PubMed Health⌕ Search

Biomedical subjects

C R Pope

Publications and source records attributed to C R Pope.

At least 37 records · Page 2Linked to original sources
PubMed1986

Another look at sex differences in the use of medical care: illness orientation and the types of morbidities for which services are used.

The purpose of this investigation is to build on the findings of earlier studies and, focusing on specific disease categories, further explore the factors which may contribute to the sex differential in medical care utilization rates. In pursuing this objective, the study attempts to differentiate those types of disease categories for which illness orientation has a significant effect on utilization rates from those where the effects are minimal. The study population includes 1648 adults between the ages of 18 and 59. Medical record data covering 7 years of outpatient services are linked with survey data on the respondents. The findings show that the largest sex differences in utilization rates occur in those categories which represent more mild morbidities and those where there is more discretion in defining illness and/or the need for care. It is in these categories showing the largest sex differences in doctor office visits in which illness orientation factors appear to be most influential. Thus, the findings provide further evidence for the hypothesis that sex differences in morbidity reports and utilization rates are due to differences in the way symptoms are perceived, evaluated and acted upon. Interpretations and implications are discussed.

Adult↗
PubMed1985

Utilization patterns among long-term enrollees in a prepaid group practice health maintenance organization.

Criteria used in this study established that 13% of long-term adult members of a prepaid group practice health maintenance organization (HMO) were consistently high users of outpatient medical care services. This population accounted for 31% of the total doctor office visits (DOVs), 35% of the hospital admissions, and 30% of the outpatient surgical services for long-term members. The most frequent reason for DOVs in this high user group was treatment and/or follow-up of chronic conditions. Patterns of utilization were unrelated to marital status, income, occupation, and perceived social class. Smoking and alcohol use also were not associated with utilization patterns. However, the consistently high users were more likely to perceive their health status as fair or poor and to report a higher number of physical symptoms. They were also more likely to be characterized by a higher degree of psychological distress, especially depression. Contacts with the HMO's mental health department constituted less than 1% of their total medical care contacts, and only 13% made at least one mental health contact over the study period. The findings are discussed in terms of their health and medical care implications.

Adult↗
PubMed1985

Employment status, employment characteristics, and women's health.

This study looked at characteristics of employment which are related to positive health among women. Aspects of employment which may account for health status differences between employed women and those not in the labor force were also studied. The subjects were 1140 adult females, aged 18 through 64. Medical record data covering seven years of inpatient and outpatient services were linked with survey data of the respondents. For all ages, women employed in jobs with a higher degree of social support and integration had better health than women in jobs with little social support and integration through work. The findings suggest that the social support and integration gained through work is a salient aspect of employment which contributes to health status differences between employed women and those not participating in the labor force.

Adolescent↗
PubMed1984

Disability and health status: the importance of longitudinal studies.

This paper discusses the evolving societal perspective on and response to disability, social factors affecting the incidence and prevalence of disability, trends relating to morbidity and mortality and their measurement as social indicators and the potential for using measurements of disability among populations as indicators of quality of life or societal well-being. The essential point of the paper is that disability is a dynamic rather than a fixed phenomenon which can best be understood through longitudinal studies of various types.

Attitude to Health↗
PubMed1983

Gender roles, illness orientation and use of medical services.

The study investigates illness orientation as a factor which may account for sex differences in the utilization of medical care. First, sex differences in the way symptoms are perceived, evaluated and acted upon (illness orientation) are analyzed. Then gender role factors which may account for sex differences in illness orientation are examined. Finally, the degree to which gender role factors and illness orientation account for sex differences in medical care utilization are assessed. The study population includes 1648 adults between the ages of 18 and 59. Medical record data covering 7 years of outpatient services are linked with survey data on the respondents. The findings show that while females are more likely to perceive symptoms than males, there is no apparent sex difference in a tendency to adopt the sick role when ill. In addition, results indicate that gender role factors such as level and type of role responsibility and concern with health are related to female though not male symptom reports. Illness orientation variables are related to rates of medical utilization for both sexes. However, it is primarily the perception of symptoms and an interest and concern with health which contributes to sex differences in utilization rates. When examining respondents who report either a very low or very high number of symptoms, sex differences in utilization rates fall below statistical significance.

Adolescent↗
PubMed1983

Health status and social factors in nonprescribed drug use.

This article examines the relationship between a set of demographic, socioeconomic, sociopsychologic, and health status characteristics of a heterogeneous adult population and their use of nonprescribed drugs. The objective is to determine whether nonprescribed drug use is best accounted for by demographic and socioeconomic factors, by health and medical beliefs, by health status, or by some combination of these. The data are derived from a personal interview survey of 2603 adult members of the Kaiser-Permanente Medical Care Program, Oregon Region. The results indicated that a combination of characteristics from among these three sets were the best predictors. Sex, income, education, mental health status, tendency toward self-treatment, and level of concern with health matters were the most important variables, although they account for only a small amount of the variation in nonprescribed drug use. A portrait of the most frequent users of nonprescribed drugs raised the question as to whether these are the classic neurotics, the "worried-well," or persons whose medical care needs have not been adequately recognized or met.

Attitude to Health↗
PubMed1982

Life-styles, health status and medical care utilization.

This study examines the relationship between three life-style variables (drinking, smoking, and physical activity) and three health status measures (physical, mental and general health status) and the use of medical care services. Up to seven years of utilization data were available for linkage with survey data on life-style variables of a random sample of 2,502 adults in an HMO. Relationships between life-style variables and health status measures were examined. Then each life-style variable was examined in relation to medical care utilization for eight disease classes in an ICDA-based disease classification system. A separate analysis is performed for males and females in four age categories. While relationships between the life-style variables and health status measures are not statistically significant for all sex/age groups, they are quite consistently in the expected direction, and life-style variables show some potentially interesting relationships to utilization for diseases with strong psychological or emotional components.

Adult↗
PubMed1981

Client satisfaction in a health maintenance organization: providers' perceptions compared to clients' reports.

This study seeks to compare clients' reports of satisfaction/dissatisfaction with an HMO and its medical care program to providers' perceptions of client satisfaction. The main conclusion is that providers are fairly aware of medical care system attributes with which clients are highly satisfied and dissatisfied. Those with direct patient contact, especially physicians and nurses, are most accurate in their perceptions. Personnel without direct patient contact are about equally accurate in their perceptions of client satisfaction, though personnel without patient contact perceive relatively more dissatisfaction than clients report. Most approaches to medical care evaluation examine costs and efficiency and, more recently, the technical quality of care. Less attention has been given to the assessment of client satisfaction, and almost no attention has been given to what providers perceive as the assessment of clients. Clearly, HMOs' viability is determined largely by their ability to identify and correct major problems affecting their enrollments.

Attitude of Health Personnel↗
PubMed1980

The immunization status of children in an HMO.

The immunization status of children within a well established Health Maintenance Organization is compared to data from 1973 and 1977 national surveys. The 1977 HMO data derive from a mail questionnaire survey and the 1973 data from the medical records. The HMO children are at less risk of diphtheria, pertussis, tetanus, polio, and measles while the opposite was true for rubella and mumps. The latter findings are related to earlier HMO policy, now modified.

Adolescent↗
PubMed1979

The toxicity of hexachloroethane in laboratory animals.

Studies were conducted to assess hazards to personnel exposed to hexachloroethane (HCE) in an industrial setting. Acute testing in laboratory animals indicated HCE was moderately toxic orally and could produce reversible eye irritation and mild skin irritation. Percutaneous absorption appeared to have no practical significance. The subchronic vapor inhalation toxicity was determined in rats, guinea pigs, Japanese quail and dogs in a 6-week test, monitoring pulmonary function changes, teratogenicity and operant behavioral changes in addition to clinical chemistry, hematology and histopathology. Concentrations of 260 ppm HCE vapor caused severe systemic effects in dogs, moderate effects in guinea pigs and rats and almost no responses in quail. No differences were found between exposed and control animals at 3 months after termination of these exposures. Minimal toxic effects were found following similar 6-week tests at levels of 48 ppm with no detectable changes at 15 ppm of HCE.

Abnormalities, Drug-Induced↗
PubMed1979

Illness with a high emotional component and the use of medical services.

This article investigates the relationship between the use of medical services for illnesses with a high emotional component and the use of medical services for other conditions. The site of the research is the Kaiser-Permanente Medical Care Program (Portland). The study population comprises a sample of 2502 adults for whom up to seven years of utilization data are available. Using a specially developed disease classification system, all doctor office visits (DOVs) are summarized by disease class for the years 1967-73 and converted into annualized rates for each subject. In the analysis, the rates of DOVs for "diseases with a high emotional component," one of the ten classes in the classification system, is the independent variable. The dependent variables are the rates of DOVs for the other disease classes, both singly and in combination. Sex and age are included as control variables. Except for one disease class (chronic nontreatable) and a few sex/age groups in the case of several other classes, there is a highly significant relationship between DOVs for emotion-related illnesses and DOVs for other diseases or conditions. Some implications of these findings are noted.

Adult↗
PubMed1977

Health status, socioeconomic status and utilization of outpatient services for members of a prepaid group practice.

When evaluating the effectiveness of medical care programs, one concern is whether receipt of care is based upon health care needs or upon socioeconomic status. This study describes the relation between health status and socioeconomic status and attempts to determine which has the greater effect on ambulatory care utilization. The study setting was an operating HMO serving a cross-sectional membership of nearly 200,000 persons. Outpatient utilization data were derived from the medical records of a five per cent sample of health plan members for 1969 and 1970. Social, economic, situational, and attitudinal data were provided by 2,603 respondents in a household interview survey. Since a population's perceived health status may reflect health need, information from the survey provided measures of health status that ranged from specific symptoms and complaints to a general measure of perceived health status. Although the findings varied somewhat according to which variables were considered, they generally showed health status to correlate more highly than socioeconomic factors with the utilization of services in this medical care system. An exception was the use of preventive services, which was not significantly related to health status measures but rather, for women, to education and, to a lesser extent, income.

Absenteeism↗
PubMed1976

Reported use of nonprescribed drugs in health maintenance.

The reported use of nonprescribed drugs and its relationship to other reported illness and heal-related activities of subscribers within a prepaid comprehensive medical care system were examined. The data analyzed were abstracted from a household survey of 2603 Kaiser Health Plan subscribers. The survey gathered sociodemographic, economic, attitudinal and behavioral information. The health-related information collected included reported symptom experiences, behavior when ill, and customary health and health-related practices. The findings indicate that the use of nonprescribed drugs is a frequent and in some instances, an extensive activity. Some association was found between reported self-medication activities and selected symptom experiences, use of certain health practitioners, prescribed drug use and certain health maintenance activities and perception. It is concluded that use of nonprescribed drugs appeared to be related to other health-related behaviors, but not just randomly. Also, the use of nonprescribed medicine does not appear aberrant from the perspectives of contemporary health care.

Health↗