TMR: An Automated System for Managing Revenue

Abstract

The Total Medical Record (TMR) system used by the Division of University Health Services at Duke University is an integrated medical and management information system. One module supports the financial needs of the division. To facilitate managerial performance, TMR automatically prints insurance claims, refund statements, revenue summary data, service utilization, itemized visit statements, monthly patient bills, dunning letters, and has a host of unique features that aid management with controlling the private fees generated by the University Health Services. In addition, the servicing of prepaid programs is accommodated, and the splitting of charges between prepaid and fee-for-service programs occurs automatically.     

Men,Gender, and Health: Toward an Interdisciplinary Approach

Abstract

The anatomy and physiology of the ears, nose, and sinuses are reviewed. Diseases and injuries typically associated with water sports are discussed, with emphasis on pathophysiology, treatment, and preventative measures.

“Screening for Chlamydial Infections in Women Attending Family Planning Clinics: Evaluation of Presumptive Indicators for Therapy,” JULIUS SCHACHTER, EILEEN STONER, and JEANNE MONCADA. Chlamydia trachomatis was recovered from the cervices of 9.8 percent (268/2,729) of women attending seven family planning clinics. The infection rate varied from 5.5 percent to 22.5 percent in different clinics. Chlamydial infection could be associated with younger age, nulliparity, being black and use of oral contraceptives. Most (70 percent) of the chlamydial infections were inapparent and presumptive indicators for antichlamydial therapy that are useful for symptomatic women will not make a major impact on this reservoir. It is concluded that chlamydial cultures are needed to deal with the high prevalence of these infections. (Western Journal of Medicine 1983 Mar;138:375–379.)     

Alcohol-Related Problems Seen at the Student Health Services

Abstract

The number and types of alcohol-related problems seen by medical, nursing, and mental health professionals at the University of Massachusetts Health Services has been assessed since 1975 as part of a Demonstration Alcohol Education Project.

Medical outpatient clinic alcohol-related contacts using encounter forms completed on every outpatient visit during 1975 and 1976 revealed that 0.08% of approximately 92,500 visits annually were alcohol related, including 0.03% for chronic problems and 0.05% for acute problems (mainly contusions, lacerations, and fractures). Week-long contact surveys conducted in November 1976, and April 1977 recorded a much higher proportion of alcohol-related problems for over 60% of about 2,200 contacts each week. In November 1976, 1.4% of 1,346 reported visits were alcohol related, including 8.0% of contacts which occurred on weekends. In April 1977 2.7% of 1,582 reported visits were alcohol related, including 17.0% of weekend visits. No chronic alcohol problems were reported either week, and most of the acute problems involved traumatic injuries, such as contusions, lacerations, and sprains.

Mental health outpatient clinic alcohol-related contacts self-reported by students at the initial visit revealed that 5.8% of 1,179 initial visits between January 1976, and June 1977 were alcohol related, most involving their own alcohol use. Week-long contact surveys involving all 256 contacts during November 1976 and 192 contacts during April 1977 showed that 13.7% of contacts were for alcohol-related problems, over half due to alcohol abuse by someone else, such as a parent or boy/girlfriend.

The findings suggest that a significant proportion of students seen by student health services have acute rather than chronic alcohol-related problems, especially acute traumatic injuries and relationship problems.     

Patients' Evaluations of the Mental Health Service at a Health Sciences Campus

Abstract

Health science students, along with the health professionals they hope to become, are at increased risk for certain occupational injuries and illnesses. One of these risks is occupational exposure to blood-borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis, which may result in severe illnesses or even death. Two case studies demonstrate postexposure care of exposed individuals at the University of Texas Medical Branch Student Health Services before and after policy changes and prevention strategies were strengthened in response to exposure incidents.     

Knowledge and Attitudes of University Health Service Clients about Genital Herpes: Implications for Patient Education and Counseling

Abstract

Genital herpes virus infection is an important target for health education efforts because of its apparently rising incidence in the college student population and because it can have potentially serious psychological as well as medical consequences. In order to better understand the health education and counseling needs of students, the present study surveyed knowledge and attitudes about genital herpes of 190 university students using a gynecology clinic and of 161 students using a general medical clinic. The students were found to have a high degree of familiarity with the disease, its cause, and mode of transmission, but tended to view the consequences of the disease as more severe than is actually warranted by the common medical complications. There was some degree of misinformation about prevention and treatment of the disease and some negative attitudes about patients suffering from it, but the survey respondents endorsed a high level of responsible behavior with regard to the disease and expressed some optimism about the possibility of adapting to it. These findings suggest specific misconceptions about genital herpes that might be amenable to a mass education approach. They also suggest the need for a counseling program that centers around reasonable reassurance and appropriately positive psychological and medical management for newly diagnosed patients.     

Call to action: Better care,better health,and greater value in college health

ABSTRACT

It is time for action by leaders across higher education to strengthen quality improvement (QI) in college health, in pursuit of better care, better health, and increased value – goals closely linked to students' learning and success. The size and importance of the college student population; the connections between wellbeing, and therefore QI, and student success; the need for improved standards and greater accountability; and the positive contributions of QI to employee satisfaction and professionalism all warrant a widespread commitment to building greater capacity and capability for QI in college health. This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring QI to the forefront of college health practice – and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.     

Engaging Intercollegiate Athletes in Preventing and Intervening in Sexual and Intimate Partner Violence

Abstract

Objective: The object of this exploratory evaluation was to evaluate the “Bringing in the Bystander” sexual and intimate partner violence prevention program with a new sample of intercollegiate athletes. Participants and Methods: Fifty-three male and female athletes participated in the program (experimental group), and 86 were in the control group. All completed pretest, posttest, and 2-month follow-up surveys, including assessment of rape myth acceptance, intent to engage in bystander behaviors, bystander confidence, and bystander behaviors. Results: The program worked overall and for both women and men, improved bystander confidence and intent to engage in bystander behaviors, and did not create significant backlash effects (ie, worsening of attitudes as a result of program). Conclusions: The program fits with the intent of the National Collegiate Athletic Association CHAMPS/Life Skills program regarding its focus on the overall development of student-athletes and demonstrates the promising bystander approach compatible with the 2007 American College Health Association toolkit, Shifting the Paradigm: Primary Prevention of Sexual Violence.     

The Relation Between Therapeutic Alliance and Treatment Motivation in Residential Youth Care: A Cross-Lagged Panel Analysis

This study investigated the longitudinal relation between therapeutic alliance and treatment motivation in a sample of 174 adolescents receiving residential treatment in the Netherlands. Structural equation modeling with a cross-lagged panel design was used to examine the relation between therapeutic alliance and treatment motivation up to 9 months of treatment. Results revealed that autoregressive associations between initial therapeutic alliance and alliance at subsequent time points were significant, whereas for treatment motivation a significant association was found after 6 months, but not after 9 months. Results also showed that a higher level of therapeutic alliance after 3 months was predictive of a higher level of treatment motivation after 6 months. Furthermore, a higher level of therapeutic alliance after 6 months was predictive of a higher level of treatment motivation after 9 months. Implications for research and clinical practice are discussed.