摘要:

Arcawide hospital planning is examined and its relevance to future health planning is discussed. The study is the result of visits to 30 hospital planning councils and interviews with 75 planners in 1967. Areawide hospital planning is described as a process–a process of human involvement and exchange; an incremental process dependent on limited data, negotiation and compromise, and institutional planning; a process in large part guided by the planners. The need for a community process approach to health planning is suggested. However, with increased regulatory responsibilities vested in areawide agencies, the prospects for such a process appear doubtful.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The accelerated development of Health Maintenance Organizations on a broad scale is being encouraged as a method of improving and rationalizing services in the American health care system. Prepaid group practice plans can also serve as an important resource for training future primary care physicians. They provide an organizational setting in which interns and residents can be trained in the care of ambulatory patients, senior physicians who can serve as role models during training years, and a mode of practice to which physicians in training might aspire. Information is presented here on the current use of the large PPGP's for training medical students and housestaff, and the reasons for the limited involvement of these Plans in educational activities. The initial modest efforts of one university sponsored PPGP (Harvard Community Health Plan) are presented as an indication of some of the approaches being explored. A number of obstacles must be overcome if these efforts are to be expanded and the full potential of PPGP's in the education of future physicians to be realized.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Prescriptions are examined for their influence on the acceptance of scheduled clinic visits by chronically ill outpatients. Diets and heavy medication appear to prolong clinic attendance. The impact of prescriptions continues in spite of select controls. Persisting care needs modify the relationship suggesting that premature terminations among those on less demanding treatments will be pronounced when patients experience incongtruence between perceived care needs and medical response. Control of select factors, closely associated with attendance (education, knowledge of illness, and patients experiences in communication with their physician) reveals the continued strength of the relationship between prescriptions and attendance.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Urban public hospitals for the poor (UPHP) throughout the nation have long faced difficulties in financing, staffing, and operations. These difficulties spring from many causes, among which historical, financial, and political factors have been widely recognized. Less appreciated is a fourth factors the “dumping” or rejection of patients considered “undesirable” by voluntary hospitals. A study of outpatient department services in 33 counties containing large UPHPs shows the latter to be providing 12.7 OPD visits per hospital admission, compared to 2.8 visits per admission for the voluntary hospitals. In all these counties, the UPHPs carry a very heavy OPD load (8 to 24 per admission), but the overall volume of OPD services in the county (per 1,000 population) depends mainly on the relative load carried by the voluntary hospitals. This phenomenon of heavier public agency responsibility resulting from the unloading of difficult cases by private agencies is only one instance of a generalized pattern in America, observable also in the field of nursing home care, workmen's compensation, disability insurance, social casework, and other sectors. Solutions require a more equitable distribution of social responsibilities between public and private agencies.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The New York State Health Department required the New York City Health Department to include chiropractic in its Medicaid program. Seventeen additional states have also passed legislation to incorporate chiropractic in Medicaid. This report is a descriptive analysis of administrative controls governing the pattern and utilization of chiropractic services in the New York City Medicaid program. These controls include prior authorization of chiropractic treatment plans, post-treatment evaluation through pre-audit of invoices, spot checking of patients, and visitations to offices of chiropractic providers. Court decisions are cited which upheld the City Health Department in its modification of State regulations for chiropractic. By December 1970, 33 per cent of New York City's chiropractors were participating in the program whose vendor expenditure totaled $1,082,712 for 1970. Statistical tables are presented from Medical Participation Schedules.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

By use of an interview questionnaire survey done in the home, the Comprehensive Children and Youth Program, I SPY, at the Beth Israel Medical Center, was able to find out something about patient identification with the program, medical care patterns utilized by the interviewed population, and health perceptions within this surveyed group. Some of the findings were as follows: 70 per cent of those interviewed identified the I SPY program as the source of medical care. Better than 90 per cent of those who identified with the I SPY program knew the doctor by name. Sixty-five per cent of those interviewed identified I SPY as the only source of health care. The remaining one third used other sources, including private physicians, other clinics, and neighborhood centers. Sixty-eight per cent of the sample used Beth Israel Hospital emergency room for medical care when the I SPY program was closed. Sixty-four per cent of those interviewed went to the doctor for regular visits. Eighty per cent of those interviewed knew their child's immunization status. The majority used and expressed a preference for the appointment system. However, the need to accommodate the unplanned for sudden illness was evident.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The change to a more distant location of the University of Rochester Student Health Service provided an opportunity for a quasi-experimental evaluation of the effects of distance on utilization. Previous research has used cross–sectional data and provides a hazardous basis for predicting the effects of changes in facility location on utilization. A significant reduction in clinic visits resulted that could not be accounted for by a trend over time. No appreciable changes occurred in utilization of the infirmary whose location remained unchanged. Utilization for respiratory complaints and immunizations seemed to be more affected by the move than were more specialized services. These findings tend to support those of previous cross-sectional studies and illustrate some dilemmas involved in planning the spatial organization of health services.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Five Buffalo, New York physicians provided carbon copies of their written pharmaceutical prescriptions to the investigators. The patients were contacted by telephone and asked to completely read the label of the prescribed medication and to describe the medication itself. It was found that nearly 10 per cent of the sampled (N=223) prescriptions were dispensed with some form of error. Recommendation is made to request patients to bring their currently used medications with them on physician office visits.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Three methods designed to reduce broken appointment rates among lower socioeconomic group patients were compared at a University Medical Clinic. Patients reminded of scheduled appointments by postcard had broken appointment rates of 13.7 per cent as compared to those telephoned by nurses (19.5%) or physicians (17.6%); all three groups had lower rates than a control group (24.6%). Although telephoning was effective when the patient was contacted, over 40 per cent of the patients could not be reached. It thus appears that postal notification is the most effective method, providing a simple way to substantially reduce broken appointment rates.

ISSN:0025-7079    

出版商:OVID    

年代:1973

数据来源: OVID