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Biomedical subjects

C Caplan

Publications and source records attributed to C Caplan.

18 recordsLinked to original sources
PubMed1999

Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries.

OBJECTIVE: To estimate out-of-pocket health care spending by lower-income Medicare beneficiaries, and to examine spending variations between those who receive Medicaid assistance and those who do not receive such aid. DATA SOURCES AND COLLECTION: 1993 Medicare Current Beneficiary Survey (MCBS) Cost and Use files, supplemented with data from the Bureau of the Census (Current Population Survey); the Congressional Budget Office; the Health Care Financing Administration, Office of the Actuary (National Health Accounts); and the Social Security Administration. STUDY DESIGN: We analyzed out-of-pocket spending through a Medicare Benefits Simulation model, which projects out-of-pocket health care spending from the 1993 MCBS to 1997. Out-of-pocket health care spending is defined to include Medicare deductibles and coinsurance; premiums for private insurance, Medicare Part B, and Medicare HMOs; payments for non-covered goods and services; and balance billing by physicians. It excludes the costs of home care and nursing facility services, as well as indirect tax payments toward health care financing. PRINCIPAL FINDINGS: Almost 60 percent of beneficiaries with incomes below the poverty level did not receive Medicaid assistance in 1997. We estimate that these beneficiaries spent, on average, about half their income out-of-pocket for health care, whether they were enrolled in a Medicare HMO or in the traditional fee-for-service program. The 75 percent of beneficiaries with incomes between 100 and 125 percent of the poverty level who were not enrolled in Medicaid spent an estimated 30 percent of their income out-of-pocket on health care if they were in the traditional program and about 23 percent of their income if they were enrolled in a Medicare HMO. Average out-of-pocket spending among fee-for-service beneficiaries varied depending on whether beneficiaries had Medigap policies, employer-provided supplemental insurance, or no supplemental coverage. Those without supplemental coverage spent more on health care goods and services, but spent less than the other groups on prescription drugs and dental care-services not covered by Medicare. CONCLUSIONS: While Medicaid provides substantial protection for some lower-income Medicare beneficiaries, out-of-pocket health care spending continues to be a substantial burden for most of this population. Medicare reform discussions that focus on shifting more costs to beneficiaries should take into account the dramatic costs of health care already faced by this vulnerable population.

Aged↗
PubMed1994

Statin--a novel marker of nonproliferation. Expression in nonneoplastic lymphoid tissues and follicular lymphomas.

Statin is a 57 kDa nuclear protein exclusively found in noncycling cells. Its expression in hematolymphoid cells had not been examined previously. The authors studied statin immunoreactivity in nonneoplastic lymphoid tissues from 26 lymph nodes, 3 tonsils, and 2 spleens. Statin was detected primarily in small lymphoid cells and histiocytes, along with such accessory elements as fibroblasts and endothelial cells. The distribution of positive cells showed an inverse correlation with the proliferative activity of the various lymphoid compartments. Statin labeling was also quantified in 15 follicular lymphomas and compared with that in hyperplastic follicles. Although reactivity in benign germinal centers was less than that in neoplastic follicles, this difference did not prove statistically significant. Statin provides an alternative to proliferation-associated parameters, such as Ki-67 and proliferating cell nuclear antigen, in the analysis of hematolymphoid processes and may be helpful in the dissection of their kinetic heterogeneity.

Cell Cycle Proteins↗
PubMed1978

Cholesterol in preteen children of parents with premature coronary disease.

A pediatric population at high risk for the development of coronary artery disease has been identified. Using a simple and inexpensive protocol, serum cholesterol determinations were performed on 50 children 12 years old and younger. These children were taken from 28 families in which one parent had suffered a myocardial infarction before the age of 50. Eight of the 50 children were found to have significant elevation of serum cholesterol. This was an incidence of 16%--twice that of the general pediatric population. Subjects with both adverse genetic and metabolic backgrounds need to be identified in this simple way. Preventive and therapeutic measures in such children may alter in the future the serious morbidity and mortality of coronary artery disease.

Age Factors↗
PubMed1975

Emergency room use by patients from a family practice. Patterns of illness and motivation.

Patient visits to hospital Emergency Rooms, often for non-urgent illnesses, have increased phenomenally. Yet, an Emergency Room cannot give satisfactory care for those non-urgent illnesses since its management is fragmented and episodic, the antithesis of family practice. This study of private patients from a family practice explores the total spectrum of illness taken to an Emergency Room over a six-month period and the motivation behind the patients' visits. Diagnoses were not distributed at random but fell into discrete patterns of illness of epidemiological interest and which suggest possibilities for prevention. Emergency Room visits were made at times of self-perceived crisis when the private physician was considered inaccessible, and the hospital came to mind as a convenient and reliable source. The family physician should be aware of the special characteristics of his patients who visit Emergency Rooms and alert to the possibility of prevention of traumatic episodes. He should also consider follow-up care on those patients who make Emergency Room visits, with particular reference to exploring those common psycho-social problems which may have loomed large in the motivation for the hospital visit and yet were not recognized or treated at that time.

Adolescent↗
PubMedDate not supplied

Effects of music on exercise and perceived symptoms in patients with chronic obstructive pulmonary disease.

BACKGROUND: The purpose of this study was to examine the effects of music on exercise tolerance and perceived symptoms during treadmill walking in patients with chronic obstructive pulmonary disease (COPD). METHODS: Nineteen patients with COPD recruited from a pulmonary rehabilitation program participated in treadmill walking sessions on three separate days. The first session consisted of a practice walk. The second and third walking sessions were 6-minute timed tests in which the subjects were asked to walk as fast as possible under two conditions: a control walk and a music walk. Subjective assessments of perceived dyspnea and effort were obtained during the walks by the modified Borg scale. RESULTS: Distances walked were 331m +/- 19 (SE) for the music walk and 321m +/- 21 (SE) for the control walk (P = .25). Within each condition, ratings of perceived exertion and dyspnea increased from minute 1 to minute 6 (P < 0.05). CONCLUSION: There were no statistically significant differences observed between treatment conditions for distance walked, perceived dyspnea or ratings of perceived exertion. It should be noted that 60% of the subjects voluntarily commented that they enjoyed listening to music while they exercised.

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