摘要:

All societies, primitive and advanced, demand therapeutic services, but a society must develop sophisticated prerequisites before it can support preventive services. This discordance in the origins of curative medicine and of public health does not explain why a schism between them still persists. This gap should be closed since medicine has cured most curable diseases and the residue of chronic conditions is best handled by preventing them or detecting them before they become medical crises. Reasons for persistence of the schism include: early concentration of public health on environmental sanitation to the exclusion of medicine; identification of public health with governmental bureaucracy; linking care of the poor with tight-fisted welfarism; existence of two separate educational systems; the view of doctors, who are activists by nature, toward the excitement of cure; the custom of paying only for active therapy; and the orientation of the Hippocratic ethic toward individuals.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

This paper examines the patient's decision to select a source of care, offers a theoretical construct of this choice process, and reports on the results of a survey that tested the model among the population of Rochester, New York. Respondent reasons for selecting a source of ambulatory care are collapsed into categories that relate to individual perceptions of the utility of cost, time, convenience, sociopsychological factors, and the technical quality of care. The relative importance of these criteria and other findings relating to sociodemographic characteristics and individual patterns of utilization are reported. The data are derived from a survey (N = 521) of households representative of the area of Rochester, New York.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

This survey is a partial replication study of a community with the fictitious name of Regionville which was first studied by E. L. Koos in the period 1946-50. In the present paper, we are concerned principally with that part having to do with the changing health care beliefs in this community. The indications are that: 1) there has been considerable liberalization of opinion, particularly among upper class respondents, in terms of issues relating to national health insurance and the role of ancillary medical personnel such as social workers; and 2) social classes are much more similar in their perceptions of many medical care issues now than they were a generation ago. Finally, we suggest that the changing pattern of responses to the questions asked in the late 1940s and again in 1973 is reflective of profound changes in American life.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Two meanings of the term comprehensive care are delineated. The first refers to a wide scope of health services, the second to a humanistic approach to the patient. Findings from a sample of patients from one pediatric practice suggest that the two meanings constitute two independent variables with respect to patient expectations.Patient responses to questions regarding their expectations of the pediatrician revealed a tendency to hold a traditional disease orientation. Comprehensive care as a broad scope of health services that included mother guidance in child rearing is not a common goal for mothers utilizing the pediatric practice under study. On the other hand, a comprehensive approach by the pediatrician is a standard shared by most respondents in the sample: high priority is accorded the pattern of the personal physician with whom a patient forms a continuous doctor-patient relationship which instills in the patient trust that the physician's recommendations are based on thorough knowledge of the patient as an individual.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

In spite of the fact that emergency admission is the most common form of hospitalization for young children, as well as containing the greatest potential for trauma, almost no reference has been made to it in the psychological literature on pediatric hospitalization. To explore the theoretical and practical feasibility of research in this area, a pilot study was designed to investigate the reactions of a sample of children, parents, and staff to the first six hours of emergency hospitalization, compared with those of a similar sample to elective admission. Sixteen children (eight in each group) aged 11 to 48 months were selected on a time-sample basis from the patient population of a large, metropolitan, pediatric hospital and were followed by trained observors using a specially designed observation schedule. The results indicated that, as expected, emergency does constitute an even greater stress for children, parents, and staff than the already stressful situation of elective admission. In both conditions, however, the results were more complex and more disturbing than anticipated. The implications of these findings, as well as suggestions for further research, are discussed.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

In January 1972, California initiated a cost-sharing “experiment” as a means of containing rising costs of the Medicaid program. Beneficiaries who had some personal assets were required to pay a token amount for each doctor visit or prescription. This was expected to deter unnecessary services without affecting really needed care. An interview survey was made of beneficiaries continuously in copayment status throughout the 18 months of the experiment Most beneficiaries had poor knowledge of the program, and tended to confuse copayment with the concurrent constraint of prior authorization for certain classes of service. The beneficiaries reported that the copayment was almost always collected, and most thought it had not affected their health care, but a significant 17 per cent thought it had reduced the care available to them, and these 17 per cent were for the most part in households with high medical need.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Four separate human services programs and their West Philadelphia service consumers were studied by the 1971 Health Network Project: a hospital receiving ward, a community mental health satellite center, a public assistance district office, and a public child welfare agency. The basic hypotheses were that 1) the four consumer groups present common health, economic, and social problems, and 2) each agency confines its services to its own specialized range of problems and provides minimal linkages to other service facilities, including those available within its own subdivisions. Data were obtained by interview and record review from over 600 patients and clients. Each agency was found to respond to presenting problems with specific interventions. However, failure to detect, treat, or refer concurrent problems was pronounced. Despite the great prevalence of physical and mental illness, compounded by economic marginality, each agency made minimal use of internal support services and external referrals. The human services nonsystem is discussed conceptually in light of specialization and fragmentation. Proposals for shifting the nonsystem toward a responsive service network include the introduction of comprehensive screening devices and of service generalists for case management.

ISSN:0025-7079    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Some of the problems facing evaluators of medical care have been dealt with by individuals examining mental health programs. Mental health research has focused more on outcome studies that include a multidimensional approach to evaluation. Techniques have been devised in that field that make the evaluative process patient specific and goal oriented. Borrowing some of these methods to make medical care evaluation include a problem-oriented outcome, which incorporates patient satisfaction, compliance with medical therapy, and relief of symptoms, could lead to more accurate data on the health delivery system.

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