Can Primary Care Deliver?

Ej, Sussman; Hm, Rosen; Aj, Siegel; Jm, Witherspoon; Hr, Nesson

doi:10.1097/00004479-197908000-00005

Cited by 2 publications

(2 citation statements)

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“…Both annual and per visit costs were found to be either in line with (Davis and Schoen, 1977;Sparer and Anderson, 1972;Wingate, 1974) or less than (Gold, 1979), those in comparable services and settings, especially for Medicaid beneficiaries (JRB Associates, November 18,1980). Further savings resulted from declines in rates of inpatient hospital care among CHC clients ranging from 25% to 67% (Zwick, 1972;Klein et al, 1973;Sussman et al, 1979;Bellin and Geiger, 1970).…”

Section: Efficiencymentioning

confidence: 99%

“…For example, 80% of users are minority people, virtually all are in poverty or near poor, and the vast majority are women and young children (Department of Health and Human Services, 1980). Such improvements in access have reduced the use of costly emergency rooms (Gold andRosenberg, 1974 Hochheiser, Woodward, andChamey, 1971;Sussman et al, 1979;Moore and Bonanno, 1974) and increased the use of preventive services (Gorman andNelson, 1974 Hershey andMoore, 1975;Kent and Smith, 1967;Milio, 1970). Improvements in child health also have been documented, especially in infant mortality and infectious diseases (Davis and Schoen, 1977;Gold andRosenberg, 1974 Vaughan, 1968;Chabot, 1971;Gordis, 1973;Westermeyer, Framer, and Smelker, 1976).…”

Section: Effectivenessmentioning

confidence: 99%

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Chains of Impact from Reaganomics on Primary Care Policies

Milio

1984

Public Health Nursing

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This article analyzes the effects of federal fiscal policy in the Reagan administration on primary care programs. Within the context of the national economy and federal policy priorities, states responded to budget cuts and block gxants with fiscal and administrative restrictions that fell disproportionately on disadvantaged groups. A wide array of primary care services became less available and accessible, thereby limiting their cost-savings potential and their effectiveness in supporting people's health. These program deficits, together with lowered living standards among large segments of the population, resulted in rising rates of infant mortality in many states. A perspective that can interrelate federal and state policy actions, and broad public policies with traditional health policies, will improve public health nurses' understanding of policymaking and policy impacts, and thereby can guide renewed efforts toward health improvement Federal fiscal policy over the last three years has become the major determinant of health care policy. In the name of efficiency, other criteria of equity, effectiveness, and acceptability have had lower rank in policy choices.

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Section: Efficiencymentioning

confidence: 99%

Section: Effectivenessmentioning

confidence: 99%

Chains of Impact from Reaganomics on Primary Care Policies

Milio

1984

Public Health Nursing

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Hospital-based group practice

Fein

Hoffman²,

Goldman³

et al. 1987

J Gen Intern Med

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Initiation of a hospital-based faculty group practice to replace part of a general medical clinic was evaluated in a quasi-experimental design. Practice setting (where patients received their primary care) was the independent variable. The group practice, unlike the traditional clinic, emphasized primary care by providing 24-hour, seven day/week access by telephone; continuity between inpatient and ambulatory care (all patients admitted as private patients of group practice attending physicians) and coordination of care. Resource use, including visits to the primary care site, the emergency room and specialty clinics, and tests ordered at each site were tracked for one year by chart review. Multivariate analysis showed that, contrary to expectations, group practice patients had no fewer emergency room or specialty clinic visits, although they did make more visits to the practice. With respect to tests, practice patients had almost two more tests ordered in the primary care site than clinic patients, although there was no concomitant reduction in tests ordered at other sites. The authors conclude that ambulatory care resource use is an insufficient measure of the effect of a change in practice setting.

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Can Primary Care Deliver?

Cited by 2 publications

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Chains of Impact from Reaganomics on Primary Care Policies

Chains of Impact from Reaganomics on Primary Care Policies

Hospital-based group practice

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