PubMed Health⌕ Search

Biomedical subjects

D G Fleming

Publications and source records attributed to D G Fleming.

At least 19 recordsLinked to original sources
PubMed1988

Approaches to primary care. Physician capitation.

The first author, as a consultant to the Office of Prepaid Health Care, reviewed the financial status of nine IPAs for federal qualification in 1987. He found little to suggest any methodology being used for constructing primary care physician (PCP) capitation reimbursement systems. This article draws upon statistical theory and presents hypothetical examples to structure better financial arrangements based on five criteria: stop-loss reinsurance deductible levels, capitation of services related to physician practice, minimum panel size (number of patients) for capitation, stratified capitation, and inclusion of all PCPs in the capitation arrangement.

Capitation Fee↗
PubMed1983

Spectrophotometric investigation of pulsatile blood flow for transcutaneous reflectance oximetry.

A new method to estimate arterial oxygen saturation is suggested based on the presence of the plethysmographic pulse. A prototype skin reflectance oximeter system utilizing a miniature solid state optical transducer has been constructed. Preliminary data collected from a group of volunteers indicated good quantitative correlation between skin reflectance and arterial oxygen saturation as determined by an earlobe oximeter. We are now investigating the dependency of the measurements on various physiological conditions and skin characteristics in order to determine appropriate calibration procedures. This study has demonstrated for the first time that arterial hemoglobin oxygen saturation can be measured quantitatively using transcutaneous reflectance techniques. However, more extensive work is needed to further develop this technique into a viable clinical tool.

Humans↗
PubMed1981

Intracranial pressure telemetry system. II. Animal testing.

A small, implantable, telemetric device for the long-term monitoring of intracranial pressure has been described in part I of this article. This portion of the study is designed to demonstrate the in vivo operational characteristics of that implant device in experimental animals. Results indicate that this system can provide long-term in vivo operation with rapid and accurate responses to acute changes in pressure. Data also indicate some drift in the baseline measurement of pressure. No signs of abnormal body reactions to the units were observed.

Animals↗
PubMed1979

Echocardiographic abnormalities in patients with cystic fibrosis.

An echographic study was undertaken to evaluate left (LV) and right ventricular (RV) function in 30 patients with cystic fibrosis. Echographic recording of the pulmonary and aortic valve echogram permitted measurement of the phases of right and left ventricular systole. The ratio of the LV preejection period/LV ejection time (LPEP/LVET) and shortening of the LV internal dimension %SID was employed to reflect LV function, while RV preejection period/RV ejection time (RPEP/RVET) has excellent correlation with pulmonary artery diastolic pressure. RPEP/RVET and two other echographic measurements, right ventricular wall (RVW) and internal dimension (RVD) were compared with pulmonary function tests and clinical scores. RPEP/RVET correlated well with percent vital capacity(%VC), r = -0.73, percent residual volume (%RVol) r = +0.72, and clinical score, r = -0.77. Multilinear regression of RPEP/RVET, RVD, and RVW improved correlation for %VC (r = -0.80), %RVol, r = +0.82, and clinical score, r = -0.84. Patients in overt right heart failure exhibited elevated RPEP/RVET (mean = 0.48) when compared to patients not in right heart failure (mean = .33). Marked diminution of LV function was present in two patients. A variety of cardiovascular abnormalities were demonstrated echographically and were valuable in assessing the degree of cardiac involvement in patients with cystic fibrosis.

Adolescent↗