摘要:

This paper seeks to provide a framework for understanding differential access to medical care in the U.S. population and to suggest ways to achieve equity of access. The framework is provided by a behavioral model of health services utilization which suggests a sequence of predisposing, enabling and illness variables that determine the number of times people will visit a physician. The model is operationalized using a path analytic technique. The data come from a national survey of the noninstitutionalized U.S. population conducted in late 1975 and early 1976. The results suggest services are generally equitably distributed since age and level of illness are the main determinants of the number of services people receive. However, remaining inequities might be reduced by providing people who report no regular source of medical care with a familiar entry into the health service system.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A framework for conceptualizing the process of health care delivery is presented. The framework identifies broad categories of activities by which the functions of a health care provider can be organized, and has practical application to studies of the roles of a variety of health care personnel. By permitting clear identification of each component of a health professional's role, the model provides a method for quantitatively determining what an individual or group of individuals does. The utility of the model in operationalizing investigations of health care roles is illustrated by its application to a study of nurse practitioners. In this study, the conceptual model was used to structure a questionnaire for obtaining information about professional nursing roles. By providing a theoretical framework for the relationships between specific role components and certain outcome variables the model was also used in the generation of hypotheses and the design of statistical analyses. Results of some of these analyses are summarized.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

For several years, the government of Ontario has undertaken to foster and develop experimental systems for the delivery of primary health care in the province. At the same time, the government wished to devise a strategy whereby the new health care programs could be rigorously evaluated. A Task Force on Evaluation of Primary Health Care Services produced a plan which yields quantitative information about the function of primaiy health care units. Three essential indexes of performances, comprising categories of Utilization and Financial Performance (UF-Index), Availability, Accessibility and Scope of Services (A-Index) and Quality of Care (Q-Index), were designed. Two additional quantitative indexes, Consumer Satisfaction and Health Professional Satisfaction, were proposed. The derivation and determination of the three essential indexes are provided in the paper in detail, along with acceptable criteria for performance and methods for comparing the performances of different types of practices in different kinds of population.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

We discuss several linear and nonlinear regression models and their appropriateness in modeling a set of data from a cohort study of the use of medical services in a prepaid medical plan. Although computational considerations once forced researchers to use linear models almost exclusively, modern computer hardware and efficient algorithms have made it possible to use nonlinear models almost as easily as linear ones. Thus, in choosing a regression model, a researcher should give strong consideration to how well the model reflects (presumed) intrinsic properties of the phenomena under study, even if the consideration leads to the choice of a nonlinear model. Modern computer programs for nonlinear minimization should be employed to fit the model. The model should be judged on how well it describes the data and how reasonably it predicts the future.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

In comparison to the living conditions that existed before 1949, the People's Republic of China (PRC) represents a remarkable story of achievement. Western knowledge about the PRC has recently increased by leaps and bounds as detente with the United States has allowed many Americans to witness the “awakening of the dragon.” Many of the achievements have been in the development of a health care delivery system that uniquely addresses the needs of the most populous country. There are numerous reports on the advancements made in manpower development and deployment, infectious disease control, family planning and acupuncture anesthesia and therapy. Yet there is little information about dental care in China. Dental disease being an essentially preventable disease has an interesting status in the Chinese health care system which relies on prevention rather than cure. In September and October 1974, the author visited five cities in China, Kwangchou (Canton), Peking, Tientsin, Suchou, and Shanghai and the respective countrysides except for Tientsin. Though any account or description is certain to be but a glimpse of Hsin Hua (the New China), the story is worth being told even if it must be accomplished by small chapters contributed by many individuals. In this light, the author explores the following areas: dental manpower training, which in China has produced stomatologists, dental technicians and dental nurses; the oral health status of school age children, dental care delivery and facilities, and probably the most remarkable while at the same time provocative areas, acupuncture analgesia and therapy.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The purpose of this paper is to compare the overall health status of blacks with whites in Alameda County, California, using an index based on the mortality and disability experiences of the two population groups. It is demonstrated that this index, which requires disease-specific mortality and disability data, can be easily adapted to make use of existing data files containing data on mortality and any indicator of morbidity or disability. It was found that in the year 1974, the blacks lost approximately 10,000 productive years unnecessarily through higher mortality and disability rates than those of the white population. This disparity between the two populations may be underestimated because Chicano/Mexican Americans, who are known to enjoy a lower health status than whites, were included as part of the white population. The implications of the findings are discussed.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The aims were twofold: to determine differences between the very old and younger patients in ambulatory care and to examine their self-assessments of health and whether these related to: subjective data such as symptoms and attitudes, objective data such as utilization of health services, and physician assessments of the patient's health. Although they had about one more diagnosis, the very old were similar in most respects to younger patients. Variables that discriminated the groups were physician ratings. About two-thirds of the older and younger patients regarded their health as good. Good health perceptions were associated with fewer symptoms, outpatient visits, and hospitalizations in both groups. Physician assessments were only lowly correlated with patient assessments of health. Patient perceptions of health were highly stable over a two month follow up. The subjective belief that one is healthy or ill may be more important than actual medical condition in maintaining good emotional and behavioral functioning.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID