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Biomedical subjects

D Pathman

Publications and source records attributed to D Pathman.

6 recordsLinked to original sources
PubMed1996

Do physicians cost shift?

This study analyzes whether physicians charge their privately insured patients more-a practice known as cost shifting-in response to Medicare payment reductions. As part of congressional legislation in 1989 and 1990, Medicare reduced its payment rates for selected procedures by as much as 30 percent. Here we examine whether reductions in Medicare rates increase how much physicians charge privately insured patients. Our data provide no evidence that physicians respond to Medicare payment reductions by shifting costs to their privately insured patients.

Aged↗
PubMed1995

Obstetrical practice among new rural family physicians.

BACKGROUND: Fewer family physicians now practice maternity care than a decade ago, a trend that is worsening access to obstetrical care in some rural areas. This study explores the effects of a wide range of factors on the likelihood of newly settled rural family physicians providing maternity care. METHODS: Subjects included 782 family physicians who moved to nonmetropolitan areas nationwide during the years 1987 through 1990. Physicians who located in health professional shortage areas were oversampled. Questionnaires were mailed in 1991, with a 72% response rate. The final sample used in the analyses included 338 eligible respondents. RESULTS: A total of 151 (45%) of these rural family physicians performed routine deliveries during the previous year. Family physicians more likely to provide maternity care worked in practices they owned and were not solo practitioners (P < or = .05). Maternity care by family physicians also was more common in counties that were less populated, had fewer obstetricians, and had more family physicians. State-by-state differences in the cost of medical malpractice insurance and Medicaid reimbursement rates for obstetrical care were not among the factors associated with the provision of maternity care for these rural family physicians. CONCLUSIONS: These data suggest that features of rural family physicians' practices and communities are the best predictors of whether they provide maternity care. Contrary to what family physicians often claim, we found that malpractice premium costs and Medicaid reimbursement rates were not associated with family physicians' likelihood of providing maternity care.

Adult↗
PubMedDate not supplied

Cyclic adenosine 3',5'-monophosphate, adenylate cyclase and physical dependence on ethanol: studies with tranylcypromine.

Tranylcypromine, a monoamine oxidase inhititor, was administered to rats during chronic ethanol treatment. The severity of the hyperactive withdrawal behavior observed upon removal of ethanol was, during the first 60 hours of treatment, similar in both ethanol and ethanol + tranylcypromine treated animals. However, after 84 hours of ethanol treatment, tranylcypromine slightly depressed the withdrawal severity. Rises in cerebral cortical cyclic adenosine 3',5'-monophosphate (cAMP) levels and adenylate cyclase activity associated with withdrawal behavior in ethanol-treated rats, though, were not observed. (Adenylate cyclase activity used throughout this paper refers to % conversion of 3H-adenine into 3H-cAMP). Based on this and previous data, a model invoking two neurochemical adaptations--one in adenylate cyclase and one, as yet, unknown-is proposed for the mechanism of physical dependence.

Adenylyl Cyclase Inhibitors↗