摘要:

Little is known about the health status of the population in poverty areas where the concentration of the poor is high. The purpose of the study was to compare prevalence of chronic conditions among the poor in ten poverty areas with the national average for poor and then relate the level of chronicity to physician utilization.Some findings were: 1) the poor in poverty areas have a much higher level of chronic conditions, especially major chronic conditions, than would be suspected from national data on the poor; 2) persons with chronic conditions in poverty areas see physicians at a high rate regardless of income; and 3) for the vast majority of persons residing in poverty areas — the nonchronics — physician utilization is low.Conclusions are: 1) the escape from poverty by the poor in poverty areas is not optimistic without intensive effort at prevention of chronic conditions; and 2) perhaps some relationship may exist between low utilization of ambulatory care by the majority of the poverty population—the nonchronics—and the high chronic rate.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Medicaid legislation intended to remove financial barriers to health care for the poor. A household interview survey of the Metropolitan Baltimore area in 1968-69 shows that persons on Medicaid are the highest users of health services. More Medicaid recipients in Baltimore visited a physician in two weeks and one year; more were admitted one or more times to a hospital. The total number of days in a hospital per 100 persons was considerably greater for Medicaid adults.Higher utilization of health services in Baltimore can be explained by the fact that Medicaid recipients are sicker than the rest of the population. Fewer Medicaid recipients are healthy; more are acutely, chronically, or acutely and chronically ill; more are chronically ill with impairment.The higher rate of chronic illness accounts for higher hospital use for the working age population. When compared by morbidity categories, ill Medicaid recipients are using services at least at the same level as others, but healthy Medicaid recipients are using more services.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

A study was conducted comparing prescription drug utilization by a sample of patients in similar three-month periods before and after enactment of a Medicaid drug program. Prescription audits and personal interviews were used. After necessary adjustments, total utilization was shown to increase from 5.43 prescriptions per patient pre-Medicaid to 9.48 prescriptions post-Medicaid. The number of different drugs used per patient also increased. The average quantity prescribed increased slightly as did the average cost per dose dispensed. Some changes in prescribing habits might be indicated since the nature of program economics make old habits more costly.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

In September, 1966, Massachusetts initiated a Medicaid program which included a sizeable dental component. The purpose of this study, conducted during the summer of 1971, was to determine dentist attitudes toward the Medicaid program. Since a similar study had been conducted in 1968, it was possible to gauge attitude shifts over the intervening three years.The data for this study were obtained from returns to a mail questionnaire. The returns were from a stratified random sample of 439 dentists in the Boston Standard Metropolitan Statistical Area. Of the 408 possible respondents, 252 questionnaires were returned for a response of 62 per cent.The older dentists in most cases were more tolerant of certain elements of the Medicaid program. Older dentists, for example, were more likely to agree that Medicaid patients do not present special behavior problems for the dental office. They were less likely to have disagreements with the welfare department.Younger dentists react more critically to the components of the dental Medicaid program. They do, however, support mandatory continuing education to a greater degree than the older dentists which seems antithetical to their concern for government intervention.In general, dentists approved of a special program to deliver care to the poor. However, they objected to specific administrative strategies and inefficiencies.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

This paper discusses the difficulties which were encountered in attempting to analyze cost and utilization data contained in Medicaid claims tapes. Three classes of problems were encountered: 1) inaccuracy; 2) missing data; and 3) lack of standardized reporting conventions. Taken together, these problems seriously compromised the ability of the investigator to make a meaningful analysis of the utilization experience which the data presumably recorded.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

One of the major problems in attempting to use information collected in the medical care system for epidemiologic research, e.g., information from hospital medical records, is the problem of identifying the population at risk for admission to hospital. In this study, the population at risk has been identified as all residents of Charleston County, South Carolina in 1963. This population numbered some 215,000 individuals with 16,903 residents of the county being admitted to hospital during the year. Hospital admission rates by age, race, and sex were computed for the entire population while additional rates were computed for a subgroup of the population, ags 35-64 years, by place of residence, socioeconomic status, selected diagnostic categories, hospital services utilized, and status at discharge, i.e., alive or dead. Substantial differences were observed between admission rates for blacks compared to whites with whites having an admission rate 1.8 times that for blacks. The highest admission rates were for residents of urban areas while the lowest admission rates were for blacks from rural areas. Middle-income whites and low-income blacks show the highest admission rates. Overall, blacks experience an inhospital mortality rate eight times that experienced by whites.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

The methodological development of a scale to measure attitudes toward physicians and primary medical care, and efforts to ascertain its reliability and validity have been reported previously. As a direct result of further experience with this scale, several modifications were incorporated and the revised scale subjected to additional evaluation. The modifications specifically address the methods employed in developing a revised set of items, the rationale for changing the response alternative format, and the derivation of a modified Scale Product scoring method. When compared to the traditional Thurstone scoring method, the reliabilities of the Scale Product method, using corrected split-half reliability coefficients, were found to be consistently superior. The complete scale is published with scale values and direction of affect, such that it can be used without modification or additional information by other investigators.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID