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Care Market (care + market)
Selected AbstractsHealth Care Markets, the Safety Net, and Utilization of Care among the UninsuredHEALTH SERVICES RESEARCH, Issue 1p1 2007Carole Roan Gresenz Objective. To quantify the relationship between utilization of care among the uninsured and the structure of the local health care market and safety net. Data Sources/Study Setting. Nationally representative data from the 1996 to 2000 waves of the Medical Expenditure Panel Survey (MEPS) linked to data from multiple secondary sources. Study Design. We separately analyze outpatient care utilization and whether an individual incurred any medical expenditure among uninsured adults living in urban and rural areas. Safety net measures include distances between each individual and the nearest safety net providers as well as a measure of capacity based on local government and hospital health expenditures. Other covariates include the managed care presence in the local health care market, the percentage of individuals who are uninsured in the area, and local primary care physician supply. We simulate utilization using standardized predictions. Principal Findings. Distances between the rural uninsured and safety net providers are significantly associated with utilization. In urban areas, we find that the percentage of individuals in the area who are uninsured, the pervasiveness and competitiveness of managed care, the primary care physician supply, and safety net capacity have a significant relationship with health care utilization. Conclusions. Facilitating transport to safety net providers and increasing the number of such providers are likely to increase utilization of care among the rural uninsured. Our findings for urban areas suggest that the uninsured living in areas where managed care presence is substantial, and especially where managed care competition is limited, could be a target for policies to improve the ability of the uninsured to obtain care. Policies oriented toward enhancing funding for the safety net and increasing the capacity of safety net providers are likely to be important to ensuring the urban uninsured are able to obtain health care. [source] Movement and change: independent sector domiciliary care providers between 1995 and 1999HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2001Patricia Ware Abstract Promoting the development of a flourishing independent sector alongside good quality public services was a key objective of the community care reforms of the last decade. This paper charts some of the ways the independent domiciliary care sector is changing, as local authorities shift the balance of their provision toward independent sector providers and away from a reliance on in-house services. Two surveys of independent domiciliary care providers were carried out in 1995 and 1999. The aims of the studies were to describe the main features of provider organisations, such as size of business, client group and funding sources; to examine the nature of provider motivations and their past and future plans; to consider how local authorities manage the supply side of social care markets; and to examine the effects on providers of the development of the mixed economy. The first survey in 1995 was conducted in eight local authority areas, which by 1999 had increased to 11 because of the creation of three new unitary authorities. The findings are based on 261 postal surveys together with 111 interviews between the two studies. The research illustrates a domiciliary care market that is still relatively young with many small but growing businesses. There are considerable differences in the split between in-house and independent sector services in individual authorities and a common perception among independent providers that in-house services receive favourable treatment and conditions. Spot or call-off contracts continue to be the most common form of contract although there are moves toward greater levels of guaranteed service and more sophisticated patterns of contracting arrangements. There remains an ongoing need to share information between local authorities and independent providers so that good working relationships can develop with proven and competent providers. [source] Proximity to death and participation in the long-term care marketHEALTH ECONOMICS, Issue 8 2009France Weaver Abstract The extent to which increasing longevity increases per capita demand for long-term care depends on the degree to which utilization is concentrated at the end of life. We estimate the marginal effect of proximity to death, measured by being within 2 years of death, on the probabilities of nursing home and formal home care use, and we determine whether this effect differs by availability of informal care , i.e. marital status and co-residence with an adult child. The analysis uses a sample of elderly aged 70+from the 1993,2002 Health and Retirement Study. Simultaneous probit models address the joint decisions to use long-term care and co-reside with an adult child. Overall, proximity to death significantly increases the probability of nursing home use by 50.0% and of formal home care use by 12.4%. Availability of informal support significantly reduces the effect of proximity to death. Among married elderly, proximity to death has no effect on institutionalization. In conclusion, proximity to death is one of the main drivers of long-term care use, but changes in sources of informal support, such as an increase in the proportion of married elderly, may lessen its importance in shaping the demand for long-term care. Copyright © 2008 John Wiley & Sons, Ltd. [source] Health Care Markets, the Safety Net, and Utilization of Care among the UninsuredHEALTH SERVICES RESEARCH, Issue 1p1 2007Carole Roan Gresenz Objective. To quantify the relationship between utilization of care among the uninsured and the structure of the local health care market and safety net. Data Sources/Study Setting. Nationally representative data from the 1996 to 2000 waves of the Medical Expenditure Panel Survey (MEPS) linked to data from multiple secondary sources. Study Design. We separately analyze outpatient care utilization and whether an individual incurred any medical expenditure among uninsured adults living in urban and rural areas. Safety net measures include distances between each individual and the nearest safety net providers as well as a measure of capacity based on local government and hospital health expenditures. Other covariates include the managed care presence in the local health care market, the percentage of individuals who are uninsured in the area, and local primary care physician supply. We simulate utilization using standardized predictions. Principal Findings. Distances between the rural uninsured and safety net providers are significantly associated with utilization. In urban areas, we find that the percentage of individuals in the area who are uninsured, the pervasiveness and competitiveness of managed care, the primary care physician supply, and safety net capacity have a significant relationship with health care utilization. Conclusions. Facilitating transport to safety net providers and increasing the number of such providers are likely to increase utilization of care among the rural uninsured. Our findings for urban areas suggest that the uninsured living in areas where managed care presence is substantial, and especially where managed care competition is limited, could be a target for policies to improve the ability of the uninsured to obtain care. Policies oriented toward enhancing funding for the safety net and increasing the capacity of safety net providers are likely to be important to ensuring the urban uninsured are able to obtain health care. [source] The End of an Era: What Became of the "Managed Care Revolution" in 2001?HEALTH SERVICES RESEARCH, Issue 1p2 2003Cara S. Lesser Objective. To describe how the organization and dynamics of health systems changed between 1999 and 2001, in the context of expectations from the mid-1990s when managed care was in ascendance, and assess the implications for consumers and policymakers. Data Sources/Study Setting. Data are from the Community Tracking Study site visits to 12 communities that were randomly selected to be nationally representative of metropolitan areas with 200,000 people or more. The Community Tracking Study is an ongoing effort that began in 1996 and is fielded every two years. Study Design. Semistructured interviews were conducted with 50,90 stakeholders and observers of the local health care market in each of the 12 communities every two years. Respondents include leaders of local hospitals, health plans, and physician organizations and representatives of major employers, state and local governments, and consumer groups. First round interviews were conducted in 1996,1997 and subsequent rounds of interviews were conducted in 1998,1999 and 2000,2001. A total of 1,690 interviews were conducted between 1996 and 2001. Data Analysis Methods. Interview information was stored and coded in qualitative data analysis software. Data were analyzed to identify patterns and themes within and across study sites and conclusions were verified by triangulating responses from different respondent types, examining outliers, searching for disconfirming evidence, and testing rival explanations. Principal Findings. Since the mid-1990s, managed care has developed differently than expected in local health care markets nationally. Three key developments shaped health care markets between 1999 and 2001: (1) unprecedented, sustained economic growth that resulted in extremely tight labor markets and made employers highly responsive to employee demands for even fewer restrictions on access to care; (2) health plans increasingly moved away from core strategies in the "managed care toolbox"; and (3) providers gained leverage relative to managed care plans and reverted to more traditional strategies of competing for patients based on services and amenities. Conclusions. Changes in local health care markets have contributed to rising costs and created new access problems for consumers. Moreover, the trajectory of change promises to make the goals of cost-control and quality improvement more difficult to achieve in the future. [source] Behenamidopropyl Dimethylamine: unique behaviour in solution and in hair care formulationsINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 4 2010M. Minguet Synopsis The rise of ecological awareness among consumers and industry has impacted the cationic surfactants market. The most used cationic surfactants present some drawbacks in this sense. Therefore, new molecules are being studied and developed which fulfil eco-toxicological requirements without losing performance. One of these surfactants is Behenamidopropyl Dimethylamine (BAPDMA). This biodegradable amidoamine, which converts into a cationic surfactant at acidic pH, shows outstanding water solubility, despite its very long alkyl chain. Its behaviour in solution has been exhaustively studied. The conditioning performance of this product is superior to that of commonly used cationic surfactants, providing a superior sensorial profile and improved combing force reductions on hair. Moreover, other applications for this product in the non-ionic form have been studied, such as conditioning agent in 2 in 1 shampoos, where it also shows colour protection effects, and as gelling agent in hair colouration creams. This multifunctional and high performance profile, together with an improved biodegradation and aquatic toxicity compared with currently used cationic surfactants, make this product a very interesting eco-friendly alternative for the hair care market. Résumé L'essor de la conscience écologique parmi les consommateurs et l'industrie a eu un fort impact dans le marché des tensioactifs cationiques. Les plus employés d'entre eux ont quelques désavantages de ce point de vue. À ce sujet, on est en train d'étudier et développer des nouvelles molécules qui accomplissent les conditions éco-toxicologiques, sans perdre leur efficacité adoucissante. Un de ces tensioactifs c'est la Behenamidopropyl Dimethylamine (BAPDMA). Cette amidoamine, qui est totalement biodégradable et non toxique pour l'environnement, évolue dans un tensioactif cationique à des pHs acides. Dans l'eau le produit montre une solubilité inespérément élevée, malgré qu'il a une chaîne alchilyque très longue. On a étudiéà fond son comportement en dissolution. L'efficacité de conditionnement du produit se montre supérieure à celle des tensioactifs cationiques employés habituellement, en donnant un profil sensoriel supérieur et en améliorant la souplesse de coiffure. En plus, pour ce produit, d'autres applications ont étéétudiées dans la forme non ionique, par exemple, son emploi comme agent conditionneur dans des shampooings 2 en 1, où il montre aussi un effet protecteur de la couleur et comme agent de texture dans des crèmes de coloration capillaire. Ce profil multifonctionnel et de haute efficacité, ainsi que un bon profil éco-toxicologique, en comparaison avec les tensioactifs cationiques employés actuellement, fait que la behenamidopropyl dimethylamine soit une très bonne alternative pour le marché du soin capillaire. [source] Ehealth: Market Potential and Business StrategiesJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 4 2001Pamela Whitten Due to the economic and social priorities afforded health services in the United States, research on new delivery modalities such as the Internet is gaining in popularity. Claims of the Internet's potential range from a promise to revolutionize the fundamental way health care is delivered to a tool for empowering patients through enhanced interaction with providers (Rice, 2001). Even though a great amount of attention has been given to e-health activity, the preponderance of publications to date has focused on the Internet as a source of health information. However important this form of e-health is, this type of service simply does not face the same constraints that must be addressed by those actually delivering health care services or tightly regulated pharmaceutical products. In this paper, we examine e-health by focusing explicitly on the delivery of health care products and services. Our examination of e-health activity is guided by two broad research questions. First, we ask what the potential is for the development of online health care services by examining its potential in major health care service and product sectors. Second, based upon case studies of two online health service firms, we seek to understand the emerging strategies of firms that are attempting to enter the health care market with an entirely online approach. Our examination of current e-health trends, as well as our two case studies, demonstrates the tremendous potential for health-related commercial activity on the Internet. However, our examination of the barriers facing ehealth from the US health system also pointed out the almost insurmountable challenges. We therefore conclude that a "click and mortar" model may perhaps be the optimal strategy for e-health. [source] Beyond skin feel: innovative methods for developing complex sensory profiles with siliconesJOURNAL OF COSMETIC DERMATOLOGY, Issue 1 2006Isabele Van Reeth Summary In today's competitive skin care market, formulators strive to meet consumer demand for products that combine performance with superior esthetics. Although skin feel has always been a key esthetic parameter, consumers increasingly select products based on a more complete sensory experience, including texture, scent, visual esthetics in the container, tactile effects on application, and the performance of active ingredients such as vitamins or sunscreen. [source] Movement and change: independent sector domiciliary care providers between 1995 and 1999HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2001Patricia Ware Abstract Promoting the development of a flourishing independent sector alongside good quality public services was a key objective of the community care reforms of the last decade. This paper charts some of the ways the independent domiciliary care sector is changing, as local authorities shift the balance of their provision toward independent sector providers and away from a reliance on in-house services. Two surveys of independent domiciliary care providers were carried out in 1995 and 1999. The aims of the studies were to describe the main features of provider organisations, such as size of business, client group and funding sources; to examine the nature of provider motivations and their past and future plans; to consider how local authorities manage the supply side of social care markets; and to examine the effects on providers of the development of the mixed economy. The first survey in 1995 was conducted in eight local authority areas, which by 1999 had increased to 11 because of the creation of three new unitary authorities. The findings are based on 261 postal surveys together with 111 interviews between the two studies. The research illustrates a domiciliary care market that is still relatively young with many small but growing businesses. There are considerable differences in the split between in-house and independent sector services in individual authorities and a common perception among independent providers that in-house services receive favourable treatment and conditions. Spot or call-off contracts continue to be the most common form of contract although there are moves toward greater levels of guaranteed service and more sophisticated patterns of contracting arrangements. There remains an ongoing need to share information between local authorities and independent providers so that good working relationships can develop with proven and competent providers. [source] The End of an Era: What Became of the "Managed Care Revolution" in 2001?HEALTH SERVICES RESEARCH, Issue 1p2 2003Cara S. Lesser Objective. To describe how the organization and dynamics of health systems changed between 1999 and 2001, in the context of expectations from the mid-1990s when managed care was in ascendance, and assess the implications for consumers and policymakers. Data Sources/Study Setting. Data are from the Community Tracking Study site visits to 12 communities that were randomly selected to be nationally representative of metropolitan areas with 200,000 people or more. The Community Tracking Study is an ongoing effort that began in 1996 and is fielded every two years. Study Design. Semistructured interviews were conducted with 50,90 stakeholders and observers of the local health care market in each of the 12 communities every two years. Respondents include leaders of local hospitals, health plans, and physician organizations and representatives of major employers, state and local governments, and consumer groups. First round interviews were conducted in 1996,1997 and subsequent rounds of interviews were conducted in 1998,1999 and 2000,2001. A total of 1,690 interviews were conducted between 1996 and 2001. Data Analysis Methods. Interview information was stored and coded in qualitative data analysis software. Data were analyzed to identify patterns and themes within and across study sites and conclusions were verified by triangulating responses from different respondent types, examining outliers, searching for disconfirming evidence, and testing rival explanations. Principal Findings. Since the mid-1990s, managed care has developed differently than expected in local health care markets nationally. Three key developments shaped health care markets between 1999 and 2001: (1) unprecedented, sustained economic growth that resulted in extremely tight labor markets and made employers highly responsive to employee demands for even fewer restrictions on access to care; (2) health plans increasingly moved away from core strategies in the "managed care toolbox"; and (3) providers gained leverage relative to managed care plans and reverted to more traditional strategies of competing for patients based on services and amenities. Conclusions. Changes in local health care markets have contributed to rising costs and created new access problems for consumers. Moreover, the trajectory of change promises to make the goals of cost-control and quality improvement more difficult to achieve in the future. [source] Similar and Yet So Different: Cash-for-Care in Six European Countries' Long-Term Care PoliciesTHE MILBANK QUARTERLY, Issue 3 2010BARBARA Da ROIT Context: In response to increasing care needs, the reform or development of long-term care (LTC) systems has become a prominent policy issue in all European countries. Cash-for-care schemes,allowances instead of services provided to dependents,represent a key policy aimed at ensuring choice, fostering family care, developing care markets, and containing costs. Methods: A detailed analysis of policy documents and regulations, together with a systematic review of existing studies, was used to investigate the differences among six European countries (Austria, France, Germany, Italy, the Netherlands, and Sweden). The rationale and evolution of their various cash-for-care schemes within the framework of their LTC systems also were explored. Findings: While most of the literature present cash-for-care schemes as a common trend in the reforms that began in the 1990s and often treat them separately from the overarching LTC policies, this article argues that the policy context, timing, and specific regulation of the new schemes have created different visions of care and care work that in turn have given rise to distinct LTC configurations. Conclusions: A new typology of long-term care configurations is proposed based on the inclusiveness of the system, the role of cash-for-care schemes and their specific regulations, as well as the views of informal care and the care work that they require. [source] | ||||||||||||||||||||||