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Biomedical subjects

R L Kane

Publications and source records attributed to R L Kane.

At least 235 records · Page 13Linked to original sources
PubMed1976

Is good nursing-home care feasible?

A program using a team consisting of a nurse practitioner and a social worker to provide care for nursing-home patients was established. An important feature is the use of a specially designed problem-oriented record. The project disclosed a number of current deficiencies in nursing-home care and demonstrated ways to remedy many of these. The overall cost of the project was offset by the savings realized from reduced hospitalization and related medical costs.

Cost-Benefit Analysis↗
PubMed1976

Medical care as a commodity: an exploration of the shipping behavior of patients.

A 10% household sample of high- and low-income census tracts was interviewed to assess the extent of doctor shopping. In 632 households studied, 53% of high socioeconomic status and 51% of low socioeconomic status families had shopped for or changed doctors of their own volition. During the previous year, 4% of each socioeconomic group had consulted more than one doctor without referral for the same episode of illness. Shoppers could be distinguished from non-shoppers--shoppers were younger, were better informed about medical specialties, were less self-reliant, more hypochondriacal, expressed less hostility towarn physicians, and had less positive attitudes toward the medical care system. The differences between shoppers and non-shoppers were generally similar for both high and low socioeconomic status groups. In addition, 52% of the families studied had been forced to change doctors because of circumstances beyond their control, i.e., the patient moved or the doctor moved, retired, or died.

Adult↗
PubMed1976

Here we go again.

Explore the source record for details and available documents.

Health Occupations↗
PubMed1976

Measuring outcomes of care in an ambulatory primary care population. A pilot study.

This study developed a practical method for determining the functional outcome status of patients in an ambulatory setting. Health status of 1,840 primary care patients in an ambulatory setting. Health status of 1,840 primary care patients was compared at three points in time: patient's usual status, status at the initial visit, and status at time of telephone follow-up. Follow-up status was also compared with the physician's expectation, which was estimated at the time of the initial visit. Of the patients, 62% showed improvement, 31% remained at the same level, and 7% deteriorated from the time of their initial clinic visit. Physicians tended to overestimate either the speed or degree with which patients return to their usual functional status; 32% of the patients studied reported themselves as being less well than usual at the time of follow-up.

Ambulatory Care↗
PubMed1976

Communication patterns of doctors and their assistants.

Communication patterns between physicians and their assistants (Medex) were observed in 19 practices to describe and evaluated the nature of their relationship. Observations demonstrated that interaction around patient problems was approximately 30 minures per day and informal, with the Medex more often initiating the contact. Medex were more likely to ask for, and physicians were more likely to give, suggestions. Physicians appeared to regard the accomplishment of the immediate task as more important than maintaining good relations. In most practices, supervision was available when requested. Generally, both the physician and the Medex show a striking similarity in communication styles.

Communication↗
PubMed1976

Adding a Medex to the medical mix: an evaluation.

Three classes of Medex were followed during their preceptorship training and subsequent employment to assess the impact of adding such physician assistants on 13 private practices. The data suggest that the Medex are readily incorporated into the practice, seeing a similar spectrum of patients and generally functioning as a semicolleague. Although the Medex was almost universally a contributing addition to the practice, increasing patient volume, the specific effects varied with the setting.

Adolescent↗
PubMed1976

Ventricular elastic modulus as a function of age in the Syrian golden hamster.

Analysis of passive right and left ventricular pressure-volume curves for hearts of 72 Syrian golden hamsters studied in vitro showed increases in ventricular weight, volume, and compliance at mid-age. Both ventricles were filled by syringe pumps at a constant rate. Ventricular compliance (dV/dP) was determined by electronic differentiation of the intraventricular pressures and formation of the ratio (dV/dt)/(dP/dt) as a continuous function of intraventricular pressure between 0 and 30 mm Hg. By relating, with justification, the left ventricle to a thin-walled elastic sphere, ventricular elastic moduli, E, for different ages were compared at constant levels of myocardial wall stress, sigma. The elastic modulus E proved to be a linear function of sigma. The slope of the E-sigma plot yielded a stiffness constant, K, for each age group. Body weight, heart weight, end-diastolic volume, and dV/dP all varied by more than 200% up and then down as a function of age, but K was not a significant function of age. These results suggest that the aging heart does not normally undergo substantial alterations in passive properties that affect the muscle cells and fibers themselves, but rather that the observed changes in compliance are primarily attributable to alterations in ventricular size.

Aging↗
PubMed1976

Social work in the nursing home: a need and an opportunity.

Working on a Nursing Home Demonstration Project seeking alternative forms of care for this "abandoned" population, and testing the cost-effectiveness of these forms, is the vantage point from which the social worker involved assessed how her professional skills meshed with patient needs. How patients' levels of functioning and behavior were improved through the exercise of administrative, educational and practice skills is defined.

Activities of Daily Living↗
PubMed1976

The use of utilization review records as a source of data on nursing home care.

Data form the Utah nursing home Utilization Review Program, 1970-73, provide a description of the population of nursing home patients in Utah and changes over time in patient medication and measures of activity. These data are analyzed according to type of care in home: personal, intermediate, or comprehensive. The collection of data in utilization review programs can help to evaluate the quality of care as well as appropriateness of placement, provided the information collected is designed with these ends in mind.

Adult↗
PubMed1976

Issues underlying prevalence of "doctor-shopping" behavior.

Data were collected on all persons within a sample of upper-and lower-income households who had seen physicians for illness episodes within a year prior to the interview. Forty-eight percent of upper-and 37 percent of lower-income families in the sample had changed doctors because of dissatisfaction with some aspect of the care. Factors related to tendency to shop for doctors in both upper-and lower-income groups were a lack of confidence in doctors' competence, unwillingness of doctors to spend time talking with patients, hostile feelings toward doctors, high cost of services, inconvenience of location and hours, and unfavorable attitudes toward doctors' personal qualities. Hypochondriasis was related to doctorshopping in the upper-income group. Results of this investigation suggest that patients may be becoming more discriminating in their choice of physicians.

Attitude↗
PubMed1975

Mail-order medicine; An analysis of the Sears Roebuck Foundation's Community Medical Assistance Program.

Of the 625 rural communities that originally applied to the Sears Roebuck Foundation's Community Medical Assistance Program, 253 were accepted. One hundred sixty-three went on to build clinics, and 132 had physicians at the time of follow-up. From the standpoint of physician coverage of the community once a clinic had been built, the rate of physician availability was 78 percent, The communities' success in recruiting and retaining physicians was compared against 13 variables; none was significantly related to the recruitment, and only two--numbers of service clubs and distance to nearest physician--were related to retention.

Community Health Services↗