Biomedical subjects

J Kasteler

Publications and source records attributed to J Kasteler.

3 recordsLinked to original sources

PubMed1980

Mortality surveillance in collaborative trials.

The Hypertension Detection and Follow-Up Program (HDFP) carried out two pilot surveillances covering the enumerated population to test procedures to be used in assessing the ability of the program to influence life expectancy in the total population. A rigorously sequenced pilot survey of 2,611 households was conducted and carefully monitored through two mailings, telephone contacts, home visits, and communication with "contact" persons. The response rates at each stage varied among the 13 centers. Overall, there was a 42.7% yield from the first mailing; 42.5% of those receiving a second mailing was completed; 78.0% for telephone 61.3% for the home visits and 55.2% from the "contact" persons. Overall, 97.4% of all persons had vital status ascertained. The second phase relaxed the rigorous sequential survey requirements and reduced the reporting requirements from every ten days to monthly. Overall, 93.3% were successfully ascertained. Reduced survey structure, slightly increased mobility (from 12% to 13%), increased workload from 200 to 400 households per center, and a longer time interval between initial enumeration and the mortality ascertainment are among the reasons for performance decline.

Adult↗

PubMed1976

Medical care as a commodity: an exploration of the shipping behavior of patients.

A 10% household sample of high- and low-income census tracts was interviewed to assess the extent of doctor shopping. In 632 households studied, 53% of high socioeconomic status and 51% of low socioeconomic status families had shopped for or changed doctors of their own volition. During the previous year, 4% of each socioeconomic group had consulted more than one doctor without referral for the same episode of illness. Shoppers could be distinguished from non-shoppers--shoppers were younger, were better informed about medical specialties, were less self-reliant, more hypochondriacal, expressed less hostility towarn physicians, and had less positive attitudes toward the medical care system. The differences between shoppers and non-shoppers were generally similar for both high and low socioeconomic status groups. In addition, 52% of the families studied had been forced to change doctors because of circumstances beyond their control, i.e., the patient moved or the doctor moved, retired, or died.

Adult↗

PubMed1976

Issues underlying prevalence of "doctor-shopping" behavior.

Data were collected on all persons within a sample of upper-and lower-income households who had seen physicians for illness episodes within a year prior to the interview. Forty-eight percent of upper-and 37 percent of lower-income families in the sample had changed doctors because of dissatisfaction with some aspect of the care. Factors related to tendency to shop for doctors in both upper-and lower-income groups were a lack of confidence in doctors' competence, unwillingness of doctors to spend time talking with patients, hostile feelings toward doctors, high cost of services, inconvenience of location and hours, and unfavorable attitudes toward doctors' personal qualities. Hypochondriasis was related to doctorshopping in the upper-income group. Results of this investigation suggest that patients may be becoming more discriminating in their choice of physicians.

Attitude↗