Refugee research in Africa: problems and possibilities

The author discusses the magnitude of the refugee problem in selected countries of Africa, with a focus on the "conceptual, methodological and practical problems faced by refugee researchers in Africa." (SUMMARY IN FRE AND SPA)     

Measurement of Hispanic ethnicity in the U.S. census: an evaluation based on latent-class analysis

"Two models, the U.S. census model and the latent-class model, are compared in their application to evaluating measurements of ethnicity. Although the census approach assumes that the response categories of a questionnaire item correspond to groups in the population, the latent-class approach seeks to assess whether any set of response categories can represent observed ethnic heterogeneity. Data collected using the 1990 census Hispanic-origin question and other instruments for measuring ethnicity suggest that the latent-class approach is superior whenever the response categories are not known to be valid. In particular, using the latent-class model, this article rejects the census model's assumption of a single dimension of meaning underlying responses to the Hispanic-origin question."     

THE EFFECTS OF PRESTIGE NAMES IN QUESTION WORDING

Although survey researchers are often warned against using prestigenames in questions (e.g., identifying Contra aid as "PresidentReagan's policy"), prestige names are still commonly used. Tolearn more about the effects of using prestige names, we analyzetwo sets of experiments—on judicial confirmation electionsand on an initiative on tax indexing. The results indicate thatprestige names do more than shift responses in one direction—they eliminate the effect of education on DKs and provide moreof a political basis for the responses.     

Religion: friend or foe of the aging?

Religion can be a guide in the quest of older adults for a fuller understanding of their lives and purposes as they cope with the diminishments brought about by aging.     

Population and towns in Senegal: demo-geographic growth

Using data from the 1976 and 1988 censuses, the author notes that the population of Senegal has grown by 37.6 percent over the period and that this growth is concentrated in urban areas. One feature of this trend has been the growing primacy of the capital Dakar and a decline in the relative importance of smaller towns. The need to discourage rural-urban migration by promoting socioeconomic development in rural areas is stressed. (SUMMARY IN ENG)     

Bringing baby home: a comprehensive case management program for obstetrical services

Originally presented to the Society of Home Health Care Management of the American College of Physician Executives at its November 16, 1993, meeting in Tucson, Ariz., the program described in this article was the winner of the College's 1994 Innovations Award in Medical Quality Management, sponsored by Merck Sharp & Dohme. The program shows the potential of case management for both improvement in the quality of care and containment of costs for a managed care population with a substantial Medicaid segment. This article is part of a continuing series on innovative programs in home health care.     

I get paid fast; what about you?

The process of billing an insurance company for health care services has changed radically. In the past few years, the emphasis has been on automation. The change is fueled by the opinion of cost containment experts who claim that automation will help reduce costs in the U.S. health care delivery system. Key to success for the provider in adapting to this change will be understanding the coding used in the billing process and following standards of accuracy and fairness. This article is not intended to represent the adjudication rules of any particular insurance company. It is the result of experience as a practicing surgeon and as a consultant in the health care field.     

Practice standards use with internal partners

U.S. Department of Defense experience with internal partnership programs has indicated that a lack of close supervision by medical treatment facilities can result in cost increases. The use of medical practice guidelines or standards is the subject of active investigation. The global guidelines tend to be too rigid or too vague to affect the provision of care. Their general acceptance can often be low. The use of clinical guidelines, with supervision by a clinic peer, has been determined to be a provider-friendly method of delivering cost-effective, high-quality care. Comparisons were made between the supervised partners against the total expenditures for ENT outpatient CHAMPUS care. The results indicated not only a savings but a reduction in the rate of cost increases by more than 250 percent. It is our feeling that specialty provider, peer-directed medical standards can be applied in a cost-effective manner. Their adoption as an organization-wide standard for referral can be an important tool in maintaining quality while containing costs.