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At least 19 recordsLinked to original sources
PubMed1976

Medical economics survey-methods study: design, data collection, and analytical plan.

This paper describes the background, methodology, data collection, and analytical plan of a pilot investigation conducted under contract for the National Center for Health Statistics during 1975. The objective was to determine the cost effectiveness of a variety of strategies under consideration for national application to develop previously unavailable information on utilization of, and the costs and payments for, health care. Detailed data on health care utilization and expenditures were collected periodically from a panel of 691 Maryland households over a six-month interval. Issues to be tested through a random experimental design include whether periodicity (monthly vs bimonthly interviews) and type of contact (in-person vs telephone) are significant factors in the cost effectiveness of this type of survey. An extensive record check involving all providers and third-party payers identified in the household survey was carried out. Record information will be used to 1) provide a basis for measuring accuracy of household data, 2) fill gaps in household knowledge, and 3) determine whether a subset of the record sources can provide adequate information for correcting household data. The household survey resulted in an initial response rate of 77.5 per cent with a subsequent attrition rate over six months of 13.6 per cent. Signed permission to access record data was obtained for 84.9 per cent of the individuals completing the entire survey. The most intensive survey strategy, monthly, mostly in-person contact, resulted in the lowest participation. The analytical plan presents details of the approaches to be taken in making judgments on the relative accuracy and completeness of data obtained by the various survey strategies and the contribution made by availability of data from record sources.

Adolescent↗
PubMed1978

Medical economics survey-methods study: cost-effectiveness of alternative survey strategies.

The Medical Economics Survey-Methods Study was conducted under contract for the National Center for Health Statistics during 1975-76. The objective was to determine the cost-effectiveness of a variety of strategies under consideration for application in a national survey in 1977. Detailed data on health care utilization and expenditures were collected periodically from a panel of 691 Maryland households over a seven-month period. Issues tested through a random experimental design included the relative effectiveness of monthly versus bimonthly interviews and in-person versus telephone contact. Completeness and accuracy of information were determined through an extensive record check involving all providers and third party payers identified in the household check involving all providers and third party payers identified in the household survey. The results indicate that there are substantial deficiencies in the household reporting and that the household data for all types of medical services would benefit from the availability of record data in order to improve theri accuracy. The frequency of contact (monthly versus bimonthly) had little effect on the accuracy of reporting. Given the higher rate of attrition observed for the monthly procedures and their considerably greater cost, the bimonthly interval appears to offer advantages. In-person contact resulted in significantly better reporting compared with telephone contact in the Baltimore area, but no difference was found in more rural Washington County. Thus, the 10 per cent cost increase for in-person contact may well be justified by the improved accuracy of the data obtained for certain types of populations.

Cost-Benefit Analysis↗
PubMed1978

Medical economics and morality: the conflict of canons.

The more the economics of cost containment becomes an ideology, taking on a moral tone, the more it conflicts with the traditional medical morality. Looking at the canons of "good" economics in health care and at the canons of "good" medicine and examining the potential conflicts may point to methods of equilibrating their opposing tendencies.

Costs and Cost Analysis↗
PubMed1978

[A safe alternative for the diagnosis of pernicious anemia--a contribution to medical economics (proceedings)].

Mucosal biopsies of corpus and antrum were performed in 17 patients with pernicious anemia. In all patients the corpus mucosa showed atrophic gastritis, while in 16 the antrum was normal or showed only superficial gastritis. This combination is conclusive for pernicious anemia. Over 80% of megaloblastic anemias are caused by pernicious anemia. It is therefore proposed that endoscopy and biopsy be performed as the first examination in these patients. In this way the diagnosis is simple, rapid and economical.

Anemia, Pernicious↗