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Biomedical subjects

R Pineault

Publications and source records attributed to R Pineault.

At least 55 records · Page 3Linked to original sources
PubMed1985

Randomized clinical trial of one-day surgery. Patient satisfaction, clinical outcomes, and costs.

One hundred and eighty-two patients undergoing tubal ligation, hernia repair, or meniscectomy were randomly assigned to either one-day or inpatient surgery. The study's objective is to compare these two modes of care with regard to patient satisfaction, clinical outcomes, and costs of the episode of care. A significantly higher proportion of one-day patients than their hospitalized counterparts found their stay to be too short and would prefer hospitalization as an alternative. Clinical outcomes were comparable in both groups. One-day tubal ligation and hernia repair were found to be cost-efficient and averaged hospital savings of $86.00 and $115.00 more than inpatient care. Meniscectomy deviated from this trend in that treatment costs were significantly higher for one-day surgery patients. Analysis of personal and physician costs did not show any significant difference between the two modes of care.

Adult↗
PubMed1985

Physicians' acceptance of an alternative to fee-for-service payment: a possible source of change in Quebec medicine.

This article reports on a survey conducted on a sample of Quebec physicians at the end of 1981. The objective of the study was to assess the acceptance by physicians of a possible change in their current mode of remuneration and to identify the consequences of such a change on the physicians' practice and on the attainment of broader health care objectives. The results presented in this article seem to indicate that neither the present fee-for-service mode of payment nor a change to time-based remuneration can reconcile both professional and broader health care objectives. Implications of these findings for health policies are discussed.

Attitude of Health Personnel↗
PubMed1985

The physician episode of care: a framework for analyzing physician behavior regarding use of clinical and technical resources.

The purpose of this study is to determine the influence of style of practice on physicians' use of clinical resources, that is office visits and telephone calls, and technical resources, that is X-rays and laboratory procedures, in the context of ambulatory care. The universe of the study consists of 34 internists practicing in the prepaid group practice setting of Kaiser in Portland, Oregon, in 1970. Style of practice is conceptualized and operationalized by referring to the physician episode of care. This provides a framework for explaining variations in the use of clinical and technical resources by physicians. Such factors as being a regular rather than a temporary physician, and referral activity, appear to be important in determining the use of clinical and technical services by physicians.

Ambulatory Care Facilities↗
PubMed1985

[A conceptual framework for the evaluation of health programs].

Evaluation can have three distinct goals: to help plan and develop programs, to provide information which will improve programs and to determine the outcomes and impact of programs. Evaluation questions flow from each of these goals. Described in this paper are different types of evaluation useful in answering these questions. Whatever type of evaluation is chosen, the evaluator must attempt to assess its validity. This validity concerns the equivalence between answers to evaluation questions and the "true value" of the program. It is just as concerned with measurement strategy and instruments as it is with the designs and techniques of analysis used, and the population studied.

Evaluation Studies as Topic↗
PubMed1979

[Descriptive analysis of psychiatric emergencies in the greater Montréal area.].

In. September 197S1, a research team from the Department of Health Administration of the University of Montreal, completed a research study on psychiatric emergencies financed by the Planning section of Quebec's Ministry of Social Affairs. The purpose of this research was on the one hand, to measure the importance of psychiatric problems in the emergency services of hospital centers in Montreal's metropolitan region (22 institutions) and, on the other hand, to describe the characteristics of patients who have access to these emergency services for the purpose of psychiatric treatment. This article summarizes the first section of this research study. Firstly, the authors explain the problem underlying the study, as well as the objectives pursued. Subsequently, a brief description of the research is made, according to its major methodological features. Finally, in the third section, data relative to the number of psychiatric emergencies and to the distribution of this care demand in Montreal's hospital centers, are presented. A second article will deal with the main characteristics of the psychiatric clientele requiring emergency resources i.e. age, sex, marital status, socio-professional categories, types of emotional distress, profiles of past-utilization of services (etc.).

English Abstract↗
PubMed1977

The effect of medical training factors on physician utilization behavior.

The purpose of this study is to determine the influence of medical school, teaching hospital, and specialization on physicians' use of clinical and technical resources. The universe of the study consists of 34 internists practicing in the prepaid gorup practice setting of Kaiser in Portland, Oregon. The data reported here show that physicians trained in medical schools and hospitals with a scientific medical orientation generally use fewer such resources than other physicians. However, under conditions of uncertainty, that is, when diagnosis is unknown, they tend to use more services. In other words, these physicians are conservative in theri use of resourses when ambiguity is low, and liveral when ambiguity increases. Graduates of the more scientifically oriented institutions seem therefore more flexible in adjusting to the demands of the disease situation.

Age Factors↗
PubMed1976

The effect of prepaid group practice on physicians' utilization behavior.

The study is concerned with the practice of physicians in a prepaid group practice setting. Specifically, it is concerned 1) with investigating the extent of variation in physician behavior concerning use of clinical resources, that is, office visits and telephone calls, and technical resources, that is, x-rays and laboratory procedures, and 2) with determining the factors that account for such variation. The universe of this study consists of all internists practicing in 1970 in the prepaid group setting of Kaiser Permanente at Portland, Oregon, a total of 34. The overall framework for the study is based on the belief that medical training and the setting in which physicians work are significant determinants of their use of clinical and technical resources in different disease situations. Specifically, the framework posits that different sets of organizational variables are important in determining use of resources for acute and undiagnosed conditions. The findings reported in the study suggest that while the teaching environment in which a physician is trained is important in shaping his clinical personality, the setting in which he actually works contains its own source of influence over his professional activity. These results also provide supportive evidence for the widely held notion that prepaid group practice, through changing the nature of the incentives to physicians and introducing professional regulation, leads to a more efficient way of providing medical care by reducing the use of costly resources.

Consumer Behavior↗
PubMedDate not supplied

A critical appraisal of the Navajo health care system.

The purpose of this study is to assess the health needs of the Navajo Indians of North America, and the appropriateness of the health care services provided by the Navajo Health Care System with respect to these health needs. Our study is based on the analysis of the secondary socioeconomic and health related data collected and compiled in the Navajo area, and on the interviews conducted among health care professionals and administrators working in the Area. The 'Q index' was used for priority ranking of the most prevalent diseases. Appraisal is based on the holistic health concept components. Navajo Indians have not yet reached the health status of the general US population. In spite of the fact that the Indian Health Services has decreased the disparity between the Indians and the US population in general, especially regarding communicable diseases, other more complex health problems created by biculturalism and the on-going acculturation exceed the limits of the Navajo Health Care System which is basically oriented toward medical care. Alcoholism and alcohol abuse, inadequate nutrition and lack of geographic and socio-organizational accessibility are the main risk factors in the Area. This situation is further aggravated by economic problems and the high unemployment rate of the Navajo Indians.

Alcoholism↗
PubMedDate not supplied

Perceptions of parents' participation in the care of their child undergoing day surgery: pilot-study.

In Canada, more than 100,000 children have procedures in day surgery units. In spite of certain programs designed to prepare those children and their parents for the procedures and events that take place in a hospital, the parents' role during the day stay is not openly and directly approached. Although many pediatric centers recognize the importance of the role of the family in the life of children with health problems, the perceptions of parents with children undergoing day surgery and their role in the hospital have not yet been studied. Therefore, the objective of our study was to describe parents' perceptions regarding their participation in the care of their children in a day surgery. Godin and Kok's (1996) integrated behavior prediction model related to health, which was drawn from Ajzen's theory of planned behavior (1991), was chosen for this research. An interview questionnaire was developed as the measurement instrument. Content analysis was the basis for the analysis of the data gathered through the interview questionnaire. Our article presents the results of this pilot study.

Adolescent↗