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CULTURALLY ACCEPTABLE HEALTH-CARE SERVICES FOR SAUDIS ELDERLY POPULATION - THE DECISION-MAKERS PERCEPTION

INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT 1995年第2期10卷 129-138页

作者： ALSHAMMARI, SA FELEMBAN, FM JARALLAH, JS ALI, ES ALBILALI, SA HAMAD, JM KING SAUD UNIV COLL MED DEPT FAMILY & COMMUNITY MED RESIDENCY PROGRAM PRIMARY HLTH CARE RIYADH SAUDI ARABIA

This article reports on a study carried out in 1993 to elicit the opinions of decision makers (medical and non-medical) as to the types of facilities, locations and culturally acceptable levels of health care appropriate for the elderly in Saudi Arabia. In addition, the study sought to find out the procedures and likely constraints in the development of future health care services for the elderly. An opinion survey was carried out on a randomly selected sample of decision makers, drawn from: hospitals of 100-bed capacity or more;and, from directorates of education, agriculture, police, municipalities, commerce, transport and media, in each of the regions of Saudi Arabia. A predesigned Arabic questionnaire was completed by the respondents during February-April, 1993. Of the 244 respondents, the most important categories of elderly to be cared for were considered to be those with handicaps, the chronically ill, and those without family support. The non-medical decision makers gave higher scores to these alternatives than did the medical decision makers (P < 0.05). Use of the family home for elderly health care was rated as the most appropriate, followed by medical rehabilitation centres, and only then by hospitals. Non-medical respondents gave more emphasis on rehabilitation centres (P < 0.02). Medical respondents thought that primary care doctors (87.2%), physiotherapists (87.2%) and general nurses (78.2%) can adequately fulfil the needs of most elderly patients. In contrast, non-medical respondents demanded the presence of specialist doctors (72.3%), specialist nurses (78.9%), laboratory and X-ray facilities to run such services (P<0.05). Medical decision makers were also more concerned than the non-medical respondents that the availability of such medical facilities might encourage some people to neglect their elderly parents (P<0.04). Equally, medical respondents were seemingly more aware of the high cost of hospital beds than their non-medical counterparts (P<0.0

关键词：医务工作者的态度文化评价研究卫生服务需求/统计学和数值数据卫生服务研究老年人保健服务/统计学和数值数据家庭医疗保健服务问卷调查沙特阿拉伯老年人人类

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Health care services and pricing

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Journal of Hospital Marketing 1990年第1期4卷 47-54页

作者： Kingsley, Bernard R. Marketing Department Durham NC 27704 3643 N. Roxboro St. United States

In a recent survey it was found that the use of optimum pricing would yield not only greater income for the health care provider, but also lower prices for consumers, resulting in greater participation on part of consumers. Consumer demand, however, could sometimes also pose some ethical problems for the health care provider. © 1990 Taylor & Francis Group, LLC.

关键词：年龄因素胆固醇/血液伦理学医学卫生服务/经济学卫生服务需求/统计学和数值数据卫生服务研究/统计学和数值数据收入乳房X线摄影术/经济学普查/经济学模型统计学支付标准制定和审核/方法性别因素美国成年人女(雌)性人类男(雄)性

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Stress and Coping Among Missouri Rural and Urban Children

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The Journal of Rural Health 1993年第2期9卷 149-156页

作者： Krantz, Steven School of Nursing University of Missouri—Kansas City Kansas City Missouri 64108‐2676 2220 Holmes St. United States

Abstract: A cross‐sectional survey using a convenience sample of 157 Missouri rural and urban children (ages 8–13 years) yielded no significant differences in perceptions of stressors or use of coping strategies for dealing with those stressors between rural and urban children. The Feel Bad Scale and the Schoolagers' Coping Strategies Inventory measured the children's perceptions of stressors and use of coping strategies. Rural children experienced stressor levels equivalent to urban children, yet they were underserved in mental and physical health needs. The children studied reported self‐care through coping strategies for management of their stressors. Longitudinal research is needed to identify the impact of stress and interventions on the health and behavior of children in rural settings. Copyright © 1993, Wiley Blackwell. All rights reserved

关键词：适应心理学青少年健康态度儿童横断面研究女(雌)性卫生服务需求/统计学和数值数据人类婴儿新生男(雄)性缺医地区精神卫生服务密苏里/流行病学知觉精神病状态评定量表农村卫生/统计学和数值数据院校应激心理学/流行病学城市卫生/统计学和数值数据

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Growth and decline in the supply of providers of medicare-covered home health services in the 80's: National and regional experience

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Home Health Care Services Quarterly 1994年第1期15卷 3-17页

作者： Scalzi, Cynthia C. Zinn, Jacqueline S. Guilfoyle, Michael J. Perdue, Sondra T. School of Nursing and Wharton School University of Pennsylvania Philadelphia United States Department of Health Administration Temple University Philadelphia United States University Data Center University of Pennsylvania Philadelphia United States Statistical Scientist United States

Using Health Care Financing Administration (HCFA) data, this study documents national and regional patterns of market entry and exit in the home health industry from 1980 to 1990. Nationally, agency origination rates accelerated during the early 1980's, then dropped abruptly in the second half of the decade. The for-profit sector exhibited the greatest volatility. Of the 3,620 proprietary agencies in existence during the decade, 3,284 (90.7%) were new entrants, and 1,551 exited the market by 1990. Regional differences in growth rates and the timing of market entry are also evident. Both growth and decline in the home health industry appear. © 1994 Taylor & Francis Group, LLC.

关键词：数据收集地理学卫生设施私立/发展趋势卫生服务需求/统计学和数值数据卫生服务需求/发展趋势家庭医疗保健服务/统计学和数值数据家庭医疗保健服务/发展趋势 Medicare/统计学和数值数据 Medicare/发展趋势所有权/统计学和数值数据美国

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SUPPLIER INDUCEMENT - ITS EFFECT ON DENTAL SERVICES IN NORWAY

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JOURNAL OF HEALTH ECONOMICS 1990年第4期9卷 483-491页

作者： GRYTTEN, J HOLST, D LAAKE, P UNIV OSLO MED STAT SECTN-0316 OSLO 3NORWAY

In many western countries, supply of dental services exceeds demand, mainly because of the marked reduction in the prevalence of dental diseases during the last 10–15 years. An important issue is whether dentists can counteract this fall in demand by stimulating increased demand and/or utilization for their services. Some evidence that this may be the case was found in the present study, in Norway. The results indicate that demand and utilization for dental services are influenced by supplier inducement.

关键词：聚类分析数据收集经济学牙科/统计学和数值数据评价研究(主题) 卫生服务需求/统计学和数值数据挪威诊疗工作管理牙科/经济学

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Geographic Barriers to Child Health Services in Rural Northern New England: 1980 to 1989

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The Journal of Rural Health 1992年第2期8卷 106-112页

作者： Goodman, David C. Barff, Richard A. Fisher, Elliott S. Department of Maternal and Child Health Dartmouth Medical School in Hanover New Hampshire United States Geography Department Dartmouth College Hanover New Hampshire United States

Despite substantial recent increases in the number of rural physicians, it is unknown whether rural children still face significant barriers to medical care. To address this question, we determined travel times in 1980 and in 1989 to child health services for the rural pediatric population of northern New England–the area with the highest per‐capita primary care physician supply of any non‐metropolitan region in the United States. The study population in 1989 included 363,443 children living in 936 nonmetropolitan towns. The study revealed important spatial relationships in health service supply and demand not identified using other methods of assessing physician availability. Although travel times to physicians decreased slightly during the decade, we found that 15.5 percent of the children in our population were more than 30 minutes from pediatricians in 1989, and travel time to emergency rooms was more than 30 minutes for 9.9 percent of the children. In contrast, only 1.8 percent of children faced excessive travel times to family/general practitioners. While towns with pediatricians were likely to also have a family physician or an emergency room, the majority of towns with family physicians had neither a pediatrician nor an emergency room. Towns with poor geographic access to pediatricians and emergency rooms had low population densities and were distant from metropolitan areas. The analysis indicates that even in rural areas of high physician supply, access to pediatricians and emergency rooms for many children remains limited, and family physicians are the dominant medical providers for children. Future work using travel time variables will clarify the relative importance of travel to medical care as a factor in rural health outcomes. Copyright © 1992, Wiley Blackwell. All rights reserved

关键词：儿童保健服务/人力儿童保健服务/供应和分配数据收集地理学卫生服务易得程度/统计学和数值数据卫生服务需求/统计学和数值数据新英格兰医师家庭/供应和分配医师家庭/利用农村卫生/统计学和数值数据时间因素运输青少年儿童儿童学龄前人类

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THE VALIDATION OF INTERVIEWS FOR ESTIMATING MORBIDITY

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HEALTH POLICY AND PLANNING 1992年第1期7卷 30-39页

作者： KALTER, H WHO RES & TRAINING TROP DIS SPECIAL PROGRAMMECH-1211 GENEVA 27SWITZERLAND CARNEY HOSP COMMUNITY ORIENTED PRIMARY CARE PROGRAMBOSTONMA

Health interview surveys have been widely used to measure morbidity in developing countries, particularly for infectious diseases. Structured questionnaires using algorithms which derive sign/symptom-based diagnoses seem to be the most reliable but there have been few studies to validate them. The purpose of validation is to evaluate the sensitivity and specificity of brief algorithms (combinations of signs/symptoms) which can then be used for the rapid assessment of community health problems. Validation requires a comparison with an external standard such as physician or serological diagnoses. There are several potential pitfalls in assessing validity, such as selection bias, differences in populations and the pattern of diseases in study populations compared to the community. Validation studies conducted in the community may overcome bias caused by case selection. Health centre derived estimates can be adjusted and applied to the community with caution. Further study is needed to validate algorithms for important diseases in different cultural settings. Community-based studies need to be conducted, and the utility of derived algorithms for tracking disease frequency explored further.

关键词：算法贝叶斯定理传染病/流行病学数据收集/标准发展中国家诊断卫生服务需求/统计学和数值数据健康调查年患病率可重复性结果选择偏倚人类

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An epidemiologic approach to assessing primary care needs in rural Illinois

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JOURNAL OF RURAL HEALTH 1996年第2期12卷 110-119页

作者： Leitner, DW Gast, JA Sarvela, PD Ring, MC Newell, LA SO ILLINOIS UNIV CTR RURAL HLTH & SOCIAL SERV DEVCARBONDALEIL 62901 USA

One persistent problem that faces state and federal health policy-makers is determining the level of primary care needs of the citizens they serve. To refine the decision-making process in Illinois, a model was developed to compare the 84 rural countries of Illinois and their potential need for additional primary care interventions. Using experi panel methods, a group of public health professionals selected a set of 31 health status indicators that were available at the country level throughout the state. Next, the panel developed a weighting system for those indicators. These weighted values were then applied to the demographic and epidemiologic data from each of the counties to rank the counties on the basis of need. Indicators having the highest correlation with the weighted sum were the percent of the population enrolled in Medicaid, lung cancer mortality rate, general population mortality rate, proportion of population at poverty level, and percent of births to teens. Data also showed that the rural countries with the greatest needs clustered in five geographic regions. The identification of these five geographic clusters may facilitate collaborative efforts in meeting the primary care needs of these populations.

关键词：流行病学方法卫生服务需求/统计学和数值数据卫生服务研究/方法健康状况指标伊利诺伊/流行病学政策制订初级卫生保健/利用政府政策乡村卫生服务/供应和分配乡村卫生服务/利用农村人口/统计学和数值数据

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WELFARE GAINS FROM USER CHARGES FOR GOVERNMENT HEALTH-SERVICES

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HEALTH POLICY AND PLANNING 1992年第2期7卷 177-180页

作者： GRIFFIN, CC UNIV OREGON DEPT ECONEUGENEOR 97403 USA

The World Bank's Financing health services in developing countries emphasizes demand-side issues - highlighting user fees, insurance, and the private sector as tools for strengthening the health sector. That approach is a major departure from the focus on the supply side - public sector spending, costs, management, and efficiency - that has dominated the international health finance agenda for many years. An important set of empirical papers by Paul Gertler and his co-authors coincided with the release of the policy paper. Gertler's work has questioned a policy of greater dependence on user fees by emphasizing the potential welfare costs to consumers of higher fees for medical services. Many health professionals have adopted the jargon of this new approach without understanding the underlying analysis. This article attempts to demystify the debate that has ensued by illustrating economists' idiosyncratic approach to welfare, explaining how the policy paper and Gertler differ, and suggesting alternative approaches to testing the feasibility of the policy paper's prescriptions.

关键词：费用医疗筹资政府/经济学卫生服务需求/经济学卫生服务需求/统计学和数值数据模型经济计量学规划技术支付标准制定和审核社会福利/经济学社会福利/发展趋势美国

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Use of readily available data for identifying local health care needs and resources

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Journal of Health and Social Policy 1993年第1期5卷 9-22页

作者： Roberts, F.B. Shima, S. Dockery, B. Hayes, M.H. Stevens, R. Planning Development and Education Tennessee Department of Health Nashville TN 37217 800 Ben Allen Road United States

No abstract available for this article.

关键词：数据收集/方法卫生工作重点卫生服务需求/统计学和数值数据规划技术规划制订/方法公共卫生管理/经济学公共卫生管理/发展趋势地区卫生计划/组织和管理农村卫生田纳西

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