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Health Insurance: The Pro-Competition Proposals

Description: For more than a decade, Congress and the Executive Branch have tried to stem spiraling health care costs through various regulatory actions at the Federal and State levels. Planning laws, for example, focus regulatory attention on the capacity of the health care industry to provide health services. Other laws have created programs to monitor and control the use of services provided to individual patients. Direct wage and price controls were applied to the health industry in the early 1970's and in recent years Congress has debated whether to impose controls over hospital spending in the United States. This report discusses the debate surrounding various approaches to lower health care costs.
Date: December 6, 1982
Creator: Lundy, Janet P. & Markus, Glenn
Partner: UNT Libraries Government Documents Department

AIDS: The Ryan White CARE Act

Description: This report discusses the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which makes federal funds available to metropolitan areas and states to assist in health care costs and support services for individuals and families affected by the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS). This report discusses related legislation and appropriations.
Date: February 22, 2006
Creator: Johnson, Judith A. & Morgan, Paulette C.
Partner: UNT Libraries Government Documents Department

President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry

Description: The Advisory Commission on Consumer Protection and Quality in the Health Care Industry was created by President Clinton to "advise the President on changes occurring in the health care system and recommend such measures as may be necessary to promote and assure health care quality and value, and protect consumers and workers in the health care system."
Date: March 13, 1998
Creator: President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry
Partner: UNT Libraries Government Documents Department

The Impact of the Balanced Budget Act of 1997 on the Home Health Benefit

Description: Widespread concern about the rapid growth of Medicare spending in recent years initiated a legislative response that resulted in the Balanced Budget Act of 1997. The effects of the BBA were far reaching and created shock waves throughout the health care industry. This study presents background information on the history of the Medicare home health benefit, enumerates specific provisions and goals of the BBA of 1997, examines how the BBA has changed the delivery of Medicare home health services, and proposes survival strategies for home health care providers.
Access: This item is restricted to UNT Community Members. Login required if off-campus.
Date: May 2000
Creator: Coker, Joseph E.
Partner: UNT Libraries

Tuberculosis in the Nursing Home: A Policy and Procedure Manual

Description: Tuberculosis in the nursing home is an ever-growing problem for the health care community. The incidence of tuberculosis in the United States has risen alarmingly since 1982, and high-population environments such as nursing homes are among the places where it is most prevalent. The first part of this document is an introduction to the current concerns faced by nursing home infection control personnel. It includes information about the history, symptoms, and epidemiology of the disease, as well as other topics. The second part is a policy and procedure manual that contains a basic guide to methodical testing for tuberculosis, steps for dealing with active cases of the disease, and suggestions for education of nursing home health care workers.
Access: This item is restricted to UNT Community Members. Login required if off-campus.
Date: May 2000
Creator: Mounts, Camilla M.
Partner: UNT Libraries

A Retrospective Study: The Relationship Between Health Care Costs, Absenteeism and Body Mass Index in a Group of Municipal Employees

Description: This study evaluated the relationship of varying body mass index and average annual health care costs and absenteeism in a group of 524 municipal employees. The 269 employees with health care claims and the 487 employees with attendance records were categorized into five different BMI categories based on self-reported weight and height. Findings from the study suggest that as BMI increases, average annual health care costs and average annual absenteeism increase. However, BMI was only significantly related to absenteeism. The study also found significant relationships between education and health care costs and absenteeism. No significant differences for health care costs or absenteeism were found based on race, age, gender, wellness center membership, or smoking status.
Date: August 2000
Creator: Satterwhite, Monica L.
Partner: UNT Libraries

The Application of a Health Service Utilization Model to a Low Income, Ethnically Diverse Sample of Women

Description: A model for health care utilization was applied to a sample of low income women. Demographic Predisposing, Psychosocial Predisposing, Illness Level, and Enabling indicators were examined separately for African American (n = 266), Anglo American (n = 200), and Mexican American (n = 210) women. Structural Equation Modeling revealed that for African American and Anglo American women, Illness Level, the only significant path to Utilization, had a mediating effect on Psychosocial Predisposing indicators. The model for Mexican Americans was the most complex with Enabling indicators affecting Illness Level and Utilization. Psychosocial Predisposing indicators were mediated by Illness Level and Enabling indicators which both directly affected Utilization. Implications of the results for future research are addressed.
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Date: August 2000
Creator: Keenan, Lisa A.
Partner: UNT Libraries

Dallas Area Health Care Use: Study of Insured, Uninsured, and Medicaid Enrolled Children

Description: This research investigated physician and emergency room use among representative samples of children in the Dallas metropolitan area (N = 1606) and among patients who used Children's Medical Center of Dallas' First Care services (N = 612). Through telephone interviewing, caregivers to children under fifteen years of age were asked about an array of health service use behaviors, social-psychological issues related to acquiring health care for their children, and demographic characteristics as outlined by the Andersen & Newman model of health care service use. Children's use of physician services is best predicted by whether or not they have medical insurance, their level of income, and whether or not they have medical homes. Although having commercial managed care and fee-for-service Medicaid insurance consistently predicted increased physician use, neither independently reduced reliance on emergency rooms for non-emergent care. Managed care insurance and Medicaid did, however, significantly improve the odds that children would have medical homes, which significantly decreased emergency room use for non-emergent care. Further, increasing physician use and reducing reliance on hospital emergency rooms for non-emergent care will require ensuring that children have medical homeseither private physicians or community health centersat which they can readily and consistently receive sick and well care. Although some ethnic differences were observed, few of the broad array of factors in the Behavioral Model significantly predicted either physician or emergency room use. Moreover, educational levels and health beliefs rarely, and if significant negligibly, influenced physician and emergency room use. Health policy for children would best be served by focusing on programs that facilitate parent's ability to secure health insurance for their children and allocating children to medical homes where they can readily and consistently access sick and well care.
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Date: August 2000
Creator: Roy, Lonnie C.
Partner: UNT Libraries

Predictors of Use and Outcomes of Youth and Family Centers

Description: This study analyzed data from Dallas Public Schools and Dallas Youth and Family Centers (YFCs) to explore variables associated with referrals to and utilization of Youth and Family Centers. Data from students enrolled in third, eighth or tenth grade during the 1996-1997, 1997-1998 and 1998-1999 school years were analyzed to determine the reasons for YFC referral and utilization, and to compare standardized test scores and attendance. Of the 6956 students in third, eighth and tenth grades initially referred to YFCs during those three school years, 5173 (74.3%) made at least one YFC visit. The 5173 students made an average of 2.69 visits and accessed an average of 1.18 services per year. Medical visits accounted for 42.5% of YFC visits, and mental health visits accounted for 46% of YFC visits. Results of logistic regression analyses indicate a significant difference for utilization upon referral and continued use of the YFC when the constant is compared to a set of predictor variables. For both analyses, the predictor variables were Chapter I status, LEP status, reason for referral, gender, special education status, ethnicity, distance from home school to referral YFC, food stamp eligibility and referral source. While outcome data regarding attendance and scores on standardized tests was limited to records available, results suggest that mean reading scores for eighth graders were significantly higher during Year 1 for the group that accessed YFC services. School attendance was better for eighth graders who made continued use of a YFC. Use of medical services by third graders was associated with a gain in attendance rather than a slight loss for the third graders who did not access medical services upon referral. Results of this study were limited by missing data for several records. The competitive atmosphere of health care service delivery and the practical need to know ...
Date: May 2001
Creator: Scharff, Karen
Partner: UNT Libraries

Inequality in Access to, and Utilization of, Health Care - The Case of African American and Non-Hispanic White Males

Description: Using data from the Household Component of the 1996 Medical Expenditure Panel Survey, the study compares (1) the accessibility, and (2) the predictors of health care services utilization among African American and non-Hispanic White males, 18 to 65 years old in the United States. Using ANOVA procedure in comparing the means for use of physicians, hospitals, doctors, and difficulty obtaining care, seven hypotheses were tested in the study. First, it was hypothesized that African American men of working age will have less access to health care services (physicians, hospitals, and dentists), and be more likely to report having experienced delay or difficulty obtaining care, compared to non-Hispanic white males of working age. Second, it was hypothesized that, controlling for health status, African American men of working age will have less access to health care services (physicians, hospitals, and dentists), and will also be more likely to experience delay or difficulty obtaining care, than non-Hispanic white males. This was followed by the third hypothesis which compared utilization of physicians, hospitals, dentists, and difficulty obtaining care among African American and non-Hispanic white males, controlling for health status and insurance coverage (any insurance, private insurance, any public insurance, and Medicaid). Hypotheses four through six compared the utilization of physicians, hospitals, and dentists, as well as difficulty obtaining care among African American and non-Hispanic white males, controlling for the following variables sequentially: health status and poverty status; health status and having a usual source of care; and health status and employment status, in that order. Finally, it was hypothesized that, controlling for health status, any insurance, poverty status, and employment status, African American men of working age will have less access to physicians, hospitals, and dentists, and experience more difficulty and delay obtaining care, compared to non-Hispanic white males of working age. Results from ...
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Date: May 2001
Creator: Sakyi-Addo, Isaac
Partner: UNT Libraries

Uninsured Adult Working-Age Population in Tarrant County: Access, Cost of Care, and Health--Hispanic Immigrants

Description: This study uses secondary survey data collected from a sample population of clients from JPS Health Network in Tarrant County, Texas from July-August, 2000. Respondents for this study represents a group of working-age Hispanic immigrant adults, N=379. Andersen's "Behavioral Model for Vulnerable Populations" is used to as the theoretical framework. Bivariate crosstabulation revealed significant relationships for dependent variables: problems getting needed healthcare, doctor visits, emergency room visits, overnight in the hospital, and obtaining prescription medication. Findings confirm that lack of coverage, competing needs, and difficulties in the health care system are significant in access health care. Subsequent implications and policy recommendations suggests the inevitability of short and long term health consequences unless changes are made to policies and programs.
Date: August 2004
Creator: Queen, Courtney M.
Partner: UNT Libraries

A Comparative Analysis of Diseases Associated with Mining and Non-Mining Communities: A Case Study of Obusai and Asankrangwa, Ghana

Description: Disease prevalence varies with geographic location. This research pursues a medical geographic perspective and examines the spatial variations in disease patterns between Obuasi, a gold mining town and Asankrangwa, a non gold mining town in Ghana, West Africa. Political ecology/economy and the human ecology frameworks are used to explain the prevalence of diseases. Mining alters the environment and allows disease causing pathogens and vectors to survive more freely than in other similar environments. Certain diseases such as upper respiratory tract infections, ear infections, sexually transmitted diseases such as HIV/AIDS and syphilis, certain skin diseases and rheumatism and joint pains may have a higher prevalence in Obuasi when compared to Asankrangwa due to the mining in Obuasi.
Date: August 2005
Creator: Reddy, Sumanth G.
Partner: UNT Libraries

An empirical investigation of the salient dimensions of Baby Boomer and Generation Y consumers' health care decision choices.

Description: The purpose of this research is to empirically investigate consumers' health care decision choices in a dynamic market setting. The unprecedented demands on the U.S. health care system coupled with the mounting controversies surrounding health care reform suggest that consumers' health care decisions warrant empirical research attention. Toward this end, this dissertation empirically explored (1) the characteristics of consumers who possess a willingness to use non-conventional treatments over conventional treatments, (2) the characteristics of consumers who elect self-medication in lieu of health care practitioner-directed medication, and (3) the salient dimensions of consumers' channel choice for the procurement of health care products. Each of these decision choice factors were tested across two U.S. generational segments to assess whether differences existed across Baby Boomers' and Gen Yers' health care decision choices. The conceptual framework for empirical assessment is Bandura's (1986) social cognitive theory. From Bandura's social cognitive theory, a general model of healthcare decision choice is proposed to assess consumers' states of mind, states of being and states of action (decision choice). Results indicate that social cognitive factors (e.g., self-efficacy, objectivism) play an important role in each of the decision domains explored in this dissertation. Moreover, health value was found to be an important moderator between the social cognitive factors and health care decision choices. The predictors of the health care decision choices were found to vary across the Baby Boomers and Generation Yers on several dimensions, confirming the notion that generational differences may be a salient dimension of consumers' health care decision choice. The research offers several implications for practitioners, academicians and policy makers. Both descriptive and normative implications are gleaned from the research findings. Most notably, the results indicate that consumers' social cognitive factors and health value may be mechanisms for managing health care decisions.
Date: August 2006
Creator: Krishnankutty Nair Rajamma, Rajasree
Partner: UNT Libraries

Too Ill to Find the Cure? - Health Care Sector Success in the New Democracies of Central and Eastern Europe

Description: This study examines the factors that have contributed to the success of some Central and Eastern European countries to improve their health care sector in the post communist period, while leaving others to its demise. While most literature has been focused on the political and economic transition of Eastern Europe, very little research has been done about the welfare aspects of the transition process, especially the health care sector. While the focus on political consequences and main macroeconomic reforms has shed light on many important processes, the lack of research of health care issues has lead to consequences on our ability to understand its impact on the future of the new democracies and their sustainability. This model looks at the impact of international (World Bank) and domestic institutions, corruption and public support and how they affect the ability of some countries to improve and reform their health care sector in the post-transition period.
Date: August 2006
Creator: Radin, Dagmar
Partner: UNT Libraries

Health Care Among Low-income, White, Working-age Males in a Safety Net Health Care Network: Access and Utilization Patterns

Description: This study seeks to provide information relevant to public policy that will lead to increased access and utilization among this vulnerable population and to reinforce the validity of the behavioral model for vulnerable populations. This study is a secondary analysis of data collected in a study that examined adult, working-aged patients within the John Peter Smith Health Network, which is a large, urban, tax supported county health care system in Fort Worth, Texas. From a sampling frame of 10,000 patients, the study analyzed data for 243 low-income, white, working-age males, collected from computer assisted telephone interviews in 2000. Cross-tabulations and bivariate logistic regressions were used to analyze the effect of 8 independent variables (age, marital status, insurance, employment status, a usual source of care, competing needs, experiences with paperwork, and perceived health status upon 5 dependent variables pertaining to unmet health care, unmet prescription medicine needs, unmet dental needs, utilization of doctors in emergency departments, and overnight hospital stays. The results show the safety net system is failing to meet the needs of this vulnerable population. The findings indicate white men who found it necessary to forgo health care due to other needs were almost five (4.973) times as likely as those who did not find it necessary to forgo care due to other needs, to report having a problem getting the health care that they need (p = ≤ .001). The odds of having a problem getting needed dental care are about 66% lower for white men who have private insurance through work compared to those who do not have private insurance through work (p ≤ .05).
Date: August 2006
Creator: Whitworth, Keith Hugh
Partner: UNT Libraries

Government Spending on Health Care Benefits and Programs: A Data Brief

Description: In a country where health spending accounts for more than 16% of gross domestic product (GDP), health care costs and spending are often described as a problem for consumers and their families; for employers that provide (or seek to provide) health benefits; and for government, which finances a mix of health care services, health research and training, and health safety programs. To describe government spending on health care benefits and programs, this report presents data from the Office of Management and Budget (OMB), the Congressional Budget Office (CBO), and the Centers for Medicare and Medicaid Services (CMS).
Date: June 16, 2008
Creator: Jenson, Jennifer
Partner: UNT Libraries Government Documents Department

The False Claims Act, the Allison Engine Decision, and Possible Effects on Health Care Fraud Enforcement

Description: The False Claims Act (FCA), an important tool for combating fraud against the U.S. government, generally provides that a person who knowingly submits, or causes to be submitted, a false or fraudulent claim for payment to the U.S. government may be subject to civil penalties and damages. This report provides an overview of the FCA and the Allison Engine decision, analyzes how this decision could affect certain FCA health care claims, and discusses the proposed False Claims Correction Acts (S. 2041 and H.R. 4854), which, if enacted, could limit the application of the Allison Engine decision.
Date: November 6, 2008
Creator: Staman, Jennifer
Partner: UNT Libraries Government Documents Department

Citizens' Health Care Working Group

Description: Congress authorized the Citizen’s Health Care Working Group as a provision of the Medicare Prescription Drug, Improvement, and Modernization Act Of 2003. This provision was sponsored by Senators Ron Wyden of Oregon and Orrin Hatch of Utah. The mission of the Working Group has been to provide a nationwide public debate about improving the American health care system so that health care “works for all Americans” and to use the results of that debate to provide recommendations for Congress and the President to consider as they work to achieve high quality, affordable health care. Working Group members were named February 28, 2005 and released various sets of recommendations.
Date: September 29, 2006
Creator: Citizens' Health Care Working Group
Partner: UNT Libraries Government Documents Department

The Tax Exclusion for Employer-Provided Health Insurance: Policy Issues Regarding the Repeal Debate

Description: Employer-provided health insurance is excluded from the determination of employees' federal income taxes, resulting in significant tax savings for many workers. The federal income tax exclusion -- the focus of this report -- is criticized for several reasons. These arguments about the exclusion merit careful consideration as Congress is starting to debate broad health care reform for the first time in 15 years. This report discusses this issue at length, including advantages and disadvantages to keeping the income tax inclusion as Congress undergoes the health policy reform process.
Date: November 21, 2008
Creator: Lyke, Bob
Partner: UNT Libraries Government Documents Department

Employment-Based Health Coverage and Health Reform: Selected Legal Considerations

Description: It is estimated that nearly 170 million individuals have employer-based health coverage. As part of a comprehensive health care reform effort, there has been support (including from the Obama Administration) in enacting comprehensive health insurance reform that retains the employer-based system. This report presents selected legal considerations inherent in amending two of the primary federal laws governing employer-sponsored health care: the Employee Retirement Income Security Act (ERISA) and the Internal Revenue Code (IRC).
Date: June 12, 2009
Creator: Staman, Jennifer & Liu, Edward C.
Partner: UNT Libraries Government Documents Department

Cigarette Taxes to Fund Health Care Reform: An Economic Analysis

Description: A cigarette excise tax increase of 75 cents per pack has been proposed to finance part of the President's universal health care program. The tax enjoys considerable public support, would raise about $11 billion per year, and would be relatively simple to administer because it would increase an existing manufacturer's excise tax. This report discusses these rationales, as well as other effects of and concerns about the tax, organized into topics of market failure as a justification for the tax (i.e., economic efficiency); potential for revenue; equity; and the job loss the tax might cause in tobacco growing regions.
Date: March 8, 1994
Creator: Gravelle, Jane G. & Zimmerman, Dennis
Partner: UNT Libraries Government Documents Department

Veterans Affairs: Health Care and Benefits for Veterans Exposed to Agent Orange

Description: This report provides an overview of health care services and disability compensation benefits available to Vietnam veterans, Children of Vietnam Era veterans, and non-Vietnam veterans exposed to herbicides. This is followed by a discussion of litigation pertaining to Navy veterans of the Vietnam Era who served offshore and were never physically present on Vietnamese soil. The report concludes with a discussion of epidemiologic research conducted to study the health effects of Agent Orange and dioxin exposure on Vietnam veterans.
Date: September 22, 2010
Creator: Panangala, Sidath Viranga & Weimer, Douglas Reid
Partner: UNT Libraries Government Documents Department