摘要:

This study analyzes the institutional, economic, and regulatory deficiencies of the long-term care sector of the health industry and develops an incentive reimbursement model as a means for correcting or ameliorating some of the stated deficiencies. The reimbursement model presents a schema which attempts to match patients to facilities, needs to services, and services to cost. A capital expansion coupon program is proposed, both as a suitable vehicle for channeling incentive rewards accruing to nonprofit institutions, and as a mechanism for subsidizing the approved expansion and/or renovation plans of “efficient” providers of care.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

This survey study of 433 admissions to four health-related facilities and 738 admissions to 40 skilled nursing facilities in the Rochester region describes the reasons for placement, the patients' physical, mental, and functional characteristics and their personal, nursing, and other care requirements in the institutional setting. The differences and similarities between the two levels of care and between the four HRF's are analyzed in the light of national data; the appropriateness of placement is evaluated and the implications for regulatory systems are discussed.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Utilization of the emergency room at an urban community hospital is studied in a format designed to accomplish three complementary objectives: 1) to characterize a sample of individual patients, rather than an unweighted sample of visits, 2) to estimate the number of individuals served during a specified period and the magnitude of the relationship between these patients and the utilization of other hospital services, and 3) to introduce the patient's “frequency-of-visit” as an important variable in the analysis of emergency room utilization.Some specific findings are: 1) the vast majority of patients who used the emergency room did so very infrequently; 46,527 visits were made in one year by an estimated 34,286 different patients; 2) an estimated 2,586 patients made three or more visits during the year; a disproportionately large number of these “high-frequency” users were black, low-income, and from inner-city areas; a relatively small percentage of their visits were for accidental injury, 3) approximately 53 per cent of the hospital's inpatient admissions and 68 per cent of the inpatient days were generated by patients who also made at least one emergency room visit during the year studied.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A classification system for surgical patients and a quantitative index of services have been developed to determine the resources utilized for medical care in an urban hospital emergency department. Five classes of surgical patients based on patient management reflect the amount of diagnostic and therapeutic work performed. Quantitative estimates of workload and rates at which services are delivered to each patient class are included. This classification of patients which is derived from a natural grouping of common patient problems with common patterns of management, can be an important aid to effective analysis and planning of medical care in outpatient settings.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Contrary to the traditional role of the emergency room (ER) as a care source for the treatment of urgent medical needs, it is evident that substantial numbers of people now use the ER for the treatment of nonurgent problems. In this paper, we report on public opinion about the role of the ER, the perceived urgency of the problems that people bring to the ER, the accessibility of medical care, and factors that prompt the use of the ER rather than other sources of care.The data result from a community survey of households (N = 521) in the area of Rochester, New York, representative of a population of about 580,000 people. The findings, which relate ER utilization to source of payment, use of other sources of care, demographic variables, and consumer attitudes illustrate the rationality of the patient's use of ER facilities and reflect the patient's view of the ER as a place to obtain medical treatment when other sources are not available.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A computerized system has been developed which potentially enables a single expert physician to monitor a large number of hypertensive patients being seen at distant locations. The patients may receive their care directly from primary care physicians or nurse-physician surrogates. Primary care physicians can use the same data bank to monitor their own panels of patients. These goals are accomplished through a special purpose, interactive programming language which can be used to perform sophisticated data retrieval along different complexes of parameters. The physician is able to query the computer, via a terminal, about any group of patients he defines and have displayed to him the clinical data requested. The system is open-ended, enabling one query to lead to another.Four hundred and ninety-three patients have been entered into this program so far, including 29 patients with diastolic pressures greater than 115, 92 with diastolic pressures of 104 to 114, and 372 with diastolics of 90 to 104. Among patients who have been on therapy for at least six weeks, 80 per cent were at goal blood pressure. Ten to 14 weeks after therapy was initiated, 69 per cent of all patients in the program were at goal blood pressure.The system provides a useful means of monitoring a large hypertensive population of patients. Such a system can result in a more efficient utilization of medical personnel and can bring the consultative services of highly trained specialists to larger segments of the population.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A standardized system for recording patient care data for medical audit was developed and implemented in six community hospitals' coronary care units. It utilized the principles of predefining the data base and having both nurses and physicians participate. This system was compared with conventional retrospective record abstraction as a source of information for medical audit. The results suggest that the proposed system produces slightly more clinical data relevant to diagnostic impressions. Accuracy is comparable to that achieved by standard computerized abstraction procedures. Such an approach is readily adaptable for implementing medical audit to meet the requirements currently imposed upon community hospitals.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

This study investigated a sample of persons treated for acute drug reactions (overdoses) in a hospital emergency room setting to determine the general characteristics of these drug abusers and the incidence of drugs responsible for their admission. Detailed information is provided on the race and sex composition of these drug abusing patients and comparisons are made with the general population of the area serviced by the hospital. The sample consisted of 1,128 persons who entered Jackson Memorial Hospital, Miami, Dade County, Florida during 1972. A profile of the typical admission for emergency care of a nonfatal overdose reveals a white female, who is 18 to 24 years old and who has overdosed on a single legally manufactured and distributed substance, usually a sedative. Implications from the data for changes in health care delivery for acute drug reactions are provided.

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