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Biomedical subjects

R J Willke

Publications and source records attributed to R J Willke.

10 recordsLinked to original sources
PubMed1995

Re-engineering drug development: integrating pharmacoeconomic research into the drug development process.

Pharmacoeconomic research will be an increasingly important aspect of drug development as providers, third-party payers, and worldwide government health agencies use cost-effectiveness and quality-of-life data to assist in making decisions on optimal pharmaceutical treatment protocols, formulary listings, and reimbursement. It is in the best interest of pharmaceutical companies to have an established, well-integrated pharmacoeconomic research program that can respond to the dynamic health-care environment and proactively plan a program to optimize patient care. The new paradigm for pharmacoeconomic research will require establishment and successful management of many internal and external customer relationships. This article discusses one company's organization of these relationships and how they are integrated into the drug development process during each stage of the product life cycle.

Drug Evaluation↗
PubMed1993

Assessing the validity of the geographic practice cost indexes.

Data on physician practice inputs were used to test the degree to which the geographic practice cost indexes (GPCIs) of the Medicare physician payment schedule reflect geographic variation in input prices. For purposes of this study, input quantity information was collected through the American Medical Association's Socioeconomic Monitoring System survey in 1990 and 1991. These data, along with practice expense information, were used to construct unit input prices. The GPCIs were correlated with input prices; however, "real" or GPCI-adjusted prices varied significantly across locations. We conclude that the GPCIs are useful, but imperfect measures of geographic differences in physician practice input prices.

American Medical Association↗
PubMed1992

Young physicians most and least likely to have second thoughts about a career in medicine.

To identify factors associated with apparent disaffection with medicine as a career, the authors analyzed data for 4,931 young physicians surveyed in 1987. Using survey responses, the authors classified 932 of the physicians (18.9%) as most likely to have second thoughts about their career choices and 1,094 (22.2%) as least likely to have second thoughts. The group with the greatest reservations included significantly higher proportions of white women, blacks, and Hispanics. This group reported significantly lower incomes, higher educational debt, and more hours and patients' visits per week. Among employee physicians, those most disaffected were significantly more likely to report inappropriate use of tests and procedures and lack of autonomy in their practices. The authors conclude that it is important to reexamine the heavy reliance on debt financing of medical education, especially for minority students, and to explore the equality of career opportunities for women and minorities in medicine.

Adult↗
PubMed1992

Physician-based measures of Medicare access.

Physician payment reforms implemented in January 1992 have dramatically changed the way payments for services are determined under the Medicare Part B program. This paper presents new measures of access using physician-level data that provide a baseline for monitoring changes in access that might occur as these payment reforms unfold and that allow us to examine recent access trends. Our results suggest that Medicare beneficiaries as a group currently have a high degree of access to care, and that access generally improved between 1986 and 1990.

Financial Management↗
PubMed1991

Practice mobility among young physicians.

This study examines practice mobility among young physicians, based on a large nationwide 1987 survey of physicians under age 40 years and in their second through fifth years of practice. Averaged across all physicians, there is a 10% to 12% chance of changing practices for each of the first 3 years, and about one in three physicians changes within the first 5 years. While the most common transition is from employee to self-employed practices, many practice changes are within employment type. Those starting in a self-employed solo practice are least likely to change practices, while those starting as HMO employees are most likely to change. Multinomial analysis of practice change choices reveals some specialty-specific differences in these choices, as well as the effects of experience, schooling, race, sex, debt, family constraints, and locational preferences. High debt is a factor in practice changes, but neither competition nor discrimination against minorities appear to play significant roles.

Adult↗
PubMed1991

Teaching hospital costs: the effects of medical staff characteristics.

This article examines the effect of medical staff behavior on the cost of hospital-based care and graduate medical education, and shows its implications for estimation of hospital costs. The empirical work brings a unique new data source for these characteristics to the estimation process. Our results indicate that there are important economies of scale and scope in hospital production, both for inpatient stays and for residency training. Controlling for medical staff characteristics significantly reduces the estimated costs of residency training. Staff characteristics may be capturing aspects of the quality of inpatient care and residency training provided by the hospital.

Costs and Cost Analysis↗
PubMed1990

Physician contact with and attitudes toward HIV-seropositive patients. Results from a national survey.

The growing population of HIV-seropositives raises serious concerns about who will provide medical care to this group. This article presents the first national estimates of physician involvement in, and attitudes toward, the treatment of HIV-seropositive patients. Nearly 50% of the nonfederal patient care physicians in our nationally representative sample have treated at least one HIV patient, with an average of 6.7 such patients being treated per physician. Perceived responsibility to treat HIV-seropositive patients is uniformly strong across such physician and practice characteristics as specialty, years of experience, and practice type. However, there are pronounced differences in actual physician involvement along these dimensions.

Age Factors↗
PubMed1989

Young physicians and changes in medical practice characteristics between 1975 and 1987.

This article examines the proposition that an increasing representation in the total physician population has subjected young physicians to "baby boom" cohort effects seen in the general population. Analyzing comparative changes in income and other medical practice characteristics between 1975 and 1987, we find moderate evidence to support this proposition, particularly when specialty selection and changes in the income distribution are taken into account. Young male physicians experienced a significant income decline, as did certain specialties. Other characteristics also suggest that young physicians are working relatively harder now than a decade ago. However, the income decline for young physicians is smaller than for other baby boomers.

Adult↗