摘要:

Panel data are presented from the Los Angeles Health Survey, in which 1 year of symptom experience is analyzed. Of the 1,210 individuals originally in the panel, 769 reported at least one symptom in reinterviews conducted every 6 weeks during the study year. The dependent variable in the analysis is whether or not the individual decided to seek medical attention for his symptoms. Hierarchical multiple regression was used to organize the independent variables into five groups: 1) need; 2) social structure; 3) organization of care; 4) general social network patterns and health orientations; and 5) social network influences and personal beliefs specific to the symptoms. Of the 57 per cent of the variance explained by the entire set of independent variables, need factors accounted for 12 per cent and network influences and personal beliefs specific to the symptom accounted for 42 per cent. In spite of the amount of variance explained in this analysis, the allocation of the explained variance among the predictor variables raises some disturbing questions regarding our ability to understand the decision to use health services.

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The importance of understanding the manner in which symptoms are interpreted is generally recognized, but has received relatively little direct research attention. In an attempt to obtain some evidence on the meaning attached to each of a set of 45 symptoms, subjects were asked to rate the symptoms on eight semantic properties. The symptom ratings on the various properties were then correlated and the correlation matrix subjected to a principal components factor analysis. Three factors of perceived meaning emerged. The first factor is defined by the extent to which symptoms are perceived as threatening, disruptive and painful. The second factor consists of the familiarity of symptoms and the perceived personal responsibility for their occurrence. The third factor reflects how embarrassing the symptoms are. This structure of preceived meaning of symptoms is discussed with reference to the literature on delay in seeking medical care.

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

It is generally agreed that patients have a right to be adequately informed. However, little is known about the extent to which doctors and patients agree about information that should be disclosed. We studied what patients want to know, as contrasted with what physicians report actually disclosing, in a population of physicians who treat seizures and patients or parents of patients who have this disorder. In general, it was found that patients prefer far more detailed disclosures than physicians routinely offer and that the two groups have widely different beliefs about the consequences of detailed disclosures. Patients and parents preferred extensive disclosures, particularly regarding risks and alternative therapy. Physicians were likely to disclose only risks with a relatively high probability of occurrence and they provided little information about alternative therapies. Patients and parents were also much more likely than physicians to believe that the final decision concerning therapy should rest with the patient. The data suggest that a better empirical understanding of the consequences of detailed disclosures may help resolve differences of opinion regarding how much information should be provided to patients.

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Patients' characteristics and no-show patterns are analyzed in order to determine the number of patients to schedule in outpatient clinics. This predictive model is evaluated on a second sample of data and compared with another scheduling technique that is based on the average no-show rate for each clinic. Our survey suggests that it is possible to predict accurately the number of no-shows with a small set of variables, and that patient scheduling can be improved by paying attention to the characteristics of individual patients. The most important single predictor is the patient's previous appointment-keeping pattern.

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The effect of continuity of physician on satisfaction with medical care was examined in a sample of 370 families of disabled children receiving care from four specialty clinics of teaching hospitals. Families of children with myelodysplasia, cystic fibrosis (CF), cerebral palsy and multiple physical handicaps were included. A comparison of scores on the eight scales of the Patient Satisfaction Questionnaire across the four clinics revealed marked and consistent differences: patients of cystic fibrosis clinic scored significantly higher than patients of other clinics on most scales. Multiple regression analysis in which source of care (CF clinic versus other clinics), continuity of care, waiting time and patient and family characteristics (income, race, education, level of disability) were used as predictors indicated that continuity of care accounted for a large part of the association between source of care and satisfaction. Further, when continuity of physician and waiting time in the clinic were held constant, patients of the CF clinic were indistinguishable from patients of other clinics in their satisfaction with doctors and with medical care. Further analysis revealed that continuity of care contributed to patient satisfaction not only in a clinic that constitutes a patient's principal source of care, but also in a clinic in which only specialized care is given, excluding care for intercurrent illnesses or immunizations.

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

This article reexamines some evidence on the effects of prepaid group practice on medical care utilization. It is argued that intertemporal variations in longitudinal cohorts must be evaluated in the context of a cohort's longitudinal use patterns. The longitudinal pattern is comparable to the random effects against which cross-section statistics are ordinarily assessed. Failure to do so may result in unwarranted identification of “experimental” effects.

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A survey was conducted of people who disenrolled from a prepaid group practice Health Maintenance Organization (HMO). Disenrollees were more dissatisfied with the organization of the HMO and the care they received than those who remained in the plan. Changes in eligibility for HMO coverage and dissatisfaction with medical service were the first and second most frequently reported reasons for disenrollment. Although the sample was drawn during a period when there was an increase in the cost of HMO premiums and a concomitant decrease in the cost of comparable Blue Cross/Blue Shield premiums the disparity of costs for health insurance was given by only a small proportion of respondents as the reason for disenrollment.

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1981

数据来源: OVID