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Biomedical subjects

P Gertman

Publications and source records attributed to P Gertman.

8 recordsLinked to original sources
PubMed1997

Telematics in the neonatal ICU and beyond: improving care for high-risk newborns and their families.

The Beth Israel-Deaconess has recently been awarded one of 19 contracts from the National Library of Medicine (NLM) to develop, implement and test a telemedicine application to support the care of Very Low Birth Weight Infants. This project is the only one to focus on the care of newborns. We believe that this project will provide a new national approach to managing the care of high-risk newborns by leveraging evolving communication technology.

Computer Security↗
PubMed1989

Can payment incentives improve quality and efficiency of care?

Faced with increasing health care costs, America's major corporations are beginning to explore a variety of mechanisms to assure that health care providers are delivering high quality care. The General Motors Corporation (GM), with approximately two million employees, retirees and family members, and annual health care expenditures of approximately $3 billion, has developed a quality review system and a hospital payment mechanism that includes incentives to enhance the quality of care provided to GM beneficiaries. The following article describes this project.

Cost Control↗
PubMed1985

Referral of musculoskeletal disease patients by family and general practitioners.

We surveyed general and family practitioners to evaluate their patterns of referring musculoskeletal disease patients to rheumatologists and orthopedists. Patients who had rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis were most often referred to rheumatologists, whereas patients with osteoarthritis, persistent low back pain, and post-traumatic knee pain were most often referred to orthopedists. As conditions worsened in severity, referrals were more frequent. Patients with conditions that were difficult to diagnose, such as possible shoulder tendinitis that was unresponsive to initial nonsteroidal therapy, undiagnosed polyarthritis, and intermittent knee swelling with pain, were most often treated without referral and, when referred, were most often sent to orthopedists. Belief in the effectiveness of rheumatologists or orthopedists correlated strongly with reported referral behavior, yet most respondents considered themselves capable of managing the majority of patients with musculoskeletal diseases. Neither practice arrangement, board certification, nor educational background affected referral behavior. However, younger physicians were more likely (P = 0.002) to refer patients to rheumatologists. Multivariate analysis showed that the significant predictors of global referral behavior were belief in the effectiveness of subspecialists and a small number of musculoskeletal problems seen by the generalist. The predictors of referral to rheumatologists were belief in rheumatologist efficacy and young physician age.

Adult↗
PubMed1984

The dimensions of health outcomes: a cross-validated examination of health status measurement.

Two independently developed patient outcome measurement instruments were administered to forty-eight subjects with rheumatoid arthritis using a random cross-over design. The independent estimates of physical disability and pain are highly correlated. Each instrument displayed highly significant relationships with global health, providing evidence for convergent validity. The results demonstrate that health status is composed of at least three major dimensions: physical disability, psychological disability, and pain.

Arthritis, Rheumatoid↗
PubMed1979

The cost of cancer.

In the last 30 years medical science has developed an array of new technologies such as cell cytology, radio-isotopic scanning, soft tissue X-rays (mammography and computerized tomography), etc., which have potential for the early detection of cancer, and when coupled with current or future therapeutic techniques may lead to improved rates of cure or prolonged survival of patients with cancer. Whenever preliminary evidence of efficacy is developed, considerable public pressure mounts both within and outside the medical community to implement screening programs on a widespread basis. Advances in screening and treatment, however, are coming at a time when there is serious nationwide concern over the total amount now being spent for health care in the nation and the rate of inflation that has occurred almost every year. In the medical literature, the little existing identification of the costs and economic benefits of screening (and of disease control programs in general) is often presented in a fairly simplistic fashion. Yet, just as many of the biologic issues in cancer screening are complex, so too are the economic ones. This paper will begin to identify: 1. the economic approaches to evaluating screening, 2. the problems in specifying costs, 3. the issues involved in selecting benefit measures, and 4. how these interact in the formulation of screening policies. In addressing these issues, new data on cost of cancer treatment, based on the third National Cancer Survey, will be presented. These data include hospital and nonhospital costs, disaggregated by source, cancer site and stage.

Cost-Benefit Analysis↗