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Biomedical subjects

E Vayda

Publications and source records attributed to E Vayda.

At least 55 records · Page 3Linked to original sources
PubMed1977

Surgery and anesthesia in Ontario.

Operative and case-fatality rates in Ontario for eight elective (discretionary) and seven nonelective (nondiscretionary) operations and the proportions of these operations and their anesthetic procedures performed by general practitioners were calculated. Cholecystectomy increased in frequency 32% from 1968 through 1973, tonsillectomy and adenoidectomy decreased 37%, and hysterectomy increased 41%. Except for colectomy the rates for nonelective operations changed only slightly over the 6 years. Case-fatality rates (hospital deaths per 10000 operations) for the discretionary operations in 1973 were as follows: extraction of lens, 23.1; tonsillectomy and adenoidectomy, 0.4 (2 deaths among 52938 operations); varicose vein stripping, 6.1; nonrecurrent inguinal herniorrhaphy, 21.9; cholecystectomy, 61.0; hemorrhoidectomy, 9.8; prostatectomy, 115.9; and hysterectomy, 9.6. In 1973 general practitioners did 32% of tonsillectomies and adenoidectomies (61% in 1971), 10 to 20% of inguinal herniorrhaphies, hemorrhoidectomies and appendectomies and 6% or less of the other operations. However, they performed 35% or more of the anesthetic procedures for these four operations as well as for varicose vein stripping, cholecystectomy and hysterectomy. Rates of general-practice surgery and anesthesia in an urban centre in Ontario were substantially less than those for the province as a whole.

Adolescent↗
PubMed1977

Prepaid group practice under universal health insurance in Canada.

This paper describes the experience of the two prepaid group practice plans in Ontario before and after universal health insurance. Both plans were capitalized, before national health insurance, by member contributions and both have had persistent problems with enrollment constraints and professional opposition. The Sault Ste. Marie Plan began in 1963, six years before Canadian medicare. The plan was paid a capitation fee for medical services but did not share in savings from its reduced hospital use. After universal insurance sharing in decreased hospital use was offset by regulations which allowed plan members to use non-plan physicians at Plan expense. Payments to non-plan physicians now take up 20 per cent of Plan income. Active enrollment of members has been replaced by a Ministry of Health registration system which is based on overall utilization. The St. Catharine's Plan began at the same time as universal insurance in 1969. Its out-of-plan use averaged about 40 per cent of total income. Most recently this program has shifted from capitation to cost-reimbursement payment. In Canada present trends include cost containment, financing by general tax revenues rather than premiums and increased categorical benefits. Under Canadian universal health insurance prepaid group practice has an uncertain future.

Canada↗
PubMed1976

Surgical rates in the Canadian provinces, 1968 to 1972.

Canadian and provincial rates for eight elective and seven nonelective operations were determined from 1968 through 1972. Of the elective procedures considered, the Canadian tonsillectomy rate decreased substantially and rates for hysterectomy and cholecystectomy showed large increases. The provinces reflected national trends for these three operations. Except for coletomy, which increased 36%, rates for the nonelective procedures showed little change. Correlations between the numbers of surgical personnel and the elective surgery rates in the provinces were demonstrated in 3 of the 5 years; these are best shown at the extremes. Newfoundland had the fewest surgeons, a bed: population ratio below the national average and the lowest combined elective surgical rate; Alberta ranked high in all three categories. In the seven other provinces, there was less variation in the number of surgeons, hospital beds and elective surgical rates. Provinces with extensive insurance coverage prior to universal medical insurance reduced their combined elective surgery rate, while provinces where fewer people were insured showed increases. In the absence of different methods of payment for surgical services and marginal changes in the number of hospital beds and the number of surgeons, more insured persons produced more elective surgery.

Canada↗
PubMed1975

Emergency department use at two Hamilton hospitals.

This report compares emergency department use at two urban Hamilton hospitals. One mainly serves lower socioeconomic and industrial groups and the other predominantly suburban residents. Although the groups served are different, the patterns of use at both hospitals were found to be similar. Over one third of visits at both are classified as nonurgent. The urban industrial hospital has higher proportions of visits that are nonurgent, by men and due to trauma. However, other parameters such as arrival time, use of ambulance, proportion admitted, percentage of emergencies, percentage of repeat visits, use of radiology and laboratory facilities and proportions of visits in different categories of presenting complaint were similar at the two hospitals. Similarities in use patterns may be due to universal health insurance, for 90% of users have medical insurance and have family doctors.

Adult↗
PubMed1975

Comparison of provincial surgical rates in 1968.

Studies have been made of age- and sex-adjusted 1968 provincial rates for individual surgical procedures. For elective and discretionary operations, such as tonsillectomy and adenoidectomy, hysterectomy, vein stripping and lens extraction, provincial rates varied by approximately 100 percent. Newfoundland, with few surgeons and hospital beds, had the lowest discretionary rates, and Alberta, which ranked hgih both for surgeons and hospital beds, the highest. Interprovincial differences were of smaller magnitude for non-discretionary surgery (radical mastectomy, cesarean section, colectomy., lobectomy, etc.). Ther were statistically significant correlations between numbers of surgeons and elective and discretionary surgical rates and between numbers of hospital beds and bed use in the provinces. The effect of disease prevalence on discretionary surgical rates was minimized because the rates were age- and sex-adjusted. Provincial organization of, and payment for, medical services has been similar. Hence, the ratio of surgical personnel to population in each province is postulated as a major determinant of the differing interprovincial rates.

Age Factors↗
PubMed1971

Medical care.

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Insurance, Health↗