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Biomedical subjects

D A Kindig

Publications and source records attributed to D A Kindig.

At least 55 records · Page 3Linked to original sources
PubMed1985

Growth in the international physician supply. 1950 through 1979.

The recent growth in domestic physician supply prompted an investigation of international trends. Using data from the World Health Organization, it was determined that the number of physicians in the world grew from 4.8 per 10,000 population to 10.1 per 10,000 during the period 1950 through 1979. There was a 96% increase in industrialized nations, 223% in nations with centrally planned economies, 164% in middle-income nations, and 29% in low-income nations. Relationships in growth in physician supply and production of medical graduates are discussed. Implications of the inequities between the various groupings of countries are discussed.

Brazil↗
PubMed1967

Growth and intracellular development of a new respiratory virus.

The multiplication of a new, ether-sensitive, ribonucleic acid virus, 229E, isolated from the human respiratory tract, has been studied in cultures of WI-38 human diploid cells. In thin sections of these cells examined with the electron microscope, particles appeared in vesicles in the cytoplasm of cells at a time corresponding to the initial increase in infectious virus. Antigen was also detected in the cytoplasm of cells by the immunofluorescent technique. Extracellular particles of similar morphology were prominent soon after. These events preceded a detectable cytopathic effect. Later, an electron-dense particle appeared within vacuoles in the cytoplasm but was never found extracellularly. Its role in virus development is not known. Complement-fixing antigen developed along with the increase in infectious virus.

Cell Line↗
PubMedDate not supplied

Purchasing population health: aligning financial incentives to improve health outcomes.

OBJECTIVE: To review the concept of population health, including its definition, measurement, and determinants, and to suggest an approach for aligning financial incentives toward this goal. DATA SOURCE, STUDY DESIGN, DATA EXTRACTION: Literature review, policy analysis PRINCIPAL FINDINGS: The article presents the argument that a major reason for our slow progress toward health outcome improvement is that there is no operational definition of population health and that financial incentives are not aligned to this goal. Current attempts at process measures as indicators of quality or outcome are not adequate for the task. It is suggested that some measure of health-adjusted life expectancy be adopted for this purpose, and that integrated delivery systems and other agents responsible for nonmedical determinants be rewarded for improvement in this measure. This will require the development of an investment portfolio across the determinants of health based on relative marginal return to health, with horizontal integration strategies across sectoral boundaries. A 20-year three-phase development strategy is proposed, including components of research and acceptance, integrated health system implementation, and cross-sectoral integration. CONCLUSIONS: The U.S. health care system is a $1 trillion industry without a definition of its product. Until population outcome measures are developed and rewarded for, we will not solve the twenty-first century challenge of maximizing health outcome improvement for the resources available.

Delivery of Health Care, Integrated↗
PubMedDate not supplied

Will minority physician supply meet U.S. needs?

We project the future racial and ethnic composition of the U.S. physician workforce under different assumptions. Our projections show that reaching racial and ethnic population parity with a managed care-based requirement of 218 physicians per 100,000 population would require the number of first-year residents to roughly double for Hispanic and black physicians, triple for Native American physicians, and be reduced by about two-fifths for white physicians and two-thirds for physicians of Asian or Pacific Island origin.

Cultural Diversity↗
PubMedDate not supplied

The health care system should produce health.

Reform of the U.S. health care system along the lines to be proposed by the Clinton Administration will not be an easy task, and it will not be accomplished quickly. A fundamental objective of the changes should be a health system whose purpose is improvement in the health of U.S. citizens, and not just the provision of services to all. This column is jointly edited by Kevin M. Fickenscher, MD, and David A. Kindig, MD, PhD, chair and member, respectively, of the College's Forum on National Health Policy. Dr. Fickenscher is participating in various advisory capacities on health care in the Clinton Administration, and Dr. Kindig is Senior Advisor to HHS Secretary Donna Shalala.

Group Practice↗