摘要:

Noting the increasing nationwide concern with factors relating to rising health care costs, the Association of American Medical Colleges surveyed 119 U.S. medical schools in the summer of 1978 to ascertain the degree of program activity in the area of cost containment education. A 100 percent response was achieved. An analysis of this data indicates that considerable activity is underway. Forty-one institutions (34 percent) have programs underway or planned specifically to teach health care cost containment to undergraduate medical students or residents or both. The majority of such programs were introduced during the past two years. The costs of such programs are fairly modest, averaging $22,680 per year. Respondents indicated that further activities might be enhanced by development of a primer for faculty and students on elements of cost containment education and the organization of a series of regional workshops related to this subject.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

As the cost of health care in the United States has increased to consume an ever greater portion of the gross national product, various strategies for cost containment have been advanced. Too little attention has been paid to the education of physicians for more responsible use of expensive resources. Current data on the role of physician knowledge, attitudes, and behavior in cost containment are reviewed; several intervention strategies are presented; and recommendations are proposed for increasing the sensitivity of physicians to the financial implications of their clinical decisions.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A Student Model Utilization Review Committee Project is in progress at Jefferson Medical College. Students participate in the program for 90 minutes during the six weeks of their clerkship in family medicine at the university hospital. Information collected from participants and controls before and after the program indicates that the experimental group has greater knowledge and more positive attitudes about utilization review and cost control in the health care field than do the controls. Students express positive feelings about the program. More importantly, one year later, as seniors, those in the experimental group demonstrated clinical behavior which was more consistent with the objectives of the program than other students. These results have led the Department of Family Medicine to incorporate the utilization review program into its formal curriculum beginning in the 1979–1980 academic year.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Students in their clinical clerkship performed retrospective reviews of their peers' laboratory usage patterns. Data covering the patient's history and physical examination, problem list, and treatment plan had been completed by students during internal medicine and pediatrics rotations. This information, along with the first day's diagnostic orders, was provided to community medicine clerkship students who then evaluated the cost and medical necessity of diagnostic tests ordered in light of the problem information. Application of such cost control programs, before students form definitive conceptions of treatment, may contribute to more cost-conscious behavior in their future medical practice.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A cost containment program initiated in 1975 on the medical teaching service of an 890-bed university affiliated hospital has led to a significant improvement in house staff utilization of facilities and procedures. During the first three and one-half years of the program the average length of stay on the general medical service was reduced by 21 percent; and the cost per admission rose at a rate of only 4.3 percent per annum, while the cost per admission on other services rose at an average rate of 14.5 percent per year. In the outpatient setting eliminating unnecessary laboratory procedures resulted in an actual reduction in patient-encounter cost initiated by interns despite price increases on all procedures. Overall cost advantage gained by reduction in utilization will rapidly be negated, however, if the current rate of inflation continues.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The value of educational programs designed to promote optimal use of laboratory tests by physicians remains unsolved. To assess the effects of level of training and knowledge of test characteristics in determining laboratory ordering habits, physicians' use of laboratory tests as applied to asymptomatic patients was surveyed and their knowledge of four specific procedures was tested. The survey included 148 physicians both in training and in practice in Rochester, New York. Increased selectivity in the use of tests occurred during residency training, but selectivity correlated poorly with knowledge of test characteristics. These data underline the need for additional studies to determine the role of factors other than knowledge which contribute to the use of laboratory tests. Planners of cost containment programs and educational strategies will need to direct attention to these factors.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A substantial portion of hospital beds are in institutions that are in multiple hospital systems having varying degrees of formal linkage. Relatively few core teaching hospitals are part of such systems, but they do share strong relationships with their parent medical schools and affiliated hospitals. The missions of core teaching hospitals are patient care, education, and research. The traditional affiliation arrangement between hospitals permits the parent university to achieve these missions. The possible benefits to be gained through participation in a multiple hospital system do not appear to be of sufficient magnitude to either core teaching hospitals or their parent universities to persuade them to join or form such a system.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

To characterize patterns of scientific productivity in a medical school faculty, the authors assessed the quantity and apparent scientific quality of publications by a large sample of the full-time faculty at Baylor College of Medicine. The apparent quality of an article in a given journal was taken to be the average extent to which articles in that journal are cited. Productivity varied greatly among the faculty members; a few prolific authors produced 10 times as much as the average of their colleagues, and a substantial fraction of the faculty published nothing in a four-year period. When productivity was related to length of academic career, two peaks of scientific accomplishment were noted. The first was for young faculty members whose relatively few publications were of high apparent quality. The second was for more mature faculty whose high productivity was attributable to more publications of less apparent quality.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

To determine the effectiveness of teaching interpersonal skills in a general internal medicine residency, a program was developed utilizing videotape feedback of house-staff/patient interactions, a modification of Interpersonal Process Recall (IPR). Fifty-one randomly selected house officers at different levels of training were included in a controlled, pretest-posttest study design. The major pre-post measures were three independent ratings of videotapes of actual first-visit interviews between resident and patient. House officers in the experimental group significantly increased the proportion of each interview devoted to psychosocial issues compared with controls, although the interviews remained predominantly medical; increased the use of effective responses; and improved their level of empathy with patients. Personality and attitude measures were found not to correlate with observed interpersonal skills on pretest or posttest videotapes. House officers rated the training program as being interesting, valuable, relevant, and nonthreatening. The data suggest that interpersonal skills can be effectively taught to internal medicine residents utilizing a videotape feedback training program.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

No abstract available.

ISSN:0022-2577    

出版商:OVID    

年代:1979

数据来源: OVID