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Biomedical subjects

R L Kane

Publications and source records attributed to R L Kane.

At least 199 records · Page 11Linked to original sources
PubMed1981

Short- and long-term residents of nursing homes.

This article analyzes reported data on length of stay of discharged patients from the 1977 National Nursing Home Survey. Assuming that patients admitted to nursing homes are one of two types, short-stayers and long-stayers, the statistically best-fitting proportions and expected lengths of stay for the two types are derived. The results are applied to statistics on characteristics of resident and discharged patients to find admission characteristics that differentiate the two groups. Because long-stayers and short-stayers have quite different characteristics, nursing home statistics will be very different if one bases them on discharges or a cross-section of residents. For example, we estimate that short-stay patients represent 61 per cent of discharges but only 9 per cent of residents. A further application shows that, including deaths in hospitals, almost half of discharged patients die, rather than the usually cited figure of 25 per cent.

Aged↗
PubMed1981

Improved care for patients on a new geriatric evaluation unit.

An analysis is presented of a geriatric evaluation unit (GEU) established at the Sepulveda VA Medical Center in 1979 to provide comprehensive interdisciplinary assessment and treatment of geriatric inpatients. The data on 74 patients admitted during the first year show that major improvements can occur in several outcome areas. Placement location was improved over expectations in 48.4 percent of patients, thus permitting a higher level of independence with a lower level of care requirements. Functional status (Katz ADL scale) improved in two-thirds of the patients who could have shown improvement. An average of almost four new treatable disorders not noted by previous physicians were diagnosed per patient. The mean daily number of prescribed drugs was reduced by 32 percent per patient, and the total number of drug doses by 43 percent. Though limited by the unique aspects of the vA situation and by lack of a control group, the findings lend support to the efficacy and value of the GEU concept. (A randomized controlled study is in progress.)

Activities of Daily Living↗
PubMed1981

A guide through the maze of long-term care.

Complicated requirements regarding eligibility and coverage as well as variations in the availability of programs confuse even the most diligent physicians trying to advise elderly patients about health care services. Nevertheless, awareness of such government and community resources is critical because physicians play an essential role in assisting the elderly to receive maximum health care benefits, particularly during long-term illness.

Aged↗
PubMed1979

Looking inward.

Explore the source record for details and available documents.

Preventive Medicine↗
PubMed1979

Cardiovascular effects of exercise in hamsters with experimental thiamine deficiency.

The hemodynamic effects of daily treadmill exercise were evaluated in hamsters with experimental thiamine deficiency to test the hypothesis that increased energy consumption might be a contributory factor in the pathogenesis of beriberi heart disease. Daily exercise enhanced thiamine deficiency and was manifested by earlier development of symptoms of neuropathy compared to non-exercised animals. Hemodynamics of exercised thiamine deficient animals were characterized by significantly lower O2 consumption, lower cardiac output, and lower left ventricular minute work, compared to exercised, pair-fed control animals. Left ventricular end-diastolic pressure was slightly but not significantly higher in thiamine deficient animals. Left ventricular function, therefore, was depressed in this group. There was no evidence of hyperkinetic circulation, cardiomegaly or congestive heart failure. Neuropathy and depressed ventricular function, characteristic of pure thiamine deficiency, were observed in the absence of high cardiac output or high output failure, the pathogenesis of which may require other unknown factors.

Animals↗
PubMed1978

Care of the aged: old problems in need of new solutions.

Long-term care for the aged in the United States is overly dependent upon the nursing home. This hospital-like model for long-term care is particularly inappropriate since it imposes a medical solution on a variety of social problems. An adequate long-term care program requires a range of resources in the community as well as in institutions; sheltered housing options seem a desirable alternative to the nursing home. To ensure the quality of nursing home care, the present focus on setting standards for care activities should be abandoned in favor of a focus on care outcomes (physical, mental, and social). In an effort to change our present perverse incentives in the nursing home industry, the proposal is made that nursing homes be reimbursed according to the degree to which patient outcomes meet predicted outcomes.

Aged↗
PubMed1978

Effects of adding a Medex on practice costs and productivity.

Archival data on ten rural practices employing a Medex and on ten matched controls were compared to determine changes in the volume of patients seen and changes in the practice finances before and after the employment of a Medex. There were no significant differences in the changes in patient volume; however, the practices that employed a Medex showed an increase in revenue and in net profit per physician. On the average, the net profit increased approximately $11,000 (22%) for the physicians with Medex, compared with $9,000 (21%) for the control physicians.

Costs and Cost Analysis↗
PubMed1978

Differences in the outcomes of acute episodes of care provided by various types of family practitioners.

This study was designed to compare the outcomes achieved in a series of acute care episodes by different levels of family practice providers working in the clinic setting. The study utilizes a method which depends upon the provider to estimate level of function expected and earliest date of recovery for each episode. When the patients are viewed as a single group, those patients treated by the medex appear to fare considerably better and those seen by a faculty member do worse; however, when each functional status group is examined separately, only the asymptomatic but clinically ill patients (45 cases) show a statistically significant difference in outcomes among the providers, with the medex having good results and the faculty poor results.

Acute Disease↗
PubMed1978

Toward the measurement of primary care.

The renaissance of rhetoric about primary care--"continuous, coordinated, comprehensive, family-centered"--has paralleled the growth of entrants into formal training programs. The extent to which primary care is actually practiced this way has not been examined, nor have the routes to preparing for it. A preliminary set of measurements is suggested.

Adolescent↗