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Biomedical subjects

C C Pegels

Publications and source records attributed to C C Pegels.

17 recordsLinked to original sources
PubMed1998

Patenting medical and surgical techniques: an ethical-legal analysis.

Considerable controversy has recently arisen regarding the patenting of medical and surgical processes in the United States. One such patent, viz. for a "chevron" incision used in ophthalmologic surgery, has especially occasioned heated response including a major, condemnatory ethics policy statement from the American Medical Association as well as federal legislation denying patent protection for most uses of a patented medical or surgical procedure. This article identifies and discusses the major legal, ethical and public policy considerations offered by proponents and opponents of such patents. The existing literature divides up into those who favor such patents essentially without qualification, and those who condemn and wish to outlaw them. We advance a compromise position where administrative and legislative action is called for to provide more specific guidelines regarding the patentability of such processes by the Patent and Trademark Office. Our position, in sum, will be that too much is at stake in this complicated area for either the blanket prohibition, or wholesale, uncritical acceptance, of the patenting of medical and surgical processes or techniques.

American Medical Association↗
PubMed1994

Evaluating relative efficiencies of Veterans Affairs Medical Centers using data envelopment, ratio, and multiple regression analysis.

Several forms of analysis are used to evaluate the efficiency of acute care Veterans Affairs hospitals. The smaller hospitals with fewer than 100 beds and hospitals not in operation a full year have been excluded. The types of analysis used are input ratio analysis and productivity analysis of three outputs consisting of surgeries, discharges and emergency and outpatient visits. Also used is data envelopment analysis (DEA) of two subsamples segmented by whether the hospital is a member or not of the Council of Teaching Hospitals. Finally, multiple regression is used to find indicators of the relative efficiencies generated by the DEA. Results show that about one half of all hospitals are relatively inefficient. Also promising indicators of efficiency are hospital size, inpatient surgeries, outpatient surgeries, and the aggregate emergency room and outpatient visits.

Ambulatory Care↗
PubMed1990

Health care expenditures for the elderly: a current and future dilemma.

Financing health care for the elderly is becoming a familiar topic in the popular press. Considering that those aged 65 yr and older constitute 12% of the population and consume about 30% of all health care expenditures, health care financing for the elderly makes a timely and interesting topic. In this paper the financing issue is addressed. With the elderly, on average, becoming more affluent, the issue of self-financing must be explored. This of course does not mean the elimination of Medicare but possibly development of a different/alternative approach. As part of our analysis, the potential political pressure from the younger generation is considered.

Aged↗
PubMed1982

HMO enrollment projection process and a proposed linear model.

Estimation of enrollment penetration of target employee' groups, as a percent of total employees, is a critical task in the planning and development process of HMOs. A heuristic process to estimate penetration rates of employee groups is described. Next, a multivariate linear statistical model is proposed and the parameters of the proposed model are estimated on the basis of a data base comprising 83 employee groups for which penetration rates have been estimated using the heuristic process. The linear multivariate model is found to be statistically significant for both the singles and family (marrieds) penetration rates. The proposed model simplifies the method for estimating penetration but has not been tested against actual data.

Forecasting↗
PubMed1982

Health care expenditures for the elderly. Who pays for them?

The degree to which Medicare and Medicaid programs provide health coverage for the elderly still leaves a large financial burden on this population. Although the sale of supplementary health insurance to the elderly has been fraught with abuse, a policy purchased from a reputable organization can be advantageous. Knowledge of the large amount spent on personal health care will hopefully stimulate the search for alternative, less expensive ways to provide health care.

Aged↗
PubMed1980

Institutional vs. noninstitutional care for the elderly.

The question of institutionalization vs. home care of the aged in need of medical care has been debated extensively. The arguments for deinstitutionalization have stressed the issue of cost. Home care is felt to be more cost efficient than institutional care. In this paper, both sides of the issue are investigated in detail by drawing on published conference proceedings and empirical studies reported in the literature.

Aged↗
PubMed1978

Relationships among HMO hospital utilization, physician visits, and years operational.

Statistical tests are performed on the membership of HMOs for which data are available (N = 124) to determine if (1) hospital utilization by HMO members is correlated with physician visits, (2) hospital utilization is correlated with the number of years a HMO is operational, and (3) physician visits is correlated with the number of years a HMO is operational. Statistical tests indicate that there is no correlation among the three pairs of variables.

Ambulatory Care↗
PubMed1977

An analysis of selected blood service policy changes.

Prinicipal national goals for a blood service system are concerned with shortage, quality, acessibility, and efficiency. Since regional blood service operating objectives based on these goals are in partial conflict, a single policy does not exist. Using a computer-based planning system, four policies are examined and tested for their effects on these objectives. [corrected] The policies are: use of frozen red cells ( a technological alternative); extension of the useful life of fresh blood (a legal alternative); improved collection planning (a planning alternative), and improved inventory management (a management alternative). Model projections of the effects of each policy and comparative performance of each policy with respect to the principal objectives are discussed.

Blood Banks↗
PubMedDate not supplied

A crossectional country group study of three health level outcomes and four potential causes.

A crossectional study of four country groups segmented by per capita income of the majority of the world's countries was made to evaluate the relationship between health level outcomes and potential causes which may impact on the health level outcomes. The health level outcomes consist of life expectancy at birth, infant mortality rate and child mortality rate. The potential causes consist of secondary school children per 100 in school age group, daily calory supply per capita, population per physician and population per nurse. For the two lower income country groups the two important determinants of life expectancy were daily calory supply per capita and secondary school children per 100 in school age group. For the upper middle income the country group the important positive determinant of life expectancy was population per nurse and for the upper income country group the important negative determinant of life expectancy was daily calory supply per capita. Infant and child mortality rates were associated with secondary school children per 100 in school age group and population per physician or population per nurse for the two lower income country groups. For the upper middle income country group population per nurse or population per physician was supplemented by daily calory supply per capita for both infant and child mortality. For the upper income country group only infant mortality had statistically significant determinants. They were daily calory supply per capita and secondary school children per 100 in school age groups.

Child, Preschool↗
PubMedDate not supplied

A computer-based interactive planning system for scheduling blood collections.

Seasonal imbalances between supply and demand for blood products are common. This paper describes a planning system which utilizes conversational computer facilities to assist the manager of a regional or communitywide blood agency in scheduling bloodmobiles and fixed facility collections from one to 18 months in advance. The benefits from changes to only one day of a collection schedule recover the annual costs of using the system, estimated at at $600 for a blood service which collects 65,000 units annually.

Blood Banks↗
PubMedDate not supplied

Cost effectiveness of use of frozen blood to alleviate blood shortages.

Human blood shortages are a perennial problem because of the relatively short life span (21 days) of stored blood and the traditional shortage periods during summer vacation months and other vacation periods. This study evaluates the use of frozen blood during these traditional shortage periods. An empirically-based simulation model is used. During periods of excess supply surplus blood is frozen and during shortage periods frozen blood is thawed and used as a substitute for stored blood. The results of the study indicate that the use of frozen blood during shortage periods alleviates shortages but at a high cost. Improved blood collection scheduling management and promotion will attain the same results at a lower cost.

Blood Banks↗
PubMedDate not supplied

Statistical effects of varying blood life span from 14 to 28 days.

Human blood can be stored in the liquid state for only 21 days. Although the 21-day limit appears to have been somewhat arbitrarily set, there is general agreement that quality of blood, especially the red blood cells' oxygen carrying ability and viability declines with age. Lengthening the shelf life could help in reducing outdating and shortages. Shortening the shelf life, on the other hand, would make it even more difficult to supply blood needs. This paper studies the effect of varying the blood's life span from 14 to 28 days using a simulation model and collections and utilization data from an actual blood region.

Blood Physiological Phenomena↗
PubMedDate not supplied

Marketing hospitals to physicians in the United States.

This paper discusses the application of multidimensional scaling (MDS) in formulating the strategies for marketing a hospital to physicians. An extensive hospital factor survey was used to provide information for interpreting the MDS results, and to formulate specific strategies to: attract new physicians to the hospital; and, to make the hospital attractive to affiliated physicians for patient referrals. We conclude that MDS provides a unique approach for formulating strategies for similar non-conventional situations.

Attitude of Health Personnel↗