Physician reports average only 2% of all reports of suspected elder mistreatment. Primary care physicians in counties with low physician to population ratios appear to be more active in reporting mistreatment of older people. Increasing physician awareness of the problem of elder mistreatment and providing physicians with the tools to screen for mistreatment should increase the number of cases that are reported to the agencies responsible for assisting mistreated older people.

No abstract

The dramatic increase in CEAs following the Asymptomatic Carotid Atherosclerosis Study clinical advisory suggests that the conclusions of the trial have been accepted by the medical community throughout the Veterans Affairs medical centers.

According to traditional concepts of hospital governance, each institution is considered responsible for the care of a defined community. Evaluation of hospital performance and effective service planning both require that hospitals' service communities be identified. However, in metropolitan regions it is difficult to associate a geographic population with any one hospital because of the wide choice of facilities available to area residents. The service community concept becomes more meaningful in these regions if several hospitals with overlapping geographic communities are defined as a cluster. This paper describes a two-step method for identifying hospital clusters and their associated service communities. The first step involves analysis of patient origin data to identify logical clusters of hospitals. Three algorithms for performing this analysis are presented. In the second step, analytical findings are reviewed by a panel of area planners and hospital experts who, considering additional qualitative factors, determine how the hospitals may be most appropriately grouped. Experience in using this method for hospitals in the seven-county region around Detroit, Michigan suggests that reasonable clusters can be identified, although clusters of central city hospitals are less well-defined than those in the suburban areas.