Biomedical subjects

L A Straub

Publications and source records attributed to L A Straub.

6 recordsLinked to original sources

PubMed1999

Consumer and provider evaluation of rural pharmacy services.

This paper compares consumer and provider perceptions regarding access to pharmacy services in rural Illinois, given a decrease in the number of pharmacies. Consumer data are from the Illinois Rural Life Panel in which more than 1,800 respondents answered questions about availability and use of pharmacy services and about insurance coverage and cost. A survey of all licensed retail pharmacies in 74 rural Illinois counties and in seven non-rural counties provided pharmacy background information and was the source of data on changes in profitability and payment sources. The data provided insight on factors that affect access. Descriptive statistics were used to analyze data from both groups to compare perceptions about access. The objective was to evaluate current access to pharmacy services and implications for future access from the perspective of consumers and pharmacists. Results from rural consumers show access is currently good; 77 percent have a local pharmacy, and 64 percent prefer this source. Future access is of more concern. Pharmacy survey results show 81.5 percent of rural pharmacies are experiencing declining profits from drug sales. Restricted reimbursements from third-party payers, demands of managed care and expanded competition are seen as threats to retention of local pharmacies and continued good access. An important finding, especially given survey evidence of increased managed care penetration, is the difference in views of pharmacists and consumers regarding the effects of managed care on access. Pharmacy survey data also revealed differences between rural and non-rural pharmacies.

Adult↗

PubMed1997

Restrictive practice environment and nurse practitioners' prescriptive authority.

This study analyzes the impacts of several variables, including a restrictive practice environment, on a nurse practitioner's level of autonomy with respect to prescribing selected categories of medicines. A general linear model is applied to data from the 1992 national sample of nurse practitioners. Results show that among the significant independent variables, a restrictive environment of imposed state laws and regulations reduces nurse practitioners' level of autonomy in prescribing medications and acts as a barrier to their practicing to full potential. Results and policy implications are discussed.

Drug Prescriptions↗

PubMed1994

Birth outcomes to rural Illinois residents: is there a crisis?

In recent years, the supply of obstetric services in rural areas has been a concern. At the same time, the demand for such services has been affected by the reduction in population and economic base. This article explores the extent of these trends in Illinois and whether they have led to a deterioration in amount of prenatal care and birth outcomes. Using birth certificate and infant death data for residents of rural Illinois counties in 1983 and 1988, prenatal care and birth outcomes for each year are compared within rural areas and to the rest of the state, as well as between the two time periods. Although rural residents began prenatal care later, they obtained similar qualities of care as their urban counterparts. The data revealed no adverse impact on birth outcomes of residing in increasingly rural areas, nor was there a deterioration during the time period. An attempt was made to identify rural counties that lost providers and/or facilities and those that gained them. Although such a classification scheme is subjective, similar results ensued. While indirect costs such as time and effort to obtain care may have increased, at 1988 levels of care availability there was no crisis in Illinois.

Data Collection↗

PubMed1990

Financing rural health and medical services.

The provision and utilization of health care services in rural areas are tied directly to the structure of financing. The model of rural health care shaped by federal policies over three decades was significantly altered by changes during the 1980s. With reactions of third-party payers to health care costs rising faster than inflation, the difficulty of accommodating access to care and cost efficiency in provision became evident. This review begins with the literature on patient services and capital financing of rural hospitals, then continues with the financing of clinics, community centers, and other supply forms. Research during the 1980s provides insight into the effects of various financing policies on the supply of services. The demand for health care in rural areas is characterized by less generous third-party coverage, leaving residents paying a larger share of their incomes for care than do urban residents. As a consequence, access to care is especially difficult for low-income and elderly people, heavily dependent upon government financing. Third-party payers have severely reduced cost shifting as a mechanism for taking care of the health care needs of a sizable share of the population, thereby placing providers in an uncomfortable position. Several potential and more formalized financing options for replacing cost shifting are discussed. Several important changes will take place with rural-focused legislation enacted in the late 1980s. These are used to present a rural financing research agenda for the 1990s.

Capital Financing↗

PubMedDate not supplied

Clinical database repository--a solution for outcomes assessment.

This paper describes how implementation of a Clinical Database Repository (CDR) presents health care organizations with a tool to respond actively to quality and cost demands of the current delivery setting. The CDR is an innovative technological solution to integrate unlimited laboratory data with data from other systems, thereby expanding the contribution of routinely collected laboratory data to broader outcomes assessment goals of an organization. The technical components of a CDR, implementation methods, and deployment benefits to an organization are discussed. The resulting outcomes assessment from this tool will enable an organization to positively and cost-effectively influence how care is provided through system rules validation, measuring benefits of new technology, reducing unwarranted practice pattern variation, and validating practice guidelines. Although the value of systems such as CDR has been documented, their full potential for outcomes assessment has yet to be explored.

Clinical Laboratory Information Systems↗

PubMedDate not supplied

RCTs: not the answer to the nursing shortage.

An economic analysis was made of the proposal to create registered care technologists (RCTs) as an alternative to nurse market disequilibrium. RCTs may be a short-term solution to some, but more effective options may make use of existing resources.

Allied Health Personnel↗