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Biomedical subjects

R A Connor

Publications and source records attributed to R A Connor.

At least 19 recordsLinked to original sources
PubMed2000

Medical residencies and increased admissions in rural hospitals with fewer than 200 beds.

Medical education programs in general, and rural residency programs in particular, can be beneficial for rural hospitals. This study of 1,792 non-metropolitan statistical area, acute general hospitals with fewer than 200 beds from 1993 to 1996 was designed to help rural hospitals and communities to quantify the likely effects of rural residency programs on hospital admissions. Data came from the hospital Prospective Payment System minimum data set. The results show that additional residents at rural hospitals with fewer than 200 beds generally result in an increase of approximately 100 to 200 admissions per resident--more for smaller hospitals and fewer for larger hospitals. Because increased admissions generally improve the financial health and continued operation of rural hospitals, this study confirms the importance of education-based strategies in ensuring access to care in rural communities.

Aged↗
PubMed2000

Movement toward individual health benefit accounts.

There are strong pressures for employers to pursue defined contribution health benefits with individual health benefit accounts such as Medical Savings Accounts (MSAs), Health Care Reimbursement Accounts (HCRAs), and Comprehensive Individual Medical Accounts (CIMAs). Health care consumers are becoming more assertive. The political backlash against managed care is eroding provider-based cost control mechanisms. Health insurance premium inflation is intensifying. Advocates of the movement toward individual health benefit accounts view them as a means of restoring autonomy to the physician-patient relationship and controlling costs. Opponents are concerned that individual health benefit accounts of any type will segment insurance markets, benefiting the healthy and wealthy at the expense of the chronically ill and the poor. Can these accounts be designed so as to achieve their positive effects and minimize negative effects?

Community Participation↗
PubMed1995

An analysis of physician recruitment strategies in rural hospitals.

This article analyzes the importance and effectiveness of several physician recruitment strategies in 60 short-term general hospitals in rural Minnesota. The results suggest that rural hospitals should continue to attract physicians with quality facilities and services, increase efforts to facilitate group practice opportunities, and rely less on direct financial incentives.

Group Practice↗
PubMed1995

Competition, professional synergism, and the geographic distribution of rural physicians.

This study provides a theoretical and empirical investigation of competition and synergism among physicians in rural areas. The results show that rural primary care physicians cluster together rather than distribute themselves evenly. This suggests that public policy makers and rural communities must take an active role to ensure provider availability in all rural areas. There is less clustering among subspecialists. The results also reveal a disturbing negative relationship between young children and physician availability in rural areas. Finally, the results provide strong evidence that the relationship between rural physicians and hospitals is synergistic.

Adolescent↗
PubMed1995

U.S. hospital workforce-to-population ratios by service area.

Traditionally, hospital productivity has been measured in terms of episodic patient services such as days or admissions. However, the delivery of health care is shifting toward a greater focus on the health of a covered population. Thus, population-based indicators of hospital productivity are needed. This work analyzes hospital FTEs per 10,000 served population across the United States as a function of regional demographic, socioeconomic, and geographic factors. For managers of integrated service networks, it provides benchmarks for hospital FTEs per service population for several personnel categories. Important findings for public policy include an 11 percent increase in FTEs per 1 percent increase in interns and residents and a 2 percent increase in FTEs per 1 percent increase in the elderly.

Catchment Area, Health↗
PubMed1994

Do case-mix adjusted nursing home reimbursements actually reflect costs? Minnesota's experience.

Some states have adopted Medicaid reimbursement systems that pay nursing homes according to patient type. These case-mix adjusted reimbursements are intended in part to eliminate the incentive in prospective systems to exclude less profitable patients. This study estimates the marginal costs of different patient types under Minnesota's case-mix system and compares them to their corresponding reimbursements. We find that estimated costs do not match reimbursement rates, again making some patient types less profitable than others. Further, in confirmation of our estimates, we find that the percentage change in patient days between 1986 and 1990 is explained by our profitability estimates.

Cost-Benefit Analysis↗
PubMed1994

Association between rural hospitals' residencies and recruitment and retention of physicians.

PURPOSE: To analyze the association between rural hospitals' participation in residency training and their subsequent success in physician recruitment and retention. METHOD: The units of observation were 1,789 short-term, general hospitals that were located in nonmetropolitan U.S. countries, had medical staff information available, and did not close, open, or merge from 1985 through 1989. Multivariate analysis was done using ordinary least-squares estimation. The dependent variable was the change in the size of the medical staff at each hospital. Several characteristics of the hospitals and their counties were used as independent variables, the primary one being the number of housestaff at each hospital in 1985. RESULTS: The 66 rural hospitals that invested in housestaff were found to be more successful in physician recruitment and retention in subsequent years. On average, for every eight housestaff in 1985, each hospital gained approximately one additional physician on its medical staff from 1985 through 1989. CONCLUSION: The rural hospitals with residencies were more likely to be successful at recruiting and retaining physician staff than were the hospitals without residencies. Because most of the residencies were probably in primary care specialties, this finding is suggestive in light of the national need for primary care training as well as for successful recruiting strategies for rural hospitals.

Hospitals, Rural↗
PubMed1987

Genetic aspects of early childhood scoliosis.

Eighty-seven families with early onset scoliosis were evaluated. These were divided into 3 groups: resolving infantile idiopathic scoliosis (15 families), progressive infantile idiopathic scoliosis (21 families), and congenital scoliosis due to vertebral malformations (51 families). The children with congenital scoliosis were subdivided into those who had closed neural arch defects (19 families) and those who did not (32 families). Resolving infantile idiopathic scoliosis was usually associated with plagiocephaly, and both deformations tended to show spontaneous recovery. These children were otherwise normal. Seven (33%) of the children with progressive infantile idiopathic scoliosis were mentally retarded, but only 2 had a congenital malformation. In contrast, 18 (33%) of the children with congenital scoliosis had other malformations, but only 2 were mentally retarded. The recurrence risk for scoliosis was low in each group studied. However, there was an increased risk (4% for sibs) of neural tube defects in the families with congenital scoliosis (with or without neural arch defects). This sib risk was apparent for probands with only a single hemivertebrum in addition to probands with more extensive vertebral defects and would support an etiological relationship between neural tube defects and other vertebral malformations.

Abnormalities, Multiple↗
PubMed1986

Monozygotic twins concordant for congenital short femur.

We report concordant male monozygotic twins with congenital short femur (proximal focal femoral deficiency) and discuss the aetiological implications. Coincidentally, they and their father have benign familial macrocephaly.

Femur↗
PubMed1985

Lethal neonatal chondrodysplasias in the West of Scotland 1970-1983 with a description of a thanatophoric, dysplasialike, autosomal recessive disorder, Glasgow variant.

Complete ascertainment of lethal neonatal short-limb chondrodysplasias was attempted in the West of Scotland for the period 1970-1983. Forty-three cases were identified, representing a minimum incidence of 1 in 8,900. The differential diagnosis included 11 well-delineated skeletal dysplasias, one case of warfarin embryopathy, and one apparently new condition with presumed autosomal recessive inheritance that has radiographic similarities to those of thanatophoric dysplasia (TD). In this series TD had an incidence of 1 in 42,221, which is consistent with new dominant mutation at a rate of 11.8 +/- 4.1 X 10(-6) mutations per gene per generation. Ultrasonic measurement of fetal long bone length was performed in eight subsequent pregnancies at risk. Five unaffected fetuses were predicted correctly and three affected fetuses were detected during the second trimester (one with rhizomelic chondrodysplasia punctata-second trimester prenatal diagnosis not previously reported; one with achondrogenesis type II; and one with the new lethal condition).

Chondrodysplasia Punctata↗
PubMed1981

A management strategy for prospective case-based payment.

Now is the time for developing prospective case-based payment systems, which expand managerial responsibility. Many states are considering implementing these systems for potentially decreased health care costs, more refined measurement of productivity and increased political control.

Costs and Cost Analysis↗