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Biomedical subjects

J P Mullooly

Publications and source records attributed to J P Mullooly.

At least 19 recordsLinked to original sources
PubMed1992

Social networks as predictors of ischemic heart disease, cancer, stroke and hypertension: incidence, survival and mortality.

Three social network measures were obtained from a randomly sampled cohort of 2603 HMO members in 1970-71. Mortality and first incidence of ischemic heart disease, cancer, stroke, and hypertension were assessed over the next 15 years. Outcome data were adjusted for age, sex, smoking, SES, and baseline health status. Persons with histories of a given morbidity at or prior to baseline were excluded from the analyses of that morbidity. Social network measures, particularly network scope (a measure of the number of different domains in which a person has social contacts), were powerful predictors of 15-year mortality hazard, but weak predictors of incident disease. Only network scope predicted IHD incidence, and none of the other morbidities was predicted by the social network measures. However, social network measures were strong predictors of both cause-specific and all-cause mortality among persons who had incident cases of IHD, cancer, and stroke. These data suggest that social networks may be more effective in supporting recovery after illness has occurred than in preventing the incidence of new disease.

Adult↗
PubMed1990

The effects of data entry error: an analysis of partial verification.

Modern data entry technology has greatly reduced entry errors by building quality control mechanisms such as cross-field and range edits directly into data entry programs. In many application areas the increased accuracy of modern data entry techniques has made 100% verification unnecessary to assure high standards of data quality. Verification of randomly selected forms combined with 100% verification of critical fields provides a cost efficient alternative to 100% verification of all fields. This paper analyzes the effects of data entry error on study findings and provides a basis for designing a partial verification scheme for achieving quality control goals in a cost efficient manner.

Data Collection↗
PubMed1990

Consistently high users of medical care among the elderly.

This study identified consistently high and low users of medical care services in a group of older HMO members continuously enrolled for six years. Consistently high users made up 26% of the sample, but accounted for more than 50% of total outpatient contacts and hospital admissions. Average ambulatory care costs were more than four times greater for the high users compared with the low users. Consistently high users were older than consistently low users, but did not differ significantly in other sociodemographic characteristics. Compared with the low users, the high users reported more total medical conditions and were more likely to indicate they had arthritis, high blood pressure, heart conditions, and other chronic problems. They perceived themselves to be in poorer health and reported higher levels of psychologic distress. The low users tended to be less satisfied, but the two user groups were not significantly different regarding use of services outside the HMO.

Aged↗
PubMed1990

Acyclovir use and its surveillance in a general population.

This study examined the extent and patterns of use of acyclovir in a health maintenance organization (HMO) population. The development and implementation of a system to survey acyclovir users for possible acute adverse effects is also described. Acyclovir users were members of Kaiser Permanente (KP), Northwest Region, who received one or more prescriptions for acyclovir from an automated outpatient prescription system over a two-year period (1986 and 1987). KP members with genital herpes were identified from the automated Outpatient Utilization System, which abstracts medical record data from a random sample of about two percent of KP members. Acyclovir users with hospital admissions were identified from the automated KP hospital discharge abstract system. During the two years, there were 2940 users who received a total of 6182 prescriptions for acyclovir; 47 percent used oral acyclovir and 56 percent of prescriptions were for the oral dosage form. Females received two-thirds of the prescriptions, and people 15 through 45 years of age received 80 percent of the prescriptions. The estimated incidence density of oral acyclovir usage was 2.3/1000 KP members. Most oral acyclovir prescriptions were for the treatment of genital herpes. More than 60 percent of the prescriptions appeared to be for first treatment, more than 30 percent for repeat treatment, and about 6 percent for continuing treatment. Hospitalizations of oral acyclovir users appeared to be unrelated to the use of the drug.

Acyclovir↗
PubMed1990

Smoking and consistently high use of medical care among older HMO members.

Smoking behavior of consistently high and low users of medical care services were compared in two groups of older health maintenance organization (HMO) members continuously enrolled for five years and a subgroup who were continuously enrolled for 10 years. Smokers and former smokers, combined, were more likely than never-smokers to be consistently high users of ambulatory services (52 percent vs 34 percent in the five-year group, and 45 percent vs 30 percent in the 10-year group).

Aged↗
PubMed1990

Morbidity and medical care utilization of old and very old persons.

This report compares the morbidity, health care and drug utilization, and health status of random samples of HMO-enrolled Medicare beneficiaries ages 65-79, and 80 and over. The population represented 3,683 person-years of Kaiser Permanente eligibility (59.2 percent female). Those 80 and over were 20 percent of the person-years (64.1 percent female). The effects of age and sex on morbidity and utilization were analyzed using log linear models that controlled for eligibility, and using two-way analyses of variance of rates. Few differences were found in the morbidity experiences and utilization rates of the two age groups. Indicators of self-reported health status did differ. The findings support the idea that noninstitutionalized very old persons are the healthy survivors of their cohort. Their health care needs may not be much different than younger old persons in terms of the types and amounts of health care services needed.

Age Factors↗
PubMed1987

Sample sizes for estimation of exposure-specific disease rates in population-based case-control studies.

This paper discusses sample sizes for estimation of exposure-specific disease rates for population-based case-control studies. Neutra and Drolette's confidence limits, which are based on the approximate normality of the logarithm of the ratio of independent binomial exposure rates, are used to determine the sample sizes required for precise estimation of exposure-specific disease rates. It is shown that, for large sample sizes, the disease rate in the exposed population is more precisely estimated than the disease rate in the unexposed population when more than 50% of the cases are exposed, and that the converse is true when fewer than 50% of the cases are exposed. Expressions are derived for the optimal case and control sample sizes that ensure the required level of precision and minimize the total study size. The optimum control-to-case ratio is found to be equal to the square root of the exposure odds ratio. The optimum number of cases and the total study size are found to be smaller for precise estimation of the disease rate in the exposed population than for precise estimation of the exposure odds ratio when the disease is rare.

Humans↗
PubMed1979

The effect of length of membership upon the utilization of ambulatory care services. A comparison of disadvantaged and general membership populations in a prepaid group practice.

The relationships between duration of membership and the use of outpatient medical care services for disadvantaged and general membership groups in a prepaid group practice were analyzed. The effects of duration of membership upon utilization rates during a six-year study period were estimated by retrospective cohort analyses. Rates were computed for successive three-month intervals. There were no significant start-up effects on use for new enrollees in either study population. This finding is in contrast to what has been reported in other studies. New HMOs or existing HMOs with many new members may not require the additional resources previously thought necessary. Average cohort utilization rates were higher for the disadvantaged cohorts, with the exception of young males 0 to 14 years old. We also examined the persistence of utilization patterns over time. Consistently high users and nonusers were found in both populations. In general, these findings suggest that length of time does not affect ambulatory care use. Age, sex, socioeconomic background and health status are more important than duration of membership in accounting for differences in utilization.

Adolescent↗