This observational study compared a nationwide sample of older patients with substance use disorders (n = 3,598; age > 55) with a demographically and diagnostically matched sample of younger patients on initial functioning, subsequent outpatient mental health service use, and 12-month follow-up outcomes. Older patents were initially functioning a well as or better than younger patients according to substance use, psychiatric, family, and legal criteria. The groups received comparable amounts of outpatient mental health care. At a 12-month follow-up, older patients generally had better substance use and functioning outcomes than did younger patients. The findings suggest that older patients with substance use disorders are keeping pace with demographically and diagnostically comparable younger patients in obtaining specialized outpatient mental health services and that they have positive treatment prognoses.
This compendium of articles provides a clear view of the factors affecting the health of Americans and the role of public health, medical care, and the community in ensuring the nation's health. The Seventh Edition continues the emphasis of earlier editions on the health of the population, the determinants of health, women's health, long term care, and the precarious set of circumstances faced by the nation's public health and health care systems as we begin the 21st century.
New issues, particularly related to bioterrorism and community health are addressed in this edition. This volume also includes coverage of tobacco, immunizations, HIV/AIDS, environmental health, dietary guidelines, physical activity, and food safety. In addition, a major new feature is an article on community problem solving, emphasizing a multidisciplinary approach to collaborative practice and research to improve community health.
We analyze the relationship between the supply of new technologies and health care utilization and spending, focusing on diagnostic imaging, cardiac, cancer, and newborn care technologies. As anticipated by previous research, increases in the supply of technology tend to be related to higher utilization and spending on the service in question. In some cases, notably diagnostic imaging, increases in availability appear associated with incremental utilization rather than substitution for other services. Policy efforts to assess and manage the availability of new technologies could benefit society where the additional spending produced by new services is not associated with strong quality improvements.
The mid-1990s saw dramatic changes in mental health care in the Department of Veterans Affairs (VA), the largest provider of such care in the United States. Spending for specialized inpatient mental health care fell 21 percent from 1995 to 2001, while spending for specialized outpatient care rose 63 percent. The shift from inpatient to outpatient care was accompanied by rapid increases in outpatient medication costs. Overall, the VA reduced the average cost (per VA user) of specialized mental health care by 22 percent while it increased the number of users of these services by 35 percent.
This seminar is part of SPRIE's Fall 2003 series on "High-Tech Regions and the Globalization of Value Chains."
Eric Benhamou is the chairman of the board of directors of 3Com Corporation, of Palm Inc. and of PalmSource, Inc. He served as chief executive officer of 3Com Corporation from September 1990 until December 31, 2000. In 1981, Benhamou co-founded Bridge Communications, an early networking pioneer, and was vice president of engineering until its merger with 3Com in 1987. Before joining Bridge Communications, he worked at Zilog, Inc. as project manager, software engineering manager and design engineer.
Benhamou holds honorary doctoral degrees from Ben Gurion University of the Negev, Widener University, Western Governors University, and the University of South Carolina. He has a master of science degree in electrical engineering from Stanford University and a Diplome d'Ingenieur from Ecole Nationale Superieure d'Arts et Metiers, Paris.
Benhamou currently serves as chairman of the board of Cypress Semiconductor and as a member of the board of Legato. He serves on the board of directors of privately held companies, Intransa and Atrica. He serves on the board of the New America Foundation, a Washington DC-based think tank. Benhamou serves on the executive committee of TechNet and of the Computer Science and Technology Board (CSTB). In addition, Benhamou is a champion of Smart Valley II, an initiative for deployment of state-of-the art information technology in Silicon Valleys health care, transportation, and education to enhance the quality of life for community members.
Philippines Conference Room
Over the last two decades, employers have increasingly offered workers a choice of health plans. The availability of choice has the potentially beneficial effects of lowering the cost and increasing the quality of health care through greater competition among health plans for enrollees as well as allowing consumers to enroll in the type of coverage that most closely matches their preferences. On the other hand, concerns about the potential for adverse selection within employment-based purchasing in response to the availability of choice exist. In this paper, I examine the effects of offering choice in employment-based purchasing groups on access to and the cost of employer-sponsored coverage. I find that greater availability of choice was associated with a reduction in the premium of employer-sponsored coverage and an increase in the proportion of workers covered by the plans offered by employers. However, most of the premium reductions were due to a shift from family to single coverage within employment-based purchasing groups and a reduction in the generosity of the plans in which employees were enrolled. The results are not consistent with the availability of choice leading to lower premiums through greater competition among plans for workers.
Shorenstein APARC's Korean Studies Program, begun in September 2000 and led by Gi-Wook Shin, features weekly luncheon seminars on Korea-related issues, from war reporting to health care to democracy. Heavily attended by students and faculty alike, the series is often standing-room-only.