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Biomedical subjects

N Givner

Publications and source records attributed to N Givner.

15 recordsLinked to original sources
PubMed1990

The effects of area health education centers on primary care physician-to-population ratios from 1975 to 1985.

The purpose of this study was to explore how the primary care (PC) physician-to-population ratio changed from 1975 to 1985 in counties that were served by an Area Health Education Center (AHEC) in contrast to those counties that were not. The investigation attempted to determine whether any observed changes in this ratio were dependent upon either degree of urbanization or contiguity to a Standard Metropolitan Statistical Area (SMSA). The data source for this study was the Area Resource File. Results indicated that: (a) irrespective of AHEC status, increased degree of urbanization across counties was associated with relatively more PC physicians in both 1975 and 1985; (b) PC physician-to-population ratios increased from 1975 to 1985 for all American Medical Association (AMA) county code categories, regardless of AHEC versus non-AHEC designation; (c) AHEC counties demonstrated greater (or equivalent) absolute improvement for all AMA county code categories except for several categories which represented more urbanized counties; (d) for the least urbanized counties in the AMA code, the percentage improvement in PC physician-to-population ratios for AHEC counties ranged from 3 to 5 percent higher than corresponding percentage improvement in ratios for non-AHEC counties; and (e) AHEC counties showed greater absolute and percentage improvement in PC physician-to-population ratios than did non-AHEC counties for counties not contiguous to SMSAs.

Area Health Education Centers↗
PubMed1983

Physician distribution in a predominantly rural state: predictors and trends.

The present study examined changes in physician distribution across time in a predominantly rural state to determine the generalizability of national studies of physician distribution. Contrary to recent national findings, decreases in the population/physician ratio occurred only for counties having populations greater than 25,000. When county population was controlled for by entering it hierarchically as the first predictor in the regression analysis, number of applicants to medical school from a county was the only consistently significant predictor of physician distribution.

Education, Medical↗
PubMedDate not supplied

Computerized medical records and clinic function.

Formal studies of computerized information systems for ambulatory patients are rare. As part of an evaluation of the effects of such a system on clinic function, we divided the residents in our teaching clinic into a study group with access to COSTAR and a control group with access to conventional medical records alone. Nurses and clerical personnel in the clinic were allowed to use the computerized records only for patients of residents in the study group. We sampled the attitudes of nurses and clerical personnel toward use of the computer and performed detailed time studies of patient flow in the clinic. Responses to questionnaires reflected acceptance of computerization by the personnel sampled, who favored COSTAR records over conventional records, primarily because of the increased availability of information for telephone management and demand care. The residents never became facile users of COSTAR--a problem that we attribute to the infrequency of their clinic sessions. As a result, and because the workloads of residents using COSTAR were larger, waiting times were longer in clinics attended by these residents. Overall, the most intensive users of the computerized medical records were not the physicians. Improved productivity and better use of time among the nurses and clerical personnel were thought to outweigh the residents' perceptions.

Attitude to Computers↗