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Biomedical subjects

B Peters

Publications and source records attributed to B Peters.

119 records · Page 7Linked to original sources
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Born in the USA. The medicalization of social problems.

As the debate over health care reform intensified a few years ago, Americans questioned their delivery system and pointed to Canada, Great Britain, and other countries as potential models for reform. NHA conducted its own examination of these models and concluded: the United States, and Michigan in particular, will have difficulty improving the health status of its citizens and controlling health care expenditures unless we more effectively deal with a uniquely American phenomenon--the medicalization of social problems.

Adolescent↗
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Managed care has taken root.

Managed care has taken root in Michigan. While its growth in rural areas of the state may occur at a slower pace, managed care--and capitated reimbursement--will ultimately replace fee-for-service health care in the Upper Peninsula for the same reasons it is doing so in Detroit. Both private and public payers want to increase the predictability of their outlays for health care. They want to contain cost growth, and receive demonstrable value for their investment.

Capitation Fee↗
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The modern doctor.

How satisfied are physicians with the current health care environment? The "next wave" of health--particularly the steady growth of managed care--has ushered in new realities that in many cases has strained the traditional physician-hospital relationship, while at the same time created unprecedented opportunities for collaboration. For hospitals and other providers, it is critical to understand the sources of dissatisfaction--as well as the motivation--of physicians in their community.

Attitude of Health Personnel↗
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The wonderful world of Disney. A look at the future of health care?

What does the future hold for health care delivery? What will prove to be the most effective model for health services delivery in the next century? These are the questions that are foremost in the minds of health policy analysts across the country. While any discussion about the future of American health care typically centers around alternative payment methodologies or emerging physician-hospital integration models, one company believes it has a unique solution and is eager to share its vision for the future. That company is none other than Disney, and Celebration Health--with its grand opening on Nov. 23, 1997--is its latest venture.

Community Health Planning↗
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Anticipating wildcards.

Wildcards are simply events that have a low chance of materializing but have the potential to significantly change the operating environment. Every hospital has a well-established disaster plan that spells out the organization's response to an emergency condition that is unlikely to ever occur. Wildcard strategic planning is a logical extension of this concept, with the focus shifted to the organization's survival rather than medical care for individuals and communities.

Certificate of Need↗
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Driving performance and workload assessment of drivers with tetraplegia: an adaptation evaluation framework.

The purpose of this study was to establish a baseline for further research on adaptation evaluation for drivers with disabilities. Driving performance and workload for 26 drivers with spinal cord injuries (tetraplegia) was studied and compared to a matched group of able-bodied drivers in a driving simulator. Drivers with tetraplegia used two types of hand-operated controls for accelerating and braking. Able- bodied drivers drove with standard pedals. The drivers with tetraplegia performed the driving task equally as well as the control group but had a slightly longer reaction time (10%). Workload assessment revealed that drivers with tetraplegia experienced a significantly greater time pressure and spent more effort than did the able-bodied drivers. They were also more tired from braking and accelerating. The drivers with tetraplegia using separate levers had greater standard deviation in lateral lane position (7 cm), while those using a combined lever were more tired from braking and accelerating. Observed differences could be interpreted as indicators of insufficient adaptation.

Automobile Driving↗
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Improving access to health care.

It is a problem that has plagued the American health care system for years, and it is not getting any better. While the majority of our population enjoys ready access to the finest health care in the world, a steadily growing number are joining the ranks of the uninsured. Despite a strong economy throughout the last decade, the uninsured rate in Michigan is at a higher level today than it was in 1990, and more than one million residents currently have no health care insurance.

Community Participation↗
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A trial with a new peripheral implanted vascular access device.

In a prospective study, a new implanted vascular access device designed for peripheral placement in the arm was evaluated. Thirty-two patients requiring long-term venous access received the Port-A-Cath P.A.S. Port over a 13-month period. The access devices were used for multiple therapies including chemotherapy, antibiotics, antivirals, antifungals, and blood products. After 4,896 patient days (range 12-388), 19 complications occurred in 14 patients or 3.88/1,000 catheter days. The infection rate was 3% or 0.2/1,000 catheter days. Port pocket cellulitis was reported in 3% of patients or 0.2/1,000 catheter days. Vein phlebitis occurred at 12.5% or 0.8/1,000 catheter days. Two instances of vessel thrombosis occurred (6.2% or 0.4/1,000 catheter days). Ten incidents in six patients of inability to aspirate blood samples were noted (18.75% or 2/1,000 catheter days). No infiltrations or extravasations were reported. Nurses involved in this early trial found performance similar to the standard venous chest ports. Peripheral port placement was accepted well by patients.

Adult↗