ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The last 10 years have seen increasing use of telephone surveys in public health research. This paper reviews issues of sampling, data quality, questionnaire development, sćheduling of interviewers, respondent burden, interviewer effects, and the use of the computer in telephone interviewing. Throughout, the authors focus on findings from recent research, with particular emphasis on those studies suggesting new advances or protocols for conducting telephone health surveys. The findings of this review suggest four conclusions. First, telephone interviews can be highly recommended for follow-up interviews in panel surveys that use an initial face-to-face interview. Second, telephone surveys can be recommended as a viable alternative to costly face-to-face surveys in cross-sectional studies of the general population. Third, when the focus of the survey is on subgroups of the population that have both low telephone coverage and higher rates of nonresponse (e.g., low income and low education respondents), telephone interviews should be used more cautiously. In these situations, a dual sampling frame approach (using a combination of face-to-face and telephone interviewing) may be considered. Finally, computer-assisted telephone interviewing (CATI) represents one of the most important and innovative technologic advances in health survey research in recent years. The advantages of CATI in improving survey management are noteworthy and ideally suited for moderate- to large-sample surveys. CATI also provides an attractive (and largely untapped) resource for testing and refining other methodologic protocols in survey research.

ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

To be of greatest use for the measurement of significant variations in treatment outcomes, a health status index should have ratio properties. Previous attempts to construct such a scale using the magnitude estimation technique have failed, principally because of an inappropriate choice for the zero point. By rejecting death as the logical zero point for a scale of social preference and choosing instead the absence of that being measured (dysfunction and discomfort), the authors attained reliable values from patients, for an illness index, using magnitude estimation. This type of scale allows comparative judgments between treatment methods to be made with greater validity. It should aid in the wise allocation of health care resources

ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The authors examined the issue of learning by doing in terms of both the cost and outcome of treating coronary artery disease at one hospital between 1977 and 1981. Over time, the quality of outcome improved for both medical and surgical patients. During this time of cost-plus reimbursement, there was less conclusive evidence of concurrent technical efficiency gains. These findings are consistent with the hypothesis that the benefits of experience can be substantial but they do not just happen: they require proper provider motivation.

ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This article explores the relative importance of maternal employment as a determinant of pediatric care utilization using data from a 6-month longitudinal study of pediatric clinic use. This study sample (N = 167) was taken from a population of users of a pediatric ambulatory care clinic of a large urban hospital. The clinic served an inner city with a predominantly low-income, working-class population. Independent variables come from personal interviews conducted with the mothers of the preschoolers and from a 4-week health diary. Data on episodic illness care use were obtained from the children's medical records. Results indicate that children of working mothers made fewer visits to the clinic than children of housewives. Somewhat different factors were associated with clinic use for children with employed mothers as compared with children with nonemployed mothers. Findings from multivariate analyses suggested that mother's employment influenced utilization through its relationship with social support and daily stress. Work outside of the home was associated with greater social support as well as greater daily stress. Both social support and stress predicted utilization. Implications of these findings for future research are discussed.

ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A growing number of researchers have demonstrated an inverse relation between the number of patients treated with specific diagnoses or procedures in a hospital and subsequent adverse outcomes. Such findings support the notion that policies should be explored to concentrate patients in selected hospitals to reduce preventable patient mortality or morbidity. The authors used data from 15 diagnoses and procedures demonstrating an inverse relation between volume and mortality to explore the different implications of regionalization policies across categories of patients. In some instances, concentrating patients in hospitals with high volumes of such patients could avert more than 60% of all deaths. For some procedures or diagnoses, however, such mortality savings are. either medically infeasible because of the emergency nature of the problem or logistically impossible because of the extent of regionalization implied.

ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The authors discuss the objectives and definition of the Severity of Illness Index, which has been developed and refined at The Johns Hopkins University over the past 5 years. In addition, the training program for raters, the method used to ascertain reliability, and data from reliability testing in 18 hospitals are described. After at least 2 months' experience with severity scoring, the average agreement between hospital raters and the staff reliability rater varied between 90.8% and 97.7%, with an overall weighted average agreement of 93.5%. Several methods to evaluate the validity of the Index are presented. The conclusion is that the Severity of Illness Index is a reliable and valid tool for measuring inpatient severity of illness.

ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A reduction in newborn (NB) mortality is contingent on efforts of NB stabilization. The authors attempted to quantify stabilization into a score, the neonatal stabilization score (NSS) that correlates with outcome. The population for the study comprised 192 transported NBs who weighed less than 1,000 g at birth moved from level 1 hospitals in New York City during 5 years, 1977-1981. The NSS score was based on five components: vital signs, laboratory investigations, respiratory support, I.V. fluid administration, and specific managements. Each was rated 0, 1, or 2. A maximum score of 10 indicated excellent stabilization. Analyses for the validity and reliability of the NSS included the Mantel-Haenszel test (which controlled for birth weight and Apgar) and measurement of interrater agreement "&OV0445;" (kappa statistic). Mortality rates were lower in those with higher NSS and odds of death were 2.39 times greater in NB with low NSS (X2= 5.16;P< 0.025). The calculated index of agreement &OV0445; on 16 charts represented an excellent agreement beyond chance (&OV0445; = 0.76,P< 0.01).

ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1986

数据来源: OVID