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Biomedical subjects

A Maynard

Publications and source records attributed to A Maynard.

49 records · Page 3Linked to original sources
PubMed1980

Applying resource allocation formulae to constituent parts of the U.K.

If the health care budgets of the constituent nations of the United Kingdom in 1977-78 are added together and then redistributed on the RAWP formula there would be a significant movement of resources from Scotland and Northern Ireland and to England and Wales. The differential geographical allocation of resources within the U.K. is critically appraised, and it is argued that the higher resource allocations of the Thames regions and of Scotland and Northern Ireland have been examined imperfectly with polemics rather than analysis. However, the political costs are such that RAWP-type goals for the U.K. would be difficult to achieve.

England↗
PubMed1979

Failure of long surviving, passively enhanced kidney allografts to provoke T-dependent alloimmunity. I. Retransplantation of (AS X AUG)F1 kidneys into secondary AS recipients.

Long survival of (AS X AUG)F1 rat kidney allografts in AS recipients was induced by passive enhancement with AS anti-AUG antiserum at the time of grafting. After 1-3 mo, the kidney allografts were transferred to second AS recipients, either naive or sensitized against AUG tissue. Naive second recipients did not reject the grafts acutely and failed to mount T-dependent immunity against AUG targets. When later challenged with spleen cells carrying the AUG haplotype, the naive second AS recipients showed strong IgM, IgG, and cytotoxic T-cell responses after grafting, and the kidneys were rapidly destroyed by immune rejection in all but one rat. It is concluded that long-surviving kidney allografts fail to activate helper T cells and induce in naive second recipients the same state of unresponsiveness observed in the first recipient.

Animals↗
PubMed1979

Failure of long surviving, passively enhanced kidney allografts to provoke T-dependent alloimmunity. II. Retransplantation of (AS X AUG)F1 kidneys from AS primary recipients into (AS X WF)F1 secondary hosts.

Long surviving, passively enhanced (AS X AUG)F1 kidneys carried by AS recipients were retransplanted into (AS X WF)F1 second hosts. Acute graft rejection did not occur. Only one of six secondary recipients mounted a significant T-dependent IgG lymphocytotoxic antibody response. In all six, generation of cytotoxic T cells was markedly slower and depressed. These results are compatible with the hypothesis that kidney parenchyma, although carrying major histocompatibility complex specificity is able to induce T-independent but not T-dependent alloimmunity. A corollary is that passenger cells are responsible for exciting the T-dependent allimmune response normally observed after grafing. The practical difficulty of eliminating all T-dependent immunogenicity from (AS X AUG)F1 kidneys was emphasized by the observation that a 3-d residence in an intermediate AS recipient was insufficient time to prevent acute graft rejection after retransplantation.

Animals↗
PubMed1979

Pricing, demanders, and the supply of health care.

This paper is divided into three substantive sections. In the first section the conventional neoclassical paradigm is augmented by consideration of the agency relationship in which the physician is considered not only as the agent who controls the supply of health care, but also as the decision maker who articulates demand because patients forego this role and rely on "expert" advice. The next section is concerned with the effects of pricing on consumer demand and draws on the available empirical evidence to present estimates of price elasticity, cross elasticity, and other characteristics of the choice process. This analysis is completed by integrating the agency relationship into the discussion and arguing that if the policy objectives are expenditure containment and greater efficiency in resource utilization, the price mechanism should be used to affect the behavior of the primary demander and the supplier: the physician. In the final section the implications of this analysis are discussed in the contexts of two competing perspectives: the liberal market perspective and the collective "needology" perspective, and an attempt is made to distinguish some of the characteristics of the two views of the world.

Canada↗
PubMed1977

Avarice, inefficiency, and inequality: an international health care tale.

The paper is concerned with impact of a medical profession, physicians, on the delivery of health care. The basic economic motivation of self-interest and avarice has led this profession to produce health care outcomes which are inequitable and inefficient. In the first section of the paper the regional geographical distribution of physicians in four disparate health systems--England, Ireland, France, and West Germany-is analyzed and found to be highly unequal. The next section is concerned with the efficacy of therapies and the cost-effectiveness of health care delivery systems in a variety of countries. The final section discusses how health care can be more equitably and more efficiently delivered. It is argued that both markets and bureaucaracies are likely to be inadequate unless carefully monitored. In particular, there is a great need to investigate the cost-effectiveness of therapies and then persuade physicians, via pecuniary and nonpecuniary incentives, to behave in a manner which leads to more equitable and efficient health care outcomes.

Cost-Benefit Analysis↗