摘要:

The study is intended to elucidate the factors that affect the creation of a hospital's image in the eyes of the patient and their relative weight in producing that image. The image of a hospital is important for enhancing the patient's reassurance and relief from possible anxiety that is hazardous to the health, which may result both from the patient's subjectively perceived seriousness of his condition and from his inability to judge the efficacy of the medical treatment in promoting recovery. A study was carried out among a representative sample of expatients of one of Israel's most prestigious university hospitals. Data ascertain the centrality of the physicians' and nurses' affective behavior in the creation of the image. They also show that the crucial factors that predict that image in the patient's eyes are the nurses' affective behavior and the hospital's perceived competence level, which is based predominantly on the patient's satisfaction with the medical treatment given by the physicians. That, in turn, is, to a great extent, predicted by the extent of satisfaction with the physicians' humane attitude toward the patient.

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

This study concentrates on utilizing registries and assessing their quality for population-based research. A method of successive comparisons is used to develop and update a summary record of coverage (length of time on the registry) and mortality for each individual in the Manitoba Health Services Commission data base. Various ways to ascertain the accuracy of the summary records are discussed. These techniques are validated by efforts to follow over an 8-year period 4,794 individuals interviewed in 1971 as part of ongoing research on the Manitoba elderly. Ninety-seven percent of the total elderly sample (and 99% of those successfully matched with interviewees) were traced over 8 years. Deaths recorded on hospital claims but not on the master registry and possible unrecorded out-of-hospital deaths are outstanding problems with the Manitoba data base. Further checks against 1970-1977 vital statistics information in the Canadian Mortality Data Base will be made.

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Predictors of dropping out of care were examined for 171 treated hypertensive patients enrolled in a randomized trial of social support strategies designed to improve compliance and blood pressure control. Control patients who continued to receive routine care were more than twice as likely to drop out as patients who received routine care and periodic home visits by nurses or pharmacists (odds ratio [OR]= 2.7). The combination of home visits and a second intervention, having family members monitor patients' blood pressure and compliance behavior, was no more effective than home visits alone (OR = 1.1). The home visits intervention was one of six variables identified by a stepwise regression as significant predictors of dropping out. Patients with four or more high-risk characteristics constituted 15% of the sample but contributed almost half (46%) of the dropouts. Targeting support strategies at high-risk patients may be a cost-effective means of reducing uncontrolled hypertension.

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The authors present new results from the 1978 National Health Interview Survey concerning the use of physician services by the least healthy segment of the low–income population: those who are limited in their activities due to chronic conditions. Poor and nonpoor persons with chronic activity limitations report similar levels of physician visits. However, lower-income persons report more severe chronic conditions and hence appear to use less physician care relative to their needs. In addition, low-income persons with chronic activity limitations report more visits in hospital outpatient clinics and emergency rooms and fewer in doctor's offices compared with others with such limitations, and they are more likely to report hospital outpatient departments as their usual source of care. Unfortunately, hospital-based ambulatory care is often more episodic and fragmented than care provided in other settings. The authors conclude that care for this population could be improved greatly by restructuring responsibility for the care of the chronically ill within hospital outpatient departments.

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The influence of selected variables on the prescribing volume of eighty family practitioners in a large HMO was quantified through multiple regression analysis. Over 70% of the variation was explained. The patient panel size and age composition were the most important determinants and accounted for 45.7% of the variance. The number of patients seen per clinic hour explained 14.3% and interclinic differences explained another 8.1% of the variance. Further, the data indicated two processes that might have affected results of earlier studies. First, female patients tend to select female physicians, as indicated by a high correlation between the sex of a physician and the proportion of females in the panels. Second, older physicians tend to have older patients. This implies that physician age does not explain higher prescribing rates, but is merely a proxy for older panels of patients who generally have more chronic illnesses and need more drugs.

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The Health Care Finance Administration has developed a Medicare reimbursement methodology that will include an adjustment factor for hospital case mix. The patient classification scheme proposed for use in determining a hospital's case mix is the AUTOGRP Diagnosis-Related Groups (DRG) methodology developed at Yale University. The reliability of a case mix measure calculated using the DRG methodology is dependent on complete and accurate diagnostic and surgical data. The source of this data for the HCFA data base (MEDPAR) is the Medicare billing form, which is based on the patient medical record. Data from the MEDPAR file, the original medical record discharge order, and a reabstracted record are compared and analyzed for their effect upon DRG classification and the resultant Medicare reimbursement ceiling for one large teaching hospital. The study results show widely divergent diagnostic and surgical data that results in a significant variation in DRG classification and reimbursement ceilings.

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Survey data collected from a random sample of the Danish population in the first phase of a research investigation of self-care behavior are discussed. Self-administered postal questionnaires were used to obtain data on behavioral responses to common illness conditions. Information was obtained from 1,462 persons regarding care of 3,100 illness episodes. Log-linear analyses of multiway frequency tables were used to examine the effects of sociodemographic and attitudinal variables on the illness responses. Age, sex, perceived health status, and a reliant attitude toward physicians were the more important variables related to the illness behaviors. Interactions among these variables suggest directions for productive research into the factors shaping responses to illness. Income and social class, among respondents in relation to differences in activity levels maintained while ill suggest that some people may have limited options for caring for themselves during illness.

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1983

数据来源: OVID