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Biomedical subjects

R N Forthofer

Publications and source records attributed to R N Forthofer.

At least 19 recordsLinked to original sources
PubMed1993

Investigation of nonresponse bias: Hispanic Health and Nutrition Examination Survey.

This report presents an investigation of potential nonresponse bias in the Hispanic Health and Nutrition Examination Survey (HHANES) conducted during the period 1982-84. Data from a household and medical history interview were used to investigate factors related to examination status. The study includes a comparison of data for examinees in HHANES with data from interviewees in the National Health Interview Survey during 1982, 1983, and 1984.

Adolescent↗
PubMed1992

National standards of blood pressure for children and adolescents in Spain: international comparisons. The Spanish Group for the Study of Cardiovascular Risk Factors in Childhood and Youth.

This study determined age-specific patterns of blood pressure (BP) in Spanish children aged 1-18 years for the purpose of developing BP guidelines for this population. Age- and sex-specific BP levels were constructed by pooling data from 15 studies conducted in Spain. Pooled mean BP levels were then compared with those reported by the US Second Task Force on Blood Pressure Control in Children and those recently reported from a separate pooled analysis of the relevant published surveys collected worldwide. In the Spanish data, the average 1-year age increment in Systolic BP (SBP) was uniform for boys and girls until 13 years at 2 mmHg; for boys aged 13-18 the increase was 1.3 mmHg/year; in contrast, girls reached their maximum values at age 13 and the means remained basically unchanged for female adolescents. Fifth-phase diastolic BP (DBP5) values showed a uniform increase for both boys and girls from ages 6 to 18 years at 0.9 mmHg/year. In most age-sex subgroups, mean SBP values were higher (7-8 mmHg on average) in Spain than in the US. However, Spanish values for SBP were in general only slightly higher or approximately equal to those for the international data, from ages 6 to 18 years. The patterns of change in SBP with age differed somewhat in the three data sets. Comparisons for DBP were limited to the age groups for which readings of DBP5 were available. For DBP5, only slight differences between the Spanish and International pools were observed (ages 6-18 compared), but these values were notably higher than those from the US (ages 13-18 compared). These findings suggest that the use of any particular age-based standard to evaluate readings in children in diverse populations cannot be recommended, at least until there is a better understanding of the true differences in BP between populations.

Adolescent↗
PubMed1992

A profile of black and Hispanic subgroups' access to dental care: findings from the National Health Interview Survey.

This study examined which black and Hispanic minority subgroups were least likely to obtain dental care and why, based on logistic regression analyses of the 1986 National Health Interview Survey. Blacks and Hispanics were less apt to have private dental insurance coverage, to be knowledgeable about the purpose of fluoride, to have been to a dentist in the past year, and, when they did go, were more apt to have gone in response to symptoms rather than for preventive reasons, compared to whites. Logistic regression analyses for adults 18 years of age and older and for children and adolescents 2 to 17 years of age showed that the following individuals had the lowest probability of having been to a dentist in the past year: males, members of larger families, adults who were unemployed or in blue-collar jobs, those who lived in the South or nonmetropolitan areas, people who perceived their health to be fair or poor, and those with no private dental insurance. Mexican-Americans were least likely to have been to a dentist regardless of their income or education. In general, the findings confirmed the importance of dental insurance, as well as suggesting a need for more school-based dental programs and public health clinic-based dental health education and outreach efforts for targeting minority children and adults.

Adolescent↗
PubMed1985

Living arrangements and dietary patterns of older adults in the United States.

Living arrangements and dietary patterns were examined for 3,477 adults aged 65 to 74 from the first National Health and Nutrition Examination Survey 1971 to 1974 (NHANES I). Several indicators of dietary variety, diet composition, and energy and nutrient intake from both the 24-hour recall, and the dietary frequency questionnaires were analyzed. Dietary patterns of older men were associated more strongly with type of living arrangement and income compared with older women. Men living with a spouse consistently had more favorable dietary patterns than either those living alone or those living with someone other than a spouse. Low income men who were not living with a spouse were at highest risk of poor dietary intake. Income was associated more consistently with the dietary indicators than type of living arrangement for women. Income, however, was still a less consistent influence on dietary patterns of older women compared to older men.

Aged↗
PubMed1984

DRGs in psychiatry. An empirical evaluation.

On October 1, 1983, Medicare began paying general hospitals by a prospective payment system based on DRGs. Psychiatric settings are exempted automatically or by request. By January 1985, however, a decision is required on how to integrate psychiatric settings into this system. This article provides an empirical analysis of the current DHHS DRGs categories for mental disorders. Current mental disorder DRGs and alternate DRGs examined here explain less than 3-12% of the variation in psychiatric length of stay. This is in contrast to 30-50% explained variation for other disorders. Alternatives and policy implications are discussed.

Adult↗
PubMed1984

Diagnosis-related groups for mental disorders, alcoholism, and drug abuse: evaluation and alternatives.

Under the new federal prospective payment system, 15 of the 467 diagnosis-related groups (DRGs) cover mental disorders, including alcohol and substance abuse. The authors compare these 15 DRGs with some criteria of an ideal patient classification system. According to their assessment, the DRGs for mental disorders pose no administrative problems, but are not sufficiently homogeneous within categories or heterogeneous between categories. The authors conclude by discussing their own attempt to develop alternative DRGs, based on such variables as age, marital status, and type of treatment as well as on diagnosis.

Alcoholism↗
PubMed1983

Investigation of nonresponse bias in NHANES II.

In the second National Health and Nutrition Examination Survey (NHANES II), there was a 27% nonresponse rate in the examination phase. This report investigates the potential bias in these data due to this large nonresponse rate. Data from a household and medical history interview are used in the investigation of factors related to examination status. In addition, data from the examined group are compared to data from the 1976 National Health Interview Survey (NHIS). Since there was only a 3.7% nonresponse rate for the 1976 NHIS, proportions calculated from these data represent reasonable estimates of the true population values. Several variables have a significant association with the interview and examination status. However, it appears that the nonresponse and poststratification adjustments performed by the National Center for Health Statistics have removed most of these factors as sources of bias. There is excellent agreement in the marginal distribution of variables between NHANES II for examined persons and the 1976 NHIS.

Adult↗
PubMed1982

Catastrophic health insurance and HMO's.

The catastrophic health insurance bills introduced during the 96th U.S. Congress failed to consider the current role that Health Maintenance Organizations (HMO's) play in providing catastrophic protection and the potential negative impact such legislation may have on their competitive position. This article demonstrates that HMO's are providing this coverage by using the simulated health care expenditures for families in one HMO. The estimated proportion of families that incur catastrophic expenditures varies from 0.3 to 14.4% depending on the definition used for catastrophic. The paper closes with a discussion of the potential adverse impact that the legislation would have had on HMO's.

Adolescent↗
PubMed1982

Relationship between dietary and biochemical measures of nutritional status in HANES I data.

Data from the first National Health and Nutrition Examination Survey were examined for individual 24-h dietary intakes of protein, vitamin A, thiamin, riboflavin, and iron, and for laboratory indices of the same nutrients in blood and urine. Mean intake values were close to or above reference standards for all nutrients except iron. Substandard laboratory values were recorded for: serum albumin and vitamin A--less than 3% of subjects; urinary thiamin/creatinine excretion--3 and 8% of white and Black subjects, respectively; Hb, hematocrit, and percentage transferrin saturation--5 to 15% of whites and 18 to 27% of Black subjects; serum iron--less than 6% of subjects. Individual dietary recall data were of limited value in predicting the laboratory indices; regression analyses indicated that sociodemographic variables may be of greater predictive value.

Adolescent↗
PubMed1982

Indicators of response to a mass media CPR recruitment campaign.

Respondents to a mass media cardiopulmonary resuscitation (CPR) recruitment campaign in Harris County, Texas were more likely than non-respondents to be White, female, and under 45 years of age, to have had previous CPR training, experienced an incident in which knowledge of CPR might have been useful, or to have a friend or relative with a relevant medical history. The majority of the respondents were housewives, and professionals or technical workers, particularly in the health field. Findings can be used to identify audiences for future mass media CPR campaigns.

Adolescent↗
PubMed1979

Life table analysis of membership in an HMO retention.

The retention patterns of the Kaiser Foundation Health Plan (Oregon Region) were studied over a six-year period using a life table analysis. A 5% random sample, consisting of subscriber units that were enrolled at the initiation of the study of subsequently joined during the six-year period, were followed with respect to enrollment retention. The analysis presented here focuses on the 2,112 subscribers enrolled during the 1967-1970 period. These subscribers were characterized by the year they joined the plan and by their age and sex. The analyses showed that age of the subscriber and length of time on the plan consistently affected the probability of continued enrollment. The sex of the subscriber and the initial year of enrollment showed only a slight differential affect. A general pattern of high attrition in the first year, but rapid slackening thereafter, existed in all subgroup specific analyses. The utility of the analyses and the impact of the effect of differential membership retention on the plan are discussed.

Actuarial Analysis↗
PubMed1979

Utilization of services of an HMO by new enrollees.

This study investigates whether there is a built-up demand for health services that surfaces when people enroll through a group plan in a Health Maintenance Organization. The study population consists of newly enrolled subscriber units of the Kaiser Foundation Health Plan (Oregon Region). The utilization variables examined include the number of inpatient and outpatient contacts with the Plan, the number and type of specific services performed, and the type of outpatient contact. The enrollees were followed over 12 quarters (three years). The analysis showed that the first quarter stood out in three respects: its average number of inpatient and outpatient contacts were the lowest of any quarter; the mean numbers of radiology services and laboratory tests per outpatient contact were the highest during this quarter; and the highest proportion of regularly scheduled contacts and the lowest rate of patient cancellation of visits occurred during the first quarter. Hence, these data are not supportive of the idea of a built-up demand. Rather they suggest that the enrollee requires some time to learn how to deal with the system; and, once a new member contacts the system, the system may perform a number of tests to obtain baseline data about the enrolee. Additional analysis did not suggest the presence of any time trends in the utilization data.

Evaluation Studies as Topic↗