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Biomedical subjects

J S Buechner

Publications and source records attributed to J S Buechner.

71 records · Page 4Linked to original sources
PubMed1991

Methodological issues in using hospital discharge data to determine the incidence of hospitalized injuries.

Estimates of the incidence of hospitalized injuries based on hospital discharge data are inconsistent because of variations in 1) the definition of injury and 2) the criteria for excluding repeat admissions for the same injury event. Using 1983 data from the Uniform Hospital Discharge Data Set for the state of Rhode Island, the authors demonstrate the effects on injury incidence rates associated with the various definitions and exclusion criteria used in previous studies. The overall injury rate (11.9/1,000 population) was substantially reduced (rate difference, 1.7; 95% confidence interval 1.2-2.1) when adverse effects or complications of medical and surgical care ("medical injuries"), not usually defined as injuries by injury researchers, were excluded. Estimates of the incidence of "true" injury hospitalizations (excluding medical injuries, late effects, and complications of care) ranged from 9.9/1,000, when repeat admissions identified as transfers from another acute facility were excluded, to 7.2/1,000, when repeat admissions identified as elective admissions were excluded. Marked variability in incidence rate estimates by age, sex, nature of injury, and state of residence of victim was also noted. The addition to hospital discharge data sets of a separate variable to identify readmissions for the same problem would result in more valid incidence estimates for injury research and surveillance.

Adolescent↗
PubMed1991

Acute bacterial meningitis in Rhode Island: a survey of the years 1976 to 1985.

There were 667 recorded cases of bacterial meningitis in the hospitals of Rhode Island during the ten year interval of 1976 to 1985 yielding an average annual incidence rate of 6.9 cases per 100,000 population, and a case fatality rate of 10.3%. These rates are similar to those generated in other retrospective surveys in the United States. This survey corroborates the well-established observation that bacterial meningitis is largely a disease of early childhood. But these data also suggest that meningitis in the very elderly is more common than had previously been assumed. Many of the elderly cases in this series, particularly those caused by the coliform organisms, followed shortly after body trauma or appeared in individuals burdened by disseminated cancer or diabetes mellitus.

Acute Disease↗
PubMed1990

Framework for the Rhode Island response to the injury problem.

Injuries are the fourth leading cause of death in Rhode Island as well as the US and are responsible for the greatest amount of premature death. Recent years have brought more national attention to the role of public health in injury prevention. The Rhode Island Department of Health has been involved in a variety of injury control research, programs and legislation. In 1989, the Injury Prevention Program was funded through a grant from the Centers for Disease Control to coordinate and implement injury control programs in the Department. Injury prevention priorities are set on the basis of mortality and morbidity data. An analysis of Rhode Island death certificate data from 1979 to 1988 reveals that motor vehicle crashes, suicides, falls, and homicides are the leading causes of injury deaths. Age patterns vary for each cause, but males predominate in all categories of injury deaths. Activities to reduce injuries are underway or planned. Physicians will play key roles in this effort.

Adolescent↗
PubMed1986

Cigarette smoking behavior among Rhode Island physicians, 1963-83.

A survey of practicing physicians in Rhode Island revealed a cigarette smoking rate of only 8.3 per cent in 1983. This represents a continuation of the consistent decrease seen in the percentage of physician smokers in each such survey since 1963. Under age 30, the rate was only 4.5 per cent. An exponential model suggests that the overall rate for Rhode Island physicians will be below 3 per cent by the year 2000.

Adult↗
PubMedDate not supplied

Smoking rates among Rhode Island physicians: achieving a smoke-free society.

Over a 25-year period, regular surveys of physicians licensed in Rhode Island have recorded their smoking behavior. The six surveys show a decrease in the rate of cigarette smoking from 33% in 1963 to 4.6% in 1988. In the most recent survey, 65% of respondents reported never having smoked, and 87% of those who had ever smoked reported having quit. However, the statistic for the maximum number of cigarettes smoked regularly was higher for current smokers than for former smokers. Among physicians in the 1988 survey, most former smokers (85%) reported using only unassisted personal effort in quitting, whereas nearly half (48%) of current smokers tried methods involving assistance, such as self-help programs, group programs, or nicotine gum. Among former smokers who quit after 1983, the percentage trying assisted methods (34%) was closer to the percentage among current smokers. Apparently, remaining smokers include many heavy smokers who require more potent interventions in order to quit. Physicians in Rhode Island have almost become a smoke-free group. Their experience, coupled with their involvement in smoking prevention and cessation for their patients, can lead the rest of society on its path to becoming smoke-free.

Adult↗
PubMedDate not supplied

A study guided by the Health Belief Model of the predictors of breast cancer screening of women ages 40 and older.

In late 1987, a total of 852 Rhode Island women ages 40 and older were interviewed by telephone (78 percent response rate) to measure their use of breast cancer screening and to investigate potential predictors of use. Predictors included the women's socioeconomic status, use of medical care, a provider's reported recommendations for screening, and the women's health beliefs about breast cancer and mammography. The Health Belief Model guided the construction of the interview questions and data analysis. Logistic regression was used to identify leading independent predictors of breast cancer screening according to contemporary recommendations: reporting that a medical provider had ever recommended a screening mammogram (odds ratio [OR] = 18.77), having received gynecological care in the previous year (OR = 4.92), having a regular source of gynecological care (OR = 2.63), having ever had a diagnostic mammogram (OR = 2.32), and perceiving mammography as safe enough to have annually (OR = 1.93). The findings suggest that programs intended to increase the use of breast cancer screening should include "inreach" and "outreach" elements; inreach to patients with established patient-provider relationships, by assuring that physicians recommend screening to all eligible patients, and outreach to all eligible women, by helping them overcome barriers to effective primary care, and by promoting mammography, emphasizing its effectiveness and safety. The findings also suggest that socioeconomically disadvantaged women, who are less likely to be screened than other women, should become special targets of inreach and outreach interventions.

Adult↗
PubMedDate not supplied

WIC program participation--a marketing approach.

Recent evaluation studies have described the benefits accruing to low-income women and children who participate in the Special Supplemental Food Program for Women, Infants, and Children (WIC). However, participation is not uniform among all groups of eligible persons. This study examines the geographic variation in WIC participation rates of eligible pregnant women in Rhode Island to determine whether the program is effective in reaching the neediest segments of the population. Eight groups of small geographic areas in Rhode Island (census tracts) were formed on the basis of need for maternal and child health services, as determined from a statistical method employing factor and cluster analysis of existing health and sociodemographic data. Among these eight groups, participation rates in WIC during 1983-84 ranged from 46 percent to more than 100 percent of estimated eligible pregnant women. The rates were positively correlated with measures of need, strongly (r = 0.92) with an index of maternal risk, and less strongly (r = 0.79) with an index of birth outcomes. The results of this study have enabled the Rhode Island WIC Program to direct its outreach efforts more specifically to geographic areas where the need for the program's assistance is greatest. The procedures described in this report comprise a technique that can be generally applied to measure program effectiveness in marketing and outreach where relevant data are available by small geographic areas. The data requirements are (a) population-based estimates of program need and (b) program utilization measures. If these data can be aggregated to a common set of small geographic areas, the use of marketing analysis techniques becomes possible, and program benefits in the area of outreach and recruitment can be realized.

Female↗