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Access of Rural AFDC Medicaid Beneficiaries to Mental Health Services

Lambert, David; Agger, Marc S.
Fonte: CENTERS for MEDICARE & MEDICAID SERVICES Publicador: CENTERS for MEDICARE & MEDICAID SERVICES
Tipo: Artigo de Revista Científica
Publicado em //1995 EN
Relevância na Pesquisa
46.14%
This article examines geographic differences in the use of mental health services among Aid to Families with Dependent Children (AFDC)-eligible Medicaid beneficiaries in Maine. Findings indicate that rural AFDC beneficiaries have significantly lower utilization of mental health services than urban beneficiaries. Specialty mental health providers account for the majority of ambulatory visits for both rural and urban beneficiaries. However, rural beneficiaries rely more on primary-care providers than do urban beneficiaries. Differences in use are largely explained by variations in the supply of specialty mental health providers. This finding supports the long-held assumption that lower supply is a barrier to access to mental health services in rural areas.

Expenditures for Mental Health Services in the Utah Prepaid Mental Health Plan

Stoner, Tamara; Manning, Willard; Christianson, Jon; Gray, Donald Z.; Marriott, Sally
Fonte: CENTERS for MEDICARE & MEDICAID SERVICES Publicador: CENTERS for MEDICARE & MEDICAID SERVICES
Tipo: Artigo de Revista Científica
Publicado em //1997 EN
Relevância na Pesquisa
46.1%
This article examines the effect of a mental health carve-out, the Utah Prepaid Mental Health Plan (UPMHP), on expenditures for mental health treatment and utilization of mental health services for Medicaid beneficiaries from July 1991 through December 1994. Three Community Mental Health Centers (CMHCs) provided mental health services to Medicaid beneficiaries in their catchment areas in return for capitated payments. The analysis uses data from Medicaid claims as well as “shadow claims” for UPMHP contracting sites. The analysis is a pre/post comparison of expenditures and utilization rates, with a contemporaneous control group in the Utah catchment areas not in the UPMHP. The results indicate that the UPMHP reduced acute inpatient mental health expenditures and admissions for Medicaid beneficiaries during the first 2½ years of the UPMHP. In contrast, the UPMHP had no statistically significant effect on outpatient mental health expenditures or visits. There was no significant effect of the UPMHP on overall mental health expenditures.

Understanding and Improving Psychosocial Services in Long-Term Care

Bowen, Sonya E.; Zimmerman, Sheryl
Fonte: CENTERS for MEDICARE & MEDICAID SERVICES Publicador: CENTERS for MEDICARE & MEDICAID SERVICES
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
46.14%
In this issue of the Health Care Financing Review, we present research that speaks to the importance of psychosocial care and its relationship to the overall well-being and quality of life for people receiving long-term care (LTC) services in nursing homes and community-based settings. The articles address numerous psychosocial processes of care and outcomes within the LTC service spectrum. This overview discusses the rationale for examining psychosocial services in the context of quality of life in LTC; summarizes the focus of the articles in this issue; and highlights current CMS initiatives relevant to psychosocial needs in LTC including national data sources that measure psychosocial services and outcomes of care and can be used to develop programs to improve care and outcomes.

Les effets du régime des services essentiels sur la négociation collective : études de cas dans les secteurs du transport en commun et de la santé et des services sociaux

Dubé, Edith
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
Relevância na Pesquisa
36.31%
Au Québec, les négociations collectives dans les secteurs public et parapublic ainsi que dans les services publics sont assujetties aux règles du Code du travail (L.R.Q. C.-27). Certains secteurs dispensant des services dits essentiels, comme le transport en commun et le secteur de la santé et des services sociaux, ont à respecter des règles particulières, différentes de celles des autres secteurs assujettis au régime général édicté par le Code. Ces règles particulières constituent ce qu’on appelle le régime des services essentiels. Les négociations dans les services essentiels comportent des particularités importantes – considérations politiques et absence de substituts des services publics pour la population – qui les distinguent de façon notable des négociations qui se déroulent sous l’égide du modèle général de négociation collective édicté au Code et applicable dans les autres secteurs (Bergeron et Paquet, 2006). Quels sont les effets du régime des services essentiels sur la négociation collective dans le secteur du transport en commun et de la santé et des services sociaux? Dans le cadre de cette recherche, nous avons examiné les effets du régime des services essentiels (les règles du Code du travail et les décisions du Conseil des services essentiels) sur différents aspects de la négociation collective : 1) la mobilisation...

International Trade in Services : New Trends and Opportunities for Developing Countries

Cattaneo, Olivier; Engman, Michael; Sáez, Sebastián; Stern, Robert M.
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
36.31%
International trade in services also provides an assessment of how policy makers can further bolster their service industries by leveraging the changes prompted by technological advancements. The book provides policy recommendations that include the reduction of barriers to services trade across all sectors and the promotion of health- and environment-related development policies that should be promoted in parallel with a burgeoning services market. The first recommendation is considered the most important, because it focuses on the need to ensure trade openness, which helps ensure the access to services and promotes the quality of services provision through foreign and domestic competition. Moreover, the issue of temporary movement of labor is another focus of this book, given that it is one of the most important means of service exports for developing countries. This is an issue that is considered technically complex and politically sensitive because of its political and security implications. The book examines mechanisms that have been used by various countries to liberalize the temporary movement of persons and concludes that regardless of the negotiating forum- multilateral...

Trade in Services Negotiations : A Guide for Developing Countries

Sáez, Sebastián
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
36.31%
The aim of this book is to help policy makers, especially in the least developed countries, address the complexities of the organization, formulation, and implementation of trade-related reforms in the service sector. The book provides a conceptual framework for trade policy making and negotiation and practical tools that may be used to guide negotiations on policies that affect the trade and investment in services. The aim is not to be prescriptive, but to provide practical recommendations and tools that may be applied in the pursuit of negotiations on services, including consultations and regulatory audits. Negotiators often have little basic information regarding existing regulations and the purpose of these regulations. This problem is compounded by the difficulty of translating existing regulations into the terminology and concepts used in trade agreements. Different methodological approaches are needed to manage different sets of laws and regulations. This book offers a simple tool to help countries organize information to address these challenges. The book also provides practical examples and negotiation exercises that aim to enhance understanding of ways to use the conceptual framework and related tools.

Services Trade Liberalization and Regulatory Reform : Re-invigorating International Cooperation

Hoekman, Bernard; Mattoo, Aaditya
Fonte: Banco Mundial Publicador: Banco Mundial
Relevância na Pesquisa
36.31%
Trade and investment in services are inhibited by a range of policy restrictions, but the best offers so far in the Doha negotiations are on average twice as restrictive as actual policy. They will generate no additional market opening. Regulatory concerns help explain the limited progress. This paper develops two proposals to enhance the prospects for both liberalization of services trade and regulatory reform. The first is for governments to create mechanisms ("services knowledge platforms") to bring together regulators, trade officials, and stakeholders to discuss services regulatory reform. Such mechanisms could identify reform priorities and opportunities for utilization of "aid for trade" resources, thereby putting in place the preconditions for future market opening. The second proposal is for a new approach to negotiations in the World Trade Organization, with a critical mass of countries that account for the bulk of services production agreeing to lock-in applied levels of protection and pre-committing to reform of policies affecting foreign direct investment and international movement for individual service providers -- two areas where current policy is most restrictive and potential benefits from liberalization are greatest. If these proposals cannot be fully implemented in the Doha time frame...

Liberalizing Trade in Services : A Survey

Hoekman, Bernard
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
36.31%
Since the mid 1980s a substantial amount of research has been undertaken on trade in services. Much of this is inspired by the World Trade Organization or regional trade agreements, especially the European Union, but an increasing number of papers focus on the impacts of services sector liberalization. This paper surveys the literature, focusing on contributions that investigate the determinants of international trade and investment in services, the potential gains from greater trade (and liberalization), and efforts to cooperate to achieve such liberalization through trade agreements. It concludes that there is increasing evidence that services liberalization is an important source of potential welfare gains, but relatively little research has been done that can inform the design of international cooperation-both trade agreements and development assistance-so as to more effectively promote development objectives.

Services in a Development Round : Three Goals and Three Proposals

Mattoo, Aaditya
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Relevância na Pesquisa
36.3%
The benefits of services trade reform are huge but services negotiations in the World Trade Organization (WTO) are making little progress. A proximate cause is the current negotiating process, based on an inertial request-and-offer approach rather than a set of goals that would give direction and momentum to the negotiations. The paper suggests that WTO members should consider: (1) locking in the current openness of cross-border trade for a wide range of services; (2) eliminating barriers to foreign investment either immediately or in a phased manner where regulatory inadequacies need to be remedied; and (3) allowing greater freedom of international movement at least for intra-corporate transferees and for service providers to fulfill specific services contracts. A deeper problem is that WTO members have sought to negotiate market access in services without adequately addressing concerns that the General Agreement on Trade in Services (GATS) commitments limit regulatory freedom unduly and unpredictably, that regulatory institutions in many countries are too weak to cope with liberalized markets, and that there is no provision for the regulatory cooperation that is necessary for successful liberalization, particularly of temporary labor mobility. Three types of actions are needed: (1) at the current stage of its development...

Policy Barriers to International Trade in Services : Evidence from a New Database

Borchert, Ingo; Gootiiz, Batshur; Mattoo, Aaditya
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
36.31%
Surprisingly little is known about policies that affect international trade in services. Previous analyses have focused on policy commitments made by countries in international agreements but these commitments do not in many cases reflect actual policy. This paper describes a new initiative to collect comparable information on services trade policies for 103 countries, across a range of service sectors and the relevant modes of service delivery. The resultant database reveals interesting patterns in policy. Across regions, some of the fastest growing countries in Asia and the oil-rich Gulf states have the most restrictive policies in services, whereas some of the poorest countries are remarkably open. Across sectors, professional and transportation services are among the most protected in both industrial and developing countries, while retail, telecommunications and even finance tend to be more open. An illustrative set of results suggests that trade policies matter for investment flows and access to services. In particular...

Trade Dimensions of Logistics Services : A Proposal for Trade Agreements

Kunaka, Charles; Mustra, Monica Alina; Saez, Sebastian
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
36.3%
Services have a direct impact on the competitiveness of the goods sector. This paper illustrates the importance of logistics services, their trade dimension, and how regulatory issues act as perhaps one of the most significant barriers to competitiveness. The paper discusses recent developments and the role and benefits of logistics services and argues that from a trade agreement standpoint, logistics is a network industry that ultimately provides one service to a final client. It analyzes logistics services from a services trade perspective and proposes that trade agreements should ensure access to and use of the infrastructure required to provide these services recognizing their interconnectedness. The paper offers suggestions on additional policies World Trade Organization members, and countries negotiating services agreements regionally or bilaterally, could follow in order to fully exploit the opportunities provided by logistics services. Local regulations and complementary policies in areas such as trade facilitation will always remain important.

International Provision of Trade Services, Trade, and Fragmentation

Deardorff, Alan V.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
36.31%
The author examines the special role that trade liberalization in services industries can play in stimulating trade in both services, and goods. International trade in goods requires inputs from such trade services as transportation, insurance, and finance, for example. Restrictions on services across borders, and within foreign countries add costs, and barriers to international trade. Liberalizing trade in services could also facilitate trade in goods, providing more benefits than one might expect from analysis merely of the services trade. To emphasize the point, the author notes that the benefits for trade are arguably enhanced by the phenomenon of fragmentation. The more that production processes become split across locations, with the fragments tied together, and coordinated by various trade services, the greater the gains from reductions in the costs of services. The incentives for such fragmentation can be greater across countries, than within countries, because of the greater differences in factor prices...

Interim policy on establishment and operation of internet open, anonymous information servers and services

Acting Dean of Computer and Information Services
Fonte: Monterey, California: Naval Postgraduate School. Publicador: Monterey, California: Naval Postgraduate School.
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
46.05%
Purpose. To establish interim NPS general policy regarding establishment and operation of Open, Anonymous Information Servers and Services, such as World Wide Web (http), Gopher, Anonymous FTP, etc...

Regulatory Cooperation, Aid for Trade and the General Agreement on Trade in Services

Hoekman, Bernard; Mattoo, Aaditya
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH
Relevância na Pesquisa
36.31%
This paper discusses what could be done to expand services trade and investment through a multilateral agreement in the World Trade Organization. A distinction is made between market access liberalization and the regulatory preconditions for benefiting from market opening. The authors argue that prospects for multilateral services liberalization would be enhanced by making national treatment the objective of World Trade Organization services negotiations, thereby clarifying the scope of World Trade Organization commitments for regulators. Moreover, liberalization by smaller and poorer members of the World Trade Organization would be facilitated by complementary actions to strengthen regulatory capacity. If pursued as part of the operationalization of the World Trade Organization's 2006 Aid for Trade taskforce report, the World Trade Organization could become more relevant in promoting not just services liberalization but, more importantly, domestic reforms of services policies.

International Trade in Health Services and the GATS : Current Issues and Debates

Blouin, Chantal; Drager, Nick; Smith, Richard
Fonte: Washington, DC: World Bank Publicador: Washington, DC: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
ENGLISH; EN_US
Relevância na Pesquisa
36.3%
Health ministries around the world face a new challenge: to assess the risks and respond to the opportunities of the increasing openness in health services under the World Trade Organization's (WTO) General Agreement on Trade in Services (GATS). This publication addresses this challenge head-on by providing analytical tools to policymakers in health and trade ministries alike who are involved in the liberalization agenda and, specifically, in the GATS negotiations. This book informs and assists policymakers in formulating trade policy and negotiating internationally. There is ongoing and animated international debate about the impact of GATS on public services in general and health in particular. In response, the book offers different perspectives from more than 15 leading experts. Some of the authors stress opportunities linked to trade in health services, others focus more on the risks. The book offers: Detailed legal analysis of the impact of the agreement on health policy; an overview of trade commitments in health-related services; new empirical evidence from nine country studies; and a simple 10-step explanation on how to deal with GATS negotiations.

China's Accession to the World Trade Organization : The Services Dimension

Mattoo, Aaditya
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
36.3%
China's General Agreement on Trade in Services (GATS) commitments represent the most radical services reform program negotiated in the World Trade Organization. China has promised to eliminate over the next few years most restrictions on foreign entry and ownership, as well as most forms of discrimination against foreign firms. These changes are in themselves desirable. However, realizing the gains from, and perhaps even the sustainability of, liberalization will require the implementation of complementary regulatory reform and the appropriate sequencing of reforms. Three issues, in particular, merit attention: 1) Initial restrictions on the geographical scope of services liberalization could encourage the further agglomeration of economic activity in certain regions-to an extent that is unlikely to be reversed completely by subsequent countrywide liberalization. 2) Restrictions on foreign ownership (temporary in most sectors but more durable in telecommunications and life insurance) may dampen the incentives of foreign investors to improve firm performance. 2) Improved prudential regulation and measures to deal with the large burden of non-performing loans on state banks are necessary to deliver the benefits of liberalization in financial services. And in basic telecommunications and other network-based services...

International Tradability Indices for Services

van der Marel, Erik; Shepherd, Ben
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
36.31%
This paper uses a theoretically grounded model of international trade to estimate the cross-border tradability of services. The resulting indices cover up to 99 countries and ten sectors. The results show that information and communications technology capital and legal institutions are particularly important determinants of a country's ability to successfully export services. The tradability indices are strongly correlated with outcome indicators, such as trade shares of individual countries. In addition, they are strongly correlated with important inputs, including country productivity and size, factor endowments, trade costs, and regulatory measures. In particular, the results suggest that a more restrictive regulatory environment significantly reduces the international tradability of services.

Les déterminants de l’utilisation des services en santé mentale dans le sud-ouest de Montréal

Ngamini Ngui, Andre
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
Relevância na Pesquisa
36.31%
Objectif : L’objectif principal de cette thèse est d’examiner les déterminants de l’utilisation des services de soins pour des raisons de santé mentale dans le sud-ouest de Montréal. Données et méthodes : L’étude utilise les données de la première phase du projet portant sur « le développement d’une zone circonscrite d’études épidémiologiques en psychiatrie dans le sud-ouest de Montréal ». Les données ont été collectées entre mai 2007 et août 2008 auprès d’un échantillon de 2434 personnes sélectionnées au hasard dans tout le territoire de l’étude. De cet échantillon, nous avons sélectionné un sous-échantillon de personnes ayant eu au moins un diagnostic de santé mentale au cours de la dernière année. 423 personnes ont rencontrées ce critère et constituent l’échantillon pour les analyses de la présente thèse. Le modèle comportemental d’Andersen a servi de cadre pour le choix des variables à analyser. Parce que l’approche socio-spatiale a été privilégiée pour modéliser les déterminants de l’utilisation des services, les analyses ont été effectuées à l’aide de quatre logiciels distincts à savoir : SPSS, AMOS, ArcGIS et MlWin. Résultats : Les résultats montrent que 53...

Réorganiser les services de réadaptation destinés aux enfants : utilisation d'une recherche-action participative pour documenter un nouveau modèle de services

Camden, Chantal
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
Relevância na Pesquisa
36.31%
Cette thèse a pour but de documenter la réorganisation des services effectuée au programme Enfants et adolescents (PEA) du Centre de réadaptation Estrie, Sherbrooke. Une démarche de recherche-action participative (RAP) est utilisée afin de collaborer au développement, à l’implantation et à l’évaluation d’un nouveau modèle de services visant à accroître l’accessibilité et la qualité des services de réadaptation offerts aux enfants ayant une déficience physique. Spécifiquement, les objectifs sont : 1) de documenter les retombées de la réorganisation des services; 2) de réaliser une analyse critique du processus de changement. Des méthodes quantitatives et qualitatives sont utilisées afin d’atteindre ces objectifs. Tout d’abord, la Mesure des processus de soins (MPOC) documente la perception de la qualité avant (2007), pendant (2008) et après (2009) l’implantation du nouveau modèle de services. Au total, cet outil est employé auprès de 222 familles et 129 intervenants. À quatre reprises, les intervenants et les gestionnaires répondent également à un questionnaire sur leurs perceptions des forces, des faiblesses, des opportunités et des menaces au PEA. En 2008 et en 2009, des focus groups et des entrevues téléphoniques sont réalisées auprès des familles (n=5)...

Medicaid Waiver Personal Care Services: Results of a Statewide Survey

Glass, Anne P.; Roberto, Karen A.; Brossoie, Nancy; Teaster, Pamela B.; Butler, Donna Q.
Fonte: CENTERS for MEDICARE & MEDICAID SERVICES Publicador: CENTERS for MEDICARE & MEDICAID SERVICES
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
46.1%
Through a statewide telephone survey of 819 beneficiaries (or their proxies), we collected data regarding client and aide demographics, as well as clients' satisfaction, outcomes, perspectives on staff performance, and complaints associated with home-based personal care services provided under the Virginia Medicaid Elderly and Disabled (E&D) waiver. Most respondents indicated that services improved their lives, and they were generally satisfied. Opportunities for improvement exist, however, especially related to the amount of time spent with the client, the need for training, and communication issues. Ongoing use of client/family caregiver surveys is warranted to allow continued monitoring of service provision.