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Biomedical subjects

S P Taylor

Publications and source records attributed to S P Taylor.

At least 19 recordsLinked to original sources
PubMed1991

A methodology for resource allocation in health care for South Africa. Part IV. Application of South African Health Resource Allocation formula.

The primary concern of this concluding article in a series is the application of the South African Health Resource Allocation (SAHRA) formula proposed in the previous article (SAMJ 1990; 77: 456-459). Target allocations based on this formula are compared with current budgets to estimate the extent of geographical maldistribution of health care resources. Under the present health service structure, the direction of redistribution of these resources should be from the provinces to 'homelands'. A number of refinements to the crude formula, such as the introduction of a more rational regionalisation policy and accounting for the teaching commitments of academic hospitals, are considered and their effects illustrated. Despite data deficiencies and the wide range of possible technical modifications to SAHRA, the concept of basing resource allocation decisions on an internationally applied formula is worthy of public debate.

Education, Medical↗
PubMed1991

Effects of long-term visual display terminal usage on visual functions.

Since their rapid introduction into the workplace visual display terminals (VDT's) have been the source of a number of studies aimed at detecting effects on office workers. The published studies have been either short-term or cross-sectional, with one exception. The results have shown varying degrees of relation but by not having a comparable control group all have been limited in their value. We set out to monitor at regular intervals over a 2-year period specific visual functions that have been reported to be affected by VDT usage, and to compare VDT and non-VDT users in the same office environment. By assessing the VDT operators from the time the systems were introduced we have an accurate baseline to work from when assessing change due to the introduction of the VDT.

Accommodation, Ocular↗
PubMed1991

The Opticians Act 1989 and UK optometry.

The build-up to the original 1958 Opticians Act is used as an introduction to the more recent developments in UK optics that have culminated in the introduction of the Opticians Act 1989. The changes introduced as a result of the Health and Social Security Act 1984 and the Health and Medicines Act 1988 are briefly described before discussing the sectional arrangement of the new Act. This new legislation pulls together much of the law relating to optometry and dispensing optics in the UK and provides a single accessible source.

Optometry↗
PubMed1991

The Optical Services Audit Committee (OSAC) and UK optometry.

In 1989, following a series of legislative moves by the UK Government to remove the 'monopoly' within optical services, a proposal was made to introduce a two-tier system of eye care. Within the two tiers would be a cheap, rapid spectacle prescription assessment that took no account of binocularity or ocular health. The initial response to this within professional groups involved was split, dispensing opticians keen to see the arrival of the system, the optometric profession concerned over the possible health consequences. In order to provide an overview of the situation the General Optical Council proposed the establishment of the Optical Services Audit Committee to investigate the whole of UK eye care services and recommend direction for future developments. The main conclusions of the report produced by this committee are discussed here.

Consumer Advocacy↗
PubMed1990

Containing costs in public sector hospitals--a strategy for the future. Lessons from a large teaching hospital.

Escalating costs of providing health care are cause for worldwide concern. In South Africa there is increasing concern about expenditure in the public and the private health care sectors. Although public sector expenditure has increased in per capita terms over the past 2 decades, at the micro-level comparison of expenditure over a 14-year period in one major teaching hospital region indicates that, despite increasing complexity and sophistication, real costs have not escalated at a greater rate than the consumer price index, if extraordinary factors are discounted. The development and utilisation of productivity and performance indicators are reviewed and some mechanisms for containing costs in public hospitals are discussed. These include formalized strategic planning and allocation of resources, rationalisation and reorganisation of services, improved productivity and utilisation of scarce health manpower, improved accounting and management information systems, and the development and use of measures of outcome. Concern is expressed regarding excessive quantification of costs and efficiency to the detriment of health care in general.

Cost Control↗
PubMed1990

A methodology for resource allocation in health care for South Africa. Part II. The British experience and its relevance to South Africa.

This second article in the series on resource allocation in health care, argues for a formula-based method of resource allocation in South Africa. The model employed in England since 1976 and its application in a number of developed and developing countries is reviewed. The international experience is related to South African conditions and the principal elements necessary for a formula to achieve greater spatial equity in South African health-resource distribution are discussed.

Delivery of Health Care↗
PubMed1990

A methodology for resource allocation in health care for South Africa. Part III. A South African health resource allocation formula.

A formula to calculate the proportion of the public sector budget that should be allocated to various geographical regions of South Africa is described. The formula is broadly classified into curative and preventive components. Using data that are routinely available, indices of need are calculated for each of these components. It is concluded that resource allocation on a macro level should closely approximate regional population distribution if cross-border flow of patients and additional teaching-hospital expenditure are ignored.

Age Factors↗
PubMed1989

A methodology for resource allocation in health care for South Africa. Part I. Rationale and prerequisites.

A strategy for the equitable allocation of health care resources is needed in South Africa. The existing health administrative structures are obstacles to achieving this goal. An attempt is made to describe a framework in which the prerequisites for the equitable allocation of resources are a major restructuring of health services into a number of regional health authorities in a unified health service, and to establish a formula which is adapted from the RAWP (Resource Allocation Working Party) model used in the UK.

Health Care Rationing↗
PubMed1989

Economic aspects of smoking in South Africa.

A conservative analysis of some of the costs and benefits of smoking to our society are presented. This preliminary investigation updates and refines the methodology of a previous study. Depending on the underlying economic assumption, smoking cost South Africa between R212 and R481 million in 1985 as a result of lost productivity due to premature death. Lost productivity while smokers were undergoing treatment cost at least R22 million. Hospitalisation and other health care costs amounted to R128 million in public institutions alone. It is likely that the current level of excise duty does not compensate for the high social costs resulting from smoking. Although many of the costs and benefits of smoking are not quantifiable in monetary units, the available information as presented in this study suggests that the cost of the tobacco industry to South Africa at present, and particularly its potential cost in the future, outweigh any possible economic benefit.

Black or African American↗
PubMed1989

Effects of short-term VDT usage on visual functions.

An on-site comparative study was carried out on the effects of video display terminal (VDT) and non-VDT work on visual functions in two working populations in the same office environment. Both continuous VDT usage in a training situation over a few days and intermittent VDT usage in a normal working situation were assessed and particular attention paid to their effects on the refractive error of different refractive groups and for different age populations. Other visual functions measured were visual acuity (VA), accommodation, and convergence. Results show that VDT work does not have a significantly greater effect on visual function than non-VDT work.

Accommodation, Ocular↗
PubMed1989

Clinical evaluation of the Humphrey autorefractor.

A study is made of the accuracy and repeatability of the Humphrey autorefractor (HAR) objective refraction for different refractive groups as measured against subjective refraction. The value of the autofogging mechanism in objective refraction for different refractive groupings is assessed.

Adolescent↗
PubMed1988

Variability in the response of the rabbit uterus to progesterone as influenced by prolactin.

Ovariectomized rabbits from different breeders were treated at different times of the year with prolactin alone or with progesterone and the production of uteroglobin by the uterus was studied. There were seasonal, strain and dose variables in the uterine response to prolactin and progesterone. Treatment with prolactin (at 1 mg/day) plus progesterone generally induced higher levels of uteroglobin production than did treatment with progesterone alone. The differences were greatest in the winter for Tennessee animals and in the spring for animals from the New Mexico and North Carolina colonies. Ovariectomy produced a decrease (P less than 0.01) in the concentration of cytosolic oestrogen and progesterone receptors, and prolactin treatment restored the concentration to oestrous control values. However, there were no seasonally dependent changes in the concentration of the receptors for any of the treatment groups. Increased doses of prolactin (2 mg/day) induced high levels of uteroglobin production and new proteins to appear in uterine secretions of long-term ovariectomized rabbits but much lower levels (10-11%) when given to pregnant does. Additional ovulations were also noted plus adverse effects on the embryos.

Animals↗
PubMed1987

The health and wealth of South Africa.

The per capita gross national product (GNP) in South Africa is examined as it relates to life expectancy and the infant mortality rate. Despite South Africa's relative wealth in per capita GNP terms, life expectancy at birth is 63-65 years and the national infant mortality rate according to Unicef, is unlikely to reach the target of 50/1,000 live births by the year 2000. The distribution of expenditure on health is contrasted between the former provincial administrations, the major local authorities, the national states and the homelands. The health resources allocation distribution is unlikely to ensure health for all by the year 2000.

Developing Countries↗
PubMed1987

South African health care expenditure, 1975-1984.

South African health care expenditure is reported for the period 1975-1984 and analysed for the public and private sectors. Approximately 5.9% of South Africa's gross national product was devoted to health care in 1984-1985. This proportion appears to be increasing. Real per capita expenditure on health increased by 13% during the period under review. Trends of health care expenditure during the decade are discussed as well as some underlying causes of the increases in health care expenditure in South Africa. Precise expenditure data and outcome information are required in order to ensure appropriate resource allocation.

Financing, Government↗
PubMed1987

Use of indicators in achieving 'Health for All' in South Africa, 1987.

This review evaluates South Africa's performance in achieving health when measured against the World Health Organization's global indicators designed to achieve 'Health for All' by the year 2000. As this programme has not been implemented in South Africa, a need exists for this country to announce indicators and targets. South Africa meets the World Health Organization's targets in terms of health expenditure but available information on many of the other indicators suggest that a large segment of the population falls outside the targets set. Lack of immunisation and poor nutrition are reflected in unacceptably high infant mortality rates and relatively low life expectancies. As accurate data are needed for planning at both national and local levels a national health survey should be conducted.

Health Status Indicators↗
PubMed1987

Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part V. Hypertensive diseases.

An analysis was undertaken of mortality from hypertensive disease in the RSA between 1978 and 1982 among whites, coloureds and Asians. The age-specific mortality rates for each group are presented and comparisons are also made between these groups based on age-standardised mortality rates. As with a similar study undertaken for the period 1969-1971, marked variations are seen between the various population groups. The rates for Asians exceeded those for coloureds substantially, and both these groups had far higher rates than whites. These results demonstrate an interesting variation when compared with mortality from ischaemic heart disease and recent prevalence studies of hypertension. The possibility that this variation is due to better control of hypertension in whites or is a result of a different ratio of risk factors in each group studied is considered.

Adult↗
PubMed1987

Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part VI. Ischaemic heart disease.

An analysis of ischaemic heart disease (IHD) mortality for the period 1978-1982 showed markedly different rates for the Asian, white and coloured population groups in the RSA. Age-specific and age-standardised rates for Asians were in general considerably higher than those for whites, and did not show the marked decline with time observed in rates for whites. Although coloureds were seen to have considerably lower age-standardized rates than Asians or whites of the same sex, an increase in the age-standardised rates for coloured males over a 10-year period and a slight decrease among females suggested that rates for coloureds may be in the process of approaching those for the other groups. The observed decline in IHD rates among whites of both sexes suggests that preventable major risk factors may be coming under control, apparently to a greater extent in this group than among Asians or coloureds.

Age Factors↗