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Biomedical subjects

K W Kizer

Publications and source records attributed to K W Kizer.

At least 19 recordsLinked to original sources
PubMed1995

Hospitalization charges, costs, and income for firearm-related injuries at a university trauma center.

OBJECTIVE: To quantify the actual cost of inpatient medical care for firearm-related injuries at a university trauma center. DESIGN: Retrospective case series of all hospital admissions for firearm-related injuries for the 3 years 1990 through 1992. Total inpatient financial data were examined by means of a recently instituted cost-accounting methodology. SETTING: Level I trauma center at a university hospital that provides trauma care and tertiary care to 3.7 million residents of 23 counties. PATIENTS: A total of 787 consecutive patients were admitted to the hospital with firearm-related injuries. Information from the trauma registry and hospital finance records were linked for 750 (95%) of these patients. MAIN OUTCOME MEASURES: Total inpatient hospital charges, costs, revenues, and net income according to payer source. RESULTS: Men aged 15 to 44 years accounted for 77% of patients with firearm-related injuries. The overall mean and median hospital charges per admission were $52,271 and $28,033, respectively, whereas the overall mean and median hospital costs per admission were $13,794 and $7964, respectively. The net income per patient ranged from an average loss of $6980 for each patient having no insurance to an average profit of $28,557 for each patient with a health maintenance organization contract. The losses sustained on nonsponsored and Medicaid patients were more than offset by net income from patients having private health insurance, Medicare, or other insurance coverage such that there was an average profit of $5809 per admission for a firearm-related injury. CONCLUSIONS: Treatment of firearm-related injuries produces net income for this university trauma center by virtue of the cost shifting built into its pricing structure. If data from this institution are extrapolated to the nation, then the actual cost of providing medical care for firearm-related injuries in the United States in 1995 is projected to be $4.0 billion. The majority of this cost will be paid indirectly by private health insurance.

Adolescent↗
PubMed1995

Nail gun injury to the heart.

A case is reported of a patient who sustained a cardiac injury from a 16-penny nail fired from a nail gun and who was successfully treated at a small rural hospital.

Accidents, Occupational↗
PubMed1995

Potential carcinogenicity of chloral hydrate--a review.

Chloral hydrate is commonly used to sedate children for diagnostic or therapeutic procedures. The drug has been extensively used for many years, but there are remarkably few data on its long-term health effects. Concern in this regard is raised by recent studies showing chloral hydrate to be genotoxic, causing chromosome changes and other effects in vivo and in vitro. In addition, chloral hydrate is a reactive metabolite of trichloroethylene, a known carcinogen, and is structurally similar to other carcinogenic intermediates. Two carcinogenicity studies performed using the oral route of administration in mice indicate that the drug is potentially carcinogenic--in one case after a single dose lower than the typical dose used for sedation. Practitioners should be aware of chloral hydrate's genotoxicity and potential carcinogenicity. Discretion in its use seems appropriate until further studies clarify its long term health consequences.

Animals↗
PubMed1993

Alcohol-related mortality in California, 1980 to 1989.

OBJECTIVES: This study sought to examine the impact of alcohol use and misuse on mortality in California during the 1980s. METHODS: Alcohol-Related Disease Impact estimation software and California vital statistics data were used to calculate alcohol-related mortality, mortality rates, and years of potential life lost. Statistical tests were applied to detect significant differences in death rates by sex and race/ethnicity. Time trends in death rates for a subset of alcohol-defined diagnoses were examined using regression analysis. RESULTS: An estimated 6.2% of all deaths for California residents during 1989 were related to alcohol, making it one of the top 10 leading causes of death. Injury diagnoses were major contributors to the total estimated number of alcohol-related deaths and years of potential life lost before age 65. Alcohol-related mortality rates were significantly higher for men and for Blacks. However, age-adjusted death rates for alcohol-defined diagnoses declined significantly from 1980 to 1989. CONCLUSIONS: A structured data-base approach to analyzing mortality data represents an important advance for alcohol research that has implications for policy and program planning. Future refinements and enhancements to the disease impact estimation methodology will add precision to determining how alcohol use and misuse affect public health in California.

Accidents, Traffic↗
PubMed1993

Measles epidemic from failure to immunize.

During 1988 through 1990, California experienced its worst measles epidemic in more than a decade, with 16,400 reported cases, 3,390 hospital admissions, and 75 deaths. More than half of the patients were younger than 5 years; the highest incidence was among infants younger than 12 months. The epidemic centered in low-income Hispanic communities in southern and central California. The major cause of the epidemic was low immunization levels among preschool-aged children and young adults. Rates of complications, admission to hospital, and death were surprisingly high. Outbreak control efforts met with indeterminate success. Problems with these efforts included insufficient funding early in the epidemic and disappointing public response to community-based immunization campaigns. The cost of medical care and outbreak control for the epidemic is conservatively estimated at $30.9 million. Unless the level of immunization in preschool-aged children is increased, this type of epidemic will probably recur.

Adolescent↗
PubMed1993

HIV-1 seroprevalence among women attending sexually transmitted disease clinics in California. California Family of Surveys and Sentinel Surveillance Consortia.

To evaluate the distribution of the human immunodeficiency virus type 1 (HIV-1) epidemic among California women, we analyzed HIV-1 seroprevalence and risk factors among women attending sexually transmitted disease (STD) clinics in 21 local health jurisdictions. Using standardized protocols developed by the Centers for Disease Control, we tested unlinked serum specimens from women attending participating STD clinics in 1989. We analyzed demographic characteristics, HIV risk exposure groups, and results of HIV-1 antibody testing on 17,210 specimens with an overall HIV-1 seroprevalence of 0.57%. Seroprevalence rates were highest for African-American women, women 25 to 29 years of age, injection drug users, and women attending STD clinics in San Francisco. After multiple logistic regression analysis, HIV-1 seropositivity remained highest for these four groups. The rate of HIV-1 infection among women attending STD clinics in California underscores the continued need to make HIV counseling and testing an integral component of routine services for women being evaluated for, or presenting with, sexually transmitted diseases.

Adolescent↗
PubMed1992

Adjustment for smoking, alcohol consumption, and socioeconomic status in the California Occupational Mortality Study.

This paper presents methods for adjusting for smoking, alcohol, and socioeconomic status in death certificate-based occupational mortality surveillance. The methods were applied in the California Occupational Mortality Study, a statewide study of rates based on 180,000 deaths and census estimates of occupations. For each occupation, levels of smoking, alcohol consumption, and socioeconomic status were estimated using National Health Interview Survey and U.S. Census data, and an empirical Bayes procedure was used to improve the stability of smoking and alcohol estimates for small occupations. Expected death rates for occupations were calculated by modeling rates as a function of age, smoking, alcohol, and socioeconomic status with Poisson regression. The effect of adjustment was usually moderate and in the expected direction, and the adjusted mortality ratios were generally closer to 1.0. Full data on agricultural occupations are presented for illustration.

Adolescent↗