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Biomedical subjects

D Blumenthal

Publications and source records attributed to D Blumenthal.

At least 109 records · Page 6Linked to original sources
PubMed1989

The case for using industrial quality management science in health care organizations.

In an effort to provide health care of optimal quality, providers traditionally assess or measure performance and then assure that it conforms to standards. In cases where performance fails to conform, providers attempt to modify or improve physician behavior. The analytic scope of this traditional paradigm may not be broad enough to allow modern health care organizations to provide optimal care. At a theoretical and practical level, many conceptual limitations inherent in the traditional approach are addressed in modern industrial quality science. A fundamental principle of industrial quality control is the recognition, analysis, and elimination of variation. Based on rigorous analysis of variation in outcomes and processes, industrial quality experts have developed principles and techniques for quality improvement. Health care organizations may well make important advances in the quality of care and service through the application of these principles and techniques.

Consumer Behavior↗
PubMed1989

Genetic diagnosis. Implications for medical practice.

Genetic diagnostic techniques increasingly permit the detection of predisposition to illness long before the onset of the disease process itself. Medicine is on the verge of becoming a predictive science as well as a diagnostic and therapeutic one. Genetic diagnosis could have profound effects on many aspects of our health care system, including the prestige and effectiveness of preventive medicine, the competitive behavior of health care organizations and insurance companies, access to private health insurance, the ability of primary care physicians to serve as gatekeepers, and other matters. This article examines the range of potential effects of the new genetic diagnostics on the organization and financing of health care. For purposes of illustration the authors examine in detail the possible consequences of genetic tests for predisposition to two diseases: Reye's Syndrome and lung cancer in smokers.

Cost-Benefit Analysis↗
PubMed1989

The ownership of health facilities and clinical decisionmaking. The case of the ESRD industry.

The growth of investor-owned health care facilities raises questions about the relationship between profit seeking and medical decisionmaking. The authors compared the treatment received by patients with end-stage renal disease in private nonprofit, for-profit, and public facilities. Using data collected by the Health Care Financing Administration in 1981, they found that facility ownership had a significant independent effect on treatment of renal failure. In particular, patients at for-profit facilities were more likely to be dialyzed in the center and less likely to receive kidney transplants, home dialysis, or peritoneal dialysis than were their counterparts in nonprofit and public facilities. These findings persisted after controlling for characteristics of patients, the facility, and the local health care system, suggesting the need for further research and policy initiatives to deal with this issue.

Decision Making↗
PubMed1987

The privatization of health care and physicians' perceptions of access to hospital services.

Health care in the United States is increasingly delivered by for-profit providers, by multi-facility corporations, and under conditions of price-based competition. The joint influence of these three trends is examined through data drawn from a 1984 survey of physicians conducted by the American Medical Association. For-profit ownership and price competition are reported to restrict admission for the poor and uninsured; the effects of system affiliation are shown to be more complex. Policy responses to future restrictions on access are discussed.

Attitude of Health Personnel↗
PubMed1986

Commercializing university research. Lessons from the experience of the Wisconsin Alumni Research Foundation.

Universities that are now seeking ways to capture the financial rewards of advances made in biotechnology and other fields on their campuses have been encouraged by the apparent success of previous efforts to benefit from the commercial application of research findings by obtaining patents and granting licenses. Notable among these efforts is the Wisconsin Alumni Research Foundation (WARF). A close examination of the experience of this foundation reveals that, with good fortune and good management, a patenting and licensing organization can enjoy financial success. It also indicates, however, that the success experienced by WARF would be difficult to achieve today and that such efforts may yield lower financial returns than university administrators expect. Universities should be aware that such ventures entail financial risks and pose potential threats to traditional university values.

Academic Medical Centers↗
PubMed1986

University-industry research relationships in biotechnology: implications for the university.

The growth of university-industry research relationships in biotechnology has raised questions concerning their effects, both positive and negative, on universities. A survey of over 1200 faculty members at 40 major universities in the United States reveals that biotechnology researchers with industrial support publish at higher rates, patent more frequently, participate in more administrative and professional activities and earn more than colleagues without such support. At the same time, faculty with industry funds are much more likely than other biotechnology faculty to report that their research has resulted in trade secrets and that commercial considerations have influenced their choice of research projects. Although the data do not establish a causal connection between industrial support and these faculty behaviors, our findings strongly suggest that university-industry research relationships have both benefits and risks for academic institutions. The challenge for universities is to find ways to manage these relationships that will preserve the benefits while minimizing the risks.

Antibodies, Monoclonal↗
PubMed1986

Industrial support of university research in biotechnology.

A 1984 study of biotechnology companies reveals that nearly one-half of all such firms fund research in universities. Industry may support as much as one-quarter of all biotechnology research in institutions of higher education. These investments seem to be yielding substantial benefits to involved firms. Per dollar invested, university research is generating more patent applications than is other company research. Research relationships do pose some risks to traditional university values such as openness of communication among scholars. These risks may be greater in relationships involving small firms. The data also reveal that government is now, and seems likely to remain, the principal source of support for university research in biotechnology.

Industry↗
PubMed1986

Profits under pressure. The economic performance of investor-owned and nonprofit health maintenance organizations.

This study assesses the economic performance of investor-owned and private nonprofit health maintenance organizations by comparing their costs and revenues, controlling for other characteristics of the plans and the areas in which they are located. Data are drawn from a sample of 173 HMOs operating in 1983, one quarter under proprietary auspices. For-profit plans have average costs 10% higher than their nonprofit counterparts, primarily due to higher expenses for ambulatory care. Average revenues are also higher in investor-owned HMOs, although this difference is one third the size of the estimated difference in costs. The paper concludes with a discussion of the implications of these findings for both the future performance of the HMO industry and public policy affecting prepaid health care.

Costs and Cost Analysis↗
PubMed1984

Quantitation of cytotoxic rat antibodies by post-assay labeling of mitogen-induced target blasts with [3H]thymidine.

Cytotoxic rat alloantibodies were quantitated using concanavalin-A induced blasts as target cells. [3H]thymidine incorporation by such cells was linearly related to their number. Serial dilutions of cytotoxic antisera were incubated with a small number of target cells in presence of rabbit, guinea pig or rat complement. Following a short incubation, cultures were pulsed with [3H]thymidine to estimate the number of live cells. Cytotoxicity titers were calculated according to conventional von Krogh analysis as the reciprocal of the dilution yielding 50% lysis. Such titers were virtually identical to titers obtained in assays in which the extent of cytolysis was determined by trypan blue or ethidium bromide exclusion. The assay, which is carried out in microtiter plates, is quantitative, economical, and objective. Furthermore, automatic harvesting of the cultures allows the rapid processing of large numbers of samples.

Animals↗