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Biomedical subjects

C E Begley

Publications and source records attributed to C E Begley.

At least 19 recordsLinked to original sources
PubMed1995

Health expenditures in Texas during 1989 and 1990.

To monitor the growth of the health-care sector in Texas, we made annual estimates of aggregate health spending in 1989 and 1990 and compared them with estimates from prior years and with national trends. Expenditures are grouped by total spending, spending by the state government, and distribution of payment. To achieve data that could be compared with national figures, we followed the methods used by the federal government to estimate national health spending. Results indicate a return to the rapid rates of growth experienced in the early 1980s. Possible explanations for some major trends in spending and in sources of payment are provided. Basic features of recent efforts to contain costs are addressed and related to the trends.

Health Expenditures↗
PubMed1994

Avoidable hospitalizations and socio-economic status in Galveston County, Texas.

Population-based hospitalization rates for preventable conditions are derived for a low-income population in Galveston County, Texas using discharge data from four area hospitals and demographic data from the U.S. Census. Comparisons are made with similar rates for the general populations of two eastern states (Maryland and Massachusetts) and New York City. Results support the hypothesis that low-income persons lack access to primary care, leading to higher rates of hospitalization for preventable conditions. Alternative explanations for differences found are examined.

Demography↗
PubMed1992

Health expenditures in Texas, 1988.

Expenditures for health care in Texas during 1988 totaled $32.4 billion. Health spending by category of service and sources of payment was estimated and compared with estimates for prior years and with national trends. Texas differed from the nation as a whole in average annual increases in total spending, the percentage of spending for prepayment and administration, and the percentage of spending paid by consumers, the federal government, and private insurance. Proposed expansions in insurance coverage for the large proportion of uninsured Texans will probably require strong efforts to contain costs.

Health Expenditures↗
PubMed1992

The cost of cancer in Texas.

Direct and indirect costs of cancer for Texas are estimated for 1988 and are compared to costs for 1980. The distribution of these costs by age group and type of cancer is presented and discussed. Conceptual and methodological issues underlying the estimates are explained to assist the reader in interpretation. The authors conclude that future collection of more specific data at the state level would greatly assist policymakers dealing with cancer issues.

Adolescent↗
PubMed1991

Health expenditures in Texas for 1987.

Total, per capita, and state government health spending by category of service for 1987 were estimated along with the distribution of spending by sources of payment. Definitions, methods, and sources of data are similar to those used by the US Health Care Financing Administration in estimating national health care expenditures and payments. Comparisons are made with prior-years' spending and with estimates of spending at the national level. Spending and financing patterns are identified and possible explanations are discussed.

Health Expenditures↗
PubMed1991

Government should strengthen regulation in the weight loss industry.

Rationales for government regulation in the weight loss industry are developed on the basis of the concepts of market failure and potential harm to consumers. Evidence shows that consumers face problems in judging the quality of the industry's products and services, and they lack adequate protection against possible harm. The pros and cons of a variety of public and private strategies are examined for correcting these deficiencies. Recommendations are suggested for strengthening existing government regulations and expanding research.

Consumer Product Safety↗
PubMed1990

Estimating the mortality cost of AIDS: do estimates of earnings differ?

The future earnings of male Texans dying of AIDS in 1987 were estimated using: national earnings profiles; earnings derived from occupations listed on death certificates; and earnings reported by persons with AIDS who responded to a survey. Mortality cost estimates using the two sources of actual earnings differed by a modest amount in comparison to the estimate using national earnings profiles.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Evaluation of a primary health care program for the poor.

This paper examines the success in implementing a major program involving a partnership between public and private providers to deliver primary health care services to the poor. In 1985, the 69th Texas Legislature passed the Primary Health Care Services Act, authorizing the Texas Department of Health to contract for or directly provide primary health care services in those parts of the state that are medically underserved and have large numbers of people in poverty. This paper evaluates the potential impact of the projects with respect to access and cost. The study revealed that the basic concept of allowing local public and private providers to develop projects reflecting their community's unique needs and resources was successful. The approach lead to a wide variety of different types of projects, but the basic goals and activities of the projects are consistent with the legislation. The evaluation identified three major program areas that could be improved: (1) patient monitoring and follow-up to ensure the accessibility of the priority primary care services, (2) the need for the development of projects in other high need areas of the state, and (3) greater efficiency in service delivery.

Health Resources↗
PubMed1989

Health care spending in Texas: 1980-1986.

This paper reports health care spending and payment patterns for Texas by category of service. Various methods and sources are used to generate annual estimates of total spending, state government spending, and spending per person. The basic approach is similar to that used by the US Health Care Financing Administration in estimating national health care spending. Comparisons between spending in Texas and the nation are made and various reasons for differences are discussed.

Health Expenditures↗
PubMed1987

Prospective payment and medical ethics.

This article considers the ethical implications of prospective payment from the perspective of physicians and other health care practitioners. It focuses on the argument that prospective payment creates ethical conflict by giving physicians an economic incentive to do less for their patients. This argument is criticized in two respects. First, available evidence is reviewed which suggests that the incentives actually created by different prospective payment schemes and their effect on "optimal" patterns of practice is uncertain. Further, it is pointed out that ethical conflict originates in the dual role of physicians as agents and suppliers of service. Recognizing that such conflict exists under any payment mechanism, a better focus for the ethical evaluation of prospective payment is suggested that considers whether the incentive to do less is likely to have adverse effects on physician decisions, relative to decisions made under other payment mechanisms.

Cost Control↗
PubMed1985

Some problems with pro-competition reforms.

As the search for effective cost-containment policies continues, health care reform along pro-competition lines has gained considerable backing in the United States. By offering market competition to achieve allocational efficiency and vouchers and tax credits to achieve distributional equity, pro-competition reforms appear to satisfy what many believed were incommensurable goals. A critical review of this strategy reveals two practical difficulties, however. The first concerns the ambiguity arising from the proposals' reliance on the concept of equal access to some basic level of health care as its distributional objective and the second concerns the ethical dilemma arising from the proposals' reliance on physicians as rationers of health care. In considering the distributional goal of guaranteeing access to a basic minimum of health care, we argue that, despite its theoretical attractiveness, there exists no acceptable way of determining or justifying its content, and without a clear definition of the basic minimum there is no guarantee that any equity objective will be achieved under the pro-competition strategy. With regard to the use of physicians and other providers as society's gatekeepers, we point out that this role is in direct conflict with traditional responsibilities that patients expect providers to assume. Requiring doctors to ration services in response to market incentives may further erode the trust relationship between physicians and patients, and clearly puts the more seriously ill at a disadvantage.

Cost Control↗
PubMedDate not supplied

The incremental cost of screening, diagnosis, and treatment of gonorrhea and chlamydia in a family planning clinic.

A standard cost-finding methodology was used to estimate the incremental expenses associated with the provision of screening, diagnostic and treatment services for N. gonorrhoeae and Chlamydia trachomatis in a family planning clinic serving high risk adolescents. The study included both the personnel and nonpersonnel costs accrued in administering screening and diagnostic tests, contacting patients with infection, treating patients with infection, and administering tests of cure. The cost per screening test averaged $9.74 when part of a routine family planning visit. Diagnostic tests provided to drop-ins with symptoms averaged $19.92. Treatment-related costs per visit averaged $24.97. The total incremental cost of providing STD screening, diagnosis, and treatment services in the clinic represented 14% of the clinic's overall budget during the study period.

Adolescent↗