital discharge following delivery to examine maternal health outcomes (perceived maternal stress, social support and perceived maternal physical health), infant health outcomes (routine medical follow up visits immunizations, weight gain), morbidity (urgent care visits, emergency room visits, rehospitalizations), health care charges (urgent care visits, emergency room visits, rehospitalizations) in both groups and charges for APN follow up in the intervention group only. Data were analyzed using descriptive statistics and two-sample t-tests. Study findings indicated that intervention group had significantly lower perceived maternal stress, significantly higher rating of perceived maternal health and higher levels of social support and by the end of the 2nd month posthospital discharge compared to control group mothers. Infants in the intervention group had: increased number of immunizations; fewer emergency room visits; and 1 infant rehospitalization compared to 3 infant rehospitalizations in the control group. The intervention groups' health care charges were significantly lower compared to the control group $14,333/$497 vs. $70,834/$1,068. These study results indicate that an intervention of APN follow up telephone calls in this sample of first time low-income culturally diverse mothers was an effective, safe, low cost, easy to apply intervention which improved mothers' and infants' health outcomes and reduced healthcare charges.

Children with special health care needs: Comparison of the effects of home care setting, prescribed pediatric extended care setting, and long-term care setting on child and family health outcomes and health care service use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQLâ„¢ Generic Core Module for child health and functioning, PedsQLâ„¢ Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.