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.     

Delivery and funding are provincial matters in Canada

The following article is one of a series that deal with the provision of health care services around the world. Other countries in the series include Germany, Italy, Japan, Mexico, the Netherlands, and the United States. Countries scheduled for coverage in the series include Austria, France, Singapore, Spain, and the United Kingdom. The countries are described using a grid of characteristics so that comparisons may be made more easily. All of the analyses, along with further comparative data, will be gathered into a freestanding book to be published later in the year. Dr. Mendoza serves as editor for the project.     

Fertility incentives and participation in localities with limited means: a dynamic model of per capita resources

Several countries have attempted to change human fertility through economic incentives. This paper presents simple mathematical models of the participation of couples in a locally funded program of economic incentives. The models take as a springboard China's one-child program. Localities with low per capita incentives attract few couples to the program, while localities with high incentives attract many couples at first, but the value of the benefits is then watered down. The models show that participation in the program may persistently oscillate or may decay to a stationary level. Which behavior occurs is determined by whether there are decreasing, constant, or increasing returns in the rates of participation in response to successive equal increments in the incentive offered, and by the extent to which prospective parents learn from experience with past oscillations in the incentives. The models raise many empirical questions about the dynamics of incentive programs.     

Taikongs and Calos: the role of middlemen and brokers in Javanese international migration

"This article discusses international migration from Java in the past and present and the role brokers have played in stimulating this movement. It describes legal and clandestine labor migration to Singapore, Malaysia, and Saudi Arabia, the influence of employment brokers on the process, and the organization of the recruitment networks. The involvement of brokers is crucial but not always beneficial for the migrants. Migrants are dependent on the brokers and risk exploitation. In the case of movement to Saudi Arabia, there is a linkage with religious institutions and the Islamic pilgrimage."     

Mortality differences in Norway. Two biographical data analyses and one question about female mortality differentials

"The aim of this paper is, first, to give an overview of the local history approach developed in adult mortality differentials; secondly, to present its potentiality compared with a more usual approach.... Our methodology was applied to Norwegian data."     

Environmental hazards and the health status of women and children in a riverine community in Nigeria: Nikrowa in Edo State

Nikrowa is a riverine village located in Ovia North-East Local Government Area of Edo State. This paper examines the relationship between the environment and the health status of women and children in the village. Data used in this essay were obtained mainly in focus groups from a study of women and health service utilization in Nikrowa. Women in Nikrowa farm, fish, collect water and firewood, and process and prepare food. They also bear many children. Their hard physical labor causes them to suffer continuous body aches and pains. Environment-related illnesses such as malaria, measles, dysentery, and diarrhea are prevalent among children. The geographical isolation of Nikrowa limits access to modern health care facilities, so traditional therapies are used to treat prevailing illnesses. It is suggested that women have access to fertilizers in order to improve soil fertility and agricultural yields. Fuelwood and adequate and safe water supplies should be made readily available to women. Moreover, access roads to rural areas should be improved to facilitate transport to modern health care facilities, and rural primary health care facilities should be helped to provide efficient services by providing trained staff and ensuring regular supplies of drugs.