Hospital-based laboratories have traditionally dominated the private laboratory industry. However, as managed care strengthens, hospitals merge, and independent reference laboratories grow in prominence and market share, the laboratory industry - mirroring the health care system generally - is rapidly consolidating. Three large reference laborator
A third reported impact of non-managed care health market change has been the erosion of disease reporting efforts. Several states reported that large, national reference laboratories with regional testing centers pose a threat to the national disease surveillance effort. Michigan's PHL director noted that private, out-of-state laboratories are of
Many laboratorians interviewed suggested that the future of the commercial reference laboratory industry centered on the development of sophisticated informatics products that will be able to integrate laboratory results data with outcomes data from other health system players. Some large clinical laboratory companies have reported making large in
The growth of managed care has had a significant impact on the operations and profitability of clinical laboratories during the past five years. Cost reduction is the major driving force in the industry, and laboratories are in the process of planning strategically to adapt to these changes. As a result, the key market trends in clinical testing s
Most federal involvement with state PHLs is via the CDC. In addition, several other federal health agencies operate laboratories related to public health. FDA, EPA, USDA
Public Health Laboratories and Health System Change . Centers for Disease Control and Prevention and PHLs
Because of the close tie between the PHL core laboratory functions and the disease surveillance and epidemiology functions of the CDC, the greatest potential for collaboration between PHLs and the federal government lies within the CDC. The PHL relationship with the CDC is robust, and one that is important for national disease surveillance.
Each state’s reporting requirements identify certain individuals who are required to notify the authorities of suspected abuse. Although it varies by state, mandated reporters are typically individuals who encounter children through their professional capacity . In Pennsylvania, the statute requires all individuals who encounter a case of abu
Overview Adult day care facilities in Wyoming are licensed by the state Department of Health. Adult day care is provided under the long-term care waiver program. Medicaid providers do not have to meet requirements other than licensure. Licensure and Certification Requirements
Overview New York State (NYS) law provides general standards under which some adult day programs operate, and the NYS Department of Health (DOH) is responsible for quality assurance of adult day programs. The standards to which the services must adhere relate to admission, assessment, staffing qualifications, and patients rights. There are thr
Overview The state has two models of adult day care (ADC): the social model and the medical model. The social model is designed for individuals who need supervision and activities but not extensive personal care and medical monitoring.
Regulatory Review of Adult Day Services: Final Report SECTION 2. STATE REGULATORY PROFILES
Advance Care Planning and Public Engagement. B. Factors Contributing to Unresolved Issues in Social Engagement
At the end of 2004 the National Institutes for Health sponsored a conference of experts to clarify key questions regarding the definition of "end of life," and the factors that contribute to improved or worsened outcomes for patients and their families. The clarification was addressed to health care providers, patients and the general public. The
Advance Care Planning and Public Engagement. B. Clinical and Provider Impacts on EOL Decision Making
As recent as 50 years ago, the location of death for the majority of Americans was the home setting.
Advance Care Planning and Public Engagement. A. Social Dimensions of the EOL Decision Making Process
Reducing death to a clinical event inappropriately diminishes the personal and social dimensions of dying. Although dying occurs more often than not within a clinical setting and is nearly always “attended” by a physician, it nevertheless contains a human existential element. Humans are social beings -- all of us live and die within the contex
Advance Care Planning and Public Engagement. II. Managing Our Miracles and the Emergence of a Social Consensus
The management of the effective use of penicillin in the early 1940s is often described as one of the most important moments in the history of medicine. 14 This turning point in medical treatment provided physicians the capacity to intervene routinely in the “natural process” by eradicating lethal infection. The effect was to elevate the “
Despite local, state, and national efforts since the mid-1970s to adopt health care advance directives as the central tool to ensure that one’s health care wishes are known, only a minority of Americans have adopted this formal approach to detail their wishes and name their proxy. 1 Meanwhile, medical innovation and technological complexity ha
Myra J. Christopher and John G. Carney Center for Practical Bioethics