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Biomedical subjects

D L Cowen

Publications and source records attributed to D L Cowen.

At least 37 records · Page 2Linked to original sources
PubMed1980

Follow-up study of the impact of a rural preventive care outreach program on children's health and use of medical services.

The present study is a follow-up of a previous evaluation of a rural pediatric preventive care outreach program in Appalachia, which showed that although program participants did not differ substantially from their matched controls on health outcomes, they did have significantly lower utilization rates for outpatient services. The purpose of this second study was to determine whether replication of the original study would yield similar results on a fresh sample of children and whether differences observed between study and control groups would hold firm once families had terminated contact with the program. In general, the findings of the present study provided additional evidence to suggest that program children had lower utilization of outpatient medical services with no appreciable difference from the control children in health outcomes. Lower outpatient utilization rates were also found after termination of contact with the program, but the differences were not statistically significant.

Child↗
PubMed1978

Impact of a rural preventive care outreach program on children's health.

A "treatment-control" research design incorporating a modified "tracer disease" methodology for measuring health outcomes has been applied to the evaluation of a rural pediatric outreach preventive health care program in Appalachia. The primary research objective was to assess the general level of effectiveness of the health services provided by the program in preventing and/or reducing illness due to common childhood diseases among children receiving these services, when compared to similar (i.e., "matched") children receiving standard pediatric outpatient care but without such outreach services. The research findings indicate that prevalence rates for the selected tracer diseases were generally comparable among program children and their controls. However, evidence of effective identification and treatment of an increased prevalence of iron deficiency anemia by the program was demonstrated. Comparison of the program and control children on their sociocultural characteristics also suggests that the comparable health outcomes for the two groups may have been achieved in the case of the program children despite their somewhat disadvantaged socioeconomic and environmental circumstances relative to the controls; and apparently with lower outpatient services utilization and lower overall costs.

Child Health Services↗
PubMed1976

Problems in the development of a rural primary care center.

For 18 months between July 1973 and December 1974, the development of a primary care center for a rural Appalacian county engaged the efforts of local community leaders and the Department of Community Medicine of the University of Kentucky College of Medicine. This case study discusses some of the major events and factors contributing to this unsuccessful endeavor. The local cultural and sociomedical circumstances, including economic and political forces, and the errors in institutional relations and communication are analyzed. Many of the community problems encountered, at both the local and regional levels, are common to various rural areas. Considerations discussed in some detail include medical care payment mechanisms, rural economics, and local sociocultural systems. These community health problems, and the broader health policy issues that they represent, must be addressed before any significant changes or advances can be made in health care in rural America.

Community Health Services↗