摘要:

The validity of the Index of Medical Underservice (IMU) was evaluated by examining the ability of the IMU to discriminate among levels of need for health services reported by rural consumers in response to a mail survey questionnaire. It was hypothesized that if the IMU is a valid indicator of medical underservice, then where the IMU value for an area was relatively low, respondents would report relatively less access and availability of health services, less utilization of health services, a lower health status level, and less satisfaction with available health services. The IMU was not found to be an effective discriminator among levels of need for health services as reported by the survey respondents. Further, the dichotomous designation of areas as medically underserved or not medically underserved according to IMU values was found to display even less discriminatory ability. A comparison of areas at opposite extremes of the range of IMU values accounted for only a small proportion of the variance in six criterion measures. The findings raise serious questions about the utility of the IMU for determining funding priorities for health services programs. It is recommended that use and interpretation of the IMU be made with caution and supplemented by additional data as much as possible.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

This research analyzes the changes in individual physician surgical workload and accompanying changes in surgical rates in Manitoba, Canada between 1974 and 1978. Data covering essentially all operations on provincial residents age 25 years and older were analyzed using information from the health insurance data base. The most dramatic change was a 50% rise in outpatient surgery. An overall pattern of increased specialization seemed to be emerging; surgeons' surgical workloads were gradually growing while those of general practitioners were slowly declining. Changes in the frequency of several common surgical procedures were due much more to changes in workload of physicians remaining in the same hospital service area throughout the 1974–1978 period than to turnover (older physicians leaving practice and newer physicians coming in).

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Private insurance has been suggested as a way to relieve the growing pressure on Medicaid budgets brought about by the long-term care needs of the elderly. This paper provides premium estimates for prototype long-term care insurance policies. Alternative specifications of services covered, amount of benefits paid per day, waiting period before benefits begin, years of coverage, age at time of purchase, administrative expenses, risk selection, and tax treatments are examined. The estimates are useful in understanding the general order of magnitude of premiums for various types of policies and assumptions. They may also be useful in deriving initial rates for new types of policies or in setting initial rates for an insurer with no access to actual experience data.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Variables derived from the health locus of control construct and the Health Belief Model were used to predict compliance with medical regimen in chronically ill patients (adult-onset diabetics, hypertensives, and pulmonary disease patients). Stepwise multiple regression analyses were conducted with predictor variables: age, socioeconomic status, Internal Health Locus of Control (HLC), powerful others HLC, chance HLC, perceived severity of illness, outlook on illness, experienced symptoms, satisfaction with treatment, family support, and support of others. Dependent variables included three measures of compliance with medication regimen and two measures of compliance with self-management regimen. Patient satisfaction was a significant predictor of medication compliance, and lack of symptoms was most strongly associated with self-management compliance. Limitations of cognitive variables in predicting compliance in many chronic disease patients are discussed.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A new technique for identifying inefficient hospitals, Data Envelopment Analysis (DEA), is field tested by application to a group of teaching hospitals. DEA is found to provide meaningful insights into the location and nature of hospital inefficiencies as judged by the opinion of a panel of hospital experts. DEA provides insights about hospital efficiency not available from the widely used efficiency evaluation techniques of ratio analysis and econometric-regression analysis. DEA is, therefore, suggested as a means to help identify and measure hospital inefficiency as a basis for directing management efforts toward increasing efficiency and reducing health care costs.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To verify and elucidate the results of a previous study that documented four-fold variations in small area admission rates for diabetes mellitus in Washington state, the authors examined the hospital records of a sample of diabetes discharges from hospitals in high-, medium-, and low-rate counties. Hospitals in high-rate counties were generally smaller than those in medium- and low-rate counties and admitted a greater proportion of patients with mild illness. Also, physicians in hospitals in high-rate counties tended to be less vigorous in the diagnosis and treatment of diabetes. Variations in admission rates were not explained by coding errors or by differences in selected sociodemographic characteristics of admitted patients. The authors conclude that small area variations in hospitalization rates for diabetes were related to clinical differences in admission criteria and may also reflect differences in the medical management of hospitalized patients.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

This article examines the relationship between selected self-care practices during an episode of illness and the use of formal medical care. Stimulated by conflicting evidence and assertions, the general question addressed is: “Is self-care a substitute, a supplement, or a stimulus for use of formal medical care services?” Multiple Classification Analysis was used in a secondary data analysis of a 1976 nationwide study on access to medical care. The results suggest that self-care users may visit the physician less often and stay fewer days in the hospital, and thus they are expected to have lower expenditures for hospital and physician services. Therefore, the self-care activities examined appear to besubstitutesfor, rather than supplements or stimuli to, health services utilization. The results must be viewed with some caution due to limitations in the data. However, the results also argue for a greater research emphasis on self-care.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID