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PubMedDate not supplied

A survey of attitudes toward responsible pet ownership.

The concerns of medical and community officials about responsible pet ownership have increased. Before a practical solution can be found for irresponsible ownership and community health problems associated with pet populations, the public's attitudes on issues related to responsible pet ownership must be determined. Such issues include attitudes on dog and cat overpopulation, potential public health problems associated with pet populations, and methods of controlling pet populations and stray animals. Responses to a questionnaire were used to evaluate the attitudes of 910 pet owners and nonowners toward factors comprising responsible pet ownership. The median age of the respondents was 33 years; 414 (45 percent) were men, and 496 (55 percent) were women. At the time of the study, 18 percent owned a cat and a dog, 35 percent owned only a dog, 11 percent showed only a cat, and 36 percent were nonowners. Not only the sex of the respondent but also the category of pet ownership affected opinions on overpopulation of dogs and cats, nuisance and pollution problems associated with these animals, and methods of controlling pet populations in the community. For example, owners agreed strongly on family planning for pets, but a majority of male owners stated that they would not have their dogs neutered.

Adolescent↗

PubMed1992

Ownership and performance of outpatient substance abuse treatment centers.

BACKGROUND: Little is known about the organization and performance of outpatient substance abuse treatment (OSAT) centers. We examine several performance measures of OSAT units, including clients treated, services provided, revenue sources, financial performance, and access to care, in relation to ownership of the center. METHODS: Data were drawn from a national random sample of 575 OSAT centers (85.8% response rate) participating in a telephone survey conducted in 1988. Analysis of variance by ownership was conducted on each performance measure, with differences subjected to tests of statistical significance. RESULTS: Descriptive results show that major funding sources differ by ownership. Private for-profit centers generate higher profits, charge higher prices, and achieve higher levels of financial performance than public and not-for-profit centers. Public centers provide better access to care for persons who are unable to pay. CONCLUSIONS: There appear to be substantial and interrelated differences by ownership type in the financing and operation of OSAT units.

Financing, Organized↗

PubMed1992

Ownership and organizational performance. A comparison of technical efficiency across hospital types.

Using a national data base of urban hospitals, the effect of ownership (government, nonprofit, and for-profit) on the technical efficiency of hospitals was examined. Efficiency scores were computed using a method called data envelopment analysis. Controlling for environmental and hospital characteristics, for-profit hospitals were found somewhat less frequently and government hospitals consistently more frequently in the efficient category. When examining highly inefficient hospitals as a percentage of those receiving inefficient scores, for-profit hospitals appeared to be highly inefficient relative to the other ownership forms. Government and nonprofit hospitals were somewhat indistinguishable from one another regarding their percentages of highly inefficient scores. For-profit hospitals also tended to use supply and capital asset (hospital size) inputs less efficiently, and service and labor inputs more efficiently than hospitals in the other ownership categories.

Efficiency↗

PubMed1992

[Clear connection between gun ownership and suicide. 92 per cent of attempts result in death].

In a retrospective study involving 20 police districts in Sweden, 348 completed or attempted suicides with firearms were found to have occurred during the period, 1976-88. Statistics on civilian firearms ownership were obtained from police authorities. Firearm suicide was found to be significantly correlated to gun ownership, through the 25 per cent increase in gun ownership during the period was not accompanied by a corresponding increase in the overall suicide rate. The head was the primary target in suicide attempts, both with longarms (rifles and shotguns) and with handguns (pistols and revolvers). Handgun injuries were more common among the survivors. Only 4.6 per cent of the victims survived and could be discharged from hospital. Nearly 10 per cent of those using shotguns or rifles used a string, a rod or their toes to reach the trigger; all of them died. Apart from such well-known predisposing factors such as psychiatric disorders or alcohol abuse that were present in 43 per cent of cases, 24 per cent of the victims were found to have had somatic problems instead.

Adolescent↗

PubMed1992

Consequences of physicians' ownership of health care facilities--joint ventures in radiation therapy.

BACKGROUND: Physicians are increasingly the owners of health care facilities to which they refer patients for services but at which they do not practice. We studied such ownership arrangements, known as "joint ventures," in the field of radiation therapy, examining their effects on access, use of services, costs, and quality. METHODS: Because 44 percent of free-standing facilities providing radiation therapy in Florida in 1989 were joint ventures, as compared with 7 percent elsewhere (95 percent confidence interval, 3 to 10 percent), we compared data for Florida with comparable data for the remainder of the United States. We also compared radiation-therapy facilities in Florida that were established as joint ventures with those that were not. Since most data were derived from entire populations rather than from samples, any differences found were of necessity statistically significant. RESULTS: No joint-venture facilities providing radiation therapy were located in inner-city neighborhoods or rural areas, but 11 percent of other free-standing facilities and hospital-based facilities were located in such areas. Among free-standing facilities, joint ventures received 39 percent of their revenues from patients with well-paying insurance coverage, as compared with 31 percent for facilities that were not joint ventures (P < 0.01). The frequency and costs of radiation-therapy treatments at free-standing centers were 40 to 60 percent higher in Florida than in the rest of the United States; there was no below-average use of radiation therapy at hospitals or higher cancer rates that explained the higher rates of use or higher costs in Florida. Radiation physicists at joint-venture facilities (the principal personnel involved in quality control other than physicians) spent 18 percent less time with each patient over the course of treatment than did their counterparts at free-standing facilities that were not joint ventures (P < 0.05). Mortality among patients with cancer in Florida was not lower than the U.S. average, even though joint ventures are much more common in that state. CONCLUSIONS: Joint ventures in radiation therapy appear to have adverse effects on patients' access to care. They also appear to increase the use of services and costs substantially. Some indicators show that joint ventures cause either no improvement in quality or a decline. Our results add to the evidence indicating that physicians' self-referral generally has negative consequences. We recommend legislation to ban ownership of joint ventures by referring physicians. Such legislation needs to be carefully designed in order to achieve its objectives and forestall new, financially abusive arrangements.

Ambulatory Care Facilities↗

PubMed1992

Ownership of direct ophthalmoscopes by medical students.

In September 1986 the Department of Education and Science withdrew the equipment grant for clinical medical students. This coincided with a reduction of 50% in the level of ownership of direct ophthalmoscopes amongst a group of 51 medical students who commenced their medical studies after September 1986 (no longer eligible for the equipment grant), when compared with a group of 63 students (in the same clinical year) who started the medical course before 1 September 1986 and who were hence still able to claim the equipment grant. The majority of non-owners gave lack of finance as the reason for non-ownership. Owners of ophthalmoscopes performed ophthalmoscopy more frequently than non-owners, but the difference did not reach statistical significance.

Education, Medical, Undergraduate↗

PubMed1992

Physician ownership of physical therapy services. Effects on charges, utilization, profits, and service characteristics.

OBJECTIVE: To evaluate the effects of physician ownership of freestanding physical therapy and rehabilitation facilities on utilization, charges, profits, and three measures of service characteristics for physical therapy treatments. DESIGN: Statistical comparison by physician joint venture ownership status of freestanding physical therapy and comprehensive rehabilitation facilities providing physical therapy treatments in Florida. PARTICIPANTS: A total of 118 outpatient physical therapy facilities and 63 outpatient comprehensive rehabilitation facilities providing services in Florida during 1989. The data from the facilities were collected under a legislative mandate. MAIN OUTCOME MEASURES: Visits per patient, average revenue per patient, percent operating income, percent markup, profits per patient, licensed therapist time per visit, and licensed and nonlicensed medical worker time per visit. RESULTS: Visits per patient were 39% to 45% higher in joint venture facilities. Both gross and net revenue per patient were 30% to 40% higher in facilities owned by referring physicians. Percent operating income and percent markup were significantly higher in joint venture physical therapy and rehabilitation facilities. Licensed physical therapists and licensed therapist assistants employed in non-joint venture facilities spend about 60% more time per visit treating physical therapy patients than licensed therapists and licensed therapist assistants working in joint venture facilities. Joint ventures also generate more of their revenues from patients with well-paying insurance. CONCLUSION: Our results indicate that utilization, charges per patient, and profits are higher when physical therapy and rehabilitation facilities are owned by referring physicians. With respect to service characteristics, joint venture firms employ proportionately fewer licensed therapists and licensed therapist assistants to perform physical therapy, so that licensed professionals employed in joint venture businesses spend significantly less time per visit treating patients. These results should be of interest to the medical profession, third-party payers, and policymakers, all of whom are concerned about the consequences of physician self-referral arrangements.

Conflict of Interest↗

PubMed1992

Exposure to Toxoplasma gondii and cat ownership in Nova Scotia.

In this survey, 998 children and adolescents between 7 months and 17 years of age who attended a hospital diagnostic center in the city of Halifax, Nova Scotia, for routine evaluation were tested for Toxoplasma gondii antibody. The 5.2% prevalence rate of antibody for children living in the outlying rural areas was significantly higher than the 1.1% rate among the urban children (P = .0006). Seroprevalence increased with age for both rural and urban children. Cat ownership was associated with antibodies to Toxoplasma among rural children but not urban children. Rural children who lived in a house with more than one cat were two times more likely to be infected than children who had one cat and three times more likely to be infected than children with no cats. The geometric mean titer was also significantly higher among the rural children with more than one cat, 1:152, than rural children with one or no cats, 1:63 (P = .02). In light of these findings for children and adolescents, the association of Toxoplasma infection with cat ownership needs to be thoroughly evaluated among pregnant women in rural areas.

Adolescent↗

PubMed1992

Pet ownership and risk factors for cardiovascular disease.

OBJECTIVE: To compare risk factors for cardiovascular disease in pet owners and non-owners. DESIGN AND PATIENTS: Accepted risk factors for cardiovascular disease were measured in 5741 participants attending a free, screening clinic at the Baker Medical Research Institute in Melbourne. Blood pressure, plasma cholesterol and triglyceride values were compared in pet owners (n = 784) and non-owners (n = 4957). RESULTS: Pet owners had significantly lower systolic blood pressure and plasma triglycerides than non-owners. In men, pet owners had significantly lower systolic but not diastolic blood pressure than non-owners, and significantly lower plasma triglyceride levels, and plasma cholesterol levels. In women over 40 years old, systolic but not diastolic pressure was significantly lower in pet owners and plasma triglycerides also tended to be lower. There were no differences in body mass index and self-reported smoking habits were similar, but pet owners reported that they took significantly more exercise than non-owners, and ate more meat and "take-away" foods. The socioeconomic profile of the pet owners and non-owners appeared to be comparable. CONCLUSIONS: Pet owners in our clinic population had lower levels of accepted risk factors for cardiovascular disease, and this was not explicable on the basis of cigarette smoking, diet, body mass index or socioeconomic profile. The possibility that pet ownership reduces cardiovascular risk factors should therefore be investigated.

Animals↗

PubMed1991

Uncompensated care before and after prospective payment: the role of hospital location and ownership.

Research was undertaken to determine the effects of hospital ownership, location, and Medicare's prospective payment system (PPS) on inpatient uncompensated care. A nonequivalent group design was used with repeated measures of uncompensated care (UNCC) on 137 system hospitals taken pre- and post-PPS. Investor-owned system hospitals demonstrated the largest increase in UNCC (37 percent) under the PPS. Results suggest that not-for-profit and investor-owned system hospitals are becoming more similar in levels of uncompensated care provided and that the PPS has had a negative effect on rural hospital profitability.

Analysis of Variance↗

PubMed1992

Ethical issues in the ownership of companion animals: an empirical and normative analysis.

This article deals with the ethical aspects of companion animal ownership. Research was done by means of interviews (n = 40) and questionnaires (n = 871). Respondents were randomly chosen from Dutch telephone directories. Euthanasia, docking tails, ear clipping and sterilisation are discussed on the basis of the opinions of respondents. Owners of companion animals very often seem to have insufficient knowledge about animal behaviour. Companion animal owners as a group differ rather strongly in their moral opinions about the acceptability of certain actions towards animals. At the individual level also people are not always consequent in their reasoning as was illustrated by their opinions about ear clipping and the stopping of tail docking and vice versa. Respondents live in a community with animals and usually use a utilitarian balancing model. The different outcomes of the uses of this balancing model indicate how far the respondents are willing to adapt their life style to the needs of an animal; in other words to what extent intrinsic values and integrity are taken into account within the process of (re)creating a living community.

Animal Rights↗

PubMed1992

Excreta disposal behaviour and latrine ownership in relation to the risk of childhood diarrhoea in Sri Lanka.

A case-control study of environmental and behavioural risk factors for childhood diarrhoea was conducted in Kurunegala district, Sri Lanka. From five hospitals, 2458 children aged less than 5 years and suffering from diarrhoea were recruited as clinic cases, and a further 4140 reporting with complaints other than diarrhoea were recruited as clinic controls. Community-based cross-sectional surveys were also conducted in three of the five areas served by these hospitals, and from these a further 1659 children were recruited as community controls. Children from households where excreta were reported to be disposed of in a latrine were less likely to have diarrhoea than children whose families improperly disposed of excreta. The results obtained from comparisons of cases with clinic controls (adjusted odds ratio [OR] 1.42, 95% confidence interval [CI] : 1.01-1.98), and of cases with community controls (OR 1.35, 95% CI : 0.85-2.13) were in agreement, suggesting that no important selection bias operated on this association. If the observed proportion (91%) of improper excreta disposal among the population could be reduced to 50%, 12% of childhood diarrhoea episodes would be prevented. Although latrine ownership may be a necessary condition for safe excreta disposal behaviour, diarrhoeal morbidity may only be reduced in Sri Lanka if behavioural changes take place concomitant with the construction of sanitation facilities.

Case-Control Studies↗

PubMed1979

Self-ownership, abortion and infanticide.

Doctors have been placed in an anomalous position by abortion laws which sanction the termination of a fetus while in a woman's womb, yet call it murder when a physician attempts to end the life of a fetus which has somehow survived such a procedure. This predicament, the doctors' dilemma, can be resolved by adopting a strategy which posits the right to ownership of one's own body for human beings. Such an approach will generate a consistent policy prescription, one that sanctions the right of all pregnant women to abortions, yet grants the fetus, after it becomes viable as a potentially independent person, a right to its own body. The doctors' dilemma is surmounted, then, by requiring that abortions of viable fetuses be performed in a manner that will produce a live delivery. Hence, infanticide and termination of viable fetuses are proscribed.

Aborted Fetus↗

PubMed1992

Pet ownership by elderly people: two new issues.

Two new issues of pet ownership were considered in a mail questionnaire and an interview survey of a large number of elderly people age sixty and over. First, evidence was obtained that pets are an important determinant of housing choice. Second, many elderly pet owners have made no arrangements for the pet if they predecease it or become unable to care for it. Problems related to these issues are discussed.

Activities of Daily Living↗

PubMed1978