Regional and Racial Variation in Health Care Among Medicare Beneficiaries

Focuses on variations in healthcare delivery and outcomes among and within hospital service areas, in addition to racial and geographic disparities, as measured by five indicators. Discusses variations in spending and considers implications for reform

Federal program expenditures for working-age people with disabilities: Research Report

Public assistance programs are important sources of support for working-age people with disabilities in the United States. Using a variety of information sources, the authors estimate that the federal government spent $226 billion in 2002 on working-age people with disabilities, including both cash and in-kind benefits. These expenditures account for about 2.2 percent of the nation’s gross domestic product (GDP) and 11.3 percent of all federal outlays. States contributed an additional$50 billion under federal-state programs. The bulk of these expenditures provided income support and health care to working-age people with disabilities who were not employed or had very low earnings. The authors provide a detailed accounting of the expenditures and question whether the distribution of expenditures is properly aligned with the evolving disability paradigm

Exiled by Definition:The Salar of Northwest China

The reform of state socialism came relatively late to Qinghai Province in the Northwest of the People’s Republic of China. One of Qinghai’s most dynamic groups in the social leadership of reform has been the Salar. The Salar were one of the officially recognized nationalities identified in the People’s Republic of China during the 1950s. A relatively small group of some 100,000 currently live along the upper reaches of the Yellow River, on the borders of Qinghai and Gansu Provinces. The Salar are characterised by their commitment to both Islam and China, and by their belief that they live in permanent exile, though there is considerable uncertainty about their origins. The evidence of recent research in Qinghai suggests the perspective of being Chinese citizens, yet a people in exile, significantly shapes recent Salar social and economic activism

Prospects for the General Election of 2020: Tradition and Transition in Chinese Politics

The decision by the Chinese Communist Party in 2012 to move to open direct national elections was taken in order to ensure political stability and continued economic growth, and to enhance its position of leadership. The first national general election in 2015 followed in the wake of the landmark Constituent Assembly. Victory in 2015 by the Chinese Communist Party has been accompanied by political stability and sustained economic growth. Though there is likely to be greater competition in the General Election of 2020 the principle change in politics has been the emergence of significant public policy debate. Issues of corruption, housing, and regional development are likely to be major considerations during the election, alongside debate on the simultaneous referenda that have been called on Tibet and federalism

The Revolving Door: A Report on U.S. Hospital Readmissions

The U.S. health care system suffers from a chronic malady -- the revolving door syndrome at its hospitals. It is so bad that the federal government says one in five elderly patients is back in the hospital within 30 days of leaving.Some return trips are predictable elements of a treatment plan. Others are unplanned but difficult to prevent: patients go home, new and unexpected problems arise, and they require an immediate trip back to the hospital.But many of these readmissions can and should be prevented. They are the result of a fragmented system of care that too often leaves discharged patients to their own devices, unable to follow instructions they didn't understand, and not taking medications or getting the necessary follow-up care.The federal government has pegged the cost of readmissions for Medicare patients alone at $26 billion annually, and says more than$17 billion of it pays for return trips that need not happen if patients get the right care. This is one reason the Centers for Medicare & Medicaid Services has identified avoidable readmissions as one of the leading problems facing the U.S. health care system and now penalizes hospitals with high rates of readmissions for their heart failure, heart attack, and pneumonia patients. This report is being released in conjunction with the Robert Wood John Foundation's Care About Your Care initiative, which is devoted to improving care transitions when people leave the hospital. It looks at the issue of readmissions in two ways: by the numbers and through the eyes of the people who live them

The Health Care Financing Maze for Working-Age People with Disabilities

Much of the research on health care financing for people with disabilities has focused on the Medicaid and Medicare programs. The findings of this research often highlight the inadequacies of those programs in providing appropriate services to address the special needs of people with disabilities. A focus on these large programs, however, obscures the role of other public and private insurers, as well as the role of programs that provide many additional services to this population – all of which add complexity to the system. The purpose of this paper is to describe the health care financing system as a whole, including the large public programs, other public and private insurers, and the many other programs that provide additional services. The description of the system highlights structural problems that need to be addressed in order to substantially improve the delivery of health and related services to people with disabilities. In the next section, we describe each source of health care financing for working-age people with disabilities and highlight its implications for service delivery and quality of life. In the concluding section, we describe the key structural shortcomings of the current financing system, assess the extent to which current reform efforts are addressing these shortcomings, and discuss the implications for broader efforts to reform health care financing system

E-Choice option for Elsevier's Science/Direct

If there's one thing that seems to be as reliable as the rising sun, it's that each year brings a new ScienceDirect pricing scheme from Elsevier. This might be seen in the positive context of flexibility and a willingness to adapt and/or learn. With E-Choice Elsevier has formally adopted the perspective of those institutions for which quality trumps quantity