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Biomedical subjects

T N Chirikos

Publications and source records attributed to T N Chirikos.

29 records · Page 2Linked to original sources
PubMed1986

Accounting for the historical rise in work-disability prevalence.

The growth in prevalence of functional disability among adults is commonly and uncritically attributed to changes in demographic, medical, and socioeconomic factors. Detailed analysis of self-reported work disability over the past 25 years shows that two-thirds of such disability is attributable to the growing prevalence of chronic diseases. Even as mortality rates continue to fall, the health status of adult Americans may be deteriorating.

Adolescent↗
PubMed1985

Economic status and survivorship in digestive system cancers.

This study investigates economic differentials in cancer survival in a sample of 1180 white men, focusing in particular on the relationship between income level and survivorship in the various subsites comprising the digestive system cancer category. Using the Cox proportional hazards model to control for confounding variables, the economic status-survivorship relationship is estimated for several subgroupings of primary malignancies. The results show significant variation in this relationship across different cancer sites, with a pronounced effect observed in carcinomas of the small intestine, peritoneum and, especially, colon and rectum. High-income patients with these malignancies had a significantly lower risk of dying from the disease (P less than 0.05) than either their middle- or lower-income counterparts, controlling for age, stage, and initial course of treatment. Differences in immunologic status, tumor characteristics, and follow-up treatment may account for these economic effects.

Age Factors↗
PubMed1985

Longitudinal analysis of functional disabilities in older men.

This study examined the prevalence of functional disabilities in a representative sample of older American men. Longitudinal changes in various disabilities and the effects of such changes on self-appraised health, normal role function, mobility and self-sufficiency in personal care were analyzed. The relationship between disabilities and survivorship was also investigated. The analysis showed that sizable percentages of men report motor-sensory dysfunctions, with blacks experiencing higher prevalence rates than whites. The risk of functional disablement rises with age and increases the likelihood of reporting unfavorable health outcomes or handicaps. There is also some evidence that functional capacities are restored and that these changes lead to more favorable health outcomes. The analysis showed finally that functional disabilities are strong predictors of mortality.

Black or African American↗
PubMed1984

Economic differentials in cancer survival: a multivariate analysis.

This study investigates economic differentials in cancer survival using more adequate measures of economic status and controlling for confounding variables more systematically than earlier studies. For 1180 white males, a variant of the Cox regression model is employed to estimate the direct and interaction effects of economic status on survivorship, controlling for age at diagnosis, stage, severity of disease, and initial course of treatment. The results do not show a strong relationship. Estimates of direct or main economic effects rarely reach even borderline statistical significance; they are highly sensitive to model specification and the measurement of the economic variable. An equally weak interaction effect between economic status and stage is detected in several cases, but the parameter estimates are unstable. Such measurement and specification errors have probably exaggerated the importance of economic factors in cancer survival in earlier investigations.

Humans↗
PubMed1984

Economic determinants and consequences of self-reported work disability.

This paper examines the determinants of and behavioral responses to self-reported work disability in samples of older men and women stratified by race. Strong support is found for the hypothesis that economic factors as well as poor health influence the probability that individuals report health conditions limit the amount or kind of work they do. In particular, lower expected wage rates significantly raise the probability of reporting work disablement, controlling for health status and health-related job requirements. The empirical analysis also shows that only a part of the reduced labor supply of disabled individuals is attributable to health conditions. The policy and methodological implications of these findings are discussed.

Black or African American↗
PubMed1984

Work disability from coronary heart disease in women.

This study investigates the comparatively high rate of work disability from coronary disease in women. A sample of working women and men hospitalized for acute myocardial infarction was followed for two years to ascertain patterns of labor market withdrawal. Women were more likely than men at 24 months to have withdrawn entirely from market work. Multivariate statistical analysis suggests this greater likelihood stems from differences in behavioral responses to disease rather than from differences in disease severity. Economic incentives to resume work are shown to play an especially crucial role in these responses. Implications of these findings are discussed.

Aged↗
PubMed1977

State health manpower poly: an appraisal.

The health manpower policies of state governments are discussed on the basis of an appraisal of a set of recently completed health manpower studies. Examination suggests that both state health manpower policy processes and outcomes may be limited in fundamental ways. Resolution depends upon changes in the ways in which we perceive health manpower problems and in the institutional mechanisms used to deal with them.

Financing, Government↗
PubMedDate not supplied

Further evidence that hospital production is inefficient.

Whether hospitals now use resources more efficiently than they did 10 to 15 years ago is unclear. This paper analyzes the level of hospital inefficiency in a longitudinal set of 186 Florida hospitals in continuous operation over the period 1982-1993. A frontier cost function comprising six outputs and six factor prices is estimated to obtain inefficiency residuals. The analysis suggests that inefficiency levels are high and essentially unchanged over the period in question.

Efficiency, Organizational↗
PubMedDate not supplied

Economic analysis of cancer treatment costs: another tool for oncology managers.

Oncology managers increasingly need more information about how much and why treatment costs vary across cancer patients. In response to this need, our Center is building an analytic capacity for investigating economic aspects of cancer treatment. Economic analysis is characterized by a simultaneous consideration of treatment costs and outcomes; it focuses on how treatment cost/outcome ratios vary across patient populations with similar diseases. In this paper, we present an overview of our work, with special emphasis on the measurement of outcomes and the inputs or costs of treatment, the variability of cost/outcome ratios, and the analysis of the factors that predict or explain this observed variation. We illustrate how the analysis is conducted, set out selected results relating to lung and breast cancer patients, and assess some of the advantages and disadvantages of the approach. Among other things, we conclude that economic analysis of cancer treatment costs is feasible and that it can provide useful data for managerial decision making.

Aged↗