Capitation and informatics

When physicians, hospitals, and allied health professionals bill for services they render, their information processing requirements are relatively simple, at least compared to those of capitated organizations. When payers (insurers or employers) accept financial risk for the health care services of beneficiaries, they have usually invested in claims processing, membership tracking, and, under managed care, utilization review and provider profiling systems. But payers, for the most part, have not invested in electronic collection of clinical information about beneficiaries, nor have they tended to keep all claims they have processed in electronic form for study after accounts are settled and payments disbursed. In this article, we will explore why informatics is so important to capitated organizations and why payers that have traditionally taken financial risk for insuring the health care costs of populations are also learning about the importance of informatics.     

Freedom of movement vs. exclusion: a reinterpretation of the "insider"-"outsider" divide in the European Union

"This article argues that the question of free movement vs. exclusion within the European Union (EU) can be addressed satisfactorily only if we move away from the narrow state-centrism inherent in the current debate. What is required is to 'open' the state concept and examine the implications of state-society relations for EU policy making. Once this is done, it can be seen that the exclusionist stance of the immigration policy and the essentially intergovernmental nature of the policy making are due to an implicit contract between states and constituents implied by the concepts of nationality and citizenship. According to this perspective, the focus on the state or the political elite alone is too one-sided and misses the more complex factors bearing upon EU policy making in this area."     

Immigration to the Federal Republic of Germany as a demographic and social problem

"Addressing the question of immigration to Western Europe and especially to Germany from east and southeast Europe and from developing countries of the South, this article considers whether such immigration can compensate for reductions in population in developed countries. It is argued that the demographic deficits of an aging population can only be corrected to a limited extent through immigration. Any solution, in order to be effective, must include a simultaneous increase in the birthrates of Germany and other European Community countries. With particular regard to future social development in Germany and the EC, it would be advisable for governments to effect measures that will provide both for controlled admissions of immigrants from outside the EC and an increase in local reproductive capabilities."     

An evaluation of population projection errors for census tracts

"In this article we evaluate the accuracy and bias of projections of total population and population by age group for census tracts in three counties in Florida. We use [U.S. census] data from 1970 and 1980 and several simple extrapolation techniques to produce projections for 1990; we then compare these projections with 1990 census counts and evaluate the differences. For the total sample, we find mean absolute errors of 17%-20% for the three most accurate techniques for projecting total population and find no indication of overall bias. For individual age groups, mean absolute errors range from 20%-29%." This is a revised version of a paper presented at the 1993 Annual Meeting of the Population Association of America.     

Managed care information needs: a summary perspective

The key to survival in managed care is management of financial risk. You need to know what is in your contract and what you are obligated to do for which population during which period. Information systems can be an enormous help in managing managed care contracts and the financial risks they entail, but poorly selected and configured information systems will do little good for the organization that licenses them. The most important activity of a physician executive who is moving his or her organization into managed care contracting is to lead the process to define the functional requirements for information the organization will need to manage managed care contracts successfully.     

《新西兰文化与认同感·序言》

《新西兰文化与认同感·序言》大卫·诺维茨比尔·威尔莫特著涂开益徐永安译编选本书的初衷,源出编者在讨论新西兰民族认同感与文化的基本命题时,对于人们所持方式的关注。我们俩人一致认为,当时的争论有两点失之偏颇：一是如何准确理解被称之为文化的这种奇特现象,二...     

Immigration dilemmas

Recent trends in immigration to Poland are reviewed, including both voluntary migration and migration forced by extreme political or economic circumstances. Data are also presented on illegal immigrants and on their countries of origin.     

日本人:公也分明,私也分明

人刚到日本,就有朋友忠告:不能用公家信封和稿纸写私人信件,哪怕是你从国内带来的也最好不用,否则人家看不起你。初听此话,居然盯着对方,将信将疑。 一日黄昏,在一家店里饮咖啡,忽见一位胸牌上写有“支配人”三个字的中年男人,急冲冲来到大堂的挂壁电话前,掏出钱包里的磁片塞进话机,告诉太太加班晚归。当头儿的放着办公室电话不用,却自己掏钱打电话的真人真事,被我写进好几封给国内亲朋好友的信中,着实当成“新闻”感慨了几番。     

A tobacco and alcohol use profile of San Francisco's Chinese community

Relatively little is known about Asian American tobacco and alcohol use patterns. This is particularly true of Chinese living in the United States--either U.S.-born or non-U.S.-born Chinese. This article presents data from a research project studying tobacco and alcohol use patterns in San Francisco's Chinese community. Data were secured both from focus groups and a self-report telephone survey of a random sample of 1,808 Chinese residents in San Francisco. This results indicate that the prevalence of both tobacco and alcohol use is lower for San Francisco's Chinese population than for the general population. Moreover, those persons who report smoking tend to be different from those who report consuming alcohol. The study concludes that specific, culturally relevant tobacco and alcohol prevention programs should be designed to better reach this target population.