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Biomedical subjects

L H Aiken

Publications and source records attributed to L H Aiken.

At least 19 recordsLinked to original sources
PubMed1990

Charting the future of hospital nursing.

Nursing roles are expanding in all health care settings; however, the majority of nurses will continue to practice in hospitals for the foreseeable future. Yet hospital nursing is experiencing great ferment and turmoil. Nurses are dissatisfied increasingly with hospital practice, and vacancy and turnover rates are high enough to raise major concerns about adverse consequences for patients. This paper focuses on the nature and causes of the current problems in hospital nursing and advances recommendations for charting a new course for hospital nursing.

Career Mobility↗
PubMed1990

Uninsured working-age adults: characteristics and consequences.

While estimates of the country's uninsured vary, ranging from 10 to 18 percent of the general population, virtually every study on use of medical services reports that lack of health insurance represents a major barrier to medical care. Based on the 1986 national Robert Wood Johnson Access Survey of 10,130 noninstitutionalized persons, the characteristics of working-age adults without health insurance, and the consequences, are examined. Among working-age adults, the uninsured are most likely to be poor or near-poor, Hispanic, young, unmarried and unemployed. Compared with the insured, they have significantly fewer ambulatory visits during a year, are less likely to have contact with a medical provider during a 12-month period, and are more likely to receive their care in a hospital outpatient clinic or emergency room. Differences in health status do not account for these findings. Especially among persons with chronic and serious illnesses, the uninsured are less likely than the insured to receive medical care. Further, the uninsured are significantly more likely to report needing but not receiving medical care, primarily for economic reasons, and although poorer, they have higher out-of-pocket medical expenses than others in the population.

Adult↗
PubMed1990

The culture of caring: AIDS and the nursing profession.

Caring for persons with AIDS calls upon a range of physical, psychological, social, and spiritual interventions that, in the absence of a cure, can make a palpable difference for patients. The "culture of caring" that nurses bring to bear on the epidemic is shaped by their education and socialization, and by shared background characteristics. The nursing profession has been among the leaders in organizing AIDS care; such care entails stress for individuals at a time when the profession and the health care system are facing a generalized crisis, but nurses have testified to the redeeming significance they find in performing their work. It remains to be seen whether the contribution nurses and their ethos of caring have made will endure to influence the relative status of this profession.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Access to medical care for black and white Americans. A matter of continuing concern.

A 1986 national survey of use of health services shows a significant deficit in access to health care among black compared with white Americans. This gap was experienced by all income levels of black Americans. In addition, the study points to significant underuse by blacks of needed medical care. Moreover, blacks compared with whites are less likely to be satisfied with the qualitative ways their physicians treat them when they are ill, more dissatisfied with the care they receive when hospitalized, and more likely to believe that the duration of their hospitalizations is too short.

Adolescent↗
PubMed1989

The hospital nursing shortage. A paradox of increasing supply and increasing vacancy rates.

A serious shortage of nurses has developed since 1984 despite a growing number of employed nurses and a substantial decline in the number of hospital inpatient days. The evidence suggests that the shortage is the result of an increased demand for nurses, not a decline in supply. The increased demand in large part has resulted from the substitution of registered nurses for licensed practical nurses, aides, and other patient services personnel. The substitution was feasible because nurses' wages have been depressed compared with those of other hospital employees. The shortage is likely to abate if nurses' wages increase, making substitution more costly. Even in the absence of continuing wage increases, hospitals could ease the shortage by restructuring patient services and enabling nurses to spend a greater portion of their time in direct patient care.

Health Services Needs and Demand↗
PubMed1986

Uncompensated care by hospitals or public insurance for the poor. Does it make a difference?

Results from two recent surveys of access to medical care, one nationwide and the other in Arizona, were analyzed to determine the consequences of reductions in Medicaid coverage for low-income Americans and the accompanying shift of responsibility for their health care to clinics and hospitals that provide uncompensated or subsidized care. The analysis indicated that in 1982, low-income persons received substantially less care from physicians if they resided in states without Medicaid programs or with only limited programs. In Arizona, the only state at the time without a Medicaid program, poor children saw physicians 40 percent less often, and poor rural residents saw physicians 22 percent less often, than poor residents of states with Medicaid programs; the proportion of poor Arizona residents refused care for financial reasons was almost double that in states with Medicaid programs. In addition, poor residents of states with the highest proportions of their low-income populations covered by Medicaid fared better than those in states with less extensive coverage. Moreover, poor elderly Americans were found to have comparable access to health care, regardless of where they lived, as a result of almost universal coverage under Medicare. Thus, this analysis suggests that the growing reliance on uncompensated care provided by hospitals and clinics may not be an effective substitute for public insurance and may adversely affect the health care received by the poor.

Adolescent↗
PubMed1984

The research program and priorities of the Robert Wood Johnson Foundation.

Since its establishment as a national philanthropy in 1972, The Robert Wood Johnson Foundation has appropriated almost $560 million in grants directed toward improvement of health in the United States. Grants are made primarily to develop innovative methods of providing health services, for research and evaluation, and for education and training of health professionals. Since 1972, more than $100 million has been appropriated for research and evaluation projects. The research supported by the Foundation is applied rather than basic, and, like all of the Foundation's programs, must be responsive to the institution's mission. In the 1980s, this mission comprises three objectives: improving access to health care for the most vulnerable underserved population groups, containing increases in health care costs, and improving functional outcomes for patients. In this article, we provide details on the Foundation's research program and priorities, including evolution of the mission, the role of research in the Foundation's overall programs, the purposes for which the Foundation supports research and evaluation activities, and the types of grants available for health services researchers.

Budgets↗