摘要:

Data are presented on office-bascd general practitioners and pediatricians working in varying practice settings. Fee-for-service physicians spend more time in direct patient care activities than those in prepaid practice, and devote more time to each patient. The data suggest that the patient load characteristic of general practice in prepaid groups encourages a more assembly line practice which is less responsive to patients than the pattern characteristic of feefor-service practice. Prepaid physicians work during scheduled hours and may deal with increased load by processing patients more rapidly. Fee-for-service physicians tend to respond to increased demand by working longer hours. The responsiveness of primary care physicians to patient problems seems to reflect primarily their social orientations to medical practice and the time pressures they face. Varying practice settings result in different techniques of coping with the pressures of practice. Data are also presented on sociodemographic and professional characteristics of primary care physicians in varying settings, workload, use of diagnostic and laboratory procedures, social orientations to medical practice, satisfactions and dissatisfactions, and attitudes toward sociopolitical aspects of medical care. Suggestions are offered for improving the responsiveness of prepaid practice.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Data on postgraduate training and work experience of a sample of 850 Foreign Medical Graduates (FMGs) taking the January 1973 ECFMG examination in the U.S. are presented. It was found that 485 (57%) of the respondents had specialty training and, of these 4S5, 59 per cent were certified in a specialty. In addition, 81 per cent reported that they had worked as a physician prior to entering the U.S. The proportions with specialty training and work experience varied by country of medical education and year of graduation. The proportions with training or experience among those not currently employed in the health system are significantly lower than among those employed in the health field.Of the 186 respondents who reported passing the ECFMG examination, 92 per cent plan further training and 84 per cent of this group plan to specialize.More detailed information on the length and content of this training and work experience for different groups of FMGs is needed.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The professional and personal characteristics of all physicians recruited into a large urban govemmentally sponsored health system were evaluated and correlated to staff retention and loss.The results were tabulated for 84 physicians, approximately 90 per cent of the physician work force, over a three-year period. Eighty per cent resided in either Denver or the state of Colorado prior to entry. This is further reflected in a significant percentage being enrolled in the local medical school or training programs prior to entry. These facts suggest a possible source of manpower for beginning programs. Twenty-six per cent came from private practice, 32 per cent from the military and 14 per cent from the Public Health Service.The turnover rate averaged 6.2 per cent per year, with 4.4 per cent being initiated by the physician and 1.8 per cent leaving because of administrative pressure. Data from other studies are reviewed.Factors which appear to influence retention positively were residency training (pediatricians), sex (females), age (over 38) and those with team experience.These factors suggest directions as to the type of physician who, if recruited, tend to reduce turnover.The establishment of a group practice atmosphere with rewards for clinical skills and the offering of unusual specialty opportunities are proposed as positive factors in the retention of staff.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

This study analyzes the relationship between medical student participation in rural training programs, including preceptorships, and the decision to locate medical practice in rural areas. Data consist primarily of responses to questionnaires mailed in 1972 to all graduates of United States medical schools in 1965. Study findings indicate that the overall impact of such programs on practice location decisions is relatively slight, but is most pronounced with respect to urban-reared physicians in nonprimary care specialties. It was also found that a large proportion of urban-located physicians had seriously considered rural practice and that the reluctance of many physicians to locate in rural areas is linked to fear of professional isolation. The findings suggest that an increased orientation toward urban-reared students and dissemination of information on nonsolo practice opportunities in rural areas are means of increasing the effectiveness of preceptorships and other rural training programs in attracting young physicians to underserviced areas.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The data used in this study was collected by the original MEDEX project in Seattle, Washington. The original use of the data by the project was to measure changes in patient characteristics. The MEDEX-dcsigned data collection system is compared with proposed systems for collecting nationwide ambulatory health care data and found to be very similar. Hence, the success of the MEDEX data collection effort is additional evidence that such data can be collected on a large scale, if the physicians and their ancilliary personnel are properly motivated.Analysis of the data yielded distributions such as patient age, sex, age by sex, diagnosis and dispositions, as well as the distributions of dispositions by diagnosis. These distributions are based on reports from over 11,000 physicianpatient contacts during the summers of 1969 and 1970 by seven physicians in five rural practices located in eastern Washington State. These results are shown for each of the practices individually and for the combination of all practices, with the exception that the dispositions by diagnosis distributions are prepared for the combined practices only. Where appropriate, the results of this study are compared with the findings of Last and White4and these results generally substantiate their findings. When differences are noted, explanations are proposed to account for the differences.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A work sampling study was initiated to provide a comprehensive description of the tasks performed by midlevel health personnel in the rural component of an experimental medical care delivery system. The investigation determined the proportion of time spent on various activities by the staff members of a rural clinic which is linked to supervisory physicians in a distant urban medical center. Over 800 observations were recorded during ten randomly selected days in a two-month period on each of the three stall members. The family nurse practitioner spent one-third of her time in direct patient care activities with almost one-half of the day devoted to indirect patient care tasks. The laboratory aide allocated one-half of her day to providing direct patient services whereas the clerk-receptionist spent over 40 per cent of her day on patient records and billing. Work sampling results were considered within a comparative framework to qualitatively assess performance. The findings were coupled with proposed changes in administrative and medical policy to provide a quantitative basis for developing cost-reducing alternative staffing configurations.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Two questionnaires were given to parents accompanying children to an outpatient pediatric center. The first was given to all Ss directly after a care-receiving visit; the second was given one week after the visit only to Ss accompanying Ps receiving throat cultures. Care was judged extremely favorably in both instances. Quality of care measures intercorrelated very highly. No strong relationship was found between length of illness or illness versus absence and rated quality of care received.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

This article provides an assessment of health services research contributions to national health policy. An examination of disciplinary-based research identifies many of the shortcomings of such research and the need for a different structure for relating research to health policy. Some definitions are offered for such terms as “applied research,” “disciplinary research,” “policy analysis,” and “policy research.” A policy research model of sequential steps in problemsolving is suggested as a useful approach. A review of the federal role in health policy is developed to set the context for viewing past contributions as well as to suggest a strategy for maximizing the relevance and usefulness of research.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Federal endorsement of the HMO concept has resulted in broad understanding of a number of concepts unknown in fee-for-service medicine. As the concepts are adapted to particular circumstances, refinement can be expected. One such refinement, applicable to financial arrangements between the HMO and contracting providers, is discussed here.

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