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Biomedical subjects

J H Hibbard

Publications and source records attributed to J H Hibbard.

At least 37 records · Page 2Linked to original sources
PubMed1993

The quality of social roles as predictors of morbidity and mortality.

This study uses a longitudinal design to examine the health effects of the quality of social roles among a cohort of women and men. The specific roles of interest are the spouse role, the parent role, and the worker role. The cumulative and interactive effects of role characteristics and role satisfactions and stresses are also examined. The study population was randomly selected from among members of a large HMO and were part of a household interview conducted in 1970-71. Medical records for the 2 years prior to the interview and for 15 years after the interview for the cohort members are linked with the survey data. The findings show that for women, particular qualities of the marital and work roles are predictive of subsequent morbidity and mortality. For married women, equality in decision making and companionship in marriage are protective against death. None of the marriage characteristics are predictive of health outcomes among men. Work support is protective against death, malignancy, and stroke among employed women, and work stress increases the risk of ischemic heart disease among employed men. None of the parental role characteristics were significant predictors of health outcomes for men or women. No interactions were found.

Adolescent↗
PubMed1993

Health effects of discontinuities in female employment and marital status.

The discontinuities that characterize women's work histories are also a factor in women's marital histories. Family obligations and childbearing contribute to women's unique employment histories, which include intermittent labor force participation and mobility between employers. While research has increasingly focussed on the effect of labor force participation on women's health, little attention has been given to the effect of the consistency or the stability of labor force participation on health. The purpose of this paper is to examine 15 years of employment histories and marital status changes among a cohort of women and to determine the cumulative effect of these histories on subsequent morbidity and self-reported health. The cohort of 556 women examined in this study were interviewed as part of a household interview survey completed in 1970-71, and resurveyed via a mail-out questionnaire, in 1985-86. Medical record data for the full 15 years of the study have been linked with the survey data. The findings suggest that work discontinuities and marital status discontinuities are unrelated to morbidity during the study period. However, two or more changes in marital status are related to poor self-reported health at follow-up.

Adolescent↗
PubMed1993

Social roles as predictors of cessation in a cohort of women smokers.

There is evidence to suggest that women's smoking and maintenance of smoking is related to the stress associated with women's roles. The purpose of this longitudinal study is to assess social role factors predictive of cessation among a cohort of women smokers over a 15-year period. The cohort of women examined in this study were interviewed as part of a household interview survey conducted in 1970-71 by the Center for Health Research, of the Northwest Region of Kaiser Permanente, and resurveyed via a mail-out questionnaire in 1985-86. This study focuses on the 168 women smokers in the cohort. Of these 168 smokers, 55 (or 33%) had quit smoking by the follow-up 15 years later. The outcome variable is smoking status at follow-up. Predictor variables include both role occupancy and characteristics of social roles. The findings show that role occupancy is unrelated to smoking cessation. Selected characteristics of the work role, however, were found to predict smoking cessation; occupational status and control over work. Public health and research implications are discussed.

Adult↗
PubMed1992

Determinants of physician acceptance of assignment: an examination of Medicare beneficiary characteristics.

This study examines the degree to which patient characteristics predict physicians' ad hoc decisions regarding acceptance of Medicare assignment. The study is based on a random sample of Medicare Part B enrollees living independently in the Salem, Oregon metropolitan area. Beneficiary characteristics and beneficiary reports of physician behavior are obtained from an hour long face-to-face survey. The findings show that patient characteristics are significant predictors of physician behavior. Those respondents with poor health, no supplementary coverage to Medicare Part B, and who are more sensitive to the cost of health care are significantly more likely to report that their physician accepts assignment than are respondents without these characteristics. Policy and research implications are discussed.

Aged↗
PubMed1992

Women's employment, social support, and mortality.

This study uses a longitudinal design to examine the extent to which social support at work is protective against death and the degree to which it explains mortality differences between employed women and those not in paid employment. Women's total role responsibilities and community involvement, as an alternative source of social support and social integration, are also considered in the analysis. The outcome examined is mortality risk over a 15 year period. The 1140 women included in this study were randomly selected from among members of a large HMO and were part of a household interview conducted in 1970-71. Medical and vital records for 15 years post interview period are linked with the survey data. The results of this analysis suggest that social support at work is protective against mortality among employed women and contributes to mortality risk differences between employed and nonemployed women. While the relative hazard of death for nonemployed women who have some community involvement is greater than for employed women, the difference is not statistically significant. Community involvement may provide an alternative, albeit weaker, avenue for gaining some of the same advantages available in paid employment. Future research directions are discussed.

Adolescent↗
PubMed1991

Effect of domestic and occupational roles on morbidity and mortality.

This study examines the effect of labor force participation, occupational status and domestic roles on morbidity and mortality among women and men over a 15-year period. The main research questions address the long-term effects of multiple roles. Does the combination of domestic and work roles result in adverse health effects, or provide some health advantage? The study population was randomly selected from among members of a large HMO and were part of a household interview conducted in 1970-71. Medical records for the two years prior to the interview and for 15 years after the interview for the cohort members are linked with the survey data. The findings show that for women there is some longevity advantage in paid employment. Overall, the combination of employment and domestic roles apparently poses no health threat to women, and may provide some advantage. Multiple roles are unrelated to mortality and morbidity outcomes among men.

Adult↗
PubMed1989

Does the dissemination of comparative data on physician fees affect consumer use of services?

The purpose of this study is to empirically examine the effect of disseminating physician-fee information on consumer behavior. Using an experimental design, the effect of access to physician-fee information on rates of doctor-office visits, expenditures for ambulatory care, and costs per visit are examined. The study includes two research samples: a random sample of 658 state government employees and a random sample of 717 Medicare Part B enrollees. Respondents in each sample were randomly assigned to experimental and control groups, with members of the experimental groups receiving a directory listing the fees charged by local physicians for common procedures. Longitudinal archival and survey data are used in the analysis. Findings reveal that the dissemination of fee data does not yield significant reductions in utilization or expenditures. Policy and research implications are discussed.

Adult↗
PubMed1989

Marital interaction and the health and well-being of spouses.

This study examines the extent to which the various dimensions of marital interaction are associated with differences in health status of spouses measured by the use of medical services and self-reported health and well-being. Dimensions of marital interaction and health and well-being measures with most covariation are identified and the relative effect of the quality of marital interaction on the health and well-being of husbands and wives are assessed. The study population includes 1004 married couples. Medical record and survey data for each respondent are linked for the analysis. The findings do support the hypothesis that the quality of marital interaction is related to the health of marital partners.

Adult↗
PubMed1989

The dissemination of physician fee information: impact on consumer knowledge, attitudes, and behaviors.

This study examines the effect of disseminating physician fee information to consumers among two study populations; a Medicare enrolled population and a younger employed population. Using an experimental design, the effect of providing physician fee information on consumer knowledge, attitudes and behaviors is examined. The total sample size is 1,715 and includes 907 State employees and 801 Medicare enrollees. The findings suggest that the distribution of physician fee information may be a minor stimulant to consumerism in health care. The findings also suggest that the strength of the effect of fee information on consumer knowledge, attitudes and behaviors varies by population characteristics and the need for services.

Community Participation↗
PubMed1989

Factors that influence the elderly to use traditional or nontraditional nutrition information sources.

This study analyzed sociodemographic variables, access to medical care, health status-related variables, and nutrition status-related variables to determine their ability to predict an orientation toward traditional or nontraditional nutrition information sources among aged subjects in Eugene, OR. Data were collected from 165 randomly selected subjects by trained interviewers using face-to-face interviews. Nutritionist orientation was measured by a Traditional/Nontraditional Index (TNT Index) developed for the study. Nutrition knowledge and misinformation, supplement use, and sources of nutrition information were also investigated. Predictors of nontraditional nutritionist orientation were acceptance of nutrition misinformation and male sex (adjusted R2 = .09). For women, predictors of a similar orientation were acceptance of nutrition misinformation, low knowledge of general nutrition information, and low functional health status (adjusted R2 = .19). Mean nutrition knowledge scores were high, with a mean of 4.7 (standard deviation [SD] = 0.8) on a scale ranging from 4 (high) to 8 (low). However, many of the subjects did not list dairy foods (28%) and grains (27%) as necessary in the diet. In addition, belief in certain nutrition myths was widespread. More than 58% were taking one or more supplements (mean = 1.4 supplements per day, SD = 1.98). Physicians were mentioned as most likely sources of nutrition information, with dietitians and health food store personnel mentioned second, indicating the importance of marketing efforts for registered dietitians.

Aged↗
PubMed1987

Consumerism in health care. Prevalence and predictors.

Current efforts to contain health care costs include a variety of strategies aimed at the users of health services. These approaches attempt to encourage users to be more cost-conscious and to shop for lower-cost services and more efficient health care plans. The primary method for achieving this is by increasing the consumer's exposure to the cost of health insurance and the cost of care. The assumption is that approaches that increase cost-sensitivity will stimulate greater consumerism among the users of care. This paper presents findings from a study that investigates the extent to which members of insured populations have a consumer approach to health care, identifies factors related to consumer behaviors and attributes, and examines the degree to which consumer cost-sensitivity is associated with other consumer-oriented behaviors. The data used are derived from face-to-face interviews. Only a minority of the respondents engage in the examined consumer behaviors. Both social demographic and attitudinal factors affect the likelihood of engaging in consumer behaviors. Being cost-sensitive appears to be only a minor stimulant to other consumer attributes. Policy implications are discussed.

Adult↗
PubMed1987

Women's roles, interest in health and health behavior.

The purpose of this study is to assess the extent to which women's roles are associated with health interest and health concerns. In addition, the degree to which interest and concern with health are related to health behaviors is examined. The study population includes 1155 women between the ages of 18 and 64 from a random sample of members of a large health maintenance organization. The subjects were part of a large household interview survey. Medical record data covering seven years of outpatient services are linked with the survey data. The findings indicate that those roles which typically include responsibilities for caring for and protecting the health of family members are associated with a greater interest in health. For example, women who have the responsibility for younger and more dependent children have a greater interest in health than those women with older or no children in the household. Both health interest and health concerns are weakly related in the expected direction to both self-defined and medically-defined health behaviors.

Adolescent↗
PubMed1987

Employment characteristics and health status among men and women.

This study examines the characteristics of jobs held by women as compared to men during the 1970s and assesses associations between job characteristics and family status with health status by sex. Sex differences in perceptions about the meaning of work, commitment to the work role, and stresses and rewards are considered. Survey data on 1490 employed men and women, ages 18-64, drawn from a random sample of enrollees of a large health maintenance organization in 1970-71 are linked with medical record data covering seven years of outpatient and inpatient services. The findings suggest important differences in the characteristics of jobs held by men and women and in the relative importance of these job characteristics in relation to health. Men held jobs with higher quality intrinsic work characteristics and perceived their jobs to be less stressful and less physically and mentally tiring than did women. Social support and integration through work and occupational status were significantly related to health status for both sexes, however, family responsibilities interact with job characteristics to affect health status for women. Single motherhood, in combination with low social support and integration through work, was related to poor health among women.

Adolescent↗
PubMed1986

Age differences in the use of medical care in an HMO. An application of the behavioral model.

The goal of this study was to determine the factors that are related to utilization rates among older compared with younger enrollees in a health maintenance organization (HMO). Andersen's behavioral model was used as the conceptual framework for examining utilization rates. The approach was to determine the relative importance of predisposing, enabling, and medical need factors in explaining utilization rates among younger and older enrollees of an HMO. The study population included 2,603 adults enrolled in a large HMO. Three years of medical record data were linked with survey data for the analysis. The findings suggest that while the model as a whole explains about the same amount of variation in total doctor office visits for both age groups, the actual predictor variables are not the same. Predisposing factors are more important in explaining variation in utilization among the younger than the older enrollees. Enabling factors are more important in explaining variation in utilization among the older than the younger enrollees. Medical need factors explain about the same amount of variation in total doctor office visits for both age groups. Theoretic and practical implications are discussed.

Adult↗
PubMed1986

Another look at sex differences in the use of medical care: illness orientation and the types of morbidities for which services are used.

The purpose of this investigation is to build on the findings of earlier studies and, focusing on specific disease categories, further explore the factors which may contribute to the sex differential in medical care utilization rates. In pursuing this objective, the study attempts to differentiate those types of disease categories for which illness orientation has a significant effect on utilization rates from those where the effects are minimal. The study population includes 1648 adults between the ages of 18 and 59. Medical record data covering 7 years of outpatient services are linked with survey data on the respondents. The findings show that the largest sex differences in utilization rates occur in those categories which represent more mild morbidities and those where there is more discretion in defining illness and/or the need for care. It is in these categories showing the largest sex differences in doctor office visits in which illness orientation factors appear to be most influential. Thus, the findings provide further evidence for the hypothesis that sex differences in morbidity reports and utilization rates are due to differences in the way symptoms are perceived, evaluated and acted upon. Interpretations and implications are discussed.

Adult↗
PubMed1985

Social ties and health status: an examination of moderating factors.

The goals of the study are to assess the relationship between social ties and health status and to determine if factors that may inhibit or enhance the mobilization of resources available in social ties specify this relationship. Two factors which may influence the effective use of social network resources perceived control and trusting others, are examined as possible moderating factors. The study population includes 2,603 adults, who were randomly selected from among the enrollees of a large health maintenance organization. The subjects were part of a large household interview survey. Medical record data covering seven years of outpatient services were linked with the survey data on the respondents. The findings indicate that having more social ties, being more trustful of others and perceiving more control are all related to having better health. Perceived control does specify the relationship between social ties and health status. The findings suggest that a larger social network is more important for those less able to utilize the resources available in their networks effectively, while among those more able to mobilize support from their networks, size is less important. The implications for health education research and practice are discussed.

Aged↗