The National Institutes of Health (NIH) is periodically asked to conduct assessments of new medical technologies to assist in coverage decisions made at the Office of Health Technology Assessment (OHTA) for the Health Care Financing Administration coverage policy. Analysis of NIH assessments indicates that even though most NIH assessments rely only on expert opinion, OHTA agreed with NIH recommendations in over 90%.
This study identified two variables, unemployment and alcohol or substance abuse related diagnoses, to be the only predictors of appointment non-compliance out of various demographic and clinical variables. The results also indicate that appointment non-compliance should be treated as a continuous rather than a dichotomous variable in future research. Programmatic implications for reducing noncompliance are discussed.
The prevalence of depression in a large suburban county was found to be lower than that estimated for either rural or urban populations. Differences in affluence probably account for much of the observed discrepancy. While the prevalence of depression among women was twice that of men, gender was not found to be a major predictor of depression because the variance accounted for by gender was largely accounted for by other, more powerful predictors. Age was the strongest predictor, with younger people being more depressed. Measures of social support and socioeconomic status were also major predictors of depression.We gratefully acknowledge the assistance of Daniel Young of Elmhurst College, Elmhurst, Illinois, for data analysis. Michael Dubinsky is now with the American Medical Association, 535 North Dearborn, Chicago, Illinois 60610.
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