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Biomedical subjects

C E McConnel

Publications and source records attributed to C E McConnel.

11 recordsLinked to original sources
PubMed1998

The demand for prehospital emergency services in an aging society.

This research examines the implications of an aging society on the demand for prehospital emergency medical services (EMS). Using a large comprehensive set of population-based EMS utilization data (N = 73874) and population data from the 1990 Census for the City of Dallas, Texas, rates of utilization for eight age groups were computed for total EMS incidents, incidents requiring transport services, and a sub-category of transport services for individuals requiring services for life-threatening conditions. The pattern of utilization associated with age was found to be tri-modal with rates rising geometrically with age for individuals aged 65 and over. Compared to the age group 45 to 64 years of age, rates of utilization for those aged 85 years and older were 3.4 times higher (P < 0.001) for total EMS incidents, 4.5 times higher (P < 0.001) for emergency transports and 5.2 times higher (P < 0.001) for incidents of a life-threatening nature. A broad categorization of all EMS incidents by reason for requiring services indicates that the observed age-associated increase in utilization is due primarily to medical conditions rather than incidents arising from trauma. Finally, gender and racial/ethnic differences in utilization are briefly considered.

Adolescent↗
PubMed1993

Urban/rural differences in health service utilization by elderly persons in the United States.

This paper presents the results of a longitudinal analysis of differences between urban and rural elderly persons in the use of hospital, nursing home, and physician services. Multivariate logistic and Tobit utilization models were estimated with data from the National Center for Health Statistics' Longitudinal Study of Aging (a national survey of more than 5,000 elderly, 70 years of age and older) and health resource data from the Bureau of Health Professions' Area Resources File. The research investigated the independent effect of residential location on both the frequency of service use and the likelihood of using a service over the period 1984-1986. Under a trichotomous definition of urban/rural residency and controlling for differences in predisposing, enabling, and need characteristics, the analysis revealed that the utilization pattern of hospital, nursing home, and physician services was unrelated to either rural or urban residential location or the availability of health resources in those areas.

Aged↗
PubMed1988

Growth and distribution of selected allied health professional groups, United States, 1970-1980.

The growth and geographical distribution of selected allied health professional groups were compared with medicine, dentistry, and nursing for the periods 1970 to 1980 using data from the US census (1970 to 1980) and AMA Physician Masterfile. GINI indexes of health professionals concentration were computed as global measures to evaluate changes in the pattern of locational choice. All allied health professional groups reflected large percentage increases ranging from 25% to 432% in supply of practitioners from 1970 to 1980, with a median percentage increase of 71.9%, and compared well with medicine and dentistry. These allied health supply increases were generally related to better distributional outcomes among the general population and physicians, although several allied health groups became less evenly distributed during this decade. These gains were realized during a decade when less federal support was available for the allied health professions compared with medicine, dentistry, and nursing.

Allied Health Personnel↗
PubMed1986

Distributional change in physician manpower, United States, 1963-80.

Using data from the American Medical Association's Physician Masterfiles (1963-80) and the GINI index of resource concentration as a global measure of changes in the pattern of locational choice, the expectation of a more uniform distribution of physicians is shown to have been met for all major categories of physicians except General Practitioners. Increases in the supply of Surgical Specialists, Medical Specialists, and Other Specialists were accompanied by increases in the index of dispersion across counties of 23.1 per cent, 17.9 per cent and 21 per cent, respectively. By 1980, Surgical Specialists were the most uniformly distributed of all physician groups. The distributional implications of location theory for physicians are addressed and evidence relevant to evaluating this economic theory of locational choice is presented.

Health Workforce↗
PubMed1983

Consumption patterns of the retired household.

Although age differences in consumption patterns are often attributed to retirement status, previous consumption research has failed to examine this assumption. In this research, data on 4,004 elderly households were drawn from the Bureau of Labor Statistics 1972 to 1973 Consumer Expenditure Survey to test the life-stage consumption hypothesis. Using multivariate techniques, expenditure differences between the retired and nonretired family were established for most consumption categories. Compared with the nonretired family, the retired family commits a smaller proportion of additional income to necessities, a much larger proportion to gifts and contributions, and an equal proportion to transportation. Although an analysis of consumption patterns suggests that the average retired household enjoys a considerable degree of economic security, medical care and energy-related expenses emerge as major budgetary problems. Finally, this research indicates that the retired family does not rely on savings to buffer the erosion of income following retirement.

Aged↗
PubMed1983

A note on methodological fallacies in the "X% fallacy" literature.

This article demonstrates that the numerical estimate of an approximately 25 percent risk of nursing home institutionalization reported in the "4-5% fallacy" literature is based on an invalid set of implicit assumptions. Using the most recent national level statistics on nursing home residency and discharge, a measurement technique is introduced to provide an estimate of the maximum and minimum number of nursing home residents in 1976, and a corresponding range for the annualized risk of institutionalization between 6 and 9 percent, within which the true risk must lie.

Aged↗
PubMedDate not supplied

Racial and ethnic patterns in the utilization of prehospital emergency transport services in the United States.

INTRODUCTION: This descriptive research used a large, urban population-based data set for prehospital, emergency medical transports to examine racial/ethnic patterns of access and utilization for several broad categories of emergency medical transport services. METHODS: Fire department files of approximately 39,000 reports on service provision were used to establish rates of transport utilization per 1,000 population in 1990, the most recent year for which reliable city-level census data were available. Data were categorized by three age groups (< 25 years, 25-64 years, > or = 65 years), three racial/ethnic groups (non-Hispanic whites, African-Americans, Hispanics), and gender. Transport rates were computed for total utilization, trauma incidents, and incidents due to medical conditions. Racial/ethnic rates were analyzed for each age and gender group and age- and gender-standardized rates were analyzed and presented in a graphical comparison. Statistical analyses of racial/ethnic differences were conducted using Tukey-type tests of multiple comparisons of proportions, with significant differences evaluated at the p = 0.001 level of significance. RESULTS: Significant differences between racial/ethnic groups in the utilization of emergency transport services existed for all pair-wise comparisons including comparisons by each of the three age groups and gender. For total utilization, unadjusted rates are highest for African-Americans (65.9/1,000) and lowest for Hispanics (25.8/1.000). Likewise, African-American rates were substantially higher for both gender groups and across all age groups. Categorized by gender and age group under age > or = 65 years, non-Hispanic whites are observed to have the lowest rates for both males and females under the age 65 years, while Hispanics have the lowest rates in the group 65 years old However, when rates are age- and gender-standardized, compared to African-Americans and Hispanics, rates for non-Hispanic whites are significantly lower for total transports and for trauma and medically related transports (p = 0.001). CONCLUSION: Age- and gender-standardized rates for emergency medical transport were found to be lowest for non-Hispanic, whites, moderately higher for Hispanics, and substantially higher for African-Americans, who experienced transport rates nearly three times higher than were the rates for non-Hispanic whites. Further research is required to establish the extent to which racial/ethnic differences observed in this geographically restricted study reflect variations between racial/ethnic groups in the underlying need for services.

Adult↗