ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Among the recent proposals for a Federal program to finance the health care costs of the Nation are plans to provide tax credits against the individual income tax to offset the cost of premiums for private health insurance. A cost analysis of four tax credit proposals is presented, including a plan limited to the poor, a proposal by Professor Rashi Fein of Harvard University, a bill (H. R. 9835) introduced by Representative Fulton of Tennessee, and the “Medicredit” plan of the American Medical Association. The methodology employed is to analyze the cost of the four plans on a comparable basis (assuming a $500 maximum tax credit) so that variations in the costs of the plans reflect differences in their eligibility and related provisions. On this basis, the gross costs of the four plans range from $6 billion to $21 billion. An analysis is provided concerning the effect of tax credit proposals on Federal and State expenditures for the Medicaid program, and the gross costs are adjusted for the estimated reduction in these expenditures. A further adjustment is made for the projected reduction in the amount of deductions for medical expenses taken on income tax returns. After the two types of adjustments, the costs of the plans range from $4 billion to $17 billion.

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

This paper investigates the effects of patient characteristics on frequency of referral at three group practices. Major findings are: for pediatricians, referral rate increases with patient age; among internists and general practitioners, variations in patient age, marital status, and payment source are consistently related to significant variations in referral rates. At the group with a large black clientele, blacks were referred significantly less than whites. A discussion of possible causes includes differences in medical conditions and utilization patterns as related to age and payment source, the economic burden of referral on fee-for-service patients, the social or psychological stresses on older unmarried patients, and variations by race in the patient-physician relationship. Methodological aspects of the study are presented in two technical appendices that deal with problems of estimation and tests of hypotheses used.

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

The methods used by health planners in Sweden to regionalize personal health services are presented. In the first part, the methodology used to estimate future demand is described, and special mention is made of the consumption unit index, by which health planners estimate the effect of demographic development upon demand for personal health services. The resources required to meet this demand for each regional level are also defined, as well as the methods by which that functional distribution is reached. In the second part, the methods used to determine the size of a region as well as the geographic distribution of resources is presented. These methods, which take into account the national and local demographic and socioeconomic development, consider accessibility to the regional center as the determinant variable to decide among different place alternatives for these centers. According to a cost-efficiency approach, measuring efficiency in terms of accessibility, the chosen alternative is the one which minimizes aggregate traveling times and costs.

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

The spatial distribution of medical care facilities in the metropolitan community and methods of representing them are analyzed. Two aspects are treated: 1. graphic and analytical techniques for presentation and analysis of areally distributed data, and 2. implications of these distributions for medical care utilization and planning. A three-dimensional analogue model is introduced which provides accurate visual representation and allows limited statistical analysis. The multimodality of the spatial distributions of medical care facilities is demonstrated. Physician offices show the greatest tendency to cluster, primarily in response to location of hospitals; dental offices are second; and pharmacies are least clustered. Location of hospitals reflects historical inertia but has little relevance to their utilization by those who are physically closest to them.

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

In the last 20 years, the public health movement in America has experienced an increased involvement in personal health services (preventive and curative) that has gone beyond traditional and classic public health activities. Some of the factors that have accelerated this trend have been: effective control of communicable diseases, increasing costs of medical care services, increasing size and mobility of the population, changing age composition of the country, and changing morbidity and mortality patterns with an increasing importance for the chronic diseases. Both local public health agencies and hospitals are examining their roles in the provision of “better health care for all people.” Throughout the U.S., and especially in the rural counties of the country, local health departments and both public and voluntary hospitals, in particular, have not coordinated their resources to provide comprehensive or integrated health care. Comprehensive health planning legislation is bringing local public and voluntary health agencies together to develop a rational health delivery system. Centralization of local authority in providing health care services will be an adjunct of such legislation.

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

A pilot study was conducted to measure the effect of a short-term outpatient psychiatric therapy benefit on the utilization of general medical services at Group Health Association of Washington, D. C. (GHA), a prepaid group practice medical program. The study group consisted of 256 patients who were referred for such outpatient therapy and who were GHA members for a full 12-month period both before and after the psychiatric referral. Study patients experienced a marked reduction during the year after referral as compared with the prior year in the utilization of GHA nonpsychiatric physician services and laboratory or x-ray procedures. The reduction in number of patients seen was 13.6 per cent for nonpsychiatric physician services, and 15.7 per cent for laboratory or x-ray procedures. In terms of visits made, reduction was approximately 30 per cent for each of these services. Basic finding of reduced utilization was still obtained when factors of age, race, sex, psychiatric diagnosis, and number of therapy sessions attended under benefit were taken into account. Results support findings of reduced utilization in other studies and suggest more efficient utilization of appropriate medical services as a result of short-term outpatient mental health benefit in prepaid health plan settings.

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1970

数据来源: OVID