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Biomedical subjects

R Andersen

Publications and source records attributed to R Andersen.

At least 91 records · Page 5Linked to original sources

Methodological issues in health care surveys of the Spanish heritage population.

This paper examines national survey data on access to medical care to explore methodological issues associated with conducting health care surveys of Spanish-heritage persons. These include problems of identifying and sampling such groups, achieving respondent cooperation, designing valid interview protocols, and controlling biases that may result from the cultural specificity of the concepts being studied. The findings suggest that more attention should be given to the following in designing health care surveys of Spanish-heritage individuals: cultural and economic heterogeneity of "Spanish-heritage" grouping, validity studies of health care utilization, and yea-saying tendencies related to health care attitude items. Given that there is a paucity of information available on methodological problems associated with health care surveys of Spanish-heritage persons, these analyses should serve to inform researchers of issues to be taken into account in designing such studies and to suggest useful hypotheses to explore in evaluating the validity of social survey data on minority (especially non-English speaking) populations' health care practices.

Adolescent

Adult respiratory distress syndrome precipitated by massive salicylate poisoning.

Pulmonary oedema has been reported in severe cases of acetyl salicylic acid (ASA) poisoning. Liberal use of intravenous fluids, to establish a forced diuresis, is usually thought to be the precipitating cause. A case of severe ASA poisoning and respiratory failure was found to have increased pulmonary vascular resistance and signs of intravascular hypercoagulability. The patient recovered rapidly on mechanical ventilation with a positive endexpiratory pressure of 18 cm H2O and systemic steroids.

Aspirin

Access to medical care in the U.S.: realized and potential.

This paper seeks to provide a framework for understanding differential access to medical care in the U.S. population and to suggest ways to achieve equity of access. The framework is provided by a behavioral model of health services utilization which suggests a sequence of predisposing, enabling and illness variables that determine the number of times people will visit a physician. The model is operationalized using a path analytic technique. The data come from a national survey of the noninstitutionalized U.S. population conducted in late 1975 and early 1976. The results suggest services are generally equitably distributed since age and level of illness are the main determinants of the number of services people receive. However, remaining inequities might be reduced by providing people who report no regular source of medical care with a familiar entry into the health service system.

Analysis of Variance

Health status indices and access to medical care.

This paper examines the uses of some health status indices in measuring equity of access to medical care. Empirical examples are provided using data from national surveys of the U.S. population conducted from 1964 through 1976. A simple indicator, mean number of physician visits, suggests that between 1963 and 1976 the poor improved their position relative to the rest of the population and, indeed, currently enjoy the highest level of access. However, a second measure, the use-disability ratio indicates that the poor may still receive less care relative to their need. A third measure, the symptoms-response ratio suggests how norms of appropriate behavior might be incorporated into an access measure.

Disability Evaluation

Insurance coverage and access: implications for health policy.

Data are presented from a recent survey of the United States population comparing the characteristics and levels of access to medical care of persons under 65 years who have group or individual private health insurance, public health insurance, or no third-party coverage. The uninsured group appeared to fall between the privately insured and publicly insured groups on measures of social and economic status. Persons with publicly subsidized forms of insurance coverage utilized services at the highest rates, and uninsured persons used them at the lowest rates. Neither of these groups was as satisfied with the convenience or the quality of the care it obtained as the privately insured group. Implications of these findings for national health insurance and other health policy initiatives are discussed.

Adolescent