摘要:

The 12 acute care public hospitals in New York City (HHC hospitals) are compared with a matched group of nonpublic hospitals (non-HHC hospitals). The following questions are considered: using DRGs to define case mix, how does the case mix of HHC and non-HHC hospitals differ; to what extent do differences in case mix account for differences in average length of stay (ALOS); can factors other than case mix be identified that may explain differences in ALOS? Although about one half of the 20 most prevalent DRGs are similar in both types of institutions, there are clear case mix differences. The higher percentage of abortion, psychiatric, and chemical dependence discharges and the lower prevalence of surgery in HHC hospitals contribute to this difference. The case load is more concentrated in fewer DRGs in HHC hospitals. HHC hospitals treat more patients in DRGs with a shorter ALOS, but, on the average, patients in the same DRG stay more than 1 day longer in HHC facilities. To some extent, this longer LOS can be explained by differences in payor type, primary diagnosis within a DRG, and, most important, in the percentage of outlier patients.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The issue of whether physicians should advertise their services has been the subject of much debate among health policymakers. This study reports data from a survey of rural residents in Illinois regarding attitudes toward physician advertising and reasons for opposition or support of the practice. The results indicate neither strong opposition nor strong support for physician advertising. While those who are opposed are largely nonspecific regarding their reasons, those in favor primarily expect that it will aid in the selection of a physician. However, few respondents indicate a predisposition to shop for a physician. Although the major concern about physician advertising is a danger of false advertising by some physicians, it appears that the respondents are not trusting of advertising in general rather than of advertising by physicians in particular. These findings suggest that regardless of its potential advantages, physician advertising may be relatively ineffective because consumers may be inattentive, unresponsive, or distrusting.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Hospitalization and use of outpatient health care services during a 1-year period by 369 pediatric patients with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps and 456 randomly selected children without congenital conditions from the Cleveland area were examined. Use of hospitalization and outpatient services by the average chronically ill or disabled child was 10 times that of the average comparison child. Physician specialists, occupational and physical therapists, and school nurses were the major outpatient categories used disproportionately by children with chronic illnesses or disabilities. The major share of health care used by children with chronic conditions was attributable to a small subset of children; All hospital care was accounted for by one third of the children, and three quarters of all outpatient care was accounted for by one quarter of that sample. Hospital care was used at similar rates by the four diagnostic groups. However, amount and type of outpatient care varied by diagnosis, level of functional impairment, race, and income. Estimated average expenditure for health services used by the chronically ill or disabled sample was 10 times that of the comparison sample. Relative distribution of estimated expenditures across types of services differed for the two samples as well as among diagnostic categories.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

This study examines Medicare utilization in the last year of life by over 10,000 beneficiaries who died in the state of Colorado in 1978. Overall, Medicare use averaged over $6,000 in 1978, compared with use by a random sample of survivors of less than $1,000. Eighty-nine percent of the charges during the last year of life were for services received in a hospital. Average charges vary by entitlement status, with the aged using, on the average, $5,955, the disabled $7,771, and end-stage renal disease (ESRD) beneficiaries an average of $44,400 in their last year. These charges are more than six times greater than yearly charges for aged and disabled survivors and more than three times greater than the yearly charges for ESRD survivors. The distribution of data for the groups who died is highly skewed, but not as skewed as that for the survivors. The top 1% of the survivors consumed 21% of the total charges, compared with less than 9% total charges consumed by the top 1% of those who died. When the data are examined by date of service divided into quarterly periods in the last year, more than 60% of the expenditures are in the last quarter just before death, with more hospital days and more intensive hospital ancillary service use during this period.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A national survey was conducted to examine the extent of adoption and use of nuclear imaging procedures in cardiology in hospitals by 1979 and to develop estimates for 1983. The data are based on the responses of 171 hospitals from a representative 200-hospital sample stratified for region, bed-size, and teaching status. Extrapolating the data, it is estimated that 2,106 hospitals nationally use cardiac nuclear imaging. In 1979, hospitals with at least 200 beds performed an estimated 396,000 cardiac nuclear imaging studies at a cost of $93 million. By 1983, it is estimated that 4,061 hospitals had the capability to perform cardiac nuclear imaging and that national expenditures would exceed $200 million (noninflated dollars). Although cardiac nuclear imaging procedures have been demonstrated to be valuable in detecting coronary artery disease or measuring ventricular function, these procedures were rapidly being adopted by the medical community at a time when only limited information about their effectiveness and efficiency are available.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Knowledge of the determinants of adult health offers important implications for planning policy that may affect the overall level of health and thus the costs of health care. One potentially important factor that has not been incorporated in previous research is the amount of information individuals have concerning health care or methods of preventive care. This study uses the number of social support networks and the degree of contact individuals have with them as an alternative measure of information. This measure of information is incorporated into an economic model based partly on Becker's Human Capital framework. Social support networks are found to have virtually no impact in explaining health outcomes for illnesses over which the individual has little control. However, when a broader range of illnesses is considered, social support networks do play a role in producing better health.

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Attitudes of physicians toward counseling patients about their smoking habits may influence whether and how counseling occurs. In this paper, the authors develop and test a conceptual model of these attitudes. The model includes four attitude dimensions: physicians' motivations to counsel, perceived health risk of smoking, perceived skills in counseling, and perceived costs and benefits to the physician of counseling. A self-report questionnaire including a 40-item measure of these attitudes was delivered to a random sample of male general practitioners, internists, surgeons, and obstetrician—gynecologists who were members of a western county medical society in 1978. The response rate was 76%. Based on factor analyses, 10 subscales and 3 global scales were formed by summing items. The item contents of scales are consistent with the authors' model, and reliability and item-discriminant validity are excellent. The authors' model may be useful in understanding the factors that affect the process and outcomes of physician counseling about smoking.

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

ISSN:0025-7079    

出版商:OVID    

年代:1984

数据来源: OVID