Accurate measurements of water vapor transmission through high-performance barrier layers.

We report a new approach to measuring very low rates of water vapor transmission through high-performance barrier layers, based on detection of the water vapor by cavity ring-down infrared spectroscopy. It provides accurate and traceable measurements with a detection limit for water vapor transmission significantly below 1 × 10(-4) g/m(2)/day. The system is underpinned by dynamic reference standards of water vapor generated between 5 and 2000 nmol∕mol with an estimated relative expanded uncertainty of ±2%.

A dynamic gravimetric standard for trace water.

A system for generating traceable reference standards of water vapor at trace levels between 5 and 2000 nmol/mol has been developed. It can provide different amount fractions of trace water vapor by using continuous accurate measurements of mass loss from a permeation device coupled with a dilution system based on an array of critical flow orifices. An estimated relative expanded uncertainty of ±2% has been achieved for most amount fractions generated.

Microfabricated planar glass gas chromatography with photoionization detection.

We report the development of a microfabricated gas chromatography system suitable for the separation of volatile organic compounds (VOCs) and compatible with use as a portable measurement device. Hydrofluoric acid etching of 95x95mm Schott B270 wafers has been used to give symmetrical hemi-spherical channels within a glass substrate. Two matching glass plates were subsequently cold bonded with the channels aligned; the flatness of the glass surfaces resulted in strong bonding through van der Waals forces.

New directions for Medicare payment systems.

This overview discusses articles published in this issue of the Health Care Financing Review, entitled "Medicare Payment Systems: Moving Toward the Future." These articles focus on the ongoing development of Medicare payment methodologies, their adoption by non-Medicare payers, and issues to be addressed in the development of all-payer systems based on these methodologies.

Defining rural hospital markets.

Objective: The purpose of this study is to examine the geographic scope of rural hospital markets.

Data Sources: The study uses 1988 Medicare patient discharge records (MedPAR) and hospital financial information (HCRIS) for all rural hospitals participating in the Medicare Program.

Study Design: Hospital-specific market areas are compared to county-based market areas using a series of geographic and socioeconomic-demographic dimensions as well as indicators of market competitiveness.

Sole providers of hospital care in rural areas.

This study examines the possibility of developing alternative targeting criteria for identifying small rural hospitals that serve as the sole providers of hospital care in their market areas. Compared to facilities currently targeted under Medicare payment policies, high market share hospitals are larger, less isolated facilities that deliver more complex care to their patients than other rural hospitals. They do not appear to serve vulnerable patient populations.

Medicare dependent hospitals: who depends on whom?

Small rural hospitals with a large proportion of Medicare patients currently receive special treatment as Medicare dependent hospitals (MDHs) under the prospective payment system (PPS). Other high Medicare hospitals (HMHs)--both urban and rural--have sought to have the additional per case payments extended to them. Current utilization patterns, the availability of alternative facilities, and the socioeconomic and demographic characteristics of the service areas were examined to determine whether either the current MDH or alternative HMH targeting criteria identify hospitals whose closure might impair access to care for Medicare beneficiaries residing in their service areas.