Regulation of board-and-care homes: research to guide policy

Information about board-and-care homes reported in the media and in federal committee hearings indicates that they are shoddy and exploitative environments that do not provide adequate care. Research done in board-and-care homes in recent years, however, demonstrates that they can provide adequate care and a satisfying environment for some of the people they serve. Policy at the federal, state, and local levels should be guided by both the need to assure the health and safety of board-and-care residents and the needs of residents and operators identified in scientific studies.     

Migration from Latin American countries to the United States: the economic,social and reproductive lives of Hispanic female immigrants, 1980

The authors describe the socioeconomic characteristics and fertility patterns of female immigrants from Latin America to the United States, with a focus on reasons for fertility differentials. "Using the one per cent public use sample from the 1970 and 1980 United States census, we first compare changes in socio economic characteristics from 1970 to 1980, and then examine the determinants of fertility of female immigrants to the United States, aged 16-49, from four Latin American areas or countries of birth.... The findings...suggest that there are direct effects of demographic, assimilation, and socioeconomic variables beyond those mediated by the variables in each of these sets. Further, regardless of the model, the effect of the clusters of demographic characteristics is most apparent. Age categories and marital status are the strongest indexed determinants of immigrant fertility.... The effect of education and employment is strong. Among assimilation variables, duration of residence and language ability are significant determinants of Hispanic immigrant fertility." (SUMMARY IN FRE AND SPA)     

Mortality among three Puerto Rican populations: residents of Puerto Rico and migrants in New York City and in the balance of the United States, 1979-81

"This study attempts to explain similarities and differences in the mortality experience of three population groups: Puerto Ricans on the island commonwealth, Puerto Rican born persons in New York City and Puerto Rican born persons in the rest of mainland United States. Mortality is much higher among Puerto Ricans in New York City than among those residing elsewhere. Much of the difference is due to excess mortality caused by cirrhosis of the liver and homicide. Puerto Rican born persons living on the mainland but outside New York City generally have low mortality, even when compared with U.S. whites."     

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.     

Application of Stein-type estimation in combining regression estimates from replicated experiments

This paper considers the application of Stein-type estimation procedure for the coefficients in a linear regression model when data are available from replicated experiment. Two families of estimators characterized by a single scalar are proposed and their large sample asymptotic properties are derived. These are utilized for comparing the performances of the two estimators along with the conventional estimator and conditions for the superiority of one estimator over the other are deduced.     

The new illegal immigration in Japan, 1980-1992

"This article presents some of the latest available figures on illegal immigration in Japan, a process that did not assume significant proportions until the mid-1980s. It also discusses briefly the latest developments around 'immigration' policy--more precisely, the law on the entry and exit of aliens."     

Ascendancy of primary care will create role intensification for physician executives

The need for physicians in management roles in the health care system has never been greater. And the years ahead will see that need broadened and intensified. To maintain their leadership role in medical affairs in hospitals and other types of health care delivery organizations, physician executives will have to envision provider organizations and systems that have not yet been conceived, let alone developed and implemented. They have to become totally open-minded and futuristic in their thinking. And they will have to help other physicians accommodate this new way of thinking if the medical profession is to continue in a leading role in health care matters. Although numerous factors will have to be anticipated and analyzed by these new physician leaders, the ascendancy of primary care in a managed health care world long dominated by the technical and technological superiority of hospital care will present a particular challenge to the physician executive.