| Issue Paper: Are Local Health Responders Ready for Biological and Chemical Terrorism? |
2002 |
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| Authors:
Lois M. Davis; Janice C. Blanchard; RAND CORP SANTA MONICA CA
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 | The public health and medical communities have long sought to address the threat of biological, chemical, or other weapons of mass destruction (WMD) and their potential effects on the health and safety of U.S. citizens. The United States has made some key advances in the past five years or so toward increasing the capacity of the public health system to conduct disease surveillance, establishing pharmaceutical stockpiles, and improving the training ... |
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| Final Evaluation Report for the TRICARE Senior Supplement Demonstration Program |
2002 |
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| Authors:
Michael Schoenbaum; Katherine Harris; Gary Cecchine; Ana Suarez; Chris Horn; RAND CORP SANTA MONICA CA
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| The National Defense Authorization Act (NDAA) for fiscal year 1999 directed the Secretary of Defense to establish a demonstration program, called the TRICARE Senior Supplement Demonstration (TSSD), under which eligible beneficiaries would be permitted to enroll in the Department of Defense (DOD) TRICARE health insurance program as a supplement to Medicare. Congress directed the DoD to demonstrate TSSD in two geographic areas, with enrollment beginning in March 2000 and the ... |
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| Executive Summary of Analyses for the Initial Implementation of the Inpatient Rehabilitation Facility Prospective Payment System |
2002 |
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| Authors:
Grace M. Carter; Joan L. Buchanan; Melinda B. Buntin; Orla Hayden; Susan M. Paddock; RAND CORP SANTA MONICA CA
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| In the Balanced Budget Act of 1997, Congress mandated that the Health Care Financing Administration (HCFA) implement a Prospective Payment System (PPS) for inpatient rehabilitation under Medicare. This new PPS will be implemented beginning January 1, 2002. This report describes the research that RAND performed to support HCFA's efforts to design, develop, and implement this Inpatient Rehabilitation Facility PPS, or IRF PPS. It presents recommendations concerning the payment system and ... |
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| Analysis for the Initial Implementation of the Inpatient Rehabilitation Facility Prospective Payment System |
2002 |
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| Authors:
Grace M. Carter; Melinda B. Buntin; Orla Hayden; Jennifer Kawata; Susan M. Paddock; RAND CORP SANTA MONICA CA
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| In the Balanced Budget Act of 1997, Congress mandated that the Health Care Financing Administration (HCFA) implement a Prospective Payment System (PPS) for inpatient rehabilitation under Medicare. This new PPS was implemented beginning on January 1, 2002. The Centers for Medicare and Medicaid Services (CMS, the successor agency to HCFA) issued the final rule governing the PPS on August 7, 2001. This report describes the research that RAND performed to ... |
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| The Digital Human: Open Source Software Framework for Organ Modeling and Simulation |
DEC 2001 |
20 pages |
| Authors:
Gerald Higgins; FEDERATION OF AMERICAN SCIENTISTS WASHINGTON DC
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 | Researchers met at the National Library of Medicine on July 23-24, 2001 to brainstorm about the next stage in the development of a "Digital Human". This meeting, called "Open Source Software Framework for Organ Modeling & Simulation", was organized to review the current state of computer-based modeling in medicine, identify critical "next steps" for technical resource development, and create a vision for building useful and functional computer models of human ... |
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| Use of Tele-Mental Health in Consultation Liaison Psychiatry |
NOV 2001 |
5 pages |
| Authors:
Harold Wain; WALTER REED ARMY MEDICAL CENTER WASHINGTON DC
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| After numerous meetings with telemedicine, DCI, and a biostatistician, a complete protocol was submitted to Walter Reed Army Medical Center Department of Clinical Investigations (WRAMC-DCI) on 14 December 2001. The protocol will be reviewed by WRAMC-DCI on 8 January 2002. Other accomplishments: -A full time research assistant was hired in August. Much progress was made after several meetings with Dr. Gregory Fant, the biostatistician. Dr. Fant helped to simplify the ... |
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| Modelling Issues of Wireless LANs for Accident and Emergency Departments |
25 OCT 2001 |
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| Authors:
Konstantinos A. Banitsas; Robert S. Istepanian; Sapal Tachakra; Thomas J. Owens; BRUNEL UNIV UXBRIDGE (UNITED KINGDOM)
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| The paper provides an overview of the application scenarios and modelling issues of wireless Local Area Networks (WLAN) in hospital and clinical ward environments and presents the concept of MedLAN system, dedicated to these environments. Furthermore, it discusses the potential problems when implementing such systems. |
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| Securing a Medical Wireless LAN System |
25 OCT 2001 |
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| Authors:
Thomas J. Owens; Sapal Tachakra; Konstantinos A. Banitsas; Robert S. Istepanian; BRUNEL UNIV UXBRIDGE (UNITED KINGDOM)
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| This paper identifies security issues that must be addressed, if a recently proposed Medical Wireless LAN System (MedLAN) is to be accepted. Two classes of security issues are distinguished, technical and managerial. |
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| A Patient Monitoring Tool For An HIV/AIDS Integral Care Model |
25 OCT 2001 |
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| Authors:
C. Caceres; E. J. Gomez; F. Del Pozo; UNIVERSIDAD POLITECNICA DE MADRID (SPAIN) GROUPO DE BIOINGENIERIA Y TELEMEDICINA
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| The success of new therapeutic procedures based on combination of antiretroviral components is driving the need of new care models for HIV/AIDS patients. This paper addresses the definition and implementation of an HIV/AIDS integral care model grounded on medical, psychological and social patient self- monitoring procedures. The care model is implemented on a web-based monitoring tool bearing three main scenarios: self monitoring personal diary, data analysis and visualisation of data ... |
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| An Integrated Software System for Medical Equipment Management |
25 OCT 2001 |
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| Authors:
Z. Bliznakov; N. Pallikarakis; PATRAS UNIV (GREECE) SCHOOL OF MEDICINE/DEPT OF MEDICAL PHYSICS
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| The evolution of biomedical technology has led to enhanced use of medical devices in healthcare delivery. Clinical Engineering Departments (CEDs), in order to improve their services and monitor the outcomes, are introducing more and more telematic means. In the present work, a new computerized, integrated, windows oriented system intended for CED management is proposed. The system model is based on a star architecture, whose implementation has been carried out by ... |
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| Workflow Management Systems: The Healthcare Technology of the Future? |
25 OCT 2001 |
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| Authors:
A. Dwivedi; R. K. Bali; A. E. James; R. N. Naguib; COVENTRY UNIV (UNITED KINGDOM) SCHOOL OF MATHEMATICAL AND INFORMATION SCIENCES
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| In recent years, healthcare institutions have had problems accessing and maintaining the large amounts of data they deal with. This paper identifies current approaches and technologies which relate to patient administration systems. It argues that, in the near future, WWW-based multimedia patient administration systems would become the norm for healthcare institutions. The development and acceptance of web-based multimedia patient administration systems is likely to aggravate the problem of healthcare institutions ... |
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| A Helpful Framework for the Organization of the Homecare |
25 OCT 2001 |
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| Authors:
Nathalie Bricon-Souf; Marie-Catherine Beuscart-Zephir; Francoise Anceaux; Regis Beuscart; LILLE-II UNIV (FRANCE) FACULTE DE MEDECINE
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| We present our contribution to a national project whose ambition is to use new cooperation tools, in the context of homecare, in order to facilitate the coordinated cooperative work of health actors. Home- care is expected to develop in the coming years, but it is still difficult to organize and such care coordination is complex. A study of homecare activity leads us to determine two specific sorts of activity : ... |
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| Validation of the European Prototype for Integrated Care at Municipal Level in Savona: Updating and Maintenance |
25 OCT 2001 |
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| Authors:
M. Giacomini; I. Peragallo; S. Bertone; C. Ruggiero; GENOVA UNIV (ITALY)
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| A European Prototype for Integrated Care (EPIC) was set up in the early nineties within one of the programs sponsored by the European Commission. The system mainly consists of a shared care database in which each groups of facilities is supported by a local area network (LAN). Each LAN is connected over a wide area network to a central node. The system can manage telemedicine tools such as telealarm and ... |
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| A New Methodology to Design Distributed Medical Diagnostic Centers |
25 OCT 2001 |
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| Authors:
P. A. Baziana; E. I. Karavatselou; D. K. Lymberopoulos; D. N. Serpanos; PATRAS UNIV (GREECE)
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| In a Distributed Diagnostic Center (DDC), patients' examinations (exams) are performed in Remote Units (RUs) and the collected data (images, lab exams, etc) are sent to expertise Diagnostic Units (DUs) for evaluation. The DDC's quality of service per exam is considered through several factors, such as patient's wailing time, RU-DU communicating load, expert's occupancy, priority, administrative cost, etc. This paper introduces a new methodology for DDC design by controlling the ... |
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| Virtual Primary Care Clinic |
OCT 2001 |
14 pages |
| Authors:
Jerald Rumph; MADIGAN ARMY MEDICAL CENTER TACOMA WA
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| The problems, or challenges as I prefer to refer to them, can be fairly well encompassed within the concept of complexity. This was an ambitious project from the start, with potential to define an e-health direction for the region. It was perhaps this ambitious nature as well as a myriad of complex technical challenges to overcome that sensitized many personnel and departments. The project required discourse between various departments, each ... |
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| Wartime Medical Requirements: Profiles and Requirement Determination Processes |
OCT 2001 |
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| Authors:
Cori Rattelman; Robert Levy; Neil Carey; Flora Tsui; CENTER FOR NAVAL ANALYSES ALEXANDRIA VA
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| CNA was tasked by N-81 as part of the Integrated Warfare Architectures (IWARS) program to examine and assess the process that determines the wartime medical manpower requirement. We examined the processes for staffing the Navy's hospital ships (T-AHs), fleet hospitals (FHs), and the OCONUS military medical treatment facility (MTF) augment. We also examined how the medical manpower requirements for the fleet and Fleet Marine Force (FMF) are determined. |
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| Operational TeleCardiology |
OCT 2001 |
7 pages |
| Authors:
Marina N. Vernalis; WALTER REED ARMY MEDICAL CENTER WASHINGTON DC
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| This project suffered numerous problems related to the infrastructure, administration, and technical aspects. All of these shortcomings were encountered during the actual deployment and implementation of the project. |
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| Combat Trauma Patient Simulation (CTPS) Program |
OCT 2001 |
438 pages |
| Authors:
Dave Bundy; MEDICAL EDUCATION TECHNOLOGIES INC ORLANDO FL
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| The purpose of the CTPS Program is to more realistically assess the impact of battlefield casualties in order to increase medical readiness. The system primarily consists of commercial-off-the-shelf (COTS) and government-off- the-shelf (GOTS) live, virtual, and constructive simulation components. Its capabilities include simulating, replicating, and assessing battlefield injuries by type and category, monitoring the movement of casualties on the battlefield, capturing the time of patient diagnosis and treatment, and comparing ... |
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| Annual Research Progress Report. Fiscal Year 2001 |
28 SEP 2001 |
547 pages |
| Authors:
Barbara Jones; Paul Froude; Mary Porreca; Troy Patience; Genie Hough; MADIGAN ARMY MEDICAL CENTER TACOMA WA DEPT OF CLINICAL INVESTIGATION
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| This report covers all research protocols that were administratively or technically supported by the Department of Clinical Investigation, Madigan Army Medical Center, during FY 2001. Included in the individual reports are title, investigators, funding, objective, technical approach, and progress for FY 2001. Also included in the report are personnel rosters for the Department, funding information, and presentations and publications emanating from Madigan Army Medical Center during FY 2001. |
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| Initiative to Recapture Orthopedics Workload Using Business Case Analysis at Evans Army Community Hospital |
AUG 2001 |
126 pages |
| Authors:
Noel C. Pace; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
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| Currently the civilian Managed Care Support Contractors (MCSC) that provide healthcare services to the military health system (MHS) are costing the government too much money. In October of 2000, the Surgeon General of the United States Army, Lieutenant General James Peake, mandated that all Army healthcare facilities "must increase their productivity and utilize a business case analysis (BCA) process to determine how to best recapture workload from the MCSC's," in ... |
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| Provision and Use of Navy Medicine Primary Care: Empirical Background for Optimization |
AUG 2001 |
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| Authors:
Daniel M. Harris; Stephen D. Tela; Kris Truong; CENTER FOR NAVAL ANALYSES ALEXANDRIA VA
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| The purpose of this research memorandum is to report and comment on the findings of an analysis of Navy Medicine Primary Care (NMPC) to members of the Primary Care Product Line (PCPL) Advisory Board (the Board) and to the Bureau of Medicine and Surgery (BUMED). This report is part of the support that CNA is providing to the product line. It analyzes Ambulatory Data System (ADS) records of visits made ... |
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| Navy-Wide Personnel (NPS) Survey 1998: Management Report |
JUL 2001 |
84 pages |
| Authors:
Murrey Olmsted; John Kantor; Gail Palmisano; NAVY PERSONNEL RESEARCH STUDIES AND TECHNOLOGY MILLINGTON TN
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| This report summarizes the results of the 1998 Navy-wide Personnel Survey (NPS). The NPS has been conducted annually from 1990 to 1998 at the request of the Chief of Naval Personnel. The 1998 NPS examined the opinions of Sailors in a variety of areas including detailing, assignment, Quality of Life, organizational climate, job satisfaction, and health issues. The information from this survey is valuable to Navy leadership to assessing the ... |
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| Pharmacy Utilization: A Study to Predict BAMC Outpatient Pharmacy Usage by Dual-Eligible Military Retiree/Medicare-Eligible Beneficiaries Resulting From Implementation of the TRICARE Senior Pharmacy Program (TSRx) |
25 JUN 2001 |
59 pages |
| Authors:
Andrew J. Lankowicz; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
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| On April 1, 2001 a new outpatient pharmacy benefit called the TRICARE Senior Pharmacy Program (TSRx) was extended to all Medicare part B eligible age 65 and over non-TRICARE Senior Prime military healthcare system authorized beneficiaries. The problem that confronted Brooke Army Medical Center (BAMC) was the lack of knowledge about the effect that the TSRx program might have on utilization of the hospital s outpatient pharmacies. A survey (Appendix ... |
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| A Prospective Computer Simulation Study to Test the Impact of Consolidating Primary Care Out-Patient Services at McDonald Army Community Hospital |
20 JUN 2001 |
58 pages |
| Authors:
William T. Echols; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
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| Computer simulation is an effective operational analysis tool gaining popularity in the health care field. Computer simulation is an objective, data driven decision support system that allows mangers to test solutions before implementation. A prospective computer simulation study was conducted at McDonald Army Community Hospital to aid in the possible consolidation of primary care operations. The primary goal of the study was to determine if the proposed floor plans could ... |
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| U.S. Army Nursing Readiness: A Field Administration of the Readiness Estimate and Deployability Index (READI) in the North Atlantic Regional Medical Command (NARMC) |
22 MAY 2001 |
40 pages |
| Authors:
Peter H. Murdock; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
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| The purpose of this observational study was to use the Readiness Estimate and Deployability Index (READI) to estimate, compare and describe the states of deployment readiness in active and reserve component Army Nurse Corps (ANC) officers affiliated with the North Atlantic Regional Medical Command (NARMC). Army Nurses must be ready to provide nursing care indeployed environments that are characterized by austere and dangerous conditions, high patient variability, and limited technology. ... |
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| Blood Sample Reliability Using Infusing Intravenous Lines |
MAY 2001 |
92 pages |
| Authors:
John R. Himberger; UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD
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| Patients receiving care, whether arriving in the Emergency Department, or admitted to the ward, often have intravenous lines for the purpose of treatment. Yet, even with a preexisting vascular access device being available, we continue to use phlebotomy as the gold standard for blood specimen collection. If nurses and medical technicians could use a preexisting intravenous lines for blood collection there would be a reduction in patient care costs, increase ... |
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| A Study to Determine the Tripler Army Medical Center Urology Clinic's FY 2001 Outpatient Service Charges to the Veterans Administration |
13 APR 2001 |
64 pages |
| Authors:
Paul M. Sander; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
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| The objective of this study was to determine the Tripler Army Medical Center (TAMC) Urology clinic's outpatient service charges to the Veterans Administration (VA) for fiscal year 2001. A sensitivity analysis was conducted using a six-month sample of TAMC Urology clinic VA beneficiary (VAB) encounters (509 clinic and ambulatory procedure visits) and six federal and civilian outpatient billing methodologies in order to determine fair and reasonable TAMC Urology clinic outpatient ... |
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| Preparation of Family Nurse Practitioners at the Uniformed Services University of the Health Sciences for Their Role in Humanitarian Assistance Operations |
11 APR 2001 |
77 pages |
| Authors:
Susan J. Lee; UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD
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| The purpose of this study was to evaluate the preparation of family nurse practitioners (FNPs) in the Graduate School of Nursing at the Uniformed Services University of the Health Sciences (USUHS) to provide health care in the humanitarian assistance setting. Three recent humanitarian assistance operations were analyzed to determine the types of illnesses/conditions that have been typically treated by military medical providers. Based on these data, a tool was developed ... |
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| An Error Reduction Initiative |
06 APR 2001 |
76 pages |
| Authors:
Paula K. Underwood; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
|
| Medical errors kill many Americans each year. Information on sentinel events gathered at military hospitals is typically presented as numerator data without much analysis. Fearing litigation and blame, health care providers appear to be reluctant to report on "near misses" where errors have occurred, but not resulted in actual harm. Using a non-punitive approach, anesthesiologists championed a method to learn from errors in order to improve patient outcomes. This graduate ... |
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| Analysis of the Selection Process for Executive Management Positions at Navy Medical/Dental Treatment Facilities |
MAR 2001 |
201 pages |
| Authors:
Mark J. Stevenson; Chad E. Roe; NAVAL POSTGRADUATE SCHOOL MONTEREY CA
|
| This study describes, analyzes and compares Navy Medicine's command screening process. Organizational structure and behavioral models, and public policy models are used to explain the process and to provide the theoretical framework for the study. Twenty-one semi-structured interviews were conducted with senior stakeholders involved in the process. A written questionnaire (Likert-scaled and closed-ranking) was developed to assess the knowledge and perceptions of Navy Medicine Captains (n = 146). Statistically significant ... |
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| Using On-Line Analytical Processing (OLAP) and Data Mining to Estimate Emergency Room Activity in DoD Medical Treatment Facilities in the Tricare Central Region |
MAR 2001 |
118 pages |
| Authors:
Cary V. Ferguson; NAVAL POSTGRADUATE SCHOOL MONTEREY CA
|
| On-line Analytical Processing (OLAP) and data mining can greatly enhance the ability of the Military Medical Treatment Facility (MTF) emergency room (ER) manager to improve ER staffing and utilization. MTF ER managers use statistical data analysis to help manage the efficient operation and use of ERs. As the size and complexity of databases increase, traditional statistical analysis becomes limited in the amount and type of information it can extract. OLAP ... |
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| Inpatient Obstetric Care at Irwin Army Community Hospital: A Study to Determine the Most Efficient Organization |
MAR 2001 |
86 pages |
| Authors:
Timothy N. Bergeron; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
|
| This study attempts to compare, analyze, and recommend the most efficient model with which to deliver inpatient obstetrics and gynecological services to the served population of Irwin Army Community Hospital. During a time in which the United States Armed Forces continue to experience increased budgetary constraints, the cost of delivering health care to military beneficiaries continues to increase. Decreases in the overall military budget after considering the effects of inflation ... |
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| Assistive Technology Research Center |
MAR 2001 |
36 pages |
| Authors:
John Toerge; Joseph Bleiberg; Michael Rose; NATIONAL REHABILITATION HOSPITAL WASHINGTON DC
|
| The ATNRC is entering the second year of its second four-year funding cycle. Its missions remain the following: Assessment and enhancement of cognitive and motor function; evaluation and support for Activities of Daily Living; applications of telehealth and Virtual Reality; and product design. Accomplishments from year one of the new cycle included the development of a turnkey Virtual Reality testbed that incorporates gaze monitoring. Automated Neuropsychological Assessment Metrics (ANAM) was ... |
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| A Prospective Evaluation of Telemedicine in Remote Naval Populations Seeking Specialty Care |
05 JAN 2001 |
26 pages |
| Authors:
Ted Melcer; Darrell Hunsaker; Bobbi Crann; Lisa Caola; William Deniston; NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA
|
| Telemedicine technologies, such as Internet and live videoteleconferencing (VTC), have great potential to provide specialty care for naval personnel in remote treatment facilities at sea or onshore. This study focused on the clinical impact of ear/nose/throat (ENT) consultations conducted via live VTC during a planned, 4-month study period in TRICARE Region 9 Also, interviews of physician and non-physician medical personnel assessed their attitudes and recent use of telemedicine. A total ... |
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| Estimating the Military Retirement Health Care Liability |
JAN 2001 |
|
| Authors:
Melvin R. Etheridge Jr; LOGISTICS MANAGEMENT INST MCLEAN VA
|
| The Department of Defense provides health care to retired military service members and their dependents and survivors. This care is provided directly at military medical treatment facilities (MTFs) and by care purchased from civilian providers in the Tricare program. DoD funds the benefit when it is delivered. The Chief Financial Officers Act of 1990 requires DoD to report the liability that has accrued for future benefits on the Department's annual ... |
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| Evaluation of the Virtual Naval Hospital |
DEC 2000 |
|
| Authors:
Peter H. Stoloff; CENTER FOR NAVAL ANALYSES ALEXANDRIA VA
|
| The Virtual Naval Hospital (VNH) is a digital medical library administered over the Internet by the Electronic Differential Multimedia Laboratory, University of Iowa College of Medicine in collaboration with the U. S. Navy Bureau of Medicine and Surgery (BUMED). A CD-ROM version of the VNH is also distributed to Navy health care providers. Its purpose is to deliver authoritative medical information to point-of-care medical providers to help take better care ... |
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| A Subacute Care Intervention for Short-Stay Breast Cancer Surgery |
OCT 2000 |
84 pages |
| Authors:
Gwen K. Wyatt; Barbara Given; Charles Given; MICHIGAN STATE UNIV EAST LANSING
|
| The purpose of this study is to add to the scientific basis for providing subacute care in the home, by testing the effects of a post-operative nursing intervention designed to facilitate quality of life and physical/ psychological well-being after diagnosis and surgery for breast cancer. A randomized clinical trial with repeated measures is examining the effects of the intervention. The intervention participants (n=1OO) receive the targeted subacute care protocol in ... |
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| Looking to the Future: Health Professions Education in Texas |
SEP 2000 |
|
| Authors:
Richard Rettig; RAND CORP SANTA MONICA CA
|
| Many of the issues faced by Texas schools as they plan for the future are really broad health care issues faced by the state and even the country as a whole: do we have enough doctors, nurses, and other health care professionals? What do the numbers look like for the future? How are these professionals distributed in terms of primary vs. specialty care, geography, and relative to ... |
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| TRICARE and Mental Health: Providing the Benefit |
SEP 2000 |
|
| Authors:
Susan Schutte; Michelle Dolfini-Reed; CENTER FOR NAVAL ANALYSES ALEXANDRIA VA
|
| (Navy medicine has identified mental health as one of the major product areas in which it wants to develop a business strategy that supports the effective and efficient provision of these services to the military health system's beneficiaries. To develop this strategy, the Navy Bureau of Medicine has established a mental health product line executive panel. It's members include both medical and non-medical Navy and Marine Corps personnel, reflecting the ... |
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| Primary Care and Regular Breast Cancer Screening Among Under-Served Minority Women |
AUG 2000 |
57 pages |
| Authors:
Ann O'Malley; GEORGETOWN UNIV WASHINGTON DC
|
| Purpose: To describe the components of primary care associated with adherence to regular breast cancer screening among low-income minority women. Scope: This study included secondary analyses of an existing dataset (completed- yr 1), conduction of focus groups (completed yr 2), and the development and conduction of a bilingual population-based telephone survey of lower income women over age 40 in Washington, D.C. to assess their experiences with breast cancer screening and ... |
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| Delays and Refusal in Treatment for Breast Cancer Among Native American and Hispanic Women with Breast Cancer |
AUG 2000 |
44 pages |
| Authors:
Elba Saavedra; Elias Duryea; NEW MEXICO UNIV ALBUQUERQUE
|
| The aim of this study was to describe the factors associated with delays in breast cancer treatment among New Mexico Hispanic, Native American and non-Hispanic white women. Scope: The study is currently enrolling a total of 70 participants, 35 patients and 35 caregivers identified by the patient This ethnographic study will gather data on the psychosocial, cultural, attitudinal, spiritual and demographic variables associated with delays and refusals in breast cancer ... |
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| A Decision Model for Senior Leaders: Reinventing Healthcare at Dewitt Army Community Hospital |
JUL 2000 |
88 pages |
| Authors:
Pamela S. Cluff; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
|
| Effective management of today's comprehensive and complex health care systems requires an integrated and future-looking approach, if these systems are to survive in today's turbulent political and economic climate. It is obvious that decisions must be made regarding the long-term health care planning strategy for Dewitt Army Community Hospital (DACH), as well as the local and regional systems that support it. Because the Department of Defense does not currently have ... |
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| The Effect of Primary Care Re-Engineering On Patient Satisfaction at McDonald Army Community Hospital: A Longitudinal Study of Ex-Post Facto Design |
12 JUN 2000 |
91 pages |
| Authors:
John F. Zeto; ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
|
| At the initiation of fiscal year 2000, 1 October 1999, McDonald Army Community Hospital (MACH) at Fort Eustis Virginia transitioned its third floor clinic from a government-owned, contractor-operated (GOCO) primary care source to a government-owned, government-operated (GOGO) primary care source. Implementation of the operational change was intended to be invisible to the supported patient population, but was expected to cause some patient turn%oil and frustration nonetheless, with resulting decreased scores ... |
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| Predictors of Satisfaction with Access to Medical Care |
01 JUN 2000 |
36 pages |
| Authors:
Mary K. Roou; GREAT PLAINS REGIONAL MEDICAL COMMAND FORT SAM HOUSTON TX
|
| The purpose of this management project was to determine if there was a relationship between staffing, the number of exam rooms, clinic operating hours, ease of making an appointment; and satisfaction with access to medical care. Additionally, a predictive model was developed. The sample population came from the clinics within Brooke Army Medical Center for FY 98-99. Three types of clinics were chosen for this analysis: high cost, high volume, ... |
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| Pediatric Outpatient Clinic Manpower Requirement Variables at Navy Medical Treatment Facilities |
JUN 2000 |
89 pages |
| Authors:
Jeanne M. Sarmiento; NAVAL POSTGRADUATE SCHOOL MONTEREY CA
|
| This thesis examines the variables that influence the determination of manpower requirements at Naval Medical Center San Diego and Naval Hospital Bremerton Pediatric Outpatient Clinics. The study reviews the military and civilian managed care program, the principles of Population Health Management, and the present medical model used by military and civilian facility to determine medical manpower requirement. The researcher sent survey questions via electronic mail ... |
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| VA and Defense Health Care: Rethinking of Resource Sharing Strategies isNeeded |
17 MAY 2000 |
11 pages |
| Authors:
Stephen P. Backhus; GENERAL ACCOUNTING OFFICE WASHINGTON DC HEALTH EDUCATION AND HUMAN SERVICES DIV
|
| We are pleased to be here today to discuss the Department of Veterans Affairs' (VA) and the Department of Defense's (DOD) sharing of federal health care resources. VA and DOD combined provide health care services to more than 12 million beneficiaries and operate more than 700 medical facilities at a cost of about $34 billion annually. You asked us to conduct a review of the sharing program, ... |
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| A Retrospective Study Comparing the Costs and Outcomes of Three Alternatives for Monitoring Patients Who Come to an Emergency Department with Chest Pain (ICD-9 Code 78650 and 78659) |
09 MAY 2000 |
111 pages |
| Authors:
Joyce K. Borgfeld; AIR FORCE INST OF TECH WRIGHT-PATTERSONAFB OH
|
| The purpose of this study is to compare the costs, length of stay, patient outcomes and physician diagnostic practices for three alternatives of monitoring patients who come to an emergency department complaining of chest pain (ICD-9 codes 78650 & 78659) in a military medical treatment facility (MTF). In addition, this study will compare TRICARE (military health maintenance organization) enrollment versus non-enrollment status on length of stay, ... |
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| Adherence to Hypertension Management Recommendations for Patient Follow- Up Care and Lifestyle Modifications Made by Military Healthcare Providers |
MAY 2000 |
82 pages |
| Authors:
Timothy J. Collins; UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD
|
| The purpose of this study was to describe military healthcare providers adherence to nationally recognized hypertensive patient guidelines concerning lifestyle modifications and follow-up instructions after an initial diagnosis of hypertension. The importance of monitoring high blood pressure (follow-up) and maintaining blood pressure control was examined. Research has shown that while hypertension follow-up is being performed, physicians are not following established guidelines aggressively enough in identifying situations in which more robust ... |
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| Women's Health and Pregnancy Outcomes: Does Access to Services Make a Difference |
MAY 2000 |
|
| Authors:
Elizabeth Frankenberg; Duncan Thomas; RAND CORP SANTA MONICA CA
|
| The question of how access to services affects health outcomes is critical for policy makers allocating resources across different programs, but it is difficult to answer with cross-sectional data sets. We use data from a panel survey in Indonesia (the Indonesia Family Life Survey) that spans a period of a major expansion in access to midwifery services to investigate whether the expansion resulted in improved health ... |
|
| DHIAP Phase I Technology Demonstration Report: Prototype for Remote Authentication Dail-In User Service (RADIUS) |
01 APR 2000 |
38 pages |
| Authors:
Lynn S. Crane; Lane H. Melton; Jack Stinson Jr.; Archie D. Andrews; Forrest V. Schwengels Ii; ADVANCED TECHNOLOGY INST CHARLESTON SC
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| The Defense Healthcare Information Assurance Program (DHIAP) involved demonstration of prototype information assurance technology to assess the impact on military Medical Treatment Facility (MTF) operations and ability to improve security of sensitive information. The prototype, developed and tested in a distributed laboratory and demonstrated at two MTFs within a region, is a system that meets the Remote Authentication Dial-In User Service (RADIUS) standard. This report describes the development and trials ... |
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HEALTH CARE FACILITIES
