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Biomedical subjects

F R Woolley

Publications and source records attributed to F R Woolley.

36 records · Page 2Linked to original sources
PubMed1977

Costs and outcomes for different primary care providers.

This study examined the relationship between levels of medical training and direct costs for 1,700 episodes of acute illness treated in ambulatory-care clinics. Faculty, family practice residents, and physician assistants were included as the providers. Total cost and four component costs were examined. An outcome was defined as good if the patient returned to his usual level of functioning after an acute illness episode. Average total cost per episode was not related to type of provider, but there were significant (P less than .05) differences among providers in laboratory and medication costs. Faculty and physician assistants produced higher costs, especially for patients who experienced bad outcomes. Both costs and percentage of good outcomes achieved were similar in first-, second-, and third-year residents.

Acute Disease↗
PubMed1977

Relationship between process and outcome in ambulatory care.

The outcomes of a series of some 410 acute episodes from two family practice centers were rated on the degree to which the patient regained his usual functional status and his satisfaction with the outcome and the process of care. A portion of outcomes (251) were then compared to process scores obtained using explicit criteria and the rest to implicit process ratings based on the problem-oriented record. In both instances those cases with good outcomes had better process scores than those with bad outcomes; neither measure of satisfaction had a consistent relationship with either process measure.

Ambulatory Care↗
PubMed1977

Community aftercare of patients discharged from Utah state hospital: a follow-up study.

To find out whether patients discharged from mental hospitals to the community are following recommended courses of aftercare treatment, the authors, with the assistance of five medical students, studied a sample of patients discharged from Utah State Hospital during 1973 and 1974. The discharge plans of 143 patients admitted from Salt Lake County indicated that 125 of them should have received aftercare services from a community mental health center. A review of CMHC records and interviews with the patients indicated that only 100 actually had contact with a center. Only 43 of the patients were still receiving aftercare services in the summer of 1975.

Adult↗
PubMed1977

A method for assessing the outcome of acute primary care.

Some 1,700 acute care episodes were studied to assess the outcomes in terms of the extent to which patients regained their usual functional status. Involving active follow-up of each patient, the study serves as a prototype for measuring several components of quality of care including actual outcomes, patient expectation of outcome, physician expectation of outcome, and patient satisfaction with outcome and care. Because this study was conducted in a family practice residency training setting, we hope that it will serve as a model of how such information may be used to increase residents' sensitivity to the course of illness commonly seen in primary care, and to encourage the residents to set expectations for the care they give.

Consumer Behavior↗
PubMed1976

Measuring outcomes of care in an ambulatory primary care population. A pilot study.

This study developed a practical method for determining the functional outcome status of patients in an ambulatory setting. Health status of 1,840 primary care patients in an ambulatory setting. Health status of 1,840 primary care patients was compared at three points in time: patient's usual status, status at the initial visit, and status at time of telephone follow-up. Follow-up status was also compared with the physician's expectation, which was estimated at the time of the initial visit. Of the patients, 62% showed improvement, 31% remained at the same level, and 7% deteriorated from the time of their initial clinic visit. Physicians tended to overestimate either the speed or degree with which patients return to their usual functional status; 32% of the patients studied reported themselves as being less well than usual at the time of follow-up.

Ambulatory Care↗
PubMed1976

Communication patterns of doctors and their assistants.

Communication patterns between physicians and their assistants (Medex) were observed in 19 practices to describe and evaluated the nature of their relationship. Observations demonstrated that interaction around patient problems was approximately 30 minures per day and informal, with the Medex more often initiating the contact. Medex were more likely to ask for, and physicians were more likely to give, suggestions. Physicians appeared to regard the accomplishment of the immediate task as more important than maintaining good relations. In most practices, supervision was available when requested. Generally, both the physician and the Medex show a striking similarity in communication styles.

Communication↗
PubMed1975

Criteria for releasing patients from psychiatric hospitals.

The authors conducted a pilot study to determine the kinds of criteria being used by mental health professionals in discharging patients from mental hospitals. Twenty-one criteria were identified in the first phase of the study, and 43 staff members later rated the items according to their perceived importance. Although there was general agreement on most of the items, reliable differences of opinion were expressed in some instances. The differences were attributed less to the respondents' professional discipline than to their hospital affiliation (VA or non-VA). The authors emphasize the need for developing a standardized list of discharge criteria and discuss uses for such criteria.

Disability Evaluation↗
PubMedDate not supplied

Successful modification of medical students' cardiovascular risk factors.

Modifying identified risk factors for cardiovascular disease should change an individual's risk. Educational interventions might change behavior to modify some risk factors. To evaluate this possibility, we evaluated the health and fitness status of freshman medical students at the University of Utah (n = 89) in 1983 and determined their cardiovascular risk factors. During a preventive cardiology course later that year, students received their results. We reevaluated the students during their senior year using the same method. For both years, we obtained complete data on 77 (87%) of the eligible students. As freshmen 83% of these students had at least one modifiable risk factor, compared with 62% with a risk as seniors. The number of reevaluated students with low levels of high-density lipoprotein cholesterol, low estimations of aerobic capacity, or both, decreased significantly (P = .009 and P = .0008, respectively). The preventive cardiology educational intervention may have changed behavior and improved cardiovascular risk factors.

Adolescent↗
PubMedDate not supplied

The role of the community-oriented primary care physician.

The role of community-oriented primary care is the subject of considerable debate and controversy, leading to confusion for both its practitioners and educators. This paper attempts to clarify this role by applying systems theory to the concept of community-oriented primary care as first-contact medical care for the patient, in the context of the community. Relationships between the primary care physician and the following entities are defined: the patient; the physician's and patient's community, culture, and society; the physician's office; the medical care system; and the physician's and patient's families. The educational implications of the resultant role are discussed.

Community Health Services↗
PubMedDate not supplied

Research skills development in family medicine fellows.

This study was conducted to identify factors that contribute to the development of research skills among Robert Wood Johnson Foundation (RWJF) family medicine fellows, and to relate this process to their overall training. All 23 of the 1981-82 RWJF fellows were surveyed. Most fellows believe they are being well prepared to conduct research, and estimate they will spend approximately one-fourth of their future time in research activities.

Adult↗