Reviews what is known about the effect of managed care on access to health services, as well as utilization of hospital care, emergency department visits, primary care services, and specialty pediatric services. The effect of managed care appears dependent on several factors and, thus, is likely to vary according to the population served. (SLD)

Determines the extent to which people with and without health care insurance use public health care facilities and various health care services. Analyzes 6,298 patients from 4 county-funded primary health care clinics. Patients were overwhelmingly poor regardless of insurance status. High cost-sharing requirements, coupled with larger families and…

Evaluated a school-based program designed to immunize adolescents in Kansas City, Missouri, schools against hepatitis B. Approximately 75 percent of 12,986 participating students completed the vaccine series. Larger schools reported decreased participation and completion rates. Both rates were highest in schools providing educational intervention.…

Purpose: Our objective in this study was to compare Medicare costs of treating older adults with and without dementia in nursing home settings. Design and Methods: An expert panel established the dementia status of a stratified random sample of newly admitted residents in 59 Maryland nursing homes between 1992 and 1995. Medicare expenditures…

Because of the vast improvements in adolescent substance use assessment, it is widely recognized that adolescent substance use disorders (SUD) encompasses diverse drugs, patterns and etiologies and are characterized by extensive heterogeneity in other life domains. The next step in advancing adolescent SUD assessment is to classify adolescents…

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (PL. 104-191) is a multitiered, comprehensive, convoluted, and controversial federal law for sweeping health care reform. Although HIPAA is dramatically broader in scope than privacy protections for health care information, a provision for privacy in the form of a Privacy Rule…

According to the U.S. Census Bureau, about 45 million Americans do not have health insurance. What's surprising is the majority of those individuals are actually employed. Part-time workers make up a full 15 percent of the uninsured population and school systems have a share of that group. Every day in the United States, approximately 10 percent…

This article describes how the rising cost of health insurance is being picked as the top budget concern of school businesses. These data were the result of a survey conducted by the Association of School Business Officials International. Schools report that the cost of insuring employees is outpacing increases in state and local budgets that…

Funding public education represents a massive state and local effort. Spending on education is second only to Medicaid in terms of the overall state budget and it consumes the largest share of local tax revenues. Between state and local taxes, Massachusetts taxpayers spent nearly $11 billion to operate the Commonwealth's PK-12 education system in…

It is widely recognized throughout the health care industry that the United States leads the world in health care spending per capita. However, the chilling dose of reality for American health care consumers is that for all of their spending, the World Health Organization ranks the country's health care system 37th in overall performance--right…

The mission of the Cornell StatsRRTC is to bridge the divide between the sources of disability data and the users of disability statistics. One product of this effort is a set of "User Guides" to national survey data that collect information on the disability population. The purpose of each of the "User Guides" is to provide…

State and federal accountability systems are pressuring public schools to improve the performance of low-achieving students. To respond, schools must be able to recruit and retain high-quality teachers, strengthen curricula, and take other steps to provide struggling students with the help they need. But such efforts are expensive and, as the…

This paper discusses factors emerging from the health care reform movement that will shape health care service delivery in general and nursing practice and education in particular. First, cost concerns will increase moves toward managed competition which will, in turn, create changes in service use patterns. These patterns seem overall to tend…

This report, sixth of a series of eight, focuses on the emotional health and well-being of children and youths. It discusses the prevalence of mental health problems among young people, development of mental health systems of care, and mental health benefits as a part of health insurance coverage. The California Center for Health Improvement asked…

This reports that health care providers, including those based in schools, can be instrumental in efforts to enroll eligible children in Medicaid or low-cost health insurance. There are 10 ways in which health care providers can help: (1) inform families about the availability of free and low-cost health insurance for children; (2) enlist all…