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Biomedical subjects

C Evashwick

Publications and source records attributed to C Evashwick.

13 recordsLinked to original sources
PubMed2001

Geriatric services offered by hospitals: predicting services by internal and external community characteristics.

This article explores the role of hospitals in providing geriatric services and identifies associated community and hospital characteristics. The sample is 4571 community hospitals responding to the 1995 American Hospital Association (AHA) Annual Survey. Most hospitals offer some geriatric services; the mean is 3.3. The dependent variable is an index of 13 geriatric services created from the AHA data. Independent variables are taken from the AHA survey, Area Resource File, and census data. Regression analysis explains fifteen percent of the variance. Hospital characteristics predicting provision of geriatric services are non-profit tax status, hospital bed size and system membership. Community characteristics predicting provision of geriatric services included higher population density, high percentage of county aged, and county nursing facility beds. Hospital characteristics yielded slightly higher predictive ability than did community characteristics. The findings suggest policies to increase hospital leadership in providing access to senior services require a multi-dimensional approach.

Aged↗
PubMed1998

The role of home care in integrated delivery systems.

The health care field is moving rapidly toward integrated delivery systems (IDS). The role of home care in such system is unclear. This study seeks to describe the current status of home care in IDS and to examine health care administrators' perceptions about the importance of IDS components. A random sample of 1600 administrators was surveyed, 400 each from home care agencies, hospitals, nursing homes, and medical groups. Results reveal that hospitals lead integration, nursing homes are least involved, and home care agencies and medical groups fall in between. Administrator's opinions vary considerably about the importance of select services and integrating mechanisms.

Administrative Personnel↗
PubMed1989

Creating the continuum of care.

Continuum of care is a concept involving an integrated system of care that guides and tracks patient over time through a comprehensive array of health services spanning all levels of intensity of care. This article presents a definition of continuum of care, including objectives, basic components, and operating principles. The purpose is to provide a concept that will encourage leadership by offering a vision for the future and providing a framework to guide day-to-day decision-making. Two case scenarios illustrate the effectiveness of the continuum of care concept in providing a framework for delivery of optimum health care to patient populations.

Continuity of Patient Care↗
PubMed1984

Factors explaining the use of health care services by the elderly.

The Anderson model of health services utilization, which relates use of service to predisposing, enabling, and need factors, has not often been applied to an elderly population. In this study, the factors of the Andersen model were used prospectively to predict utilization for a population sample of 1,317 elderly persons. Taken alone, the NEED construct was the most important single predictor of use of physician services, hospitalizations, ambulatory care, and home care. PREDISPOSING factors were better predictors of the use of dental services. Some of the variables studied were not related to utilization in the direction that would have been predicted from previous studies on general populations. Multivariate analyses demonstrated that the three constructs should be applied simultaneously when predicting use of services. These findings can be applied to the specific task of planning services for older people.

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PubMed1982

Factors related to utilization of dental services by the elderly.

A household interview survey of 883 persons aged 62 and older residing in Seattle, Washington, asked about a broad range of health care and social service issues, including the need for and use of dental care. The Anderson model of health services utilization was used to identify predisposing, enabling, and need characteristics hypothesized to affect the use of dental services. A path analysis was conducted to distinguish the direct and indirect effects of the variables. The results showed that none of the predisposing variables, including age, was a significant factor in explaining the use of dental services. Education had both direct and indirect positive relationships to use. Having a regular sources of dental care was also an important factor affecting utilization. Neither income nor insurance variables were powerful factors. Need, measured by an index of dental problems and having dentures, was the stronger determinant of dental care use. In general, the model was better at predicting whether or not dental care would be sought by an older person at all (R2 = .27) than in predicting the amount of service used (R2 = .06).

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PubMed1981

Toward understanding elders' health service utilization.

Providing appropriate health services to the elderly is emerging as one of the major challenges of this decade. Using the theoretical framework developed by Andersen and Aday, this study attempts to improve our understanding of those factors which inhibit or facilitate elders' use of health services. The data come from a 1974 statewide random probability sample of 1,625 noninstitutionalized elders 65 years of age or older living in Massachusetts. Regression analysis is used to study the effects of predisposing, enabling, and need characteristics on the use of five health services: hospitals, physicians, dentists, home care, and ambulatory care. The model explains from 5% to 27% of the variance in health service utilization. Need characteristics, in general, account for most of the explained variance.

Aged↗
PubMed1981

The structural configuration of U.S. hospital medical staffs.

Using data from the 1973 American Hospital Association national survey of hospital medical staff organization, six factors of medical staff organization structure are examined in relation to each other and to hospital ownership, size, teaching status, geographic region and size of Standard Metropolitan Statistical Area (SMSA). The six factors include 1) Resource Capability; 2) Generalist Physician Contractual Orientation; 3) Communication and Control; 4) Local Staff Orientation; 5) Physician Participation in Decision Making; and 6) Hospital-Based Contractual Orientation. Several relatively distinct patterns emerged related to hospital ownership, size, teaching activity and region of the country, as well as interrelationships among the factors themselves. Differences between smaller and larger hospitals clearly emerged as well as a distinctive pattern for for-profit hospitals. All of the factors are subject to manipulation through administrative and/or public policy interventions and the findings suggest dimensions for future investigation of important policy issues related to the medical staff's role in cost containment, utilization, quality assurance and technology adoption.

Contract Services↗
PubMed1981

Hospice: staffing and cost implications for home health agencies.

The authors describe a study done to evaluate the implementation of a home health agency-based hospice program. Forty-one hospice patients were compared with a group of terminally ill patients receiving standard home care treatment. The differences in the type, frequency, and intensity of services required by the two groups were evaluated. While hospice care was found to be slightly more staff intensive than standard home care treatment, the differences were minimal. The results suggest that a home health agency with a multidisciplinary staff could implement a hospice program without making dramatic organizational, administrative, or resource change.

Home Care Services↗