This article presents the authors' response to the invited commentaries on their paper (Wallace and Beange, 2008). On the point of "specialism", the authors emphasise a fundamental premise of their argument: the proposed "specialist" hospital-based service is inherently enmeshed within generic services at the hospital level,…

This commentary discusses whether a sufficient case has been made for specialism in hospital services as a viable alternative to existing generic services. The impact of developments in specialist care such as those outlined by Robyn A. Wallace and Helen Beange should be assessed as a means of reducing inequality. In particular, model services…

In this article, the author comments on the paper "On the need for a specialist service within the generic hospital setting" (Wallace & Beange, 2008), which raises critical issues regarding effective models of healthcare delivery for individuals with intellectual disability (ID), particularly within a hospital setting (but not…

Although the presence of intellectual disability (ID) per se is not usually regarded as a health problem, the biopsychosocial implications of cognitive impairment contribute to the vulnerability of adult patients with ID in any healthcare system. The adult patient with ID differs from a patient in the general population in terms of health…

TennCare is an approach to providing health care for former Medicaid recipients and the uninsured in Tennessee. The state designates a specific dollar amount per patient and contracts with managed care organizations to allocate funds and provide services. (JOW)

Notes that rapid escalation of health care costs is growing concern for college health administrators charged with negotiating contracts for student health and accident insurance policies. Argues that student health service can serve same function as health maintenance organization, offering students range of services available and referring to…

Notes that professionals in mental health field are increasingly challenged to provide appropriate services within parameters of what will be reimbursed by third party. Contends that these sometimes oppositional forces create philosophical, clinical, and ethical dilemmas. Explores issues, examines circumstances that have led to their creation, and…

This article compares behavioral health service use and cost for foster care versus nonfoster care children; children before, during, and after foster care placement; and successfully reunified versus nonsuccessfully reunified foster care children. Behavioral health service costs for children in foster care were higher than for children not in…

Purpose: The long-term effectiveness and efficiency of an outpatient geriatric evaluation and management (GEM) program was compared to usual primary care (UPC). Design and Method: A randomized controlled group design was used. Health care utilization, cost of care, and survival were assessed during a 48-month period among a sample of 160 male…

A group of seven private colleges in Oregon, frustrated with the erratic pricing of health care in the state, decided to band together, drop their health-plan providers, and create a consortium to self-insure their employees. The Oregon Independent Colleges Employee Benefits Trust came into existence on May 1, 2003 and offers a collective…

This document is the first of three documents which present the Senate hearings on catastrophic health insurance called to determine how the private sector and the government can work together to lend support to the elderly and their families when they are threatened by catastrophic illness and to examine the issue of coverage of catastrophic…

This document, the second in a series of three which present the text of Senate hearings on catastrophic health insurance, focuses on the impact of catastrophic health insurance on consumers and health care providers. Testimony is included by these witnesses: (1) Senator Pete V. Domenici; (2) Wilbur Cohen, professor of Public Affairs, University…

Health care cost inflation has been the most significant influence on worksite health promotion in the past. Perception of program impact on business-relevant variables currently has the greatest influence, and increased corporate attention to competitiveness and productivity will be the most influential factor in the 1990s. (IAH)

Estimated impoverishment risk for two samples of community-living elderly (N=900+). Found that for elders over age 75, 46 percent of those living alone and 2 percent of couples would spend lifetime assets and current income, becoming impoverished in 13 weeks if institutionalized in skilled nursing facility. Rates were comparable for elders over…

Using data from 1981-82 Channeling Demonstration project, examined types of health care costs (hospital, physician and ancillary care, nursing home, and prescription medicine) that contributed to overall expenses to determine sources of financially catastrophic health care expenses among disabled elderly persons. Found expenses for prescription…