ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Nine Prevention experts rated hospitalization risks of 64 hypothetical healthy adults between 20 and 65 years old. There was substantial agreement among seven out of the nine experts. Pairwise correlations between any two of the experts ranged between 0.66 and 0.86. Decision analytic tools were used to model the average of the experts' ratings. The panel of experts provided us with the factors used, the relationship between the factors, and the relative importance of each factor. An index based on this information was highly correlated with the judgments of seven experts. Thus, we concluded that the scoring procedure can simulate the experts' judgments. Next, the index was used in an interactive computer program to assess modifiable health risks of individuals. This program is provided along with the paper to facilitate further research on validity and impact of the program.

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This study reviews evidence on whether services in United States hospitals vary by racial groupings of patients. The focus is on both equity and quality of hospital services. Patients with the diagnosis of pneumonia were studied at 16 randomly selected hospitals. The services and outcomes studied include five measures of the intensity of diagnostic and therapeutic services received by patients, and death rates during hospitalization. Multiple regression was used to control for patient health status at the time of entry into the hospital. Results are presented both before and after controlling for the effects of differences in the services offered between hospitals and patient payment sources. Our findings suggest that nonwhite pneumonia patients received fewer hospital services than expected on the basis of their health characteristics, and that their hospital lengths of stay were longer than expected. These findings were apparent when the hospitals were examined in aggregate and within individual institutions. No consistent differences in death rates were apparent. Possible explanations for these results are discussed. From our data, we conclude that patient race remains a potentially significant characteristic in determining the intensity of care provided to patients in hospitals, which is not explained by differences among racial groups in health status, sources of payment, or site of hospitalization.

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Health is an important variable that determines an individual's economic as well as noneconomic well-being. A healthy individual will be more productive, will contribute more toward a nations's economy, and, keeping other things constant, will have a better life overall than a sick individual. But for a low-income individual, health could be even more crucial since it could be a major factor in perpetuating his poverty. If, as a part of our social policy, we would want to improve the economic well-being of poor people, their health in general would need attention. This paper studies the production of health and the demand for medical care of low-income working men. Low-income working men are “medically indigent” because they are not eligible for Medicaid and are not adequately covered by insurance.*This study provides insight into what role medical, preventive, and curative care—as well as other socioeconomic variables, such as income and education—plays in the production of the health of low-income men. It also shows the impact of price, income, and other control variables on the demand for medical care.

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The purpose of this study was to determine the extent to which members of families have similar and interralated health behavior. Utilization and morbidity data from more than 80,000 ambulatory visits by 693 families enrolled in a prepaid health plan for 6 consecutive years were examined using family membership as the major unit of analysis. Family members were found to resemble one another in their rates of use of services (r = 0.44;P< 0.001). Parental influence on children's utilization is significant, mothers generally being two to three times more powerful than fathers in this regard. Apart from family size, structural characteristics of families contribute little to family health behavior. Family membership explains nearly one third of the variance of individual utilization even after family size and age and sex of family members are considered. A small proportion of families (5%) accounts for a disproportionately large share (12.3%) of health care utilization. Intrafamilial patterns of morbidity were apparent for several major groupings of diagnoses, most notably for acute health problems. Intrafamilial correlation were greatest among high-utilizing families. Families establish patterns of health behavior that are stable over time and therefore may be amenable to selective interventions. We conclude that health care planning, whether for service delivery or health education intervention, should consider family health data as an important information source.

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Rather than analyzing Hispanics as a homogeneous population, this paper uses the 1977 National Medical Care Expenditure Survey in order to make separate national estimates for Cubans, Puerto Ricans, and Mexicans. Utilization of various health services by these three groups is discussed, as well as their insurance coverage, mean annual expenses by source of payment, and health status indicators. The analysis has a descriptive as well as multivariate component and focuses specifically on the use of physician and hospital services and prescribed medicines. It is found that Puerto Ricans are almost twice as likely as Mexicans, and over four times as likely as Cubans, to be covered by Medicaid; Cubans, on the other hand, are most often privately insured. Of the three groups, Puerto Ricans have the highest annual expenses and are most likely to have at least one physician visit. The number of visits for those with a visit, however, is identical across the groups. The paper discusses the policy implications of these findings, as well as the methodologic implications of classifying various Hispanic subgroups into one all-encompassing category.

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The need to address the impacts of serious disease and the effectiveness of interventions has led to the development of numerous measures of the quality of life. The research reported here explores the possibility that widely used measures do not truly distinguish among separate dimensions of the quality of life in a seriously ill population, but reflect a generalized tendency among such individuals to respond negatively to interviewers' questions about their well-being. This research examines three widely used measures—the Sickness impact Profile (SIP), the Profile of Mood States (POMS), and the McGill Pain Questionnaire (MPQ)—as applied to 536 individuals with recent cancer diagnoses. In a multitrait-multimethod matrix, correlation coefficients among measures believed to reflect the same phenomena are consistently higher than correlation coefficients among measures supposed to reflect different phenomena. In a factor analysis performed on all 536 subjects, the unrotated factor matrix indicates that no single factor explains a preponderance of the variance in individual measures. Orthogonal rotation indicates that subscales from the SIP, POMS, and MPQ generally load on factors defined by the scales of which they are part. These findings were replicated on subsamples of subjects with particularly severe disease. The study suggests that the SIP, POMS, and MPQ measure the specific dimensions their names imply, even among individuals with illnesses posing immediate threats to survival.

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Although echocardiography is frequently ordered in ambulatory settings for patients suspected of mitral valve prolapse (MVP), its impact on their subsequent management is unknown. We studied the relationship between the results of echocardiography for outpatients suspected of MVP, and two frequent medical decisions: treatment with beta blockers and the recommendation of antibiotic prophylaxis to prevent bacterial endocarditis. A medical record audit was performed on 274 outpatients referred to a university medical center echocardiography laboratory to rule out MVP. Although echocardiographic evidence for MVP significantly influenced the decision to recommend antibiotic prophylaxis (P < 0.001), symptoms were more likely to be used as indications for beta-blocker therapy in patients suspected of the condition. We conclude that echocardiographic results are used for recommending antibiotic prophylaxis to outpatients suspected of MVP, but not for beta-blocker therapy.

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This study employs the individual as the unit of analysis to examine the relative importance of medical need, sociodemographic and economic factors in determining the use or non-use of hospital care and the volume of service consumed by those who experienced an episode of hospitalization during the study period. The data were derived from the Canada Health Survey which is a stratified, multistaged sample of the entire population. The results of the discriminant and weighted regression analyses indicate that the use or non-use of hospital care and the volume of service consumed are largely determined by medical need and not by income. The findings are supportive of the view that the national health insurance scheme in Canada has resulted in a more equitable distribution of hospital care

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1987

数据来源: OVID