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H D Scott

Publications and source records attributed to H D Scott.

50 records · Page 3Linked to original sources
PubMed1976

22. Some successes and failures with long-term care data systems: the Rhode Island experience.

A project by Rhode Island Health Services Research (SEARCH) to develop, adapt, and improve data systems in several Rhode Island long-term care settings includes skilled nursing and intermediate care facilities, two chronic care hospitals, mental health institutions, and home health agencies. A successful medical review system was developed for Medicaid nursing home patients which is now a program funded by the state, as well as a good abstracting system for the two chronic hospitals. Also, steps were taken to correct omissions and inaccuracies found in mental health data used in the Multi-State Information System (MSIS), and to modify a limited management information system used by home health agencies. In retrospect, the project would have been better served had it attempted to be less comprehensive and instead focused its resources in areas of high visibility and unequivocal public concern. The approach would have given the state population-based information of much greater power than is currently available, despite the recognized successes of the project in the nursing home and chronic hospital areas.

Chronic Disease↗
PubMed1975

Decisions to hospitalize and operate: a socioeconomic perspective in an urban state.

Rates of hospital discharges for selected surgical procedures and some medical conditions were compared by socioeconomic status (SES) of patients for all 1972 hospital discharges from the 13 voluntary general hospitals located in Rhode Island. Socioeconomic status was determined by scoring the census tract of patient residence with such variables as median family income, housing status, etc. Many frequently performed surgical procedures had similar rates for the high, middle, low, and poverty socioeconomic groups. Procedures performed more frequently on the poverty than on the high SES group were tonsillectomy and upper gastrointestinal, heart, hemorrhoid, and cataract procedures. Dental procedures were performed more frequently on the high SES group. The over-all rate of hospital admissions showed a steady decline from the rate of 156 per 1,000 for the poverty census tracts to 104 for the high SES census tracts. This trend was reflected in the admission rates for several conditions requiring primary medical management, such as infections, diabetes, and skin problems. The population-based frame of reference used in this study can be a useful tool for raising pertinent questions for both professional standards review organizations and health planning groups.

Adolescent↗
PubMedDate not supplied

Smoking rates among Rhode Island physicians: achieving a smoke-free society.

Over a 25-year period, regular surveys of physicians licensed in Rhode Island have recorded their smoking behavior. The six surveys show a decrease in the rate of cigarette smoking from 33% in 1963 to 4.6% in 1988. In the most recent survey, 65% of respondents reported never having smoked, and 87% of those who had ever smoked reported having quit. However, the statistic for the maximum number of cigarettes smoked regularly was higher for current smokers than for former smokers. Among physicians in the 1988 survey, most former smokers (85%) reported using only unassisted personal effort in quitting, whereas nearly half (48%) of current smokers tried methods involving assistance, such as self-help programs, group programs, or nicotine gum. Among former smokers who quit after 1983, the percentage trying assisted methods (34%) was closer to the percentage among current smokers. Apparently, remaining smokers include many heavy smokers who require more potent interventions in order to quit. Physicians in Rhode Island have almost become a smoke-free group. Their experience, coupled with their involvement in smoking prevention and cessation for their patients, can lead the rest of society on its path to becoming smoke-free.

Adult↗
PubMedDate not supplied

A study guided by the Health Belief Model of the predictors of breast cancer screening of women ages 40 and older.

In late 1987, a total of 852 Rhode Island women ages 40 and older were interviewed by telephone (78 percent response rate) to measure their use of breast cancer screening and to investigate potential predictors of use. Predictors included the women's socioeconomic status, use of medical care, a provider's reported recommendations for screening, and the women's health beliefs about breast cancer and mammography. The Health Belief Model guided the construction of the interview questions and data analysis. Logistic regression was used to identify leading independent predictors of breast cancer screening according to contemporary recommendations: reporting that a medical provider had ever recommended a screening mammogram (odds ratio [OR] = 18.77), having received gynecological care in the previous year (OR = 4.92), having a regular source of gynecological care (OR = 2.63), having ever had a diagnostic mammogram (OR = 2.32), and perceiving mammography as safe enough to have annually (OR = 1.93). The findings suggest that programs intended to increase the use of breast cancer screening should include "inreach" and "outreach" elements; inreach to patients with established patient-provider relationships, by assuring that physicians recommend screening to all eligible patients, and outreach to all eligible women, by helping them overcome barriers to effective primary care, and by promoting mammography, emphasizing its effectiveness and safety. The findings also suggest that socioeconomically disadvantaged women, who are less likely to be screened than other women, should become special targets of inreach and outreach interventions.

Adult↗
PubMedDate not supplied

WIC program participation--a marketing approach.

Recent evaluation studies have described the benefits accruing to low-income women and children who participate in the Special Supplemental Food Program for Women, Infants, and Children (WIC). However, participation is not uniform among all groups of eligible persons. This study examines the geographic variation in WIC participation rates of eligible pregnant women in Rhode Island to determine whether the program is effective in reaching the neediest segments of the population. Eight groups of small geographic areas in Rhode Island (census tracts) were formed on the basis of need for maternal and child health services, as determined from a statistical method employing factor and cluster analysis of existing health and sociodemographic data. Among these eight groups, participation rates in WIC during 1983-84 ranged from 46 percent to more than 100 percent of estimated eligible pregnant women. The rates were positively correlated with measures of need, strongly (r = 0.92) with an index of maternal risk, and less strongly (r = 0.79) with an index of birth outcomes. The results of this study have enabled the Rhode Island WIC Program to direct its outreach efforts more specifically to geographic areas where the need for the program's assistance is greatest. The procedures described in this report comprise a technique that can be generally applied to measure program effectiveness in marketing and outreach where relevant data are available by small geographic areas. The data requirements are (a) population-based estimates of program need and (b) program utilization measures. If these data can be aggregated to a common set of small geographic areas, the use of marketing analysis techniques becomes possible, and program benefits in the area of outreach and recruitment can be realized.

Female↗