Technology and Managed Care: Patient Benefits of Telemedicine

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Technology and managed care: patient benefits of telemedicine in a rural health care network

Rural health providers have looked to telemedicine as a technology to reduce costs. However, virtual access to physicians and specialists may alter patients' demand for face-to-face physician access. We develop a model of service demand under managed care, and apply the model to a telemedicine application in rural Alaska. Provider-imposed delays and patient costs were highly significant predictors of patient contingent choices in a survey of ENT clinic patients. The results suggest that telemedicine increased estimated patient benefits by about $40 per visit, and reduced patients' loss from rationing of access to physicians by about 20%. Copyright © 2004 John Wiley & Sons, Ltd.

Smoking cessation patterns by socioeconomic status in Alaska

The ongoing disparity in smoking prevalence across levels of socioeconomic status (SES) is a significant concern in the tobacco control field, and surveillance of cessation-related activity is key to understanding progress. Historically, lower SES smokers have had much lower quit ratios but this measure can be insensitive to recent quit-related behavior. It is therefore important to examine recent quit-related behavior to assess progress toward addressing this disparity, especially in states with tobacco control programs that focus on this priority population.We compared recent quit attempts and successes among non-Native lower SES Alaska smokers to those of higher SES using data from the 2012–2013 Alaska Behavioral Risk Factor Surveillance System (BRFSS). We assessed quit ratios, one-year and five-year quit rates, and six-month abstinence between the two groups.Cessation-related measures restricted to those who smoked in the previous one year did not significantly vary by SES. However, five year quit rates were significantly lower for persons of lower SES vs. higher SES (14% vs. 32% respectively, p < .001). Results were consistent after adjustment for age, sex, and other factors.Results showed that in the previous year, smokers of lower SES in Alaska were trying to quit and succeeding at similar rates as their higher SES counterparts. However, the equivalent pattern of quit success was not reflected in the five-year time frame. Tobacco control programs should monitor cessation trends using both recent and longer-term time frames for this population. More research is needed on reasons for fewer long-term quits among lower SES smokers. Keywords: Smoking/epidemiology, Smoking/prevention and control, Smoking cessation, Social class, Socioeconomic factor

Alaska Justice Forum ; Vol. 11, No. 4 (Winter 1995)

The Winter 1995 issue of the Alaska Justice Forum examines the implementation of Anchorage Police Department’s domestic violence policy, which treats domestic violence cases as criminal offenses and reflects consistent concern for victim safety. During 1993, according to the Bureau of Justice Statistics, 38 men were executed in the U.S.; at year’s end, 34 states and the federal prison system held 2,716 prisoners under sentence of death, 5.3 percent more than at yearend 1992. As part of an national five-year study of drug users, AIDS, and HIV, researchers at the University of Alaska Anchorage have assembled data measuring the risk perceptions of individuals in Anchorage who are at some actual risk for contracting HIV — data which may have some implications for correctional systems."Implementation of Police Domestic Violence Policy" by Carrie D. Longoria / "Capital Punishment, 1993 (A BJS Report)" / "Capital Offenses, by State, 1993" / "HIV Risk Perception" by Andrea M. Fenaughty, Holly A. Massay, & Dennis G. Fisher / "National AIDS Study" / "ASLET Seminar