Charity: urban hospital's local and statewide significance.
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Charities↗
Biomedical subjects
B Manuel
Publications and source records attributed to B Manuel.
A consensus process to determine the relative complexity-severity of frequently performed surgical services.
Current prevailing fees represent initial charges inflated over time, and it is well known that some services, such as surgical treatment of the coronary arteries, are less demanding services today than in the early days of the specialty, when morbidity, mortality and operative stress were extremely high. Resource costs are difficult to measure accurately and time is an inappropriate indicator of complexity and severity. If society is looking for ways in which physicians will support changes in reimbursement, the C-S index resulting from the consensus process which has been described herein could provide an acceptable basis for a variety of payers to assess services. We plan to validate this consensus method in other geographic areas and will report the results in appropriate publications. We hope that the C-S index will be valuable in future policy discussions about the basis for physician fees, as well as for other health policy purposes.
Costs and Cost Analysis↗
A cytogenetic study of spontaneous abortions in Hawaii.
Cytogenetic results on 234 spontaneous abortions showed 109 (46.6%) to have a chromosome abnormality. The results were analysed separately for the four major ethnic groups of which the population was composed and no differences in the proportion or types of chromosome abnormalities seen. The results of this survey were found to be very similar to other major published surveys and it therefore appears, on present evidence, that neither geographic location nor racial group affects the frequency of chromosome abnormalities seen among human spontaneous abortions. The sex ratio among the chromosomally normal and abnormal abortuses and the effect of parental and gestational age were discussed.
Abortion, Spontaneous↗
The origin of human triploids.
A series of 26 triploid foetuses was ascertained in a survey of spontaneous abortuses and the origin of the additional haploid complement determined in 21 of them by the study of foetal and parental heteromorphisms. In 17 the additional haploid set was paternal in origin, in 3 it was maternal in origin and in one the parental origin could not be determined. The best fit for the data using a maximum-likelihood method was that 66.4% of the triploids were the result of dispermy, 23.6% the result of fertilization of a haploid ovum by a diploid sperm formed by failure of the first meiotic division in the male and 10% the result of a diploid egg formed by failure of the first maternal meiotic division. The possible sources of error inherent in the technique are reviewed and our results compared with previously published data.
Chromosomes, Human↗