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Biomedical subjects

C Roseman

Publications and source records attributed to C Roseman.

13 recordsLinked to original sources
PubMed1995

A seasonal pattern of hospital medication errors in Alaska.

Specific behavioral consequences of seasonal affective disorder have not been closely examined. Length of daylight is evaluated in relation to medication errors in a medical center located in the far north. Factors such as numbers of patient admissions, discharges, and deaths were controlled with data collected in Anchorage, Alaska, over 5 consecutive years, 1985-89. These data revealed that 58% of all medication errors occurred during the first quarter of the year. Medication errors were 1.95 times more likely in December than September. The best statistical prediction was for errors associated with levels of darkness 2 months earlier. There may be not only an impairment of work performance among hospital nursing staff that reaches a peak in late winter but, more importantly, medication errors appear to follow a pattern that is closely associated with the annual cycle of daylight and darkness.

Alaska↗
PubMed1990

Health care technology in Australia and New Zealand: contrasts and cooperation.

Australia and New Zealand are neighbouring countries with similarities due to their settlement by Europeans, but with major differences in their economies, populations, geography and political systems. These differences have led to contrasting approaches to the introduction and control of health care technologies. New Zealand has historically had greater success in limiting the use of health technologies which have often been adopted more widely and rapidly in Australia. Recent initiatives in health technology assessment have involved participation by both countries, giving the potential for a joint approach to policy formulation on use of some medical devices and procedures.

Australia↗
PubMed1989

Joint venture acquisition of expensive medical technology by Oahu hospitals. Planning, operations and impact of lithotripsy and magnetic resonance imaging.

Expensive diagnostic and treatment services and equipment are naturally suited to large, populous medical market areas, with sufficient forecasted service demand to justify the large investment in capital, construction and staffing. Only major tertiary or secondary medical centers with shared resources can justify the first-generation investment in the multimillion-dollar purchases of magnetic resonance imaging (MRI), megavoltage linear accelerators, or lithotripters. The regional referral system in most nations accommodates the outlying population in the less developed rural sectors.

Equipment and Supplies, Hospital↗
PubMed1985

Probable future funding priorities in maternal and child health: a modified Delphi National Survey.

Recent enactment of program consolidation block grants proposed by the Reagan administration has left many observers of public health services wondering about the impact of such a change on categorical programs in maternal and child health (MCH). This study first presents predictions about the future of 23 specific MCH services, derived from a modified Delphi Survey of MCH experts, and then examines the implications of these predictions for future public health.

Adult↗
PubMed1980

The planner as public health resource allocator: post-Proposition 13 county health services in California and the role of the HSAs in budget review and public hearings.

Immediately following adoption of Proposition 13 in California in June of 1978, the state legislature adopted a Bail-Out program which included procedures for monitoring the detrimental effects of disproportionate reductions in public health, inpatient and outpatient county budgets. For a variety of reasons, the methodology and procedures employed failed to reveal the adverse effects of Proposition 13 on health services. This paper deals with the actual and potential role of health systems agencies (HSAs) in monitoring such effects, commenting in public hearings on budget review and, in general, playing a policy analysis role that links local government with the citizenry on the one hand and the state government on the other. In addition to identifying the weakness of the State's monitoring effort in identifying negative effects in program analysis and staffing reductions, the findings point out the limited role of HSAs. Specific recommendations are offered for improvement of HSA involvement in future resource allocation planning in California and the United States as a whole.

California↗
PubMed1978

Is a national model for health planning appropriate?

In this article, a "point-counterpoint" format is used to discuss a fundamental issue concerned with the design and implementation of P.L. 93-641. Dr. Cyril Roseman first examines some implementation obstacles and argues that basic forces are at work militating against effective implementation of an implicit national model, and he argues that multiple models for planning should be formulated under the existing law. Boyd Palmer then counters with a view that the existing national model is flexible enough to accommodate the basic forces without undertaking the drastic changes implied by Dr. Roseman.

Health Planning↗
PubMedDate not supplied

Learning from the Aloha State.

Since 1974, Hawaii has required its employers to provide health insurance to all employees working at least 20 hours a week. More recently, the state created a new program to cover the "gap group" of 50,000 uninsured residents, along with a new program to create a "seamless system of health care" for all Aloha State residents. And Hawaii has managed to insure nearly all of its citizens while keeping the annual price of health insurance at nearly half of that paid in many mainland states ($1,300 per person and $4,000 per family). At the same time, life expectancy is the highest in the nation and infant mortality is among the lowest. In seeking to reform a dysfunctional national insurance system, policymakers should learn from the Hawaiian experience, which shows that small business can live with an employer mandate, universal coverage can cut costs by encouraging early preventive care, and a dominant payer can reduce administrative expenses.

Cost Control↗
PubMedDate not supplied

Workload and environmental factors in hospital medication errors.

Nine hospital workload factors and seasonal changes in daylight and darkness were examined over a 5-year period in relation to nurse medication errors at a medical center in Anchorage, Alaska. Three workload factors, along with darkness, were found to be significant predictors of the risk of medication error. Errors increased with the number of patient days per month (OR/250 patient days = 1.61) and the number of shifts worked by temporary nursing staff (OR/10 shifts = 1.15); errors decreased with more overtime worked by permanent nursing staff members (OR/10 shifts = .85). Medication errors were 95% more likely in midwinter than in the fall, but the effect of increasing darkness was strongest; a 2-month delay was found between the level of darkness and the rate of errors. More than half of all medication errors occurred during the first 3 months of the year.

Alaska↗