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Biomedical subjects

S R Garfield

Publications and source records attributed to S R Garfield.

14 recordsLinked to original sources
PubMed1977

An evaluation model for medical system change.

An evaluation model was developed and used to monitor the impact of a new mode for entering patients into an existing health care delivery system, and it compared the new mode to two alternate entry methods. In accordance with specified eligibility criteria, 6285 patients were selected and then randomly assigned to the three entry modes. The model employed a health status classification which divided patients into four groups depending upon the concurrence of medical care provider and patient as to whether the patient was well or sick. It then measured the utilization of care resources for each patient health status group. All data were then age-sex-adjusted and analyzed for each of the three entry modes for a standard mix of health status groups.

Ambulatory Care↗
PubMed1977

Cost analyses of alternative health examination modes.

Health examinations have become an essential service for a health maintenance organization to provide to ambulatory patients for determining their health status and care needs. Three methods were studied for providing health examinations to 6,285 examinees. Compared with the traditional physical examinations customarily provided by physicians, it was determined that either of two alternative systemized modes proved more economical with regard to both physician time and total resource costs for similar patient groups standardized by age, sex, and health status. The most efficient method of providing health examinations to large numbers of people used multiphasic health testing, followed by physical examinations provided by nurse practitioners supervised by physicians; this required 68% less physician time and resulted in a decrease in total examination costs of 30% as compared with traditional examinations.

Comprehensive Health Care↗
PubMed1976

Evaluation of an ambulatory medical-care delivery system.

We designed a medical-care-delivery system specifically to relieve the impaired access to care that has invariably assompanied the elimination of personal fees by prepaid plans, Medicare and other third-party payment plans. The solution involved the entry of patients through a paramedically staffed health-evaluation servece that effectively separated patients into three basic health-status groups-the well and worried well (68.4 per cent); the asymptomatic sick (3.9 per cent); and the sick (27.7 per cent)--a process that permitted matching the needs of each group with appropriate services. The system achieved increased physician accessibility to new patients by 20 times, reduced the waiting time for new appointments from six to eight weeks to a day or two, saved physician time and costs for entry work to a day or two, saved physician time and costs for entry work-up by 70 to 80 per cent reduced total resources used throughout the year by +32,550 per 1000 entrants, and proved very satisfactory to patients and generally so to staff.

Ambulatory Care↗