PubMed Health⌕ Search

Biomedical subjects

R L Douglass

Publications and source records attributed to R L Douglass.

15 recordsLinked to original sources
PubMed1994

Evaluation of a managed care program for the non-Medicaid urban poor.

In 1988, Detroit and surrounding Wayne County, Michigan, began CountyCare, an innovative managed care program designed to deliver health care services to the very poor while reducing excessive emergency-room and inpatient care. We interviewed 279 former CountyCare participants to assess differences in off-program utilization, use of clinical services, hospitalization, and patient satisfaction among respondents assigned to one of four CountyCare provider groups. Patients responded favorably to CountyCare, although off-program utilization was substantial and emergency-room and inpatient care were not significantly reduced. We conclude that how such a program is managed and administered, and a provider's degree of motivation, govern the extent to which it succeeds in reducing health care costs and increasing patient satisfaction.

Adult↗
PubMed1988

Drinking patterns and abstinence among the elderly.

For almost a decade the research literature has reflected both the scarcity of new knowledge regarding alcohol use or abuse among the elderly and the need to address the problem. Current theoretical perspectives on probable trends of alcohol-related problems among older persons include historical-cohort prediction, biological and clinical geriatric expectations, and sociocultural-economic expectations. These theoretical perspectives are frequently in opposition to each other and are largely untested with appropriate data. This paper introduces the principal theoretical perspectives of alcohol use among the elderly and presents recent data from a probability sample of noninstitutionalized elderly persons regarding alcohol consumption patterns, abstinence, and the influence of increasing chronological age and economic security on alcohol consumption.

Aged↗
PubMed1988

Representation of the black elderly in Detroit metropolitan nursing homes.

This paper presents the results of an analysis of the distribution of black elderly patients in the long-term care systems of Detroit City, Wayne, and Oakland counties, Michigan. These areas were chosen because of their proximity to Wayne State University and because Detroit has a large black population. Wayne and Oakland counties are largely suburban areas. Black, long-term care utilization was compared with the black elderly representation of the base population in these three locations. The sex-specific distribution between whites and blacks in long-term care populations revealed that black men utilized the greatest amount of long-term care and were more dependent on Medicaid. One hundred twenty-one licensed nursing homes were contacted by telephone and a follow-up questionnaire was sent to the respondents during the five-month study périod.It has been observed nationally that the elderly black population is underrepresented in the long-term care system. The findings obtained in this study, however, are not in agreement with the national trend. In Detroit, the black elderly are represented in nursing homes in approximate proportion to their representation in the larger community.This analysis raises questions of need vs utilization of long-term care by the black elderly in urban areas. This is the first study of black elderly long-term care representation in a specific urban area in the United States.

Black or African American↗
PubMed1984

Aging and alcohol problems. Opportunities for socioepidemiological research.

The social dynamics and epidemiological factors of alcoholism among old people are among the most important areas for research as the population of the United States ages and the reported incidence of alcoholism among the elderly increases. Little research has been conducted, however, that would provide an empirical basis for the development of interventions, policies, or programs designed to deal with the growing problem. This chapter reviews the current state of knowledge regarding published research in the area of aging and alcoholism and proposes areas in which research is badly needed. In addition, the results of the 1981 White House Conference on Aging that deal with alcoholism are reviewed in support of the proposed research initiatives.

Aged↗
PubMed1983

Youth, alcohol, and traffic accidents. Current status.

The interaction of youth, alcohol consumption and driving has been the leading contributor to morbidity and mortality in the United States among persons under 40 for over thirty years. While a considerable literature has evolved, only since 1968 has the literature acquired a truly scientific character; frequently the literature is not widely distributed and found only in technical reports. This contribution reviews the state of knowledge of youthful, alcohol-related traffic accidents based on both the open literature and the research which is found in technical documents. The consequences of youthful alcohol consumption and theories regarding the etiology of traffic accidents which result from drinking by youth, a review of attempts to reduce the magnitude of the problem, and recommendations for research are presented.

Accidents, Traffic↗
PubMed1983

Opportunities for prevention of domestic neglect and abuse of the elderly.

Recent research has demonstrated that domestic neglect and abuse of the elderly is not uncommon in the United States. It is a social problem that has not been extensively researched, however. One of the few studies, conducted in Michigan, found that the oldest and most frail elderly were a target group of elevated risk. Victims of neglect or abusive tend to be living with adult children or other informal caretakers who become neglectful or abuse when the burdens of providing care for a frail, elderly person interact with stress, little or no preparation for providing personal care over a long time span, medical problems of the caretaker, alcohol abuse, financial difficulties, and other situational factors. Family histories of neglect or abuse and other causal hypotheses have also been investigated. Recent studies are reviewed and found to be in general agreement regarding the nature and apparent dynamics of this emerging problem among the elderly. Opportunities for prevention are discussed in terms of current models of service to the aging and redirection of other public health and social services.

Aged↗
PubMed1981

Mistreatment of the elderly in the domestic setting: an exploratory study.

Professionals and practitioners (N = 228) involved in providing services to the elderly were interviewed regarding their experiences with the mistreatment of older people by their families. Semi-structured questions dealt with: case identification and follow-up procedures; perceptions of etiological factors; and descriptive typologies from illustrative case histories. Findings indicated that domestic mistreatment of the elderly was familiar to most professionals interviewed, to the extent that 60 per cent of the respondents dealt with such cases on a weekly basis. Among the 10 professional groups interviewed, there was little variation in their experiences with neglect; police officers, lawyers, community mental health and aging services workers had greater exposure to cases of physical abuse. Intentional mistreatment was typically viewed as a consequence of inadequacies in the caretaker, while unintentional cases were related to the victims' isolation. Most respondents indicated that there were no established procedures for dealing with, or following-up mistreatment cases, and over one-half reported that nothing was done. Differences in perception of the etiology of domestic mistreatment of the elderly were closely related to the occupational perspectives of the various respondent groups. Although incidence rates could not be established, 89 illustrative cases of domestic mistreatment of the elderly were indicative of the severity of the occurrences and the absence of appropriate interventions.

Aged↗
PubMed1979

Alcohol availability and alcohol-related casualties in Michigan 1968-1976.

In summary alcohol availability changed throughout the 1969--1976 time period with a particularly major change caused by the 18-year-old legal drinking age (1972) and increases in the numbers and hours-of-operation of on-premise consumption establishments. Eighteen to 20-year-olds experienced increases of at least 4600 additonal traffic crashes associated with alcohol of which at least 89 involved one or more fatalities in the 1972-1975 time period. Associated with the increase in crash involvement, draught beer consumption in Michigan dramatically increased. In the absence of any convincing explanations to the contrary, we consider these conservative analyses to be compelling evidence of the role of alcohol availability in the social etiology of alcohol-related traffic casualties.

Accidents, Traffic↗