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Biomedical subjects

D M Fox

Publications and source records attributed to D M Fox.

At least 55 records · Page 3Linked to original sources
PubMed1989

The history of responses to epidemic disease in the United States since the 18th century.

History offers some guidance for understanding social and policy responses to the AIDS epidemic. Pertinent themes in the history of responses to epidemic disease in the United States in the past two hundred years include an initial underestimation of the severity of the epidemic; the prevalence of fear and anxiety; flight, denial, and scape-goating as a result of fear; efforts to quarantine and isolate carriers and the sick; the assertion of rational policies by coalitions of business, government, and medical leaders; the recruitment of a special cadre of physicians to treat the sick; the similarity of responses to both epidemic and endemic infectious diseases; and the high cost of epidemics, which is shared by government, philanthropy, and private individuals. However, until more is known about the natural history of AIDS, generalizations about past epidemics must be cautiously applied to our present circumstances.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The cost of treating persons with AIDS in four hospitals in metropolitan New York in 1985.

From hospital accounting data on 402 patients, this study calculated annual, lifetime and perdiem cost, assessed the relationship to cost risk group, diagnosis, payer, and DRG, and estimated how the cost burden was shared between hospitals and third-party payers. Conclusions were as follows: Annual impatient hospital cost for adults with AIDS averaged +22,300, incurred during an average of 38 hospital days. Lifetime inpatient hospital costs averaged +38,200, incurred during an average of 62 hospital days. Patients with AIDS did not make more intensive use of hospital ancillary services than the average medical/surgical patient. They incurred exceptional per diem costs for laboratory and pharmacy services, but this was offset by lower operating room costs. Cost did not bear a statistically significant relationship to risk group in adult patients, but hospital utilization, and thus annual cost, ws very different for pediatric patients. There was limited evidence of a relationship between cost and diagnosis and between cost and payer. Eighty-two percent of the total cost was reimbursed by third-party payers: Medicaid (28 percent), Blue Cross (26 percent), Medicare (3 percent) and commercial insurance and other payers (25 percent). We estimate that self-pay patients paid 13 percent of the cost, and that 5 percent was unreimbursed.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Intensive home health care in the United States. Financing as technology.

This paper assesses the impact of mechanisms for financing intensive home health care services in the United States on their utilization. As lengths of stay have decreased in response to prospective payment methods for hospitals, demand has increased for intensive and complex services provided to patients in the home. Third-party payers, however, are willing to satisfy only some of this potential demand that their reimbursement policies have generated. It is the policies of payers rather than the safety and effectiveness of devices and procedures that are the major constraints on the expansion of intensive home health care. We describe the effects of these policies on who receives intensive home health care services, who provides them, what services are provided, how their quality is monitored, and what they cost.

Acute Disease↗
PubMed1987

Tax policy as social policy: cafeteria plans, 1978-1985.

Since the passage of Section 125 of the Internal Revenue Code in 1978, cafeteria plans have offered employees a choice of tax-free fringe benefits. Although these plans have been popular with employers and employees, Treasury Department officials and many tax lawyers soon came to regard Section 125 as a mistake. The Treasury has tried to reclaim through regulation the revenue and the fundamental principles of tax law it had asked Congress to give away in 1978. This paper is a history of Section 125 that emphasizes its relationship to health policy. On the basis of interviews and printed primary sources, the paper argues that Treasury officials made a less than rigorous assessment of the impact of cafeteria plans because they were preoccupied with a larger agenda of making tax-free benefits more equitable. Moreover, they saw no reason to collaborate with the health policy community to plan this agenda; they saw themselves as implementing a social policy already in the Internal Revenue Code.

Civil Rights↗
PubMed1987

Differential visual field-interhemispheric transfer: can it explain sex and handedness differences in lateralization?

104 men and women were tested for visual field-hemispheric transfer of spatial information on a dot-localization task. Right-handed subjects showed significant improvement when stimuli were presented to the left visual field of the right hemisphere (LVF-RH) after practice on the same task presented to the right visual field of the left hemisphere (RVF-LH) first. No improvement was found when the task was presented in the reverse order (LVF-RH first followed by RVF-LH). It was concluded that, for right-handers, transfer of spatial information to the right hemisphere is facilitated while transfer to the left hemisphere is inhibited. Left-handed subjects demonstrated no significant improvement in either condition, suggesting inhibition or lack of transfer of spatial information in either direction. No sex differences were found in either right-handed or left-handed subjects. The findings suggest that there may be different mechanisms underlying the similarities in functional lateralization of women and left-handers.

Adult↗
PubMed1986

The consequences of consensus: American health policy in the twentieth century.

For most of the twentieth century the central theme in the history of health policy in the United States was the elaboration and implementation of a consensus that health services should be organized in regional hierarchies. This consensus was based on shared beliefs about how medical advances were made and disseminated. Hierarchical regionalism became national health policy in several stages that culminated in the 1960s. Since the 1970s, however, the national policy of hierarchical regionalism has been eroded by the unexpected consequences of its success.

American Medical Association↗