摘要:

Nationally representative samples of senior physicians, interns and residents, and medical students were interviewed during the spring of 1973. The main focus of the present analysis is senior physicians’ responses to national health insurance issues. The level of support among physicians is underestimated by physicians themselves. Despite the fact that 56 per cent of the doctors were in favor of “some form of national health insurance,” almost three-fourths of the respondents believed that most doctors they knew personally were opposed. More than four-fifths of the physicians believed that NHI was inevitable, and those who saw NHI as inevitable were more likely to favor it. Doctors’ views about NHI were closely related to their general political views. In general, attitudes of AMA members and grassroots state and local medical society leaders were not greatly divergent. In terms of responses to specific components differentiating NHI alternatives, physicians preferred conservative options on how a program was to be financed and administered as well as whether the development of prepaid groups should be encouraged. Support for the liberal alternative was strongest on the question of peer reviews, with 75 per cent in favor of such reviews under a NHI program. Differentiation in the profession is considerable. Main activity, work setting, specialty, percentage of income in salary, geographical location, and career stage all contribute to differing reactions to NHI among physicians.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The study reported in this paper examines clinical reasoning styles with a focus on laboratory utilization. A stratified sample of 80 physicians participated in the solution of a simulated patient management problem. The analysis focuses on variation in the portfolio of laboratory tests ordered as a function of practice setting (e.g., physicians in practice versus physicians in training). The study also examines the response of physicians to the imposition of constraints on ordering, as well as behavior, when unlimited ordering capacity is provided. Overall, the data profiles emerging from the analysis indicate the variety inherent in physician decision-making strategies, and point to the necessity of employing a cautious and flexible approach toward any general scheme of constraints upon medical diagnostic procedures.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Process and outcome analyses were carried out on a group of patients who had uncomplicated cholecystectomy. The postoperative length of stay and patient satisfaction were also measured. A random sample of 80 charts was selected from 222 eligible records for process analysis. Outcome was evaluated in 218 of the 222 eligible patients against explicit criteria. More patients were in the symptomatic and back-to-work group than expected. The peer consensus was that these results were not related to the surgical procedure or specifically related to gallbladder disease. Ninety-five per cent of the patients assessed care as good or excellent, and 90 per cent felt the length of postoperative stay was satisfactory.When the patients were divided according to surgeon, significant differences in the length of postoperative stay were found in the 154 patients without common bile duct exploration. After the findings were presented to the surgeons through an educational program, changes occurred which resulted in a decrease of nearly one day in the postoperative hospitalization.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Numerous methodologies have been devised to measure various aspects of the quality of health care. Revised bibliographies of articles reporting these methodologies are made available periodically.This paper is an attempt to devise a useful framework for cataloguing these methods in order that health care planners and administrators can readily assess the means available to quantify aspects of health care under their scrutiny.A decision tree is presented for the decision maker to follow through according to his requirements, and a discussion presents a brief summary of the methods in each particular category. Gaps indicating the need for further research are identified.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Conditions for using single measures or combinations of measures of physician performance are discussed. Studies reporting combination indices of proficiency are reviewed for their use of equally or differentially weighted components and for the use of these with many or with single diagnoses. Comparisons of diagnostic-specific measures are made using differential and equal item weights. Under the general conditions of this research, few psychometric differences existed. The use and acceptability of differential item weights in this research are also discussed.

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

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID