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Biomedical subjects

E Moy

Publications and source records attributed to E Moy.

30 records · Page 2Linked to original sources
PubMed1995

Access to hypertensive care. Effects of income, insurance, and source of care.

BACKGROUND: This study examines the relationship between income, health insurance, and usual source of care characteristics and screening and management of hypertension. METHODS: This is a secondary analysis of data from the 1987 National Medical Expenditure Survey. Adult survey respondents constitute a sample representative of the total adult noninstitutionalized US population. Screening, follow-up care, and pharmacologic treatment for hypertension were examined among low income individuals, the uninsured, those without a usual source of care place, and those without a particular usual source of care physician. RESULTS: The uninsured, individuals without a usual source of care place, and those without a particular usual source of care physician received less screening, follow-up care, and pharmacologic treatment for hypertension. Income did not affect receipt of hypertensive care. CONCLUSIONS: Lack of health insurance and lack of a usual source of care are barriers to hypertensive care. Policies that increase access to health insurance or to usual source of care physicians may enable more individuals to attain control of hypertension.

Female↗
PubMed1995

Physician race and care of minority and medically indigent patients.

OBJECTIVE: To examine the relationship between physician race and care of racial minority and ethnic minority patients and medically indigent patients. DESIGN: Secondary analysis of data from the 1987 National Medical Expenditure Survey, a cross-sectional survey of Americans designed to provide national estimates of health care utilization and expenditures. SETTING: A sample representative of the total civilian noninstitutionalized US population with oversampling of minorities and the medically indigent. PATIENTS: Survey respondents aged 18 years or older who identified a specific physician as their usual source of care (n = 15,081, corresponding to a national population estimate of 116 million Americans). MAIN OUTCOME MEASURE: Identification of a nonwhite physician as usual source of care. RESULTS: Of adult Americans who identified a usual-source-of-care physician, 14.4% identified a nonwhite physician as that source of care. Minority patients were more than four times more likely to receive care from nonwhite physicians than were non-Hispanic white patients. Low-income, Medicaid, and uninsured patients were also more likely to receive care from nonwhite physicians. Individuals who receive care from nonwhite physicians were more likely to report worse health, visit an emergency department, and be hospitalized. Individuals who receive care from nonwhite physicians reported more acute complaints, chronic conditions, functional limitations, and psychological symptoms as well as longer visits. CONCLUSIONS: Nonwhite physicians are more likely to care for minority, medically indigent, and sicker patients. Caring for less affluent and sicker patients may financially penalize nonwhite physicians and make them particularly vulnerable to capitation arrangements.

Adult↗
PubMed1995

Continuous epithelial cell lines from ADPKD liver cysts exhibit characteristics of intrahepatic biliary epithelium.

We have produced continuous cell lines using retroviral transduction of SV40 large T antigen into epithelial cells removed from the lumen of liver cysts from four female patients with autosomal dominant polycystic kidney disease (ADPKD). Liver cyst-derived epithelial (LCDE) cell lines are grown in a hormonally supplemented medium in the presence of lethally irradiated NIH/3T3 fibroblast coculture. LCDE cells maintain their epithelial appearance and are positive for the biliary-specific markers cytokeratin 7 and 19 and gamma-glutamyl transpeptidase while being negative for hepatocyte markers. SV40 large T antigen is localized to the cell nucleus. LCDE cells have been grown continuously for periods exceeding 12 mo and 25 passages (170 population doublings). LCDE cells exhibit intracellular pH regulatory pathways that, with one exception, are similar to those found in normal intrahepatic biliary epithelium. These LCDE cell lines exhibit impaired alkalinization in response to Cl- substitution. This finding is suggestive of decreased function or abundance of a Cl-/HCO3- anion exchanger and could account for the failure of ADPKD hepatic cysts to secrete HCO3- in response to secretin.

3T3 Cells↗
PubMed1993

Access to needed follow-up services. Variations among different Medicare populations.

BACKGROUND: We developed a new approach to measuring access to care that examines post-hospitalization follow-up care. It reveals differences in receipt of follow-up care among different subsets of the Medicare population. METHODS: Medicare administrative databases from 1986, 1988, and 1990 were used to construct three retrospective cohorts. Each cohort consisted of patients from a random 1% sample of Medicare beneficiaries admitted with selected conditions that almost always require timely follow-up care. Various "vulnerable populations" within these cohorts were defined on the basis of age, sex, race, and other demographic factors. Merged outpatient records were used to determine receipt of postdischarge follow-up physician services, follow-up services in outpatient departments, and any follow-up care for these different Medicare populations. RESULTS: Beneficiaries aged 85 years or older, black beneficiaries, Medicaid/Qualified Medicare Beneficiaries, residents of urban core counties, residents of the highest-poverty ZIP codes, and residents of Health Professional Shortage Areas were less likely to receive follow-up physician services. Beneficiaries aged 85 years or older, black beneficiaries, residents of the highest-poverty ZIP codes, and residents of Health Professional Shortage Areas were less likely to receive any follow-up care. CONCLUSIONS: This method identified some Medicare populations who failed to receive needed follow-up services, suggesting problems with access to care. This method may be useful in tracking changes in access under the new Medicare fee schedule.

Aftercare↗
PubMed1985

Determination of the surface tension of various species of erythrocytes by means of the solidification front technique.

The solidification front technique is employed to determine the surface tension of fixed erythrocytes of dog, horse, human, chicken, and turkey. The results range from 65.5 erg/cm2 for dog erythrocytes to 67.6 erg/cm2 for turkey erythrocytes. A detailed error analysis shows that the differences obtained are statistically significant. Since cellular interactions are governed to a considerable extent by surface tension effects, it is concluded that caution needs to be exercised when results obtained for one species are used to predict the behavior of cells of another species.

Animals↗
PubMed1985

Biopsychosocial characteristics of children who later murder: a prospective study.

The authors document the childhood neuropsychiatric and family characteristics of nine male subjects who were clinically evaluated as adolescents and were later arrested for murder. Those subjects are compared with 24 incarcerated delinquents who did not go on to commit violent offenses. The future murderers displayed a constellation of biopsychosocial characteristics that included psychotic symptoms, major neurological impairment, a psychotic first-degree relative, violent acts during childhood, and severe physical abuse. The authors relate this combination of factors to prediction of violence and discuss ethical issues that are involved in intervention to prevent violence.

Adolescent↗
PubMedDate not supplied

Trends in specialized surgical procedures at teaching and nonteaching hospitals.

Teaching hospitals are the principal site of many specialized surgical procedures. The recipients of these procedures tend to be younger, male, and nonwhite and tend to reside in either the poorest or the most affluent neighborhoods. Although the numbers of these procedures performed at major teaching hospitals increased dramatically between 1989 and 1995, they accounted for only a modest proportion of hospital discharges and patient days. Concentration of specialized surgical procedures in major teaching hospitals will likely continue. This trend has implications not only for these hospitals but for health care purchasers, policymakers, medical educators, and clinical researchers as well.

Adolescent↗
PubMedDate not supplied

[Limitations of case-mix systems in primary care: comparison of the severity of patients in community hospitals and health care centers in the United States].

OBJECTIVE: The aim was to show the limitations of the case-mix "based on attendance", which take into account neither the seriousness of the diagnoses nor the comorbidity. DESIGN: A crossover descriptive study of a retrospective nature. SETTING: In New York, in two centres located in the Hispanic community of Upper Manhattan and a third in the Presbyterian Hospital. PARTICIPANTS: During 1991, 225 patients were studied: 150 attended in the hospital PCC and 75 in the non-hospital PCCs. A simple random sampling of the list of patients attended was performed. INTERVENTIONS: The seriousness of the conditions of the patients attended in the two different types of PCC was compared through the Duke Severity of Illness Scale (DUSOI), a patient-based case-mix which assesses the level of seriousness of each individual diagnosis and the comorbidity linked to the diagnoses grouped together. MEASUREMENTS AND MAIN RESULTS: Significant differences between the seriousness of the conditions of the patients in the two sub-samples were found when comparison by means of bivariant analysis was performed. Scoring on the Severity Scale was significantly higher for those attending hospital (65.5 and 55.1 respectively). CONCLUSIONS: Patient classification systems based on the reasons for attendance underestimate the seriousness of the condition. A case-mix in which the patient is the unit of analysis needs to be developed.

Community Health Services↗