Access and Confidentiality of Medical Records: A Legislative Response in the United States

1996 ◽  
Vol 26 (1) ◽  
pp. 33-40
Author(s):  
Judith Mair
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Records ◽  
The United States ◽  
Personal Privacy ◽  
Related Information ◽  
The Us ◽  
Us Senate

The Bennett Bill was introduced to the US Senate with the intention by its sponsors to ensure personal privacy with respect to medical records and health care-related information in the United States. The Bennett Bill has been passed into legislation by the US Senate as the Medical Records Confidentiality Act of 1995.

Transformation of the US Veterans Health Administration

2006 ◽  
Vol 1 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Jonathan B. Perlin
Keyword(s):  
United States ◽  
Health Care ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Affairs ◽  
United States Department ◽  
Veterans Health ◽  
Department Of Veterans Affairs ◽  
Health Administration ◽  
The Us

Ten years ago, it would have been hard to imagine the publication of an issue of a scholarly journal dedicated to applying lessons from the transformation of the United States Department of Veterans Affairs Health System to the renewal of other countries' national health systems. Yet, with the recent publication of a dedicated edition of the Canadian journal Healthcare Papers (2005), this actually happened. Veterans Affairs health care also has been similarly lauded this past year in the lay press, being described as ‘the best care anywhere’ in the Washington Monthly, and described as ‘top-notch healthcare’ in US News and World Report's annual health care issue enumerating the ‘Top 100 Hospitals’ in the United States (Longman, 2005; Gearon, 2005).

Psychological, Social and Technical Factors Influencing Electronic Medical Records Systems Adoption by U.S. Physicians: A Systematic Model

2020 ◽  
Author(s):  
Raghid El-Yafouri ◽  
Leslie Klieb ◽  
Valérie Sabatier
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Service Providers ◽  
Financial Burden ◽  
The United States ◽  
Care Providers ◽  
Intention To Adopt

Abstract Background: Wide adoption of electronic medical records (EMR) systems in the United States can lead to better quality medical care at a lower cost. Despite the laws and financial subsidies by the U.S. government for service providers and suppliers, the adoption has been slow. Understanding the EMR adoption drivers for physicians and the role of policymaking can translate into increased adoption rate and enhanced information sharing between medical care providers. Methods: Physicians across the United States were surveyed to gather primary data on their psychological, social, and technical perceptions toward EMR systems. This quantitative study builds on the Theory of Planned Behavior, the Technology Acceptance Model, and the Diffusion of Innovation theory to propose, test, and validate an innovation adoption model for the health care industry. 382 responses were collected and data were analyzed via linear regression to uncover the effects of 12 variables on the intention to adopt EMR systems.Results: Regression model testing uncovers that government policymaking or mandates and other social factors have little or negligible effect on physicians’ intention to adopt an innovation. Rather, physicians are directly driven by their attitudes and ability to control, and indirectly motivated by their knowledge of the innovation, the financial ability to acquire the system, the holistic benefits to their industry, and the relative advancement of the system compared to others.Conclusions: A unidirectional mandate from the government is not sufficient for physicians to adopt an innovation. Government, health care associations, and EMR system vendors can benefit from our findings by working toward increasing the physicians’ knowledge of the proposed innovation, socializing how medical care providers and the overall industry can benefit from EMR system adoption, and solving for the financial burden of system implementation and sustainment.

United States

2020 ◽  
pp. 91-126
Author(s):  
Christian Freudlsperger
Keyword(s):  
United States ◽  
Trade Openness ◽  
Type System ◽  
The United States ◽  
Power Sharing ◽  
High Propensity ◽  
The Us ◽  
Self Rule ◽  
Us Senate ◽  
Rule Systems

The first of the three case studies looks at the United States. It finds that while the states’ opportunities for individual exit have remained unconstrained in the non-coercive field of procurement in which federal pre-emption is not an option, no serious attempts have been made to systematically increase their voice. This is due, firstly, to the mechanics of the US senate-type system of multilevel representation and, secondly, to the lack of an institutionalized procedure of vertical collaboration in a policy environment characterized by ‘coercive federalism’. Persisting barriers in the internal market and a widespread politicization of international procurement liberalization as a threat to state sovereignty have further contributed to constituent units’ high propensity to seek exit from international constraints. Ultimately, the US case highlights the limits of self-rule systems in organizing trade openness across multiple levels of government. Endowing the states with little voice in polity-wide policy-making, the US model shows a marked tendency to breed resistance to internationally driven adaptational pressures among constituent units. As self-rule systems are built on a delineation of central and subcentral spheres of competence, they generally tend to lack the institutional means and ideational underpinnings to effectively organize collaborative power-sharing by establishing patterns of shared rule.

The Democratic Deficit of United States Federalism? Red State, Blue State, Purple?

2018 ◽  
Vol 46 (4) ◽  
pp. 645-667
Author(s):  
Vicki C Jackson
Keyword(s):  
United States ◽  
State Legislatures ◽  
The United States ◽  
State Legislature ◽  
Democratic Deficit ◽  
The Us ◽  
The 1960S ◽  
Us Senate ◽  
The One ◽  
Over Time

Aspects of an entrenched constitution that were essential parts of founding compromises, and justified as necessary when a constitution was first adopted, may become less justifiable over time. Is this the case with respect to the structure of the United States Senate? The US Senate is hardwired in the Constitution to consist of an equal number of Senators from each state—the smallest of which currently has about 585,000 residents, and the largest of which has about 39.29 million. As this essay explains, over time, as population inequalities among states have grown larger, so too has the disproportionate voting power of smaller-population states in the national Senate. As a result of the ‘one-person, one-vote’ decisions of the 1960s that applied to both houses of state legislatures, each state legislature now is arguably more representative of its state population than the US Congress is of the US population. The ‘democratic deficit’ of the Senate, compared to state legislative bodies, also affects presidential (as compared to gubernatorial) elections. When founding compromises deeply entrenched in a constitution develop harder-to-justify consequences, should constitutional interpretation change responsively? Possible implications of the ‘democratic’ difference between the national and the state legislatures for US federalism doctrine are explored, especially with respect to the ‘pre-emption’ doctrine. Finally, the essay briefly considers the possibilities of federalism for addressing longer term issues of representation, polarisation and sustaining a single nation.

What Is the Affordable Care Act a Case of? Understanding the ACA through the Comparative Method

2020 ◽  
Vol 45 (4) ◽  
pp. 677-691
Author(s):  
Holly Jarman ◽  
Scott L. Greer
Keyword(s):  
United States ◽  
Health Care ◽  
Welfare State ◽  
Affordable Care Act ◽  
Strong Support ◽  
The United States ◽  
The Us ◽  
The Affordable Care Act ◽  
Shed Light ◽  
The Welfare State

Abstract International comparisons of US health care are common but mostly focus on comparing its performance to peers or asking why the United States remains so far from universal coverage. Here the authors ask how other comparative research could shed light on the unusual politics and structure of US health care and how the US experience could bring more to international conversations about health care and the welfare state. After introducing the concept of casing—asking what the Affordable Care Act (ACA) might be a case of—the authors discuss different “casings” of the ACA: complex legislation, path dependency, demos-constraining institutions, deep social cleavages, segmentalism, or the persistence of the welfare state. Each of these pictures of the ACA has strong support in the US-focused literature. Each also cases the ACA as part of a different experience shared with other countries, with different implications for how to analyze it and what we can learn from it. The final section discusses the implications for selecting cases that might shed light on the US experience and that make the United States look less exceptional and more tractable as an object of research.

scholarly journals The Implementation and Evaluation of the United States Affordable Care Act

2019 ◽  
Vol 12 (1) ◽  
pp. 17-38
Author(s):  
David Schultz
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Health Care Outcomes ◽  
The Us ◽  
American Health Care

In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.

scholarly journals Cost-effectiveness Analysis of Sequential Treatment of Abaloparatide Followed by Alendronate Versus Teriparatide Followed by Alendronate in Postmenopausal Women With Osteoporosis in the United States

2018 ◽  
Vol 53 (2) ◽  
pp. 134-143 ◽  
Author(s):  
Quang A. Le ◽  
Joel W. Hay ◽  
Russell Becker ◽  
Yamei Wang
Keyword(s):  
United States ◽  
Health Care ◽  
Cost Effectiveness ◽  
High Risk ◽  
The United States ◽  
Clinical Event ◽  
Risk Of Fracture ◽  
Life Years ◽  
The Us ◽  
Des Model

Background: The US Food and Drug Administration has recently approved abaloparatide (ABL) for treatment of women with postmenopausal osteoporosis (PMO) at high risk of fracture. With increasing health care spending and drug prices, it is important to quantify the value of newly available treatment options for PMO. Objective: To determine cost-effectiveness of ABL compared with teriparatide (TPTD) for treatment of women with PMO in the United States. Methods: A discrete-event simulation (DES) model was developed to assess cost-effectiveness of ABL from the US health care perspective. The model included three 18-month treatment strategies with either placebo (PBO), TPTD, or ABL, all followed by additional 5-year treatment with alendronate (ALN). High-risk patients were defined as women with PMO ⩾65 years old with a prior vertebral fracture. Baseline clinical event rates, risk reductions, and patient characteristics were based on the Abaloparatide Comparator Trial in Vertebral Endpoints (ACTIVE) trial. Results: Over a 10-year period, the DES model yielded average total discounted per-patient costs of $10 212, $46 783, and $26 837 and quality-adjusted life-years (QALYs) of 6.742, 6.781, and 6.792 for PBO/ALN, TPTD/ALN, and ABL/ALN, respectively. Compared with TPTD/ALN, ABL/ALN accrued higher QALYs at lower cost and produced an incremental cost-effectiveness ratio (ICER) of $333 266/QALY relative to PBO/ALN. In high-risk women, ABL/ALN also had more QALYs and less cost over TPTD/ALN and yielded an ICER of $188 891/QALY relative to PBO/ALN. Conclusion and Relevance: ABL is a dominant treatment strategy over TPTD. In women with PMO at high risk of fracture, ABL is an alternative cost-effective treatment.

scholarly journals Assisted Reproductive Techniques and Catholicism(s) in the US

2019 ◽  
Vol 9 (2) ◽  
pp. 147-169
Author(s):  
María Cecilia Johnson
Keyword(s):  
United States ◽  
Health Care ◽  
Reproductive Rights ◽  
The United States ◽  
Assisted Reproductive Techniques ◽  
Documentary Analysis ◽  
The Us ◽  
Reproductive Techniques ◽  
Health Organization ◽  
Reproductive Healthcare

Abstract Assisted Reproductive Techniques (ART s) have proposed a new way of understanding notions of sexuality, reproduction, gestation, and family, and these transformations have arguably been a challenge in the religious field. This study aims to analyze the stances taken within the Catholic spectrum in the United States on ART s. Catholicism in the United States is an internally heterogeneous space, and different agents have taken diverse stances on ART s, with an impact on health care regulations, Catholic facilities administrations, and Catholics’ and non-Catholics’ reproductive rights. Drawing from a qualitative, interpretive, and documentary analysis of three organizations (the US Conference of catholic bishops, the Catholic Health Organization, and Catholics for Choice), this article proposes some guidelines to analyze and understand the arguments and strategies of various Catholics actors in the United States regarding reproductive healthcare and ART s in the United States.

National Inventory of Clinical Laboratory Testing Services (NICLTS)

2000 ◽  
Vol 124 (8) ◽  
pp. 1201-1208 ◽  
Author(s):  
Steven J. Steindel ◽  
William J. Rauch ◽  
Marianne K. Simon ◽  
James Handsfield
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Laboratory Testing ◽  
Clinical Laboratory ◽  
The United States ◽  
High Complexity ◽  
Specimen Type ◽  
The Us ◽  
Clinical Laboratory Testing

Abstract Context.—A statistically valid inventory of the distribution, both geographic and by laboratory type, of clinical and anatomical laboratory testing in the United States is needed to assess the impact of the Clinical Laboratory Improvements Amendments of 1988 and to provide information for other health care and public health policy decisions. Objective.—To present initial US laboratory testing volume data compiled by the National Inventory of Clinical Laboratory Testing Services. Design.—Stratified random sample of laboratories performing testing in 1996 with data on the number of laboratory tests performed, identified by method and analyte. Data were collected by field tabulators (moderate- or high-complexity laboratories) or through a mail/telephone survey (waived or provider-performed microscopy laboratories) for each site. Participants.—Laboratories that were enrolled in the 1996 Online Certification Survey and Reporting System, maintained by the US Health Care Finance Administration, and that performed laboratory testing during 1996. Main Outcome Measure.—Laboratory testing distribution for 1996 in the United States by analyte, method, and specimen type. Results.—An overall response rate of 79% provided data from 757 moderate- or high-complexity laboratories and 1322 waived or provider-performed microscopy laboratories. The estimated total US testing volume for 1996 was 7.25 ± 1.09 billion tests. Laboratories performing complex testing, defined as greater than 16 method/analyte/specimen type combinations, comprised 16% of the US laboratories by survey site, but performed 80% (95% confidence limits, 43% to 100%) of the testing volume. Glucose analysis was the most frequently performed test. Automated hematology and chemistry analyzers were the most frequently used methods. Conclusions.—A statistically valid, consistent survey of the distribution of US laboratory testing was obtained. Simple analysis of these data by laboratory type and geographic region can provide insights into where laboratory testing is performed. The study design allows extensions that will facilitate collection of additional data of importance to public health and medical care delivery.

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