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Biomedical subjects

R W Broyles

Publications and source records attributed to R W Broyles.

At least 19 recordsLinked to original sources
PubMed1995

Breast cancer in Oklahoma. Unnecessary deaths.

Deaths of Oklahoma women can be prevented by early detection using mammography and clinical breast examinations. This study summarizes the responses from the Oklahoma Behavioral Risk Factor Study, and the results indicate that Oklahoma women, especially low income and less well educated women, are not receiving these screening tests in adequate numbers. Physicians have a major responsibility to correct this by recommending such tests and encouraging women to take advantage of them.

Adult↗
PubMed1995

Women smokers: the tragedy is, Oklahoma is number one.

Oklahoma leads the nation in the proportion of women who smoke, and is sixth in the proportion in the childbearing ages. Furthermore, the incidence of deaths from carcinoma of the lung in women is increasing, as is the number of low birthweight babies. Both of these conditions are associated with smoking. It is clear that Oklahoma physicians should become aggressive in encouraging women to stop smoking.

Adolescent↗
PubMed1994

Progress toward Healthy People 2000: a preliminary look at Oklahoma.

Over 10,000 Oklahomans die each year from coronary artery disease or stroke. This study examined the behavioral risk factors for these illnesses present in Oklahomans. Oklahomans are at considerably higher risk than the desirable national goals for such risk factors. For example, too many Oklahomans smoke and too few exercise. The data to support these findings are included herein, and some steps to reverse these trends are recommended.

Adolescent↗
PubMed1994

Medicaid in Oklahoma.

Medicaid expenditures in Oklahoma increased 98.2% from 1986 through 1991 while those of the United States went up 111.0%. Of this increase, 21.6% was due to inpatient care and 25.9% to nursing home care. With respect to beneficiaries, 34.9% of the increase was attributable to the aged and 31.4% to the disabled. AFDC recipients accounted for only 19.1% of the increase.

Health Expenditures↗
PubMed1990

Efficiency, costs, and quality: the New Jersey experience revisited.

Focusing on two prospective payment systems that operated concurrently in New Jersey, this study employs the hospital department as the unit of analysis and compares the effects of the all-payer DRG system with those of the SHARE program on hospitals. Relative to the SHARE program, which regulated the revenue derived from Blue Cross and Medicaid, the results indicate that the comprehensive approach to prospective payment induced hospitals to control not only the direct costs of multiple dimensions of patient care per case but also the direct cost per day of nursing care and per unit of ancillary care. The results also suggest that the DRG system reduced the length of stay, the daily use of radiological procedures, and the volume of these services per case. On the other hand, the DRG system was accompanied by an increase in the daily use of laboratory procedures and the volume of laboratory care per case.

Ancillary Services, Hospital↗
PubMed1987

Short-term responses of hospitals to the DRG prospective pricing mechanism in New Jersey.

Short-term responses of hospitals to the New Jersey prospective payment system, which uses Diagnosis Related Groups (DRGs) to establish rates of compensation for all payers, were examined in this study. The sample consisted of 84 New Jersey hospitals that were subject to prospective payment and a comparison group of 76 hospitals. Hospitals comprising the comparison group located in eastern Pennsylvania, were reimbursed retrospectively. Regression equations, which included independent variables to control for market supply and demand conditions, were estimated for the cost per admission, cost per day, length of stay; and cases treated. The results indicate that increases in the cost per admission and cost per day were lower (P less than 0.05) in hospitals subject to the all payer DRG system than in those institutions that were reimbursed retrospectively. In addition, the results suggest that most of the cost savings attributed to the New Jersey DRG system are due to a reduction in the average length of stay. The paper concludes with policy implications.

Cost Allocation↗
PubMed1987

The determinants of hospital utilization under a universal public insurance program in Canada.

This study employs the individual as the unit of analysis to examine the relative importance of medical need, sociodemographic and economic factors in determining the use or non-use of hospital care and the volume of service consumed by those who experienced an episode of hospitalization during the study period. The data were derived from the Canada Health Survey which is a stratified, multistaged sample of the entire population. The results of the discriminant and weighted regression analyses indicate that the use or non-use of hospital care and the volume of service consumed are largely determined by medical need and not by income. The findings are supportive of the view that the national health insurance scheme in Canada has resulted in a more equitable distribution of hospital care.

Adolescent↗
PubMed1987

Prospective payment based on case mix: will it work in nursing homes?

This article evaluates the potential efficacy of implementing a prospective payment system based on case mix in the nursing home industry. The analysis of structural differences between the nursing home and hospital industries suggests that the mechanism of compensating long-term care facilities should be based on functional health status rather than on diagnosis and that incentives to improve quality and access should be strengthened. The article assesses several systems of classifying patients that have been proposed as the basis for implementing a prospective payment system in the nursing home industry. The article concludes with a discussion of policy issues related to the appropriate unit of payment and the scope of regulatory authority.

Costs and Cost Analysis↗
PubMed1986

The impact of the New Jersey all-payer DRG system.

Two prospective payment systems that operated concurrently in New Jersey during 1980-1982 created a natural experiment and a unique opportunity to compare the effectiveness of the two systems in restraining cost increases. Our results indicate that during that period, annual increases in the cost per case were significantly less in hospitals that were subject to the all-payer DRG system than in those institutions that were paid under the Standard Hospital Accounting and Rate Evaluation (SHARE) program. We also found that, relative to the SHARE program, the DRG system appears to have increased admission rates and reduced length of stay.

Blue Cross Blue Shield Insurance Plans↗
PubMed1985

A qualitative assessment of the Medicare prospective payment system.

This paper employs commonly accepted criteria to evaluate the potential outcomes of the Medicare pricing mechanism. The analysis suggests that the recent revisions in the Medicare payment system have less potential to contain increases in total hospital costs than those embodied in all-payer systems. In addition, this paper also suggests that the pricing mechanism will jeopardize the financial viability of many hospitals while exacerbating inequities that emanate from differential pricing policies. Finally, when viewed from the perspective of insured beneficiaries, it is reasonable to expect that the payment mechanism will reduce not only access to inpatient care but also the use of service once admitted.

Diagnosis-Related Groups↗
PubMed1984

Optimum distribution of diagnostic-specific technology.

Recognizing that the suboptimal allocation of plant assets contribute to the inflationary pressures in the health industry, this paper employs the principles of goal programming to develop a model for distributing diagnostic-specific technology among potential recipients in a given geographic region. The model allocates diagnostic-specific equipment so as to ensure that the provision of the related service satisfies the health needs of the population at risk, the capacity to provide the service in the region and in the hospital is optimal, the service is provided at minimum cost, and access to the equipment is satisfactory. An application and the practical implications of the model are also explored.

Diagnostic Services↗
PubMed1984

Managing patient receivables: a technical note.

This paper focuses on the patient receivables of the hospital and employs a Markov process to estimate the timing of cash receipts, the magnitude of cash receipts, and losses that are attributable to bad debts, courtesy discounts, and the provision of charity care. Further, the usefulness of the model in the day-to-day management of patient receivables is also explored.

Accounting↗