Access No: 00805880 ProQuest ABI/INFORM (R) Global Edition Title: The Sudan: Stop the carnage Authors: Deng, Francis M Journal: Brookings Review (BRR) ISSN: 0745-1253 Vol: 12 Iss: 1 Date: Winter 1994 p: 6-11 Subjects: Regions; War; Political behavior; International relations; Foreign policy; Recommendations Geo Places: Sudan; US Codes: 9177 (Africa); 9190 (United States); 1200 (Social policy) Abstract: The attention of US policymakers has been distracted from the twin tragedies of civil war and famine in the Sudan by recent allegations linking the Islamic regime in Khartoum with international terrorism. However, international and domestic developments in the Sudan are closely linked, for the war-torn nation has proved a fertile breeding ground for Islamic fundamentalism. A successful effort to stop war would not only put an end to untold human suffering. It could also go far in taking Khartoum off the world terrorism map. Besides suffering a human rights calamity, the Sudan has also fallen victim to insidious political instability and the virtual collapse of the economy. Compounding the tragedy is the view taken by successive governments that all civilian populations who are ethnically or racially identified with the rebels are part of the enemy, to be fought by all means, including starvation, disease, and denial of essential services. The plight of the people of the Sudan calls out for external humanitarian intervention not only to provide urgently needed relief, but to end the war and help reestablish civil order. Access No: 00831929 ProQuest ABI/INFORM (R) Global Edition Title: Tobacco hush money for black leaders Authors: Herbert, Bob Journal: Business & Society Review (BUS) ISSN: 0045-3609 Iss: 88 Date: Winter 1994 p: 62-63 Subjects: Tobacco industry; Market strategy; Impacts; Blacks; Smoking Geo Places: US Codes: 9190 (United States); 7000 (Marketing); 8600 (Manufacturing industries) Abstract: Smoking is a plague on all Americans but hits African Americans especially hard. The tobacco companies target African Americans with intensity. According to the Centers for Disease Control, more than 45,000 African Americans died from smoking-related diseases in 1992. Dead smokers do not do much for the bottom line, so companies like Philip Morris USA started giving to organizations like the NAACP, the Urban League and Associated Black Charities in 1988 to help replace the lost smokers and maintain a healthy bottom line. The leaders of these organizations should have been fanatical in their opposition to smoking, which slaughters their memberships. Instead, they lined up before the tobacco companies with their lips zipped and their hands out for their share of the industry's hush money. The tobacco companies are buying the silence of the black leaders. By accepting the money and not speaking out against the dangers of smoking, those leaders are selling out their people. Access No: 00866874 ProQuest ABI/INFORM (R) Global Edition Title: Specialized health care delivery systems for chronic illness Authors: Kretz, Sandra E Journal: Compensation & Benefits Management (CBM) ISSN: 0748-061X Vol: 10 Iss: 3 Date: Summer 1994 p: 53-63 Illus: Charts; Graphs; References Subjects: Group health insurance; Chronic; Illnesses; Health care delivery; Utilization review; Studies; Statistical analysis Geo Places: US Codes: 9190 (United States); 9130 (Experimental/theoretical); 8320 (Health care industry); 6400 (Employee benefits & compensation) Abstract: In contrast to surgical procedures, an emphasis on quality-based selection of providers to chronic illness such as asthma, diabetes, and cardiac disease has not been widely utilized. There is, however, a growing awareness that these and many other chronic illnesses are more expensive over the course of illness than individual surgeries, and a recognition that some chronic illnesses require the same level of treatment expertise as does a highly visible surgical procedure. In collaboration with the National Jewish Center, John Hancock undertook a national patient assessment to find out whether people with severe asthma were receiving care that conformed to the established best practices for the treatment of asthma. The lessons for employers from this study are: 1. Paying for expensive care does not ensure that patients are receiving quality care. 2. Allowing patients freedom to choose their own doctors does not necessarily ensure that they will find their way to the best source of care. Access No: 00866877 ProQuest ABI/INFORM (R) Global Edition Title: Managing chronic disease patients Authors: Cave, Douglas G Journal: Compensation & Benefits Management (CBM) ISSN: 0748-061X Vol: 10 Iss: 3 Date: Summer 1994 p: 74-79 Illus: Charts; References Subjects: Chronic; Illnesses; Case management; Utilization review; Health care expenditures; Guidelines Geo Places: US Codes: 9190 (United States); 9150 (Guidelines); 8320 (Health care industry) Abstract: High-cost patients can be divided into 3 categories according to the condition that is driving the costs: 1. acute long-term hospital stayers, 2. chronic disease patients, and 3. mental health/chemical dependency patients. Chronic disease patients typically consumer over 60% of the total dollars spent for high-cost cases. One reason is that approximately 55% of all high-cost patients fall into the chronic disease category. Despite the importance of chronic disease patients in driving costs, most case management programs today focus their attention on managing the acute long-term hospital stayers. A process for effectively managing chronic disease patients is defined that contains the following phases: 1. identification of potential candidates, 2. referral, 3. screening, 4. assessment, 5. active management, and 6. case closure. Access No: 00870126 ProQuest ABI/INFORM (R) Global Edition Title: The integration of public health and medicine: Reply Authors: Rundall, Thomas G Journal: Frontiers of Health Services Management (FHS) ISSN: 0748-8157 Vol: 10 Iss: 4 Date: Summer 1994 p: 42-44 Subjects: Health care policy; Public health; Integrated approach; Reforms; Recommendations Geo Places: US Codes: 1200 (Social policy); 9190 (United States) Abstract: Commentaries made on the integration of public health and medicine serve as a reminder of the importance of the first condition proposed as necessary to achieving true integration: a shared vision of the integrated health care system and the respective roles and responsibilities of public health and medical care in this system. VanAmringe's point regarding the benefits of organizing medical and public health activities around a defined population is supported. The importance of a monitoring system that continuously cycles through the stages of health status assessment, policy development and modification, and reassessment is accepted. Taking on the responsibility of such monitoring activities at the national, state, and local level is a large part of VanAmringe's vision of public health in an integrated system and is consistent with the vision of Roper, Koplan, Stinnett, and Rundall, but VanAmringe is much less convinced of the benefits of community disease prevention efforts and advises to move slowly in providing funding for these activities. Access No: 00866671 ProQuest ABI/INFORM (R) Global Edition Title: Devil hidden in the details Authors: Anonymous Journal: Business Insurance (BIN) ISSN: 0007-6864 Vol: 28 Iss: 25 Date: Jun 20, 1994 p: 8 Subjects: Health care policy; Reforms; Policy making; Bills Geo Places: US Codes: 1200 (Social policy); 4320 (Legislation); 9190 (United States); 9000 (Short Article) Abstract: Congress is urged to delay consideration of comprehensive health care reform legislation until 1995 because there simply is not enough time in 1994 to enact a carefully crafted law. An editorial cites a provision in the 1993 budget act that shifts for 18 months most of the cost of treating end-state renal disease for people over age 65 to employer-provided retiree health care plans from the Medicare program as evidence that haste makes waste. Access No: 00866627 ProQuest ABI/INFORM (R) Global Edition Title: More costs shifted to employers Authors: Geisel, Jerry Journal: Business Insurance (BIN) ISSN: 0007-6864 Vol: 28 Iss: 24 Date: Jun 13, 1994 p: 1, 21 Subjects: Retirement benefits; Group health insurance; Medicare; Disease; OBRA 1993-US; Insurance coverage Geo Places: US Codes: 9190 (United States); 6400 (Employee benefits & compensation); 4320 (Legislation) Abstract: Many benefit managers are in for a rude surprise because of an obscure provision buried in the 1993 federal budget law that shifts tens of millions of dollars of medical costs to employers' retiree health care plans from Medicare. The provision involves a complex, shared responsibility between employer health plans and Medicare for primary payment of medical bills for end-stage renal disease (ESRD), an impairment of the kidneys for which there is no cure, only expensive treatment. A law passed 20 years ago expanded the Medicare program to provide coverage for ESRD for people under age 65, the normal eligibility age for Medicare. Legislation was later enacted so that employer health care plans would be the primary payer - for an 18-month period - of medical bills for employees or retirees under age 65 who developed ESRD. After 18 months - or when an individual with ESRD turned 65 - Medicare would assume primary responsibility for these costs. However, under a provision in the 1993 budget law, employer-provided retiree health plans now are the primary payers for 18 months after retirees with ESRD become eligible for Medicare at age 65. Access No: 00865278 ProQuest ABI/INFORM (R) Global Edition Title: Restraint on use of antibiotics urged Authors: Scott, Lisa Journal: Modern Healthcare (MHC) ISSN: 0160-7480 Vol: 24 Iss: 24 Date: Jun 13, 1994 p: 47 Illus: Graphs Subjects: Hospitals; Physicians; Antibiotics; Resistance; Trends; Recommendations Geo Places: US Codes: 8320 (Health care industry); 9190 (United States) Abstract: About 1/2 of the 2 million infections acquired in hospitals each year involve bacteria that resist some of the drugs that once vanquished them. Also, more hospitals are seeing patients who acquired resistant bacteria in the community or in other health care facilities. Hospital executives have to be aware of the potential for changes in hospitals' ability to look at a simple infection as a relatively quick procedure, said Mike K. Roark of Owen Healthcare. The percentage of hospital-acquired enterococci, or VRE, that withstood the antibiotic vancomycin - as well as many other drugs - rose to 7.9% in 1993 from 0.3% in 1989 according to the National Center for Disease Control and Prevention (CDC). CDC recommends education, infection control, and the prudent use of vancomycin. Access No: 00861941 ProQuest ABI/INFORM (R) Global Edition Title: New definitions, perceptions needed in healthcare debate Authors: Toomey, Robert E Journal: Modern Healthcare (MHC) ISSN: 0160-7480 Vol: 24 Iss: 23 Date: Jun 6, 1994 p: 30 Subjects: Health care policy; Reforms; Health care networks; Health care delivery; Definitions; Perceptions Geo Places: US Codes: 1200 (Social policy); 8320 (Health care industry); 9190 (United States) Abstract: Everyone seems to believe that community-care networks and regional, comprehensive systems are needed to make healthcare affordable. If that is true, the major stumbling blocks to building such systems need to be identified and steps taken to make them operationally effective. The notion of community and the meaning of healthcare must be redefined. More attention must be paid to health status, as well as disease status, and social models of care must be built that incorporate community-based efforts to improve health status as well as to cure diseases. Access No: 00870994 ProQuest ABI/INFORM (R) Global Edition Title: Benefits of prevention outweigh costs: Experts Authors: Dauer, Christopher Journal: National Underwriter [Life/Health/Financial Services] (NUD) ISSN: 0893-8202 Vol: 98 Iss: 23 Date: Jun 6, 1994 p: 42, 44 Subjects: Employee benefits; Wellness programs; Costs; Advantages Geo Places: US Codes: 6500 (Employee problems); 9190 (United States) Abstract: According to employee benefits experts, if employers include preventive medical services in their employee benefit plans, the advantages will far outweigh the average 3% increase in benefit costs such services produce. Offering preventive medical services to employees is far more cost effective than waiting to treat miscellaneous disease and maladies later, said Rick Dreyfuss of Hershey Foods Corp. Preventive services may include screening for early detection of disabilities or risk factors, childhood and adult immunizations, and health-behavior counseling.