摘要:

The specific objectives of this study were to analyze the structure and bases of power within a local medical community and to determine the extent to which power is unitary or differentiated. The study was based upon responses to a questionnaire given to the total population of physicians in private practice in Windsor, Ontario, Canada. The response rate for the defined universe was 91 per cent or 326 physicians. A definite order of influence characterized by certain dominants with varying degrees of power emerged from the analysis. It was determined that the basis of influence within the medical community was the control of major medical community resources. Influence did not seem related to social status or ideology.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

The physician's important decision-making role in the allocation of medical resources is well recognized. An important part of this role is one physician's decision to refer a patient to another physician for care. Existing research, largely descriptive in nature, has been limited by lack of a clear theoretical and conceptual framework for analysis. The current paper develops and tests a model of physician referral behavior based on exchange theory. Differences in rates of referral among physicians are viewed as a function of the different rewards and costs perceived by physicians occupying different levels of status within a given medical community. The model is tested using data collected from 127 internists in private practice in the northern suburbs of Chicago. Findings are discussed in terms of policy issues and suggestions for further research are indicated.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Two elements which are of primary importance to the consumer or to the health care practitioner are the quality and price of medical care delivered. The purpose of this study was to attempt to relate the two for one part of medical care—community pharmacy practice. The two are obviously related, if not in fact, then at least in traditional wisdom. Stated in a layman's way, the purpose of this study was to determine if, indeed, you get what you pay for in community pharmacy services. This was accomplished through the formulation of various hypotheses concerning the relationships between the cost and quality of pharmacy services. Null hypotheses were tested with regard to these relationships. Price and quality data for this study were collected by two “shoppers” in 50 community pharmacies.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

The registered nurse is a logical health professional to be trained quickly and easily to assist the physician in adult health evaluation. A formal six-month course has prepared nurses to perform adult health appraisals under physician supervision in a large automated health appraisal unit. Their success in discharging this responsibility over an 18-month period suggests that nurse practitioners so trained can be important in health appraisal and other extended adult health care roles.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

This study evaluated the effects of drug dosage form, therapeutic class, and available pharmaceutical service on the gross margins of prescriptions. Actual prescription ingredient costs reflecting both wholesale discounts and warehouse costs were computed for each of 300 prescriptions from 29 pharmacies. These ingredient costs together with prescription prices were used to calculate the gross margins for the sample of prescriptions. The markups for the five dosage form categories and two therapeutic classes were analyzed by using analysis of variance and covariance techniques. Regression methods were used to study the effects of delivery, patient record cards, and account receivable services on average prescription gross margins per pharmacy. The results of the statistical tests revealed that when prescription ingredient cost is controlled therapeutic class does not effect prescription gross margins while drug dosage form does. Only delivery service, of the three services regressed, was found to be significantly related to prescription gross margins.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

The presentation is based upon two assumptions. First, three areas of study, epidemiology, medical care, and drug services possess a mutuality of interest with the potential for complementary productive research efforts. Second, differential approaches to organizing and providing drug services can influence effectiveness of medical care and patient outcomes.The intersection of the former, defined as an area of inquiry, provides a framework for the resulting analysis. Criteria for the analysis of drug services within the interceded space are provided by adapting Beverlee Myers' model of “good” medical care. These criteria, when defined in terms of patient, provider, and system standards and subsequently related to drug services, provide a format for the application of process and outcome measures. A select review of the literature illustrates the current state of drug services adequacy utilizing process and outcome measurements.The results indicate limited research directed to evaluating drug services using such measurements. Research results and indicator data reveal that contemporary drug services are less than adequate when appraised with medical care criteria. The results further show that analysis of contrasting approaches to drug services are limited to a few examples of comparative types of indicator data. Finally, the limited information available and the research needs suggest the conceptual area initially defined offers a unique opportunity for diverse research interests involving the three areas of study.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Major legal issues in the establishment of future systems of computerized health information are discussed, and considerations are offered for the protection of individual privacy. For the needs of individual health care, information must be identified by name and retrievable on demand. For health planning purposes, a) aggregate information must be obtainable without identification of individuals, and b) a unique identification system must be developed to link individual records in order to reveal disease patterns and outcomes. These are some of the fundamental requirements of a national centralized health information system.While such a system is being established, a network of community health information systems can serve by providing data for the continuity of care of the individual, and a laboratory for designing and testing the safeguards that will protect his privacy. This development of effective administrative and computer system guidelines is recommended, rather than the introduction of new laws at the present time. Guidelines developed for community systems will ultimately serve to enhance the purpose, structure, and safeguards of a national information system.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Planners for economic growth in developing countries tend to invest resources primarily for the purpose of increasing the GNP with little attention to health. In the last two decades, Taiwan has rocketed into the coveted state of a booming economy, thus providing an interesting model to be evaluated from the standpoint of health. Undoubtedly, some level of economic development is an essential element and a necessary prerequisite for the general improvement of health standards, but it does not in itself guarantee such improvement. In Taiwan there is a radio for each family and a TV set for every four families, but the quality of life regarding health leaves much to be desired. The country has only one practicing physician for each 3,067 in the population, despite the fact that Taiwan has been producing well-trained doctors at a rate similar to or even better than that of Japan or the U.S. Other health care resources (such as hospital beds) and the current health status in Taiwan are distinctly disproportionate to the economic progress she has achieved. However, this condition is by no means unique to Taiwan. Worse situations can easily be found in many other developing countries. The economic implications of the health status of a nation apparently have not been well proved to the development planners—a crucial challenge to health workers in the developing countries.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID