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Providing care coordination and treatment services for substance-abusing women in the Work First/New Jersey (TANF) Program. 为“工作第一/新泽西”方案中的药物滥用妇女提供护理、协调和治疗服务。
Pub Date : 2004-01-01 DOI: 10.1300/J045v18n03_01
Jeffrey C Merrill

This paper explores results of a program for substance-abusing welfare recipients in New Jersey. New Jersey hired an outside contractor, placed them in the welfare offices and proactively identified recipients with problems, assessed and placed them in appropriate treatment and then managed their care. The program eased the burden on welfare caseworkers who had had little motivation to help these recipients obtain treatment. While the initiative started slowly, because of concerns of the caseworkers and the recipients, recruitment, assessment and placement rates have continued to grow. In addition, those getting into treatment now appear to be receiving more treatment services as opposed to only detox (which was what they primarily received in the past) with no additional costs to the program. Finally, some preliminary outcomes data indicates improvements in the population in terms of both less drug use and increased employment.

本文探讨了新泽西州药物滥用福利接受者计划的结果。新泽西州聘请了一家外部承包商,将他们安置在福利办公室,并主动发现有问题的受助人,对他们进行评估并给予适当的治疗,然后对他们的护理进行管理。该项目减轻了福利社工的负担,这些社工一直没有动力帮助这些受助人获得治疗。虽然由于个案工作者和受助人的关切,这项行动开始缓慢,但招募、评估和安置率仍在继续增长。此外,那些接受治疗的人现在似乎接受了更多的治疗服务,而不仅仅是排毒(这是他们过去主要接受的),而且没有额外的费用。最后,一些初步结果数据表明,在减少吸毒和增加就业方面,人口有所改善。
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引用次数: 5
Assessing predictors of influenza and pneumonia vaccination in rural senior adults. 评估农村老年人流感和肺炎疫苗接种的预测因素。
Pub Date : 2004-01-01 DOI: 10.1300/J045v18n04_02
S Suresh Madhavan, Rohit D Borker, Ancilla W Fernandes, Mayur M Amonkar, S Alan Rosenbluth

The overall purpose of this study was to identify predictors of influenza and pneumonia vaccination among rural senior adults. A mail survey was conducted in eight rural counties. Reported immunization rate for influenza (81.5%) among respondents was higher as compared to pneumonia (74.7%). Knowing someone with influenza was the strongest predictor of influenza vaccination, and knowing someone with pneumonia was the strongest predictor of pneumonia vaccination. Belief that vaccinations are always beneficial was also a significant predictor. While several of the findings of this study are consistent with factors reported in literature to be significant predictors of immunization behavior for this age group, surprisingly, access was not a significant predictor for this rural sample.

本研究的总体目的是确定农村老年人接种流感和肺炎疫苗的预测因素。在八个农村县进行了邮件调查。应答者报告的流感免疫率(81.5%)高于肺炎免疫率(74.7%)。认识流感患者是流感疫苗接种的最强预测因子,认识肺炎患者是肺炎疫苗接种的最强预测因子。相信接种疫苗总是有益的也是一个重要的预测因素。虽然本研究的一些发现与文献中报道的该年龄组免疫行为的重要预测因素相一致,但令人惊讶的是,获取并不是该农村样本的重要预测因素。
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引用次数: 13
Unfinished business: Radiation Exposure Compensation Act (RECA) for post-1971 U.S. uranium underground miners. 未完成的事业:1971年后美国铀矿地下矿工辐射暴露补偿法案(RECA)。
Pub Date : 2004-01-01 DOI: 10.1300/j045v19n04_03
Gary E Madsen, Susan E Dawson

Congress enacted the Radiation Exposure Compensation Act (RECA) in 1990 and amended it in 2000. Included for compensation were underground uranium miners who developed health problems related to radiation exposures. Neither the 1990 Act nor the 2000 Amendments covered post-1971 workers. In this article, we will examine regulatory history and scientific evidence used for the passage of RECA for the pre-1972 miners and will present evidence supporting the inclusion of the post-1971 workers.

国会于1990年颁布了《辐射暴露补偿法案》(RECA),并于2000年进行了修订。赔偿对象包括因辐射暴露而出现健康问题的地下铀矿工人。1990年的法案和2000年的修正案都没有涵盖1971年后的工人。在本文中,我们将研究1972年以前的矿工通过RECA的监管历史和科学证据,并将提供支持纳入1971年后工人的证据。
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引用次数: 3
A comprehensive snapshot of States' small group market reforms on insurer pricing & rating practices, 1999. 1999年美国保险公司定价和评级实践的小集团市场改革的综合快照。
Pub Date : 2004-01-01 DOI: 10.1300/j045v19n04_04
Sudha Xirasagar, Carleen H Stoskopf, William R Shrader, Saundra H Glover

This paper presents a qualitative analysis of states' small group health insurance reforms that impact small group premiums, mostly enacted by the states during 1996-99, following the federal Health Insurance Portability and Accountability Act in 1996. It draws from an intensive review of statutes of 48 states and the District of Columbia as of 1999. It analyses regulations related to insurer pricing and rating practices concerning rating criteria and rating bands, pricing incentives, premium stability from year to year, minimum loss rations, reinsurance and carve-out coverage for the medically uninsurable. It also covers regulations targeting employer purchasing and coverage practices such as pooled purchasing and adverse selection. This is the second of a two-part series analyzing states' small group market reforms, the first being devoted to state reforms to promote access and improving the value of health plans offered in this market (Xirasagar et al. 2004). The variety in pricing and rating reforms illustrate the differences in the depth of reforms across states, and represent a far wider range of potential actuarial combinations than the sample of reforms documented in past literature.

本文对影响小群体保费的各州小群体健康保险改革进行了定性分析,这些改革主要是在1996年至1999年期间由各州颁布的,之后是1996年的联邦健康保险流通与责任法案。它是对截至1999年的48个州和哥伦比亚特区的法规进行深入审查后得出的结论。它分析了与保险公司定价和评级做法有关的法规,涉及评级标准和评级范围、定价激励措施、每年的保费稳定性、最低损失限额、再保险和医疗不保险的分割保险。它还涵盖了针对雇主采购的规定,并涵盖了诸如集中采购和逆向选择等做法。这是分析各州小团体市场改革的两部分系列的第二部分,第一部分专门讨论各州改革,以促进获得和提高该市场提供的保健计划的价值(Xirasagar et al. 2004)。定价和评级改革的多样性说明了各州改革深度的差异,并且代表了比过去文献中记录的改革样本更广泛的潜在精算组合。
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引用次数: 2
State level classification of serious mental illness: a case for a more uniform standard. 严重精神疾病的州级分类:一个更统一标准的案例。
Pub Date : 2004-01-01 DOI: 10.1300/J045v19n02_01
Lynn Bye, Jamie Partridge

This study reports a national survey of U.S. states that was conducted from July of 1999 through March of 2001. The lack of consistent data on serious mental illness (SMI) provided the impetus for this study. Data was collected through a survey on states' definitions of SMI, on demographic information for patients with SMI, and on total annual per capita expenditures for SMI. Based on a 100% response rate, we found considerable variation among states in the definition used for SMI and the records kept on patients with SMI. This paper also involves a state-level statistical analysis of factors that may influence rates of per capita expenditures for SMI. The main finding using regression analysis was that per capita income and state definitions of mental illness that included DSM-III, DSM-IV, and ICD-9-CM diagnoses are significant and positively associated with a state's per capita expenditures for SMI. An additional finding is that accounting for all of the above factors, there still remains significant differences across major census divisions in per capita expenditures for the seriously mentally ill. Another major finding is that more consistent data collection is needed to take an epidemiological approach toward understanding the social conditions that contribute to SMI.

这项研究报告了一项从1999年7月到2001年3月在美国各州进行的全国性调查。缺乏关于严重精神疾病(SMI)的一致数据为这项研究提供了动力。数据是通过调查各州对重度精神分裂症的定义、重度精神分裂症患者的人口统计信息以及重度精神分裂症的年人均支出总额来收集的。基于100%的应答率,我们发现各州对重度精神分裂症的定义和对重度精神分裂症患者的记录存在相当大的差异。本文还涉及对可能影响SMI人均支出率的因素进行国家级统计分析。使用回归分析的主要发现是人均收入和州对精神疾病的定义(包括DSM-III, DSM-IV和ICD-9-CM诊断)与州的人均SMI支出显著正相关。另一个发现是,考虑到上述所有因素,各主要人口普查部门在严重精神疾病的人均支出方面仍然存在显著差异。另一个重要发现是,需要更一致的数据收集,以采取流行病学方法来理解导致重度精神分裂症的社会条件。
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引用次数: 11
Drug use and harm reduction policy: alternative perspectives on the California proposal. 药物使用和减少危害政策:对加州提案的不同观点。
Pub Date : 2004-01-01 DOI: 10.1300/j045v19n03_02
Laura Stauffer

On October, 12, 2003, then California Governor Gray Davis vetoed legislation which would have created a trial period for evaluating nonprescription pharmacy access to needles and syringes for adults in California. An analysis of California Senate Bill 774 provides a case study to examine the struggle for clean syringe and needle access as a component of disease prevention along with the community fear of tacit approval for illicit drug use. Reflecting upon the empirically-supported research and community concerns for this specific type of harm reduction policy is an important step towards forming common political ground. This article underscores the relevance of syringe deregulation and its relevance as an ethical and political issue for social workers.

2003年10月12日,当时的加州州长格雷·戴维斯否决了一项立法,该立法旨在建立一个试用期,以评估加州成年人在非处方药店获得针头和注射器的情况。对加州参议院第774号法案的分析提供了一个案例研究,以审查作为疾病预防组成部分的清洁注射器和针头获取的斗争,以及社区对默许非法药物使用的恐惧。反思有经验支持的研究和社区对这一特定类型的减少伤害政策的关切,是朝着形成共同政治基础迈出的重要一步。本文强调了注射器放松管制的相关性及其作为社会工作者的道德和政治问题的相关性。
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引用次数: 0
What providers and medicaid policymakers need to know about barriers to employment for people with disabilities. 提供者和医疗补助政策制定者需要了解的残疾人就业障碍。
Pub Date : 2004-01-01 DOI: 10.1300/j045v19n03_03
Jean P Hall, Michael H Fox

Medicaid Buy-Ins provide a new and exciting opportunity for people with disabilities to engage in meaningful employment while maintaining Medicaid coverage. Through interviews with participants in the Kansas Medicaid Buy-In, we examined perceived external influences on the decision to acquire or increase employment by people with disabilities. Two major external barriers were identified. First, physicians, therapists and case workers had frequently discouraged participants from getting jobs or increasing employment levels. Difficulty accessing adequate and consistent medical care and/or medications through Medicaid was also an issue in preventing participants from being able to acquire or increase employment.

医疗补助购买为残疾人提供了一个新的和令人兴奋的机会,在保持医疗补助覆盖范围的同时从事有意义的工作。通过对堪萨斯医疗补助购买计划参与者的访谈,我们考察了对残疾人决定获得或增加就业的感知外部影响。确定了两个主要的外部障碍。首先,医生、治疗师和个案工作者经常劝阻参与者找工作或提高就业水平。通过医疗补助计划难以获得充分和持续的医疗保健和/或药物,这也是阻碍参与者获得或增加就业的一个问题。
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引用次数: 19
The Poverty and Housing Scale: report on a pilot study. 贫困和住房规模:一项试点研究报告。
Pub Date : 2004-01-01 DOI: 10.1300/j045v19n03_04
Colleen M Galambos, Samuel A MacMaster

The measurement of beliefs and attitudes on poverty and housing is important to researchers and social workers interested in examining the role that belief structures have on the development of policy and programs in these areas. This article reports pilot study findings of a new scale, The Poverty and Housing Scale (PHS), that measures this concept and evaluates its psychometric properties. Preliminary reliability was in the very good range. Examinations of content and face validity provided support of the instrument as a valid measure of beliefs and attitudes on poverty and housing. The factor analysis emerged a one factor, 13-item scale. Unlike other related scales, the PHS attempts to link the social factor of poverty and housing together. Theoretical and methodological strengths and weaknesses are considered and the implications for social work practice are discussed. The authors provide recommendations for additional testing of the instrument.

对贫困和住房的信念和态度的测量对研究人员和社会工作者很重要,他们有兴趣研究信念结构在这些领域的政策和项目发展中的作用。本文报告了一种新的量表——贫困与住房量表(PHS)的初步研究结果,该量表测量了这一概念并评估了其心理测量特性。初步的可靠性在很好的范围内。对内容和表面有效性的审查为该文书作为对贫穷和住房的信念和态度的有效衡量提供了支持。因子分析得出一个单因素13项量表。与其他相关量表不同,PHS试图将贫困和住房的社会因素联系在一起。考虑了理论和方法的优缺点,并讨论了对社会工作实践的影响。作者提供了仪器附加测试的建议。
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引用次数: 2
Tobacco Use Prevention Education (TUPE) Programs in the State of Florida: correlates and predictors of teachers' perceptions of program effectiveness. 佛罗里达州预防烟草使用教育(TUPE)项目:教师对项目有效性认知的相关性和预测因素
Pub Date : 2004-01-01 DOI: 10.1300/j045v20n01_03
Rita M Soza-Vento, Jonathan G Tubman

In Florida, data from telephone surveys were used to identify correlates and predictors of teachers' perceptions of the effectiveness of tobacco use prevention education (TUPE) prior to the implementation of the Tobacco Pilot Project (TPP). A 40% random sample of public middle and high schools yielded 296 middle school teachers (MST) and 282 high school teachers (HST). Higher perceived program effectiveness ratings were associated with: using peer leaders, frequent evaluations, parental involvement, few barriers, high student interest, and low tolerance norms for tobacco use. The importance of program features and implementation contexts to teachers' perceived program effectiveness ratings is highlighted.

在佛罗里达州,利用电话调查数据确定了在实施烟草试点项目(TPP)之前教师对预防烟草使用教育(TUPE)有效性看法的相关因素和预测因素。在40%的公立初中和高中随机抽样中,有296名初中教师(MST)和282名高中教师(HST)。较高的项目有效性评级与以下因素相关:使用同伴领导、频繁评估、父母参与、障碍少、学生兴趣高、烟草使用容忍度低。强调了项目特征和实施环境对教师感知项目有效性评级的重要性。
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引用次数: 4
Long-term care policy for older Americans: building a continuum of care. 美国老年人的长期护理政策:建立一个连续的护理体系。
Pub Date : 2003-01-01 DOI: 10.1300/J045v16n03_02
Howard A Palley

This paper deals primarily with social policy considerations relevant to the development of long-term care policy for the frail elderly in the United States. However, it also includes some commentary on meeting the acute care needs of the frail elderly. It defines chronic care treatment as a mix of "short-term" and "long-term" modes of care. Furthermore, it explores the need for treatment of such long-term illnesses to recognize the importance of alternative modes of caring which include strategies, both medical and nonmedical, delivered within and outside of hospitals and nursing homes. The paper includes an analysis of public and private sector priorities based in data published by the U.S. Health Care Financing Administration. It also includes some discussion of the PACE program in the United States and some other efforts to stimulate more in-home and community-based alternatives to nursing home care. Furthermore, it includes a discussion of the policy goal of "appropriateness" in developing long-term care (as well as general health priorities) and provides a critical discussion of problems with utilizing "cost/benefit analysis." The study concludes that too exclusive a focus on nursing home care for the elderly in the United States is unfortunate-both in terms of the desires of the elderly, their families and friends and in terms of focusing on "appropriateness" as a legitimate policy goal in the development of long-term care policy for the elderly in the United States.

本文主要讨论与美国老年人长期护理政策发展相关的社会政策考虑。然而,它也包括一些关于满足年老体弱的紧急护理需求的评论。它将慢性护理治疗定义为“短期”和“长期”护理模式的混合。此外,它还探讨了治疗此类长期疾病的必要性,以认识到其他护理模式的重要性,其中包括医院和疗养院内外提供的医疗和非医疗战略。该报告包括基于美国卫生保健融资管理局公布的数据对公共和私营部门优先事项的分析。它还包括对美国PACE项目的一些讨论,以及其他一些努力,以促进更多的家庭和社区替代养老院护理。此外,它还讨论了制定长期护理(以及一般卫生优先事项)的“适当性”政策目标,并对利用“成本/效益分析”的问题进行了重要讨论。该研究的结论是,在美国,过于专注于养老院对老年人的护理是不幸的——无论是从老年人、他们的家人和朋友的愿望来看,还是从将“适当性”作为美国老年人长期护理政策发展的合法政策目标来看。
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引用次数: 7
期刊
Journal of health & social policy
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