摘要:

Surveys were made of a sample of physicians before and after the introduction of a national health insurance plan in Montreal, Canada. Although the number of physicians in active practice seemed unaffected by the plan, their average working day was reduced 1.5 hours. Declines ranged from 0.3 hours for general internists to 2.7 hours for general surgeons. The average daily volume of services by physicians in the area also declined because of a decline in telephone consultations, and home and hospital visits. Office visits increased sharply. Changes in the type of services were clearly related to the fee schedule adopted by the government, with large declines in services for which payment was probably inadequate in relation to physician’s time required. If the fee schedule reflected actual collections prior to the health insurance plan, then gross physician income increased as the result of redirecting services to better paying activities.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

To enhance the efficient utilization of health providers, medical care researchers are increasingly concerned with the measurement of task performance. One job analysis methodology that is widely used is the task inventory technique, characterized by retrospective self-reporting. The purpose of this study was to validate the task inventory method by using the observational technique. Two data collection instruments were developed, a Task Inventory and an Observer Check List; both contained the same set of task statements. Trained observers shadowed 13 primary care physicians in their offices for one week recording the frequency and duration of task performance on the Observer Check Lists. At the end of the week, the 13 physicians completed a Task Inventory indicating how often they had performed each task in their offices and how long it normally took. The observers’ and physicians’ respective sets of data were analyzed to determine the degree of agreement The results indicate that the agreement is not sufficient between the task data obtained by the two different methods to conclude that one is substitutable for the other. The validity of the Task Inventory method is therefore not supported by the results.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The challenge of delivering health care on a more cost-effective and equitable basis has led to the formation of new kinds of organizations, which in turn require new kinds of management information systems. The system described in this article is used for planning resource allocation and monitoring the overall performance of Livingston Community Health Services, Inc., a rural community-owned health service designed to provide comprehensive care to a geographically defined target population.The Health Services Data System processes information on performance and productivity, effectiveness with respect to the target population, and billing and financial activities. Input consists of the results of a community census and two household surveys, patient registrations and patient services operating data, and financial data. Besides billing patients automatically, the system integrates financial, demographic, and health services utilization data to generate monthly summaries for the administrators, medical director, and community board. The article discusses several examples of these summaries, stratifying utilization by geographic location of residence, age, income, and race.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Vector resolution represents a new method for analyzing consumer data and comparing patterns for a variety of consumer services. The vectors are derived from a measurement of frequency of use and a geographic direction from the origin of the group to the point of service. Although the data presented were drawn from a probability sample survey of southern Utah rural households, the methodology may be readily applied to data derived from a variety of sources.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A detailed cost analysis has examined the fiscal benefits from regionalizing abortion services. Benefits were found to be virtually insignificant and not to outweigh problems of program visibility and patient accessibility incurred in such regionalization. The study covered 14 hospitals’ abortion programs providing both first trimester and second trimester abortions and analyzed each program’s total cost and six component costs for first trimester and second trimester procedures separately. The results of this study were employed for program planning by the New York City Health and Hospitals Corporation in its operation of abortion services.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The aim of the present study was that of discovering whether the prescription of drugs displaces other forms of therapy. The method adopted was that of behavior simulation. Doctors were requested to provide therapeutic proposals regarding a standard set of patient cases described in questionnaires sent to them. These cases were formulated in such a way that in the author’s opinion they could easily, and perhaps best, be treated without drugs. Nevertheless, most of the cases were treated with drugs, thereby indicating the important role of drug therapy as a means of treatment. In particular, psychic disturbances were often treated by drugs. Frequently, drugs represented the only treatment offered, and no alternative form of treatment was suggested.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A computerized health records system has facilitated an analysis of the correlated illness of a segment of population afflicted with a chronic disease. Taking the existence of clinical diabetes as a starting point, the total illness experience of 635 diabetics, as shown by clinic utilization data, has been compared with an age-sex-geographically matched control population.The comparisons show that, overall, diabetics cause a caseload rate more than double that of nondiabetics. In 17 out of 22 broad health problem areas, the diagnosis caseload rates for diabetics varied from 1.3 to 3.7 times greater than the rate for matched, non-diabetic controls. Workload (physician visit and hospital days) comparisons showed even greater disparity.Some of the comparisons confirm statistically the clinical impressions of diabetologists over the past years. Some of the findings are not reflections of orthodox clinical opinion. The results contribute to further elucidation of the natural history of this disease. They also indicate the need for the development of comprehensive clinical management programs for groups of interrelated conditions found in persons with chronic disease such as diabetes.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Utilizing structure, process, and outcomes as conceptual dimensions of appraisal of quality, data were analyzed to present an evaluation of the quality of a community’s dental health core, system as reflected in a population subgroups’ dental health status. Data were collected from 838 Caucasian third-graders and their parents through interviews, mail questionnaires, and dental screening examinations. Indicators of structure were: status of community water fluoridation in the study community, dentist to population ratio, and dental care resources in the public sector available to eligible residents. Process indicators of quality were: 1) screening, case finding, examinations, and quality of restorations as measures of provider behaviors, and 2) complaints, compliance, conditioned behaviors, level of dental health knowledge, and utilization of dental services as measures of client behaviors. Outcomes subjected to analysis included indices indicative of dental disease experience. Variables operationally defined as indicators of the subgroup’s dental health status were subjected to a descriptive analysis and were then crosstabulated with the socioeconomic status of the child’s family to identify socioeconomic differences in the process of obtaining care and in dental health outcomes. Findings indicate which elements in a community’s prevailing dental health care system function well and which would need alteration to maximize dental health for the subgroup.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID