PubMed Health⌕ Search

Biomedical subjects

D O Sawyer

Publications and source records attributed to D O Sawyer.

7 recordsLinked to original sources
PubMed1993

Malaria rates and fate: a socioeconomic study of malaria in Brazil.

This paper examines behavioural risk factors for malaria in the Machadinho resettlement area in the Amazonian forests of Brazil. Analysis suggests that economic status and knowledge of the importance and behaviour of the mosquito in transmitting malaria are significant factors in determining prevalence risk, irrespective of whether preventive precautions (DDT spraying of houses, and clearing vector breeding sites) are undertaken in the endemic area. However, a higher economic status combined with better knowledge of the vector and DDT spraying decreases the risks of infection considerably. The results suggest that economic status--which is not easily subject to intervention--plays a more important role in transmission than is normally suspected, although preventive actions diminish the disease burden significantly. One might conclude that the landless and impoverished migrants who seek income, and independence in the jungle are destined to have malaria as one of their many burdens. A more positive implication is that control programmes must work harder and more intensively on behalf of poorer migrants in order to diminish the disease burden for these groups.

Agricultural Workers' Diseases↗
PubMed1983

Pharmaceutical reimbursement and drug cost control: the MAC experience in Maryland.

The Maximum Allowable Cost (MAC) program was mandated by the federal government in 1976 in an effort to curb drug expenditures under Medicare and Medicaid by limiting reimbursements for prescription products dispensed to program beneficiaries. MAC performance is usually evaluated in terms of state compliance with federal guidelines. The present study broadens this approach to include other sources of variation in program effectiveness across states. In the case of Maryland, the MAC program offers encouraging signs of at least limited success in curbing Medicaid drug expenditures. The results of the study show a significant, but short-lived, decline in spending levels, suggesting the possibility of program-induced increases in wholesale prices or dispensing fees over time.

Cost Control↗
PubMed1982

Public attitudes toward life and death.

Opinion trends in this country indicate sharp divisions in public sentiment over a number of life-taking actions. While legal abortion and capital punishment clearly head a list, a number of other issues have gained national attention in recent years. The present paper explores the structure of belief systems giving rise to normative conflicts of this kind. Of particular interest is the notion of a "pro-life" or other generic life orientation (e.g., the alleged "right-to-die" orientation of those who favor "mercy killings" in the case of terminally ill patients) as a possible explanation for public attitudes toward specific issues such as suicide and euthanasia. The present analysis assesses the empirical claims associated with such a model. The results offer qualified support for the existence of generic value orientations as revealed by public attitudes toward legal abortion, suicide, euthanasia, and capital punishment.

Abortion, Induced↗
PubMed1982

Medicaid spending and state cost control: assessing policy impact on drug expenditures.

This article introduces a new approach to the study of Medicaid policy and its role in state efforts to limit program costs. The approach is based upon recent work in the field of program evaluation, particularly in the areas of impact assessment and intervention modeling. To illustrate its use in evaluating program changes, the study focuses on policy reforms recently adopted by the state of Maryland as a means of cutting Medicaid expenditures for prescription drugs. Data on spending levels are taken from monthly claims reports filed with the federal government between January, 1974, and December, 1979. Preliminary findings indicate an abrupt decline in program costs following the introduction of new procedures for reimbursing drug providers and the automation of previous procedures for processing payment claims.

Cost Control↗
PubMed1982

Assessing access constraints on system equity: source of care differences in the distribution of medical services.

This article shows how differences in source of care can affect the likelihood that a person will obtain the medical services that he or she requires. Previous work has shown that the setting where care is received can have important effects on the quality of the services that are provided. The present study extends this line of research to questions of system equity. Unlike prior work in the area, the present approach emphasizes systemic relations among different types of delivery sites as a means of formulating and testing alternative models of service delivery. Preliminary findings indicate significant differences in utilization patterns depending on whether one establishes contact in a physician's private office. The results of the study suggest the need for continued concern over the role of access constraints in determining service opportunities.

Health Services↗