Health care collaboration on the information highway

The managed care revolution in the USA has resulted in more than $40 billion per year spent on consolidation and reorganization of health care delivery. Accompanying this revolution has been a comparable revolution in health information technology. In its recent survey of more than 500 health information networks being developed across the USA, the Community Medical Network Society (Comnet) found that integrated delivery networks (IDNs), such as those designed to support managed care organizations, are creating the greatest level of activity in the US health-care marketplace. These networks are extensions of enterprises that reach out to communities through affiliated and contracted entities to help coordinate care and control costs. At first glance, this health information revolution seems promising: IDNs could lead to improved communications among physicians for patient treatment and referral. This, in turn, should lead to improved patient care, but will US consumers actually benefit from the types of health information networks that are currently being built?     

Preparing children for medical examinations: The importance of previous medical experience.

Investigated the relationship between past experience and children's response to preparation for medical examinations in 79 outpatients (aged 3–12 yrs). Ss were assigned to 1 of 5 preparation conditions prior to receiving a medical examination and a throat culture: sensory information, training in coping skills, combined sensory information and coping skills training, attention control, and no-treatment control. Results indicate that Ss with previous negative medical experiences demonstrated more behavioral distress during a throat culture examination than did Ss with previous positive or neutral medical experiences. The attention control condition appeared to increase the distress of Ss with previous negative medical experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement of Parity Violation in np Capture: the NPDGamma Experiment

The NPDGamma experiment will measure the parity-violating directional gamma ray asymmetry A_γ in the reaction n→+p→d+γ. Ultimately, this will constitute the first measurement in the neutron-proton system that is sensitive enough to challenge modern theories of nuclear parity violation, providing a theoretically clean determination of the weak pion-nucleon coupling. A new beam-line at the Los Alamos Neutron Science Center (LANSCE) delivers pulsed cold neutrons to the apparatus, where they are polarized by transmission through a large volume polarized ³He spin filter and captured in a liquid para-hydrogen target. The 2.2 MeV gamma rays from the capture reaction are detected in an array of CsI(Tl) scintillators read out by vacuum photodiodes operated in current mode. We will complete commissioning of the apparatus and carry out a first measurement at LANSCE in 2004–05, which would provide a statistics-limited result for A_γ accurate to a standard uncertainty of ±5 × 10⁻⁸ level or better, improving on existing measurements in the neutron-proton system by a factor of 4. Plans to move the experiment to a reactor facility, where the greater flux would enable us to make a measurement with a standard uncertainty of ±1 × 10⁻⁸, are actively being pursued for the longer term.     

Sizing up the sickest

It's lurking all the time: Clues about patients prone to costly medical crises are already sitting in your computer system. The past opens a window on the future--if only you can ID the most vulnerable and guard against their getting sick in the first place.     

Can home care services achieve cost savings in long-term care for older people?

OBJECTIVE: To determine whether efficient allocation of home care services can produce net long-term care cost savings. METHODS: Hazard function analysis and nonlinear mathematical programming. RESULTS: Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. DISCUSSION: Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date.     

Agricultural land markets in U.S. urban-fringe counties

A multivariate interaction detection model was used to assign urban-influenced counties into statistically-optimal groups. The groups delineated 3 types of farmland markets within the predefined set of counties. From a set of county-level variables representing farm and non-farm factors, the procedure found 3 farm-related factors, agricultural sales acre^-1, farm income acre^-1 and farm size, to be important in explaining the variation in average farmland values among the urban-influenced counties. The results imply a diversity among urban-influenced counties that is not accounted for in aggregate analyses that use a simple dichotomy between rural and urban counties.