Analysis of the North Carolina long-term care polypharmacy initiative: a multiple-cohort approach using propensity-score matching for both evaluation and targeting.

Background: The high cost and undesirable consequences of polypharmacy are well-recognized problems among elderly long-term care (LTC) residents. Despite the implementation of the 1987 Omnibus Budget Reconciliation Act, which requires pharmacist review of drug regimens in this setting, medical and drug costs for LTC residents have continued to increase.

Objective: This study evaluates the North Carolina Long-Term Care Polypharmacy Initiative, a large-scale medication therapy management program (MTMP) that combined drug utilization review activities with drug regimen review techniques.

Enhancing the medical homes model for children with asthma.

Background: Medical Home is an evolving concept of patient-centered care yet little information is available on its effect on health care expenditures for children.

Objectives: To quantify differences in patterns of care and costs to the North Carolina (NC) Medicaid program for children with asthma across 3 programs: fee-for-service (FFS), primary care case management (PCCM), and Medical Homes.

Research Design: NC Medicaid claims from 1998-2001 for children with asthma were used to examine monthly expenditures and patterns of health care use, including emergency department and hospital use.

State Children's Health Insurance Program achievements, challenges, and policy recommendations.

This policy statement reviews the impressive progress of the State Children's Health Insurance Program since its enactment in 1997 and identifies outstanding challenges and state and federal policy recommendations. The American Academy of Pediatrics urges Congress to reauthorize SCHIP to strengthen its historic gains. The following set of recommended strategies for reauthorization pertain to funding, eligibility and enrollment, coverage, cost sharing, payment and provider-network capacity, and quality performance.

Determinants of blood-lead levels in children in Callao and Lima metropolitan area.

Objectives: To determine blood lead levels in urban populations of children (n = 2,510) and women (n = 874) in the early postpartum in certain districts of Lima and Callao, and to correlate those levels with particular exposures.

Material And Methods: Between July 1998 and January 1999 cross sectional study was conducted. The study population was selected using three sampling strategies in the government operated school system and from public pediatric and maternity hospitals at Lima and Callao, Peru.