Role of the Chronic Dental Disease Scheme in Enhanced Primary Care: allied health or allied outlier?

This study aims to provide a comparative analysis of the Chronic Dental Disease Scheme (CDSS) and the Allied Health Profession (AHP) program as they related to the greater Enhanced Primary Care Scheme introduced by the Australian Government to manage patients with chronic and complex diseases. A retrospective analysis of data pertaining to Medicare items related to dentistry and the allied health professions were extracted from the Medicare Benefits Schedule database online, and formed the basis of this study. The highest proportion of services was provided in the state of New South Wales. There appears to be synergy in the utilisation of services with jurisdictions either overutilising or underutilising services. Costs to the Enhanced Primary Care Scheme under the CDSS model (fee for service) were up to 40 times more expensive compared with the AHP model (fee per visit). Costs and treatment associated with the CDSS experienced an increase of 13350% during the period 2007-08, coincident with an increase in subsidization. Reconstructive dentistry accounted for the majority of the increase. Gender disparities in dentistry were less distinct when compared with AHPs and were postulated to be due to males presenting with conditions that were more progressive requiring more invasive treatment. A comparative analysis indicates significant differences in costs, nature of treatment and the manner of remuneration between dentistry and the AHPs. A fee for service schedule as evidenced by the CDSS is dependent on the degree of financial incentive as indicated by patterns in utilisation over time. The amount of treatment considered necessary may be influenced by the level of subsidy with treatment that may not reflect disease management. The AHP model, which is based around a fee for visit schedule, is not without its deficiencies but has not experienced significant rises in cost compared with the CDSS.

Continuing competence in selected health care professions.

Health services professionals are confronting the challenge of maintaining and improving competence over the course of lengthy careers in diverse practice specialties. This article reviews the efforts of a selection of health care professions to ensure lifetime competence and reviews some of the challenges encountered in these efforts. Although each profession has its own issues, significant generic questions are common to all.

Use of a computer tutorial on nutritional assessment by three different groups of health professions students.

A computer tutorial on nutritional assessment was developed and used with three different groups of health professions students. Complete data were available for 45 nursing students, 36 physician assistant students, and 68 physical therapy students. Overall for the three groups there was a significant increase (p < 0.0001) from pretest to posttest scores. This increase was not significantly different among the groups, suggesting that a single computer tutorial can be used effectively to teach basics of nutritional assessment to different groups of health professions students and allow sharing of cost for computer instruction among programs.

Perfil y factores que motivan al profesional de enfermería a trabajar en el área administrativa de las Isapres / Profile and factors that encourage nurses to work in the administrative area of the HMO

La profesión de enfermería ha visto ampliar sus ámbitos de desempeño laboral en los últimos años, más allá de la clínica y lo intrahospitalario, como en el área administrativa de las Isapres. El siguiente estudio tiene como propósito, conocer los factores que han motivado a los profesionales de enfermería a trabajar en el área administrativa de las Isapres y conocer el perfil de profesionales de enfermería que se desempeña en el área mencionada anteriormente. La muestra en estudio quedó constituida por 38 profesionales de enfermería de las Isapres Vida Tres y Colmena Goldren Cross en Santiago. La metodología utilizada fue una encuesta autoaplicada, de 36 preguntas, entre agosto y septiembree de 1996. En relación al perfil del profesional, las conclusiones más importantes revelaron que la muestra está compuesta en un 100 por ciento por mujeres con un promedio de edad de 38 años, en su mayoría casadas y con hijos. Un considerable procentaje de la muestra tenía experiencia laboral previa al trabajo en la Isapre y además había realizado cursos de capacitación, postítulo o postgrado antes o durante su estadía en la Isapre. Con respecto a los factores que motivan a los profesionales de enfermería a trabajar en el área administrativa de las Isapres, destaca: el trabajo sin turnos (55,3 por ciento), los hijos (15,8 por ciento) y el estado civil (10,5 por ciento). Otros factores importantes fueron el sueldo y la preferencia por la labor administrativa (5,3 por ciento respectivamente). Además otros factores mencionados por las encuestadas, pero que obtuvieron un porcentaje bajo (2,6 por ciento respectivamente), fueron la satisfacción laboral actual, trabajo independiente y otros

Student attrition. A challenge for allied health education programs.

The Committee on Allied Health Education and Accreditation (CAHEA) attrition data, collected annually by the American Medical Association (AMA), are nationally representative and constitute the largest source of information on attrition and retention in allied health education. These data provide a cornerstone for education and manpower planning. Consistent with previous years, men who were enrolled in CAHEA-accredited allied health education programs for the 1989-1990 academic year were significantly more likely to be lost to attrition than were women. When compared with all other categories of race and ethnic origin, black students not of Hispanic origin showed a significantly higher attrition rate (25.4%), while students designated as Asian or Pacific Islander showed a significantly lower rate (13%). Congruent with attrition data documented in the literature, CAHEA attrition data show wide variances across 26 allied health occupations and within the three disciplinary groupings that comprise approximately 75% of all CAHEA-accredited programs. Attrition rates measured by the type of sponsoring institution range from 7.1% (academic health centers and medical schools) to 24.3% (vocational and technical schools). Programs sponsored by for-profit institutions and federal government-owned institutions report substantially higher attrition rates, 25.1% and 21.1%, respectively.