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Biomedical subjects

S C Crane

Publications and source records attributed to S C Crane.

At least 19 recordsLinked to original sources
PubMed1995

PAs/NPs: forging effective partnerships in managed care systems.

Three issues have dominated national health policy discussions over the past three decades--how to control health expenditures, how to improve access to care, and how to ensure delivery of high-quality health services. Cost remains the principal societal concern today. An important new dimension in this debate, however, is a critical examination of the impact of the structure of the nation's health workforce on health expenditures. Within this examination, policy makers are giving specific attention to the supply of health professionals, the role of primary care, and the identification of the most appropriate professionals to deliver primary care. In particular, a renewed interest is being shown in the potential of physician assistants (PAs) and nurse practitioners (NPs) to address all three issues. This article will examine the factors that prompted this focus on health workforce issues and the implications of the use of PAs and NPs for the structure and management of the health workforce in the future.

Cost Control↗
PubMed1987

Regulatory considerations in the establishment and expansion of office-based laboratories.

As a result of changing patterns of medical practice, technology, and reimbursement, office-based clinical laboratory testing is increasing substantially. This article reviews current federal and state regulations covering such laboratories and comments upon likely trends in these regulations. Various economic and political issues associated with office-based clinical laboratory regulation are also discussed.

Cost Control↗
PubMed1987

Adjusting capitation using chronic disease risk factors: a preliminary study.

Researchers have sought ways to modify Medicare's capitation formula, the adjusted average per capita cost (AAPCC), by including measures of individual health status. The present study assesses the value of risk factors for disease as predictors of hospitalization for Framingham Heart Study participants (1,210 males and 1,496 females) 60-65 years of age. Regression models including several common physiologic measures and prior hospitalizations yielded adjusted R2s of 9.69 percent for males and 3.61 percent for females. The contributions of the risk factors and prior hospitalization were about equal and independent. These results confirm the potential utility of disease risk factors for adjusting the AAPCC.

Actuarial Analysis↗
PubMed1986

Issues and trends in the regulation of office-based clinical laboratories.

Office-based clinical laboratories are the least regulated of all laboratories as a result of familiar forces in the politics of the regulation of medicine. This article discusses the evolution of these regulations and summarizes the applicability and intent of federal and state rules. Counterbalancing forces in the present political and medical environment tending simultaneously toward greater and lesser regulation are discussed.

Ambulatory Care↗
PubMed1985

Health insurance coverage of the unemployed.

Of 1,332 unemployed individuals in the Detroit area interviewed in late 1983, 51% did not have health insurance. Lack of insurance was directly related to length of unemployment. Of those unemployed 3 months or less, 31% had no insurance, as compared with 56% of those unemployed more than 3 years. For the most part, these were not the chronically uninsured: 78% of them were insured when they were employed. Three fourths of those without insurance were not covered by Medicaid either. These findings suggest that during the latest economic recession, the problem of health insurance loss due to losing one's job was more severe than had been assumed by most policymakers.

Adult↗
PubMed1983

The effect of alterations in ketone body availability on the utilization of beta-hydroxybutyrate by developing rat brain.

The effect of alterations in ketone body availability during the early postnatal period on the in vitro and in vivo utilization of beta-hydroxybutyrate (beta OHB) by developing rat brain was determined. Ketone body availability was prolonged by feeding a high fat diet during pregnancy and lactation and to pups after weaning. Availability was decreased by early weaning pups at 16 days to a low fat liquid diet. In the in vitro studies, oxidation of [14C]beta OHB to CO2 and incorporation into brain lipid was determined at 7, 14, 21, and 35 days of age. In the in vivo studies incorporation of [14C]beta OHB and [3H]glucose into brain lipid was measured. The results indicate that it is possible to alter the brain's utilization of beta OHB for lipid synthesis and energy metabolism during the developmental period. This was particularly evident in the in vivo studies. The in vivo results also suggest a relationship between beta OHB availability in the blood and incorporation into brain lipid. When availability was decreased by early weaning pups to the low fat diet, incorporation of beta OHB into lipid was also decreased. Likewise, when availability was increased, such as was seen in the high fat feeding study, incorporation was increased.

3-Hydroxybutyric Acid↗
PubMed1983

Brain beta-hydroxybutyrate utilization in neonatal hypothyroidism in rats.

The in vitro and in vivo utilization of 14C-beta-hydroxybutyrate (BOHB) by the brain in neonatal hypothyroidism was studied in rat pups made hypothyroid by feeding dams a diet containing 0.02% propylthiouracil during pregnancy and lactation. In the in vitro studies, the oxidation of BOHB to CO2 was lower at 14 and 21 days of age in hypothyroid pups than in pair-fed controls but higher at 35 days. The incorporation of BOHB into brain lipid was significantly higher in hypothyroid pups at 14, 21 and 35 days. In contrast, in the in vivo studies, incorporation of BOHB into lipid was significantly lower in hypothyroid pups at 14 and 21 days. These results suggest that hypothyroid pups may have a normal or increased capability to use BOHB for lipid synthesis, but were unable to achieve normal rates of utilization in vivo, possibly due to a decreased substrate availability. These findings may have implications for the decreased brain lipid content characteristic of neonatal hypothyroidism.

3-Hydroxybutyric Acid↗