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Biomedical subjects

P Galbraith

Publications and source records attributed to P Galbraith.

10 recordsLinked to original sources
PubMed2000

Managed care for uninsured patients at an academic health center: a case study.

In 1997, the University of New Mexico Health Sciences Center ("the Center") created a managed care plan ("the Plan") for its uninsured patients who were county residents. The Plan's features include pooling the resources of existing county safety-net providers, enrolling patients with primary care providers at easily accessible neighborhood-based clinics, and investing in social support services, case management, and 24-hour telephone triage. After two years of the Plan's operation, the utilization of ambulatory care services by Plan enrollees, the number of discharges per 1,000 enrollees from the Center-affiliated University Hospital, and the number of hospital days per 1,000 enrollees had all dropped significantly (p < .001 for all). For the 13,114 enrollees in the Plan, University Hospital saved an estimated $1,904,872 per year in costs. The replacement of unpaid hospital days with paying patients is estimated to have yielded over $695,000 in additional revenues per year. The authors conclude that managing the care of uninsured patients in an academic health center can reduce ambulatory care and inpatient utilization and reduce the cost of care. To achieve these favorable outcomes requires the organization of services to meet the unique needs of the uninsured and underserved population.

Academic Medical Centers↗
PubMed1996

Fostering the health of communities: a unifying mission for the University of New Mexico Health Sciences Center.

Fostering the health of communities can serve as a unifying mission of the academic health center (AHC), which can set the AHC apart from other health providers in the community. To achieve this mission, the University of New Mexico's AHC is increasingly focusing education, research, and service upon the identified health and service needs of communities in its state. Since major health problems in our society have social, behavioral, and economic roots, New Mexico's AHC has tapped into the broad expertise of its different components as well as that of its state and community partners to adequately address health problems in the community. Its hospitals offer financing and management resources, its colleges offer innovative approaches to community-based education, and the state department of health offers expertise in health policy development. To adequately respond to the complexity of community health needs, the different colleges and departments at New Mexico's AHC are increasingly merging into integrated governance units. Measures of community outreach success include evidence of strengthened community development, increased health care access, and improved indices of community health. New Mexico's AHC formed an interdisciplinary rural outreach task force, which has demonstrated its ability to form partnerships with state and local agencies and to mobilize institutional resources in education, research, and service from the AHC's different departments, colleges, and hospitals to respond promptly to unique community health needs. Evidence shows that such an integrated, coordinated AHC intervention can generate strong and lasting AHC-community alliances, improve the quality and economic viability of community health systems, and enhance the financial resources of the AHC.

Academic Medical Centers↗
PubMed1991

Absence of allelic loss on chromosome 5q by RFLP analysis in preleukemia.

Thirty-eight patients with various forms of myelodysplastic syndrome (MDS) were studied for the loss of restriction fragment length polymorphism (RFLP) heterozygosity on chromosome 5q as inferential support for the presence of a growth regulatory locus in this area of the genome. Conventional chromosomal analysis was performed in addition to RFLP studies of constitutive and granulocyte DNA using five polymorphisms from chromosome 5. Allelic loss in granulocyte DNA was identified in only one patient in whom monosomy 5 had already been defined cytogenetically. These results suggest that DNA sequence loss from chromosome 5q other than that observed cytogenetically is a rare event in MDS. Thus the potential involvement of a growth regulatory gene(s), from this area of the genome, in the leukemogenic process most likely involves a more subtle genetic change.

Alleles↗
PubMed1990

Diverticular complications of renal failure.

Ten patients with chronic renal failure presented with complications of colonic diverticula. Five had acute diverticulitis, 4 perforated diverticula, and 1 lower gastrointestinal hemorrhage. Symptoms were less severe than expected. In 3 the diagnosis was first suspected when free intra-abdominal air was detected. Seven patients had laparotomy, 5 emergently. Radiologists should be aware of the potential for diverticular complication in patients with renal failure, even with minimal or absent symptoms. Suspicion of colonic pathology either clinically or radiographically should be evaluated promptly so that aggressive therapy can begin.

Acute Disease↗
PubMed1982

Studies of human natural killer cells. III. Neutropenia associated with unusual characteristics of antibody-dependent and natural killer cell-mediated cytotoxicity.

A 52-year-old Caucasian man with chronic neutropenia and recurrent infections was found to have an increased proportion of peripheral T lymphocytes having Fc receptors for IgG (T gamma ). Although levels of antibody-dependent cell-mediated cytotoxicity (ADCC) and "natural" killing (NK) by unfractionated lymphocytes were similar to those of a control donor, the frequency of KN cells was markedly increased. Removal of E rosette-forming cells eliminated both NK and ADCC by the patient's peripheral blood, in marked contrast to the enhanced cytotoxicity seen with control lymphocytes. Both normal and patient ADCC and NK functions were removed by depletion of Fc receptor-bearing cells. These depletion experiments proved that all of the patient's killer cells were E rosette-forming T gamma cells, in contrast to the heterogeneous pattern of null gamma and T gamma killer cells seen in the blood of normal donors. The homogeneity of the T gamma proliferation suggested that ADCC and NK were mediated by the same cell type, albeit acting by different mechanisms. The addition of the patient's serum and lymphocytes to chromium-labelled normal granulocytes caused a low but significant level of cytotoxicity, indicating that the patient's neutropenia may have been caused by a similar mechanism in vivo. There was no evidence of complement-dependent serum antibody-mediated neutrophil lysis, but one serum sample taken over the course of the patient's disease agglutinated granulocytes from four of five donors tested.

Agglutination↗