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Biomedical subjects

F N Lohrenz

Publications and source records attributed to F N Lohrenz.

At least 19 recordsLinked to original sources

Utilization of prepaid services by patients with psychiatric diagnoses.

The authors document and discuss the utilization of psychiatric services in a rural group practice before and after the institution of a prepaid health plan. They found that the utilization of psychiatric services increased dramatically during the first year of the plan's operation. The increase in outpatient utilization continued throughout the 3 years studied, but inpatient utilization decreased after the first year and later reached a level lower than that seen before the plan was instituted. One possible reason for the decline in inpatient utilization is that increased outpatient care prevents hospitalization.

Ambulatory Care

Impact of membership in an enrolled, prepaid population on utilization of health services in a group practice.

Members of prepaid group-practice medical-care plans are believed to use more ambulatory, but fewer inpatient, services than populations served by fee-for-service practitioners. It is not known whether these differences are attributable to the prepayment aspects of the plan or to other circumstances. We studied the impact on use of services of only one factor-prepayment at the Marshfield Clinic, Wisconsin--with all other factors, including group practice, held constant. The findings were derived from the experience one year before, and two years after, the initiation of the prepaid program. Results showed that prepayment alone resulted in significant increases in both inpatient and ambulatory care (about 100 per cent in ambulatory-care visits, 75 per cent in hospital discharges, and 60 per cent in hospital days). These increases were far greater than comparable increases in the fee-for-service population served by the Clinic.

Ambulatory Care

Cholecystectomy peer review: measurement of four variables.

Process and outcome analyses were carried out on a group of patients who had uncomplicated cholecystectomy. The postoperative length of stay and patient satisfaction were also measured. A random sample of 80 charts was selected from 222 eligible records for process analysis. Outcome was evaluated in 218 of the 222 eligible patients against explicit criteria. More patients were in the symptomatic and back-to-work group than expected. The peer consensus was that these results were not related to the surgical procedure or specifically related to gallbladder disease. Ninety-five per cent of the patients assessed care as good or excellent, and 90 per cent felt the length of postoperative stay was satisfactory. When the patients were divided according to surgeon, significant differences in the length of postoperative stay were found in the 154 patients without common bile duct exploration. After the findings were presented to the surgeons through an educational program, changes occurred which resulted in a decrease of nearly one day in the postoperative hospitalization.

Cholecystectomy