Performance Improvement 1995. Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry

02/01/1995

Agency for Toxic Substances and Disease Registry

Listing of Abstract Titles

Assessing Prevention Effectiveness: A Collaborative Effort With Selected Health Maintenance Organizations (Phase I)

Assessment of Information Dissemination Activities--Office on Smoking and Health

Congenital Syphilis: Estimated Direct Medical Care Cost for the United States--1990

Development of an Evaluation Plan for DCPC's State-Based Comprehensive Breast and Cervical Cancer Early Detection and Control Program

Estimating Expenditures for Chronic Hepatitis B

Evaluation of CDC and ATSDR Training Activities

Evaluation of National Health Interview Survey Diagnostic Reporting

Evaluation of Sexually Transmitted Disease Clinic Flow and Utilization

Evaluation of the Morbidity and Mortality Weekly Report Series

Lessons From Implementing State-Based Diabetes Control Programs: An Evaluation

Report of the Working Group To Revise the Model State Vital Statistics Act and Regulations

Vital Records Evaluation Using 1988 National Maternal and Infant Health Survey Data

TITLE: Assessing Prevention Effectiveness: A Collaborative Effort With Selected Health Maintenance Organizations (Phase I)

ABSTRACT NUMBER: 007

ABSTRACT: This project, the first of a two-phase study, reviewed existing health maintenance organizations (HMOs) to develop a framework and the process to assess prevention effectiveness; the characteristics, organization, and types of preventive services offered; and the potential for working in collaboration with CDC. Based on essential criteria developed to guide the process of site selection, a series of site visits was conducted. A data collection instrument and semistructured interview was conducted during each of the site visits. Strengths and weaknesses of HMO data collection systems were identified and recommendations were provided to CDC on which five HMOs would most appropriately meet the needs of CDC for phase two of the study.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 4111

PERFORMER ORGANIZATION: Battelle, Arlington, VA

P.I.: Bryan R. Luce, Ph.D.

TITLE: Assessment of Information Dissemination Activities--Office on Smoking and Health

ABSTRACT NUMBER: 008

ABSTRACT: The purpose of this study was to develop recommendations for key management and operational aspects of the information dissemination function in the Office of Smoking and Health (OSH), with particular emphasis on the response system. Although the study focuses on information dissemination, its broader context is OSH's evolving leadership role within the tobacco control community. The project consisted of internal and external interviews. The external interviews were conducted with individuals representing Federal Agencies that might be using information approaches relevant to OSH. In addition to information dissemination models, reports of site visits, and telephone interviews, the final report contains recommendations to OSH on organizational considerations and strategic planning.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 4684

PERFORMER ORGANIZATION: Macro International, Atlanta, GA

P.I.: Katie Baer, M.P.H.

TITLE: Congenital Syphilis: Estimated Direct Medical Care Cost for the United States--1990

ABSTRACT NUMBER: 009

ABSTRACT: The purpose of this study was to estimate the 1990 direct medical costs of congenital syphilis in the United States. Three types of costs were included in the study: medical care incurred during the first year of life; special education for infants who experience impairment due to congenital syphilis; and lifetime custodial care for infants who experience profound effects of congenital syphilis. After classifying cases by severity, researchers created a computer model that integrated incidence data with varying assumptions (such as case severity distribution, price level, etc.). Based on the analysis, it is estimated that the present value of costs for medical care, special education, and lifetime custodial care for the 1990 incident congenital syphilis cohort was in the range of $100-$200 million.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 5301

PERFORMER ORGANIZATION: Battelle, Washington, DC

P.I.: Bryan R. Luce, Ph.D.

TITLE: Development of an Evaluation Plan for DCPC's State-Based Comprehensive Breast and Cervical Cancer Early Detection and Control Program

ABSTRACT NUMBER: 010

ABSTRACT: The primary purpose of this evaluation was to collect data pertinent to program-related decisions. The evaluation focused on State health agency breast and cervical cancer program components (public education, provider education, quality assurance, surveillance, screening, and followup) as well as the combined effect of program components. Short-term, intermediate, and long-term program and health outcomes were assessed. Assessment of program development and implementation was considered along with traditional evaluations of program efficiency and effectiveness.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 4744

PERFORMER ORGANIZATION: Research Triangle Institute, Research Triangle Park, NC

P.I.: Thomas J. Cook, Ph.D.

TITLE: Estimating Expenditures for Chronic Hepatitis B

ABSTRACT NUMBER: 011

ABSTRACT: The purpose of this effort was to provide CDC with estimates of the direct medical cost of hepatitis B, particularly the acute care costs of services rendered to individuals identified as having or having had an episode of hepatitis B. These estimates were developed using recent paid claims histories from reimbursement files for persons recorded as having been treated for one or more specific diagnoses associated with hepatitis B. Data collection proceeded on a dual track: both a private market source and Medicaid data were obtained. The Medicaid data were procured from the repository from the Tape-to-Tape data development effort conducted for Health Care Financing Administration (HCFA). States that participated in this project supplied their machine-readable files to an HCFA contractor, and those files were translated into a single common format. The States from which Medicaid data were obtained for this study are California, Georgia, and Michigan. Private market data were obtained from United Health Care (UHC), an organization that directs and/or maintains data for managed care plans in a number of States. The review of these data and methods was successful in that generally consistent estimates were computed from each of the four jurisdictions. Further, there were no bizarre variations with respect to age, race, or sex. Unanticipated results and glitches in some areas might be resolved with further examination.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 5802

PERFORMER ORGANIZATION: Battelle, Arlington, VA

P.I.: Ruth E. Brown, M.S.

TITLE: Evaluation of CDC and ATSDR Training Activities

ABSTRACT NUMBER: 012

ABSTRACT: As local health departments face fiscal upheavals, this study assessed their current and emerging training needs through focus groups and site visits. Training needs were compared with a newly developed inventory of training activities offered by CDC. Local health programs were found to need training in advocacy, evaluation, and public information. They were found to be deficient at training needs assessment, a formal way of identifying and monitoring the skills employees need to do their jobs better or to attain their career goals. CDC, which itself has limited training resources, is found to have no periodic mechanisms for staying in touch with State and local training needs. Recommendations, including those for new training technology (i.e., interactive software and satellite communications), are galvanizing CDC and ATSDR to develop training activities that dovetail with local needs.

FEDERAL CONTACT OFFICE: Public Health Practice Program Office

PERSON: Dennis McDowell

PHONE NUMBER: 404/639-3707

PIC NUMBER: 4745

PERFORMER ORGANIZATION: Macro Systems International, Atlanta, GA

P.I.: Thomas Chapel

TITLE: Evaluation of National Health Interview Survey Diagnostic Reporting

ABSTRACT NUMBER: 013

ABSTRACT: The purpose of this project was to evaluate diagnostic reporting in the National Health Interview Survey, which addressed major current health issues through the collection and analysis of national data on the civilian noninstitutionalized population of the United States. The survey provides national data on the incidence of acute conditions and injuries, the prevalence of chronic conditions and impairments, the extent of disability, and the use of health care services. The basic design of the evaluation study involved a comparison of information obtained from respondents to the basic health questionnaire, minimally modified, with reports obtained from the respondents' sources of health care. The primary objectives were to determine whether medical record documentation confirmed respondents' reports about selected conditions and impairments, to determine whether conditions mentioned in the record were mentioned by respondents, to assess the reporting and timing of doctor visits and hospitalizations, and to evaluate the validity of proxy reports to items in the questionnaire. The condition-related objectives are addressed in this final report; utilization data are addressed in an auxiliary report.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 3199

PERFORMER ORGANIZATION: National Center for Health Statistics, Hyattsville, MD

P.I.: Deborah M. Winn

TITLE: Evaluation of Sexually Transmitted Disease Clinic Flow and Utilization

ABSTRACT NUMBER: 014

ABSTRACT: This study sought to study overburdening among sexually transmitted disease (STD) clinics in metropolitan areas with high STD morbidity. It assessed the impact of challenges to STD service delivery that developed in the late 1980s and early 1990s, including increasing incidence rates for STDs, addition of HIV services, retrenchment of funding, and more elaborate patient testing. These factors led to an inability in many clinics to see all clients who present for STD testing and/or treatment on a given day. The study sought to examine the effectiveness of STD clinics in providing services to those who seek care in the clinic and to clarify the factors that lead to overburdening.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 4164

PERFORMER ORGANIZATION: Battelle, Arlington, VA

P.I.: Martha L. Hare, Ph.D.

TITLE: Evaluation of the Morbidity and Mortality Weekly Report Series

ABSTRACT NUMBER: 015

ABSTRACT: The Morbidity and Mortality Weekly Report (MMWR) is a principal means by which CDC communicates key information on a timely basis to the public health community. In recent years, the scope of the MMWR has broadened, reflecting the larger mission of CDC. This study sought to learn how well the MMWR is communicating information to this broader public health audience while continuing to convey timely information about outbreaks and infectious diseases. A mail/-telephone readership survey was given to 375 individuals on the MMWR mailing list, 375 subscribers to the MMWR through the Massachusetts Medical Society, and 250 primary care physicians who subscribe to the Journal of the American Medical Association (in which articles from the MMWR are reprinted). The study characterized selected audiences for the MMWR series, examined the public health impact of information published in the MMWR, and identified opportunities for improving the dissemination of public health information contained in the MMWR series. The study found that the MMWR was valued for its accuracy, relevance, and concise reporting format. Readers were from diverse professional backgrounds. The number of readers is likely double the 450,000 on mailing lists. Recommendations may result in some refinements to content and format.

FEDERAL CONTACT OFFICE: Epidemiology Program Office

PERSON: Richard A. Goodman, M.D., M.P.H.

PHONE NUMBER: 404/639-3636

PIC NUMBER: 5357

PERFORMER ORGANIZATION: Battelle, Arlington, VA

P.I.: James O. Hersey, Ph.D.

TITLE: Lessons From Implementing State-Based Diabetes Control Programs: An Evaluation

ABSTRACT NUMBER: 016

ABSTRACT: The purpose of this project was to assess the effectiveness and identify exemplary practices of State-based diabetes control programs (DCPs) in providing services with the potential of reducing diabetes-related mortality and morbidity. Intensive site visits to 9 of the 27 DCPs were conducted. The study analyzed archival data and interviews with DCP and non-DCP personnel in State and local programs. The study looked for exemplary practices associated with four outcomes: program reach--the number of persons screened, counseled, referred, and treated as the result of DCP activities; system change in terms of improved coverage for diabetes services and increased numbers of clinics and providers offering diabetes services; integration of diabetes services into ongoing medical service delivery; and leveraging resources for and institutionalization of diabetes programs. Findings indicated that DCPs have had measurable impact on diabetes services. Specific program accomplishments are cited, as are recommendations for program expansion and refinement.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 5299

PERFORMER ORGANIZATION: Battelle, Arlington, VA

P.I.: James O. Hersey, Ph.D.

TITLE: Report of the Working Group To Revise the Model State Vital Statistics Act and Regulations

ABSTRACT NUMBER: 017

ABSTRACT: The purpose of this project was to determine what revisions were needed in the Model State Vital Statistics Act and Regulations to accommodate changes in social customs and technology relative to the registration of vital events and the analysis of vital statistics data. A group of consultants representing State vital registration and statistics executives advised the contractor as to what changes were necessary.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 4065

PERFORMER ORGANIZATION: Pace Enterprises, Inc., Atlanta, GA

TITLE: Vital Records Evaluation Using 1988 National Maternal and Infant Health Survey Data

ABSTRACT NUMBER: 018

ABSTRACT: The purpose of this study was to compare selected data elements reported in the 1988 National Maternal and Infant Health Survey (NMIHS) with information contained in the original vital records, maintained by the States, covering the same set of birth events and/or fetal deaths. More than 3,200 live birth certificates and more than 4,500 fetal death reports were compared with data from the 1988 NMIHS. The quality and completeness of the information reported in the vital record was assessed, discrepancies with respect to the NMIHS identified, and the nature and frequency of the discrepancies examined. The four components of the study were (1) the check box items in the new birth and fetal death certificate; (2) underlying cause of fetal death; (3) industry and occupation; and (4) multiple causes of death. Of the check box items, medical risk factors, obstetric procedures, complications of labor and delivery, method of delivery, and newborn abnormalities were studied. Among the data sources, maternal alcohol and tobacco use and prenatal weight gain were compared.

FEDERAL CONTACT OFFICE: Office of Program Planning and Evaluation

PERSONS: Wilma Johnson, Nancy Cheal

PHONE NUMBER: 404/639-3453

PIC NUMBER: 4067

PERFORMER ORGANIZATION: JWK Inter-national Corporation, Annandale, VA

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