Challenges in merging Medicaid and Medicare databases to obtain healthcare costs for dual-eligible beneficiaries: using diabetes as an example.

Dual-eligible Medicaid-Medicare beneficiaries represent a group of people who are in the lowest income bracket in the US, have numerous co-morbidities and place a heavy financial burden on the US healthcare system. As cost-effectiveness analyses are used to inform national policy decisions and to determine the value of implemented chronic disease control programmes, it is imperative that complete and valid determination of healthcare utilization and costs can be obtained from existing state and federal databases. Differences and inconsistencies between the Medicaid and Medicare databases have presented significant challenges when extracting accurate data for dual-eligible beneficiaries.

Hospitals collaborate to decrease surgical site infections.

Background: Despite a large body of evidence describing care processes known to reduce the incidence of surgical site infections, many are underutilized in practice.

Methods: Fifty-six hospitals volunteered to redesign their systems as part of the National Surgical Infection Prevention Collaborative, a 1-year demonstration project sponsored by the Centers for Medicare & Medicaid Services. Each facility selected quality improvement objectives for a select group of surgical procedures and reported monthly clinical process measure data.

Motivational brochures increase the number of medicare-eligible persons with diabetes making therapeutic footwear claims.

Objective: This study tests the hypothesis that Medicare beneficiaries at high risk of foot complications who are mailed a motivational brochure describing the Medicare diabetes-related therapeutic footwear benefit will increase their therapeutic footwear-related Medicare claims.

Research Design And Methods: In this quasi-experimental study, a motivational brochure was mailed in the summer of 1997 to 5,872 Medicare beneficiaries in Washington, Alaska, and Idaho who were identified as being at high risk for foot-related claims on the basis of their prior Medicare claims history. Beneficiaries were identified through footwear claims made in these states-and also in three comparison states (Oregon, Montana, and Wyoming)-during the 18 months before and after the mailing.

Root biomass allocation in the world's upland forests.

Because the world's forests play a major role in regulating nutrient and carbon cycles, there is much interest in estimating their biomass. Estimates of aboveground biomass based on well-established methods are relatively abundant; estimates of root biomass based on standard methods are much less common. The goal of this work was to determine if a reliable method to estimate root biomass density for forests could be developed based on existing data from the literature.