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T Tokich

Publications and source records attributed to T Tokich.

7 recordsLinked to original sources
PubMed1985

Pediatric emergency department utilization in the 1970s.

An analysis was undertaken of 8,470 visits to a pediatric emergency department (ED) over a three-month period during 1975-76. The ED was busiest in the evening and on weekends. Visits were overwhelmingly for acute conditions, which varied seasonally. Very young children accounted for a large proportion of visits (22.3% less than 1 year old, 47.0% less than 3 years old). The proportion of very young children increased as the hour of day got later. Overall, 7.3% of visits resulted in admission to the hospital, and 10% of children less than 1 year old were admitted. Admission rates were significantly higher on the day and night shifts than in the evenings, and rates were higher on weekdays than on weekends. Visits were mainly by children living in areas near the hospital, and children from the most distant areas were significantly more likely to be admitted than those from the nearest areas. The authors conclude that the documented ED usage patterns reflect the conditions of the children seen (age, medical problems, and severity of illness) and diminished availability of other services on weekends and evening. This indicates reasonable utilization of medical services and suggests the need for non-ED sources of care at times of peak ED use. These ED usage patterns in the 1970s are similar to those described in the 1960s, and together with the earlier data they provide a basis for comparison of utilization patterns during the current period of rapidly changing health-service reimbursement schemes.

Adolescent↗
PubMed1985

Has Medicaid promoted needless pediatric emergency department use?

The possibility that Medicaid has encouraged pediatric emergency department (ED) use was explored as part of a study of 8470 ED visits to a pediatric teaching hospital in the period from 1975 to 1976. The proportion of the population on Aid to Dependent Children (proportion on ADC) was taken as a reasonable proxy for prevalence of Medicaid coverage of children in an area. Visit subgroups were compared using mean proportions on ADC in the census tracts of origin to measure relative rates of ED use by poor children. If Medicaid has promoted use of the ED instead of other facilities, the data would be expected to indicate relatively heavy ED use by residents of tracts with a high prevalence of Medicaid: (1) during the week when other facilities are most available; and (2) for minor problems which do not result in admission. The data show no differences in the mean proportion on ADC in the census tracts of origin of ED visits on weekdays as compared to weekends or for visits which resulted in admission as compared with those which did not. The data challenge the idea that Medicaid has encouraged pediatric ED use.

Aid to Families with Dependent Children↗
PubMed1983

Nervous tension and serum cholesterol: findings from the Chicago Coronary Prevention Evaluation Program.

Of 519 coronary-prone middle-aged men participating in the Chicago Coronary Prevention Evaluation Program, 416 reported their self-perceived state as one of no tension or tension at various periodic visits over years in the Program. Group mean serum cholesterol was significantly higher by about 4 mg/dl with tension vs. no tension (slight, moderate, or marked). This relationship was independent of weight change, intercurrent infection, use of medication, and month of year.

Adult↗
PubMed1982

Methodological problems in characterizing an individual's plasma glucose level.

Two methodological problems in characterizing an individual's plasma glucose level are examined in this study. First, how large is the intra-individual variation of an individual's 1-hr post-load glucose level and for this estimated intra-individual variation what are the probabilities of misclassifying individuals based on a one-time measurement only of glucose level? Second, do different tests-i.e. fasting, 1-hr, 2 hr post-load, GTT-yield consistent ranking for the same individual? The first of these was explored with data on subsamples from the Chicago Peoples Gas Company (PG) study and the Chicago Heart Association Detection Project in Industry (CHA) study; the second, with data from the Chicago Coronary Prevention Evaluation Program (CPEP). For both the PG and CHA studies, the estimated ratios of the intra- to inter-individual variances were generally higher for post-load plasma glucose than blood pressure, heart rate, weight and serum uric acid. The conditional probabilities of misclassifying individuals into quintiles or deciles based on one measurement of 1-hr post-load glucose were also estimated from these data. These estimated probabilities indicated that the possible attenuation due to intra-individual variation cannot abolish a strong association; however, it may create some problem if the relationship is not very strong. Furthermore, both rank correlation and quintile classification analyses show that fasting, 1-hr and 2-hr plasma glucose level characterize individuals differently. Thus it is possible that the inconsistent results of previous studies, all using a one-time measure of plasma glucose, are partially due to the large intra-individual variation of this variable, and the use of methods that are not highly consistent in their classification of individuals.

Adult↗
PubMed1982

Smoking cessation in the Chicago Coronary Prevention Evaluation Program.

Quit-rates for cigarette smokers in a lifestyle intervention program aimed at reducing coronary risk were 24 percent for all participants and 34 percent for non-dropouts. Recidivism remained very low during participation in the program. Half of the smokers who quit did so after being in the program more than two years. These data suggest that while engaging in an effort to make other changes in lifestyle, many smokers can be helped to quit. Sustained antismoking efforts in the clinical practice of medicine can be expected to share these same positive aspects. While mass public health programs to eliminate smoking and prevent young people from taking up the habit are being developed, health practitioners can make a significant contribution by including vigorous efforts at smoking cessation as part of routine practice.

Adult↗
PubMed1981

Alcohol, cardiovascular risk factors and mortality: the Chicago experience.

The association between alcohol consumption and cardiovascular risk factors, the association between alcohol consumption and the incidence of high blood pressure, and the association between alcohol consumption and mortality, both all-cause and cause-specific, were examined in the white males from the Chicago Peoples Gas Company study and the Chicago Western Electric Company study. In both studies, there was a significant cross-sectional association between heavy alcohol use--defined as problem drinking in the Gas Company and as consumption of six or more drinks per day in the Western Electric Company--and the level of blood pressure and high blood pressure. In addition, in 1340 normotensive men ages 27-64 years from the Gas Company and in 871 normotensive men ages 40-55 years from the Western Electric Company, a significant prospective relationship was shown, for the first time, between heavy drinking and risk of developing high blood pressure. In the Gas Company, among 1233 men ages 40-59 years, 38 problem drinkers had significantly higher 15-year mortality from all causes, the cardiovascular diseases and coronary heart disease than the rest of the men. In the Western Electric study, 78 men who consumed six or more drinks per day had significantly higher 17-year mortality from all causes, the cardiovascular diseases and coronary heart disease, cancer and all other causes than the rest of all men.

Adult↗