Biomedical subjects
Publications and source records attributed to F Mayo.
We describe a case of human cysticercosis appearing as an abnormal chest roentgenogram. The patient had a long history of ingestion of undercooked pork. The diagnosis was entertained only after surgical resection, but the history obtained from this patient gave an important clue toward a parasitic infestation.
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This study relates components of care, including patient characteristics, degree of initial morbidity, and process of care, to patient outcomes. One hundred twenty-two adults who were being treated for congestive heart failure by a sample of physicians in Fort Wayne, Indiana were studied. Data were obtained on the patients' personal characteristics; degree of illness at the beginning of the six-month study period; process measures (physician awareness, communication, medication use, therapeutic management, patient satisfaction, and utilization of services); and level of activity and symptoms at the end of the study period. These components were quantified and subjected to correlation and regression analysis. The largest and most significant predictors of outcome status were measures of initial disease status. Process variables were strongly and significantly associated with outcome only in a group of patients who were minimally symptomatic initially. The lack of an overall association between process of medical care and patient outcome cannot be generalized beyond these patients with congestive heart failure. A similar approach of dissection, quantification, and analysis of components of care, however, can be used to explore a possible relationship in other conditions and care delivery settings.
The health care problems that 88,000 patients presented to 118 family physicians over two years were evaluated. As a result, 526,196 health care problems were noted. Ninety percent of all problems were contained within 169 descriptive problems using the RCGP coding system for primary care. Knowledge of the profile of patient problems as they present to the family physician will alow for the development of a logical curriculum for the family practice resident and of patient care systems in family medicine. An appropriate methodology for the development of curriculum is discussed.
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This study reports on 242 diabetic patients from the practices of 42 physicians. Communication from physician to patient was studied to determine the effect of communication on subsequent patient outcomes. Patients and physicians were questioned on instructions provided for diabetic management and self-care. The average level of effective communication for all patients in the study was 67 percent. Insulin-dependent diabetics had the best communication scores, those controlled on diet alone the poorest, while oral medication patients were intermediate. Although overall communication scores showed no significant correlation with diabetic control status, patient satisfaction, compliance in taking prescribed medication, or frequency of hospitalization, specific communication items were highly correlated with corresponding behavioral outcomes.
The system of data recording and retrieval which defines a family practice population of patients is described. It is organized at two levels, as a series of manual instruments or as a single instrument used as data input to a computer. Depending on resources available, it is possible to record demographic and morbidity data from the patient populations of both teaching and nonteaching practices. Data have been collected from a patient population of 88,000 in 26 practicing sites in Virginia, totaling 380,000 diagnostic and follow-up visits. Presentations are made of some of this data. The costs of this recording process in nonteaching practices, the use of such data as an educational resource for the training of primary care physicians, and the evaluations of health care delivered are discussed.