SEARCH · PubMed Health

Results for “Demographers--changes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources

PubMed1983

More doctors: what will they cost? Physician income as supply expands.

During the 1970s, expenditure for physicians' services rose by $12.7 billion (in 1979 dollars), but only about one fifty of this amount could be attributed to an increase in number of physicians relative to population. Other factors, chiefly demographic changes and greater insurance coverage, were responsible for the bulk of higher expenditures. Despite the growth in number of physicians, real income of individual physicians remained virtually constant. Maintenance of real income was not, however, appreciably dependent on physicians inducing an unwarranted demand for their services. We predict that as the physician supply expands by 25% to 35% during the 1980s, real payments to physicians will increase by some $14 to $20 billion (1979) dollars. As in the past decade, however, only about one fifth of the amount will be attributable to an increase in physician supply. Gross income of individual physicians is likely to ri se by 10% to 15% (in 1979 dollars) over the decade, but net income probably will show little increase or may even fall slightly.

Fees, Medical↗

PubMed1983

A teaching framework for cross-cultural health care. Application in family practice.

Significant demographic changes in patient populations have contributed to an increasing awareness of the impact of cultural diversity on the provision of health care. For this reason methods are being developed to improve the cultural sensitivity of persons responsible for giving health care to patients whose health beliefs may be at variance with biomedical models. Building on methods of elicitation suggested in the literature, we have developed a set of guidelines within a framework called the LEARN model. Health care providers who have been exposed to this educational framework and have incorporated this model into the normal structure of the therapeutic encounter have been able to improve communication, heighten awareness of cultural issues in medical care and obtain better patient acceptance of treatment plans. The emphasis of this teaching model is not on the dissemination of particular cultural information, though this too is helpful. The primary focus is rather on a suggested process for improved communication, which we see as the fundamental need in cross-cultural patient-physician interactions.

Adult↗

PubMed1983

Use of age cutoff policies for adolescents in pediatric practice: report from the Upper Midwest Regional Physician Survey.

Increased pediatric participation in the health and medical care of adolescents has been encouraged over the last several years, both through the redefinition of the age range of pediatric practice by the American Academy of Pediatrics, and by the 1978 Task Force Report on Pediatric Education. Whereas the Task Force Report enunciated a framework for pediatric leadership in adolescent medicine, little is known about the extent to which adolescents are actually included in pediatric practice. Based upon the findings of the 1980-1981 Upper Midwest Regional Physician Survey, the use of age "cutoff" policies for adolescents is explored. The various types of such policies are examined, in addition to reasons for their use and non-use, the characteristics of pediatricians who include and exclude adolescents from their practice, exceptions made to adolescent age limits, differential enforcement by patient and physician gender, and anticipated changes in cutoff policies in light of projected demographic changes for infants, children and youth, and physician supply.

Adolescent↗

PubMed1982

Arthritis in the elderly.

In old age, particularly in those over the age of 75 years, the disease process is operating in a unique setting. The awareness of this uniqueness has been slow in coming to the attention of the medical profession but the weight of clinical experience imposed by demographic change in the population has made this an urgent consideration. Arthritis presents in a setting where there are multiple ageing or degenerative features and it occurs frequently in conjunction with other diseases. Early and accurate diagnosis is of paramount importance in the elderly because of the many interacting factors and the fragile 'milieu interieur'. Judicious use of drugs with close monitoring is essential if the patients's well being is to be improved and the morbidity reduced. Joint disease, osteoarthritis and rheumatoid arthritis make a significant contribution to disability and dependence in the elderly and have certain features which are more common than those found in the younger age groups.

Aged↗

PubMed1980

[Social relations in old age: the how and pros and cons].

In this article we stress three different aspects of the social relations of older people. First: the existing social relationships of older people with their children are an expression of a spontaneously grown contact as well as an expression of the societal expectations or social norms. Second: these societal expectations are in a state of transition, not only because of changes in the family system, but, third, also by important demographic changes in the structure of the population. The changes of and around marriage and sexuality are in the centre of these trends. One of the consequences is the following. The inter-generational relationships should be at least partly replaced and completed by more intra-generational relations (friends, acquaintances). An additional problem is, how to develop a program to improve the social skills of older people themselves.

Adult↗

PubMedDate not supplied

[The environment of the Moscow megalopolis and the problems of parasitic contamination].

Studying parasitic contamination is regarded as an individual research trend for large-scale land and water areas whose natural habitat is greatly modified by man-made influences. On the one hand, parasitic contamination as its particular form acts as a factor that destabilizing the environment, on the other, the man-made deformation of natural biocenoses, which is induced by socioeconomic influences promote its occurrence and manifestations. The investigations of parasitic contamination are beyond the scope of the routine parasitological goals, though they involve their whole package and should be considered as an ecological objective of environmental protection. The cenotic communications of the links of the parasitic systems with the physicochemical and biological ingredients of the habitat predetermine qualitative and quantitative differences of parasitic contamination in the large urban areas and, finally, the dissimilar course of epidemiological, epizootic, and phytototic processes in parasitic diseases in their various sectors. The major factors influencing the levels of the parasitic pollution of the Moscow megalopolis were analyzed. These included various lines of economic activities, the population's living conditions, procedures for manufacturing foodstuffs, demographic changes. In the recent years, the situation in many parasitic infections in man (trichinosis, cryptobiasis, enterobiasis, toxocariasis, etc.), animals (fascioliasis, trichinosis, etc.) and plants (viral, fungal, and nematode diseases). There is an increase in the population of mosquitos, lice, fleas, and other insects which are vectors of dangerous parasitic diseases of man and animals.

Animals↗

PubMedDate not supplied

Health care: international comparisons.

A conference held at the College in July 1994 examined the wide range of health care systems employed around the world and their varying responses to the combined pressures of demographic change and increasing patient expectations in the face of anticipated unsustainable increases in financial demand. The meeting, which was planned by Professor Roger Williams, was jointly sponsored by the College, the NHS Management Executive, Glaxo Holdings plc, the Nuffield Provincial Hospitals Trust and the Kohn Foundation.

Delivery of Health Care↗

PubMed1994

[Relationships in nursing: active and inactive sexuality in nursing staff and in old residents in nursing homes].

More awareness now exists of the issue of active and non-active sexuality as a result of the demographic changes and the increasing number of old people in residential and nursing home care. In this connection it is often assumed that sexuality in old age is a non-topic. The reasons for the misinterpretation of facts are manyfold, among them is the silence, surrounding the topic. This contribution deals with the recovery of sexuality of the very old and the correlation between residents' and their carers' active and non-active sexuality.

Aged↗

PubMedDate not supplied

The influence of changing demographic patterns on our health promotion priorities.

As we approach the twenty-first century, we face many difficult challenges in planning public health programs to promote health and prevent disease. We focus here on the changing age distribution of the American population and the resulting need to develop and enact effective health promotion efforts for older Americans. Older adults suffer from an increased burden of many chronic diseases, but contrary to past assumptions, they benefit substantially from health promotion and disease prevention efforts. Although numerous health promotion activities can be targeted to aging populations, we pay particular attention to the beneficial role of physical activity promotion, tobacco use cessation, and good nutrition for older adults. In this article, we describe some of the implications of this demographic change in terms of the health care services and needs of older adults, and we suggest priorities for future public health promotion and disease prevention programs.

Aged↗

PubMed1994

Putting an end to ageism.

The National Advisory Council on Aging in 1991 stated a need to encourage students in the health care professions to select careers in gerontology. Indeed, it may be argued that the inclusion of a comprehensive curriculum component on aging in each nursing program is essential to address the demographic changes in Canada. With the increase in longevity it is more important than ever for nursing students to value older persons and not be fearful of interacting with this age group. This raises the question as to what nursing education has done to address this issue.

Aged↗

PubMed1994

Women in dermatology. Challenges and recommendations.

The total number of women physicians in the United States tripled between 1970 and 1990. Almost 50% of incoming residents in dermatology are women. This article discusses some of the changes, opportunities, and challenges within our profession wrought by these demographic changes. The incorporation of women into all aspects of our specialty is a subject that warrants review, consideration, and creative solutions.

Dermatology↗

PubMed1993

[Projection of new cancer diseases to the year 2002--a contribution to health planning in public health by the Saarland cancer registry].

This paper provides projections of incident cases of malignant neoplasms in Saarland, Germany, between 1988 and 2002. The analyses are based on population forecasts by the National Statistical Office and on age-cohort analyses of cancer incidence data from the population-based cancer registry of the Saarland. Due to dramatic demographic changes and increasing age-specific cancer incidence rates, the average yearly number of total incident cases of malignant neoplasms is projected to increase by 63.1% between 1983-1987 and 1998-2002 in men, with the strongest increase projected for colon cancer (+114.6%). In women, a modest increase (+7.1%) is projected for all malignant neoplasms, with stronger increases for colon cancer (+50.1%), lung cancer (+44%) and breast cancer (+27.4%), whereas decreasing annual numbers of cases are projected for cervical cancer (-51.6%), stomach cancer (-18.5%) and endometrial cancer (-10.2%). The results provide a quantitative basis for health care planning in the Saarland. They may also serve as a rough guide for other parts of Germany for which reliable cancer incidence data are not available.

Adolescent↗

PubMed1993

Trends in the community dental service 1980-1990.

The recent past has seen many changes that have had an impact on the dental care of children: for example, demographic changes, changes in the prevalence of dental caries, changes in manpower and changes in the organisation of dental services. The community dental service (CDS) in particular has had a major role to play in the provision of care to many children in this country. An analysis of the statistical returns to the Department of Health for the community dental services in England and Wales for the years 1985-1990 shows that staffing in the CDS has declined from 1,544 (Whole Time Equivalents--WTE) to 1,309 (WTE) in 5 years. The total clinical hours worked has also reduced from 2.02 million to 1.59 million in ten years. Hours spent on administration have increased from 53,490 to 87,091 in the same period. Clinical time spent on treating handicapped adults has increased almost ten fold from 14,644 hours in 1980 to 122,463 hours in 1990. Time devoted to mother and child (pre-school) services in about the same as in 1985. Hours spent on school services have reduced from a peak of almost 2 million in 1985 to 1.38 million in 1989-90. Trends in eight aspects of dental treatment are presented.

Administrative Personnel↗

PubMed1994

From emergency room to morgue: deaths due to undiagnosed perforated peptic ulcers. Report of four cases with review of the literature.

Peptic ulcer perforation is well recognized as a cause of peritonitis and can result in death. Although amenable to surgery, delay in making the correct diagnosis results in increased mortality. Accurate diagnosis has been hindered by demographic changes in the affected population. In recent years, the population at risk has increased. Specifically, a rising incidence has been observed in women, in the elderly, and in patients with previously undiagnosed peptic ulcer disease. Described are four patients with perforated peptic ulcers, three of which were not detected prior to autopsy. In three of the four instances the patient had been observed in and discharged from a hospital emergency room during the 30 h prior to death. In the fourth case, the decedent had been seen in and discharged from the emergency room four times during the month prior to death. In all patients, the presenting historical, physical, and/or radiographic findings were indicative of perforation. The death of a patient within days of a visit to an emergency room should prompt a forensic autopsy. The role of medical examiners in providing quality assurance feedback to emergency rooms located within their jurisdiction is emphasized.

Adult↗

PubMed1994

[Acute myocardial infarction in patients over 70 years of age].

Demographic changes in cardiovascular disease explain the marked increase in the number of myocardial infarctions affecting individuals aged over 70. The prognosis remains poor, with hospital mortality of the order of 30%. The reticence of physicians to use reperfusion techniques (intravenous thrombolysis and coronary angioplasty) is paradoxically considerable. Several studies have nevertheless shown that the benefit/risk ratio of such methods not only persists, but is increased in this age group, which should encourage the widening of their indications. Thorough evaluation of the best management strategy would require a randomised comparative trial, but angioplasty would probably ensure early reperfusion in a larger proportion of elderly patients than thrombolysis, because of the high incidence of contraindications to the latter as well as of cardiogenic shock in this age group.

Age Factors↗

PubMed1994

[Increase in the number of admissions due to heart failure in Dutch hospitals in the period 1980-1992].

OBJECTIVE: Determination of the trend in the occurrence of hospital admissions because of heart failure in the Netherlands. DESIGN: Descriptive investigation. SETTING: Dutch general and university hospitals. METHOD: Data on hospital admissions because of heart failure from 1980 to 1992, obtained from the National Medical Register, were analysed. Three ICD-9 CM diagnoses were combined (congestive heart failure 428.x, diseases of the heart due to hypertension 402.x and myocardial degeneration 429.I). RESULTS: From 1980 through 1992 the annual number of hospital admissions for heart failure increased by 69%, for both men and women, from 14,441 to 24,368. Age-adjusted admission rates increased by 43% for men, and by 30% for women. The admission rates were strongly age-related, with higher rates in the older age groups. Among men 89% of the patients in 1992 were older than 60 years, and 63% older than 70 years. Among women these figures were 94% and 79%, respectively. During the study period the age-specific admission rates rose in all relevant age groups. The rise was higher in the older age groups. In 1992 the average duration of stay in hospital was 14 days for men and 17 for women. CONCLUSION: Probable causes of the rise in the number of hospital admissions for heart failure were the increasing median age of the population, higher survival rates after acute myocardial infarction and longer survival of persons with heart disease. Demographic changes and medical progress will probably lead to a further rise in morbidity and mortality and of costs of heart failure.

Academic Medical Centers↗

PubMed1994

California's suicide decline, 1970-1990.

From 1970 to 1990 California experienced a 32% decline in suicide, which was particularly pronounced among women, non-whites, the young, and urban dwellers. Suicide declines of over 50% were recorded in San Francisco and Los Angeles, and large decreases occurred in other coastal counties. Additionally, California was the only one of 51 states to show a consistent decline in teenage and young-adult suicide (accompanied by an 88% decrease in teenage drug and other poisoning deaths). Initial investigation of death certification, accident and homicide trends, economic measures, and prevention efforts did not produce an explanation for a suicide decrease of California's magnitude. However, the state does display anomalous trends in certain social measures (reduced divorce, rising non-White population, and rising homicide) that point to multifactorial hypotheses including demographic changes and changed attitudes toward violence. Review of the accuracy of past suicide certification procedures nationally is also indicated.

Adolescent↗

PubMed1993

[Age and sex specific incidence of primary total hip alloplasty in the county of Southern Jutland].

During the 10-year period 1981-90, 1752 primary total hip arthroplasties (THAs) were performed in the county of south Jutland, Denmark. The annual number of THA increased until a steady state level was reached during 1988-90. The age and sex specific incidences were calculated for this period using the population distribution of the County. The age specific incidences were highest in the age-group 70-79 years for both female and males, namely respectively 485 and 410 THAs per 100,000 inhabitants. The overall incidence was 82 THA per 100,000 inhabitants. During the next 30 years, the demand for primary THA in Denmark is expected to increase 32 percent (from 4013 to 5307 THAs) as a consequence of demographic changes.

Adult↗