Skip header and navigation

Refine By

77 records – page 1 of 8.

American Indian and Alaska Native Cancer Patients' Perceptions of a Culturally Specific Patient Navigator Program.

https://arctichealth.org/en/permalink/ahliterature289968
Source
J Prim Prev. 2017 Apr; 38(1-2):121-135
Publication Type
Journal Article
Date
Apr-2017
Author
Carol Grimes
Jenine Dankovchik
Megan Cahn
Victoria Warren-Mears
Author Affiliation
Northwest Portland Area Indian Health Board, 918 NE Rosa Parks Way, Portland, OR, 97211, USA.
Source
J Prim Prev. 2017 Apr; 38(1-2):121-135
Date
Apr-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Alaska Natives - psychology
Attitude to Health - ethnology
Cultural Competency
Female
Humans
Idaho
Indians, North American - psychology
Interviews as Topic
Male
Middle Aged
Models, organizational
Neoplasms - ethnology - psychology
Oregon
Patient Navigation - methods - organization & administration - standards
Patient Satisfaction - ethnology
Qualitative Research
Young Adult
Abstract
Lack of access to care, funding limitations, cultural, and social barriers are challenges specific to tribal communities that have led to adverse cancer outcomes among American Indians/Alaska Natives (AI/AN). While the cancer navigator model has been shown to be effective in other underserved communities, it has not been widely implemented in Indian Country. We conducted in-depth interviews with 40 AI/AN patients at tribal clinics in Idaho and Oregon. We developed the survey instrument in partnership with community members to ensure a culturally appropriate semi-structured questionnaire. Questions explored barriers to accessing care, perceptions of the navigator program, satisfaction, and recommendations. AI/AN cancer patients reported physical, emotional, financial, and transportation barriers to care, but most did not feel there were any cultural barriers to receiving care. Navigator services most commonly used included decision making, referrals, transportation, scheduling appointments, and communication. Satisfaction with the program was high. Our study provides a template to develop a culturally appropriate survey instrument for use with an AI/AN population, which could be adapted for use with other indigenous patient populations. Although our sample was small, our qualitative analysis facilitated a deeper understanding of the barriers faced by this population and how a navigator program may best address them. The results reveal the strengths and weakness of this program, and provide baseline patient satisfaction numbers which will allow future patient navigator programs to better create evaluation benchmarks.
Notes
Cites: Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1673-81 PMID 23045542
Cites: MMWR Surveill Summ. 2004 Jun 4;53(3):1-108 PMID 15179359
Cites: Cancer. 2008 Sep 1;113(5 Suppl):1131-41 PMID 18720374
Cites: Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1629-38 PMID 23045537
Cites: Cancer Epidemiol Biomarkers Prev. 2003 Mar;12(3):232s-236s PMID 12646516
Cites: Patient Educ Couns. 2010 Aug;80(2):241-7 PMID 20006459
Cites: J Health Care Poor Underserved. 2011 Nov;22(4):1331-43 PMID 22080713
Cites: Prev Med. 1994 Jul;23(4):461-4 PMID 7971873
Cites: J Health Care Poor Underserved. 2012 Feb;23(1):398-413 PMID 22423178
Cites: Cancer. 2007 Nov 15;110(10):2119-52 PMID 17939129
Cites: Am J Public Health. 2014 Jun;104 Suppl 3:S439-45 PMID 24754659
Cites: CA Cancer J Clin. 2004 Mar-Apr;54(2):78-93 PMID 15061598
Cites: Cancer Control. 2008 Jul;15(3):254-9 PMID 18596678
Cites: Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1691-700 PMID 23045544
Cites: CA Cancer J Clin. 2010 Sep-Oct;60(5):277-300 PMID 20610543
Cites: Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1645-54 PMID 23045539
Cites: Public Health Nurs. 1999 Jun;16(3):190-7 PMID 10388336
Cites: Cancer. 1996 Oct 1;78(7 Suppl):1587-91 PMID 8839576
Cites: J Cancer Educ. 2013 Mar;28(1):109-18 PMID 23242563
Cites: Semin Oncol Nurs. 2013 May;29(2):118-27 PMID 23651681
Cites: Clin J Oncol Nurs. 2012 Feb;16(1):73-82, 89 PMID 22297010
Cites: Hawaii Med J. 2011 Dec;70(12):257-61 PMID 22187512
Cites: Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1620-8 PMID 23045536
Cites: Am J Public Health. 2014 Jun;104 Suppl 3:S415-22 PMID 24754650
Cites: BMC Health Serv Res. 2014 Sep 19;14:407 PMID 25234963
Cites: J Urban Health. 2005 Jun;82(2 Suppl 3):iii44-55 PMID 15933330
Cites: Cancer. 1996 Oct 1;78(7 Suppl):1582-6 PMID 8839575
Cites: Prog Community Health Partnersh. 2008 Winter;2(4):329-40 PMID 20208313
Cites: Public Health Rep. 2001 Sep-Oct;116(5):424-33 PMID 12042607
Cites: Cancer Pract. 1998 May-Jun;6(3):191-4 PMID 9652252
PubMed ID
27838858 View in PubMed
Less detail

Application of monitoring data for Giardia and Cryptosporidium to boil water advisories.

https://arctichealth.org/en/permalink/ahliterature191692
Source
Risk Anal. 2001 Dec;21(6):1077-85
Publication Type
Article
Date
Dec-2001
Author
P M Wallis
D. Matson
M. Jones
J. Jamieson
Author Affiliation
Hyperion Research Ltd., Medicine Hat, Alberta, Canada.
Source
Risk Anal. 2001 Dec;21(6):1077-85
Date
Dec-2001
Language
English
Publication Type
Article
Keywords
Animals
Cryptosporidiosis - epidemiology - prevention & control
Cryptosporidium - isolation & purification - pathogenicity
Data Interpretation, Statistical
Disease Outbreaks
Giardia - isolation & purification - pathogenicity
Giardiasis - epidemiology - prevention & control
Hot Temperature
Humans
Oregon - epidemiology
Risk assessment
Water - parasitology
Water Purification - methods
Water supply
Abstract
Despite the problems associated with analyzing water samples for Giardia cysts and Cryptosporidium oocysts, the data can be very useful if their strengths and weaknesses are understood. Two municipalities in northern Ontario, Temagami and Thunder Bay, both issued boil water advisories for Giardia contamination. Data from these two cities are compared to show that only one municipality experienced a real outbreak, whereas the other did not. The concentration of Giardia cysts was much higher than background during the outbreak at Temagami, and the postoutbreak concentrations of cysts were very similar to the long-term average cyst concentration at Thunder Bay. The waterborne outbreak of giardiasis at Temagami was characterized by consistent positive results from water samples, concentrations two to three orders of magnitude higher than normal, and an obvious increase in the number of cases of giardiasis in the population. No outbreak was experienced at Thunder Bay, but a boil water advisory (BWA) was set in place for more than a year on the basis of a single sample from Loch Lomond in which only two cysts were detected but the sample equivalent volume was low. This gave the impression of a sudden increase in concentration, but 39 of 41 subsequent samples were negative. Additional factors that led to a BWA at Thunder Bay are described, and recommendations are presented to help determine when a BWA is necessary and when it should be rescinded.
PubMed ID
11824683 View in PubMed
Less detail

Assessing pesticide safety knowledge among Hispanic migrant farmworkers in Oregon.

https://arctichealth.org/en/permalink/ahliterature178108
Source
J Agric Saf Health. 2004 Aug;10(3):177-86
Publication Type
Article
Date
Aug-2004
Author
L A McCauley
S E Shapiro
J A Scherer
M R Lasarev
Author Affiliation
University of Pennsylvania School of Nursing, 420 Guardian Drive, Philadelphia, PA 19104-6096, USA. lmccaule@nursing.upenn.edu
Source
J Agric Saf Health. 2004 Aug;10(3):177-86
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Agricultural Workers' Diseases - prevention & control
Cross-Sectional Studies
Environmental Exposure - adverse effects
Female
Health Knowledge, Attitudes, Practice
Hispanic Americans - psychology
Humans
Male
Mexico - ethnology
Occupational Health
Oregon
Pesticides - adverse effects
Questionnaires
Risk assessment
Transients and Migrants
United States
United States Environmental Protection Agency
Abstract
The purpose of this article is to report on the development and initial use of a pesticide knowledge test (PKT) specifically designed to evaluate agricultural workers' knowledge of the content mandated by the federal Worker Protection Standard (WPS). The PKT is a 20-item, true-false test, used in a sample of 414 adult and adolescent migrant farmworkers in Oregon. The overall mean score, i.e., number correct, was 15.67(78.4%), with both adults and adolescents demonstrating the most difficulty with questions related to the overall health effects of pesticides. The internal consistency was 0.73, when estimated using a method to correct for small sample sizes. Only six items had less than 70% correct answers. Content validity was achieved by basing the items directly on the Worker Protection Standard; face validity was obtained by having the final version of the test reviewed by a bilingual (English-Spanish) educator familiar with the requirements of the WPS. Overall, adult participants scored better than adolescents, and those with previous pesticide training scored better than those without. There were no differences in scores based on gender or whether the test was taken in English or Spanish; however, participants who spoke indigenous languages scored significantly lower than those who did not. These results indicate that the PKT is a valid, reliable measure of worker knowledge of the content of the WPS, although it does not measure the extent to which that knowledge is actually used in the work setting.
PubMed ID
15461134 View in PubMed
Less detail

Autonomous in situ measurements of seawater alkalinity.

https://arctichealth.org/en/permalink/ahliterature268526
Source
Environ Sci Technol. 2014 Aug 19;48(16):9573-81
Publication Type
Article
Date
Aug-19-2014
Author
Reggie S Spaulding
Michael D DeGrandpre
James C Beck
Robert D Hart
Brittany Peterson
Eric H De Carlo
Patrick S Drupp
Terry R Hammar
Source
Environ Sci Technol. 2014 Aug 19;48(16):9573-81
Date
Aug-19-2014
Language
English
Publication Type
Article
Keywords
Carbon - analysis
Carbon Dioxide - analysis
Colorimetry - methods
Environmental Monitoring - instrumentation - methods
Hawaii
Hydrogen-Ion Concentration
Oceans and Seas
Oregon
Reproducibility of Results
Seawater - analysis - chemistry
Abstract
Total alkalinity (AT) is an important parameter for describing the marine inorganic carbon system and understanding the effects of atmospheric CO2 on the oceans. Measurements of AT are limited, however, because of the laborious process of collecting and analyzing samples. In this work we evaluate the performance of an autonomous instrument for high temporal resolution measurements of seawater AT. The Submersible Autonomous Moored Instrument for alkalinity (SAMI-alk) uses a novel tracer monitored titration method where a colorimetric pH indicator quantifies both pH and relative volumes of sample and titrant, circumventing the need for gravimetric or volumetric measurements. The SAMI-alk performance was validated in the laboratory and in situ during two field studies. Overall in situ accuracy was -2.2 ± 13.1 µmol kg(-1) (n = 86), on the basis of comparison to discrete samples. Precision on duplicate analyses of a carbonate standard was ±4.7 µmol kg(-1) (n = 22). This prototype instrument can measure in situ AT hourly for one month, limited by consumption of reagent and standard solutions.
PubMed ID
25051401 View in PubMed
Less detail

Bacteria associated with crabs from cold waters with emphasis on the occurrence of potential human pathogens.

https://arctichealth.org/en/permalink/ahliterature240526
Source
Appl Environ Microbiol. 1984 May;47(5):1054-61
Publication Type
Article
Date
May-1984
Author
M A Faghri
C L Pennington
L S Cronholm
R M Atlas
Source
Appl Environ Microbiol. 1984 May;47(5):1054-61
Date
May-1984
Language
English
Publication Type
Article
Keywords
Alaska
Animals
Bacteria - classification - isolation & purification - pathogenicity
Brachyura - microbiology - ultrastructure
Humans
Maine
Male
Mice
Mice, Inbred Strains
Microscopy, Electron, Scanning
Oregon
Seawater
Sewage
Washington
Water Microbiology
Abstract
A diverse array of bacterial species, including several potential human pathogens, was isolated from edible crabs collected in cold waters. Crabs collected near Kodiak Island, Alaska, contained higher levels of bacteria than crabs collected away from regions of human habitation. The bacteria associated with the crabs collected near Kodiak included Yersinia enterocolitica, Klebsiella pneumoniae, and coagulase-negative Staphylococcus species; the pathogenicity of these isolates was demonstrated in mice. Although coliforms were not found, the bacterial species associated with the tissues of crabs collected near Kodiak indicate possible fecal contamination that may have occurred through contact with sewage. Compared with surrounding waters and sediments, the crab tissues contained much higher proportions of gram-positive cocci. As revealed by indirect plate counts and direct scanning electron microscopic observations, muscle and hemolymph tissues contained much lower levels of bacteria than shell and gill tissues. After the death of a crab, however, the numbers of bacteria associated with hemolymph and muscle tissues increased significantly. Microcosm studies showed that certain bacterial populations, e.g., Vibrio cholerae, can be bioaccumulated in crab gill tissues. The results of this study indicate the need for careful review of waste disposal practices where edible crabs may be contaminated with microorganisms that are potential human pathogens and the need for surveillance of shellfish for pathogenic microorganisms that naturally occur in marine ecosystems.
Notes
Cites: Appl Microbiol. 1970 Aug;20(2):176-84921056
Cites: Appl Microbiol. 1970 Aug;20(2):179-864921057
Cites: Appl Microbiol. 1971 May;21(5):965-65574329
Cites: J Bacteriol. 1973 Jan;113(1):24-324567138
Cites: Am J Epidemiol. 1974 Dec;100(6):487-984447110
Cites: Appl Microbiol. 1975 Feb;29(2):269-74234715
Cites: Appl Microbiol. 1975 Mar;29(3):388-921090257
Cites: Appl Microbiol. 1975 Mar;29(3):393-91090258
Cites: Appl Microbiol. 1975 Apr;29(4):557-91124924
Cites: Appl Microbiol. 1975 Aug;30(2):251-71164012
Cites: J Clin Microbiol. 1975 Jan;1(1):82-8170303
Cites: Appl Microbiol. 1975 Oct;30(4):625-38811167
Cites: Appl Environ Microbiol. 1976 May;31(5):723-30776085
Cites: Appl Environ Microbiol. 1976 Oct;32(4):527-36825042
Cites: Zentralbl Bakteriol Orig B. 1977 Dec;165(5-6):487-97610254
Cites: Ann Intern Med. 1978 May;88(5):602-6646241
Cites: Appl Environ Microbiol. 1978 May;35(5):829-33350153
Cites: Appl Environ Microbiol. 1979 Jan;37(1):91-103367273
Cites: N Engl J Med. 1980 Feb 7;302(6):305-97350497
Cites: Annu Rev Microbiol. 1980;34:341-677002028
Cites: Annu Rev Microbiol. 1980;34:559-927002032
Cites: Appl Environ Microbiol. 1981 Sep;42(3):484-927294785
Cites: Appl Environ Microbiol. 1982 May;43(5):1080-56896621
Cites: Appl Environ Microbiol. 1982 May;43(5):1092-77103475
Cites: Appl Environ Microbiol. 1982 Sep;44(3):640-67138004
Cites: J Appl Bacteriol. 1982 Aug;53(1):127-97174559
Cites: Appl Environ Microbiol. 1982 Dec;44(6):1404-147159083
Cites: Appl Environ Microbiol. 1982 Dec;44(6):1466-707159088
Cites: Appl Environ Microbiol. 1983 Jun;45(6):1870-66349527
Cites: Appl Microbiol. 1959 Nov;7:388-9213807798
PubMed ID
6742824 View in PubMed
Less detail

Cancer Stage in American Indians and Alaska Natives Enrolled in Medicaid.

https://arctichealth.org/en/permalink/ahliterature289339
Source
Am J Prev Med. 2016 Sep; 51(3):368-72
Publication Type
Journal Article
Date
Sep-2016
Author
Scott V Adams
Andrea N Burnett-Hartman
Andrew Karnopp
Aasthaa Bansal
Stacey A Cohen
Victoria Warren-Mears
Scott D Ramsey
Author Affiliation
Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. Electronic address: sadams@fredhutch.org.
Source
Am J Prev Med. 2016 Sep; 51(3):368-72
Date
Sep-2016
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Alaska Natives - statistics & numerical data
California - epidemiology
Female
Humans
Incidence
Indians, North American - statistics & numerical data
Male
Medicaid
Middle Aged
Neoplasm Staging
Neoplasms - epidemiology - ethnology
Oregon - epidemiology
Population Surveillance
Registries
United States
Washington - epidemiology
Abstract
Nationally, a greater proportion of American Indians and Alaska Natives (AI/ANs) are diagnosed with advanced-stage cancers compared with non-Hispanic whites. The reasons for observed differences in stage at diagnosis between AI/ANs and non-Hispanic whites remain unclear.
Medicaid, Indian Health Service Care Systems, and state cancer registry data for California, Oregon, and Washington (2001-2008, analyzed in 2014-2015) were linked to identify AI/ANs and non-Hispanic whites diagnosed with invasive breast, cervical, colorectal, lung, or prostate cancer. Logistic regression was used to estimate ORs and 95% CIs for distant disease versus local or regional disease, in AI/ANs compared with non-Hispanic white case patients.
A similar proportion of AI/AN (31.2%) and non-Hispanic white (35.5%) patients were diagnosed with distant-stage cancer in this population (AOR=1.03, 95% CI=0.88, 1.20). No significant differences in stage at diagnosis were found for any individual cancer site. Among AI/ANs, Indian Health Service Care Systems eligibility was not associated with stage at diagnosis.
In contrast to the general population of the U.S., among Medicaid enrollees, AI/AN race is not associated with later stage at diagnosis. Cancer survival disparities associated with AI/AN race that have been observed in the broader population may be driven by factors associated with income and health insurance that are also associated with race, as income and insurance status are more homogenous within the Medicaid population than within the broader population.
Notes
Cites: Gynecol Oncol. 2015 Dec;139(3):500-5 PMID 26498912
Cites: Cancer Epidemiol Biomarkers Prev. 2014 Feb;23(2):362-4 PMID 24296857
Cites: Cancer. 2007 Nov 15;110(10):2119-52 PMID 17939129
Cites: Cancer. 2014 Oct 1;120(19):3016-24 PMID 25154930
Cites: Cancer. 2008 Sep 1;113(5 Suppl):1191-202 PMID 18720389
Cites: Am J Public Health. 2014 Jun;104 Suppl 3:S377-87 PMID 24754660
Cites: Am J Public Health. 2014 Jun;104 Suppl 3:S404-14 PMID 24754657
Cites: Am J Public Health. 2014 Jun;104 Suppl 3:S415-22 PMID 24754650
Cites: J Health Care Poor Underserved. 2015 Nov;26(4):1336-58 PMID 26548682
Cites: Cancer. 2008 Sep 1;113(5 Suppl):1203-12 PMID 18720376
Cites: Springerplus. 2014 Dec 03;3:710 PMID 25674451
Cites: Cancer. 2007 Jul 15;110(2):403-11 PMID 17562557
Cites: Am J Public Health. 2015 Mar;105(3):538-45 PMID 25602869
Cites: J Clin Oncol. 2015 Nov 1;33(31):3621-7 PMID 26371147
PubMed ID
27020318 View in PubMed
Less detail

Clinical laboratory test menu changes in the Pacific Northwest: 1994 to 1996.

https://arctichealth.org/en/permalink/ahliterature205914
Source
Clin Chem. 1998 Apr;44(4):833-8
Publication Type
Article
Date
Apr-1998
Author
K M LaBeau
M. Simon
S J Steindel
Author Affiliation
Office of Laboratory Quality Assurance, Washington State Department of Health, Seattle 98155, USA.
Source
Clin Chem. 1998 Apr;44(4):833-8
Date
Apr-1998
Language
English
Publication Type
Article
Keywords
Alaska
Family Practice - legislation & jurisprudence - statistics & numerical data
Health Care Sector
Humans
Idaho
Laboratories - legislation & jurisprudence - utilization
Oregon
Physicians' Offices
Questionnaires
Washington
Abstract
Laboratory testing services are presently undergoing dynamic changes in response to a wide range of external factors. Government regulations, reimbursement, and managed care are only a few of the influences affecting the availability of testing services and on-site testing capabilities in hospital, independent, and physician office laboratories. Medical practice changes, marketplace influences, test technologies, and costs also play a role in determining where testing is being performed. To better understand the factors influencing clinical laboratory test volumes and menus and to identify on-site testing deemed essential in physician office laboratories, we gathered information from a network of clinical laboratories in the Pacific Northwest. Questionnaires were sent to 257 Laboratory Medicine Sentinel Monitoring Network participants in March 1996. In the past 2 years, changes in on-site test volumes and test menus have been primarily due to medical practice changes and marketplace influences. When laboratories had a decrease in test volumes or test menu choices, the size of the patient workload and the volumes of test orders have had the greatest impact. Laboratory regulations and managed care contracts have played a role in shifting on-site testing to outside sources; however, these factors did not appear to be primary influences. Only 5% of physician office laboratories identified tests that they believed were essential for optimal patient care but did not perform on-site.
PubMed ID
9554496 View in PubMed
Less detail

Community participation in health care decision making: is it feasible?

https://arctichealth.org/en/permalink/ahliterature214543
Source
CMAJ. 1995 Aug 15;153(4):421-4
Publication Type
Article
Date
Aug-15-1995
Author
M A Singer
Source
CMAJ. 1995 Aug 15;153(4):421-4
Date
Aug-15-1995
Language
English
Publication Type
Article
Keywords
Canada
Community Health Planning
Consumer Participation
Decision Making
Feasibility Studies
Health Care Reform
Humans
Oregon
Abstract
Health care reform strategies proposed by provincial governments include decentralized funding and increased public participation in decision making. These proposals do not give details as to the public participation process, and a number of questions have been raised by the experience of some communities. Which citizens should form the decision-making group? What information do they need? What kinds of decisions should they make? What level of participation should they have? The results of a survey by Abelson and associates (see pages 403 to 412 of this issue) challenge the assumption that "communities" are willing to participate in health-care and social-service decision making. Willingness varied according to the composition of the groups polled, and participants' support for traditional decision makers increased after the complexities of the decision-making process were discussed. However, whereas their study measured willingness to participate at one point in time only, experience gained from Ontario's Better Beginnings, Better Futures project indicates that, given sufficient time, "ordinary" citizens are willing and can acquire the skills needed to decide how resources should be allocated for social services.
Notes
Cites: Can J Commun Ment Health. 1994 Fall;13(2):213-2710151077
Cites: Can J Commun Ment Health. 1994 Fall;13(2):229-4010151078
Cites: BMJ. 1993 Aug 7;307(6900):373-78374424
Cites: Soc Sci Med. 1993 Oct;37(7):851-78211302
Cites: Int J Health Serv. 1994;24(2):201-298034390
Cites: BMJ. 1993 Aug 14;307(6901):435-88374459
Cites: Lancet. 1991 Apr 13;337(8746):891-41672977
Cites: Can J Commun Ment Health. 1994 Fall;13(2):197-21110151076
Comment On: CMAJ. 1995 Aug 15;153(4):403-127634217
PubMed ID
7634219 View in PubMed
Less detail

Comparative costs and impacts of Canadian and American payment systems for mental health services.

https://arctichealth.org/en/permalink/ahliterature230402
Source
Hosp Community Psychiatry. 1989 Aug;40(8):805-8
Publication Type
Article
Date
Aug-1989
Author
D A Bigelow
B H McFarland
Author Affiliation
Department of Psychiatry, School of Medicine (GH), Oregon Health Sciences University, Portland 97201.
Source
Hosp Community Psychiatry. 1989 Aug;40(8):805-8
Date
Aug-1989
Language
English
Publication Type
Article
Keywords
British Columbia
Documentation
Health Services Accessibility - economics
Humans
Insurance, Psychiatric
Mental Health Services - economics - organization & administration
Oregon
Reimbursement Mechanisms
Abstract
In attempts to contain mental health costs, administrators are increasingly using incentives, competition, and accounting strategies and are creating more complicated financing systems. Yet the costs of these strategies and their impacts on the efficacy and efficiency of mental health services have yet to be studied. The authors compare mental health payment systems in British Columbia and Oregon. In the Canadian system, the patient is isolated from payment, sources of revenue are consolidated at the provincial level, only one payment mechanism per service type is used, health care documentation is oriented more to clinical needs than to reimbursement, and more discretion is delegated to providers. As a result, Canadian overhead costs are substantially less than those in the U.S. Patients have universal access to medical services in the Canadian system, and providers in hospitals, agencies, and individual practices have high incomes with low overhead costs.
PubMed ID
2759569 View in PubMed
Less detail

77 records – page 1 of 8.