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Biomedical subjects

J Hadley

Publications and source records attributed to J Hadley.

At least 109 records · Page 6Linked to original sources
PubMed1984

Evaluation of bronchial air leaks by auscultation and phonopneumography.

Bronchial fistulae in communication with atmospheric pressure can be identified by the presence of a squeaking sound heard over the chest wall during a Valsalva maneuver. Furthermore, these leak sounds can help identify the size, location, and communications of the bronchial fistulae. The size of the leak can be inferred by the pitch of the leak sound. Large leaks produce low pitched sounds, smaller leaks (or partially obstructed leaks) produce high pitched squeaks , and multiple leaking sites produce polyphonic leak squeaks . The bronchus responsible for the leak can be identified by cessation of the leak sound during balloon occlusion of the correct bronchial stump. A communication of a bronchial fistula with the chest wall facial plane produces massive subcutaneous emphysema and an early inspiratory click. This click suggests a check valve mechanism of air exiting the leaking bronchus.

Adult↗
PubMed1984

Interstate variations in the growth of chain-owned proprietary hospitals, 1973-1982.

Proprietary hospital chains are now the predominant, and the fastest growing, segment of the for-profit sector of the hospital industry. This paper examines the relationships between the growth patterns of proprietary hospital chains and state-level variations in a number of demographic and economic factors related to health care. Results indicate that increases in the market share of proprietary chains are greatest in states that have the greatest increases in population, per capita income, and insurance coverage and that already have large proprietary market shares of beds. The growth behavior of proprietary chains thus appears to be highly consistent with standard market behavior.

Data Collection↗
PubMed1984

How should Medicare pay physicians?

Medicare's system of paying physicians is criticized as being costly, inflationary , inefficient, inequitable , and confusing. Yet when alternative methods--to change practice arrangements, units of service, fee levels, and the assignment option--are examined, no one seems ideal. A fee-for-service system combined with a prospective payment schedule may offer the best compromise.

Capitation Fee↗
PubMed1984

Falling through the cracks: poverty, insurance coverage, and hospital care for the poor, 1980 and 1982.

About one-third of the nation's poor lack insurance--public or private--against the costs of illness. Data from 1980 and 1982 show that a patchwork of state and local government charitable grants, and the disparate efforts of hospitals to provide free care, cannot mend the national "safety net." A prudent short-run approach to modifying charity care is advanced, although the long-run necessity for insuring the uninsured is inevitable.

Charities↗
PubMed1983

Collecting debts.

Explore the source record for details and available documents.

Fees and Charges↗
PubMed1983

Medicaid reimbursement of teaching hospitals.

This paper examines current Medicaid policies on the reimbursement of hospitals' medical education expenses. These policies are of interest because of the pressure on Medicaid programs to reduce expenditures. Data for the paper come mainly from two sources: a survey of Medicaid programs and a survey of teaching hospitals. Teaching hospitals receive a disproportionate share, nearly 70 percent in 1978, of Medicaid short-term hospital payments. Nevertheless, most Medicaid programs either have no explicit policies in this area or have not acted aggressively to limit reimbursement of hospitals' teaching expenses. Revenues from Medicaid are most important to public teaching hospitals. Thus, across-the-board reductions in Medicaid's reimbursement of teaching expenses would most severely affect public institutions, many of which already face cuts in their local government appropriations. Savings to Medicaid would also be short-lived, since teaching hospitals would have the incentive to reduce teaching program size and substitute reimbursable personnel (nurses and staff physicians) for residents.

Education, Medical, Graduate↗
PubMed1982

Financing graduate medical education: an update and a suggestion for reform.

This article reports data pertinent to three issues in the financing of graduate medical education: sources of funds for house staff support, the financing of faculty salaries for educational activities, and reimbursement bias in favor of care provided in inpatient settings. Using data from a 1979 hospital survey, we estimate that total expenditures for house-staff stipends and fringe benefits were almost $1.6 billion. Eighty-seven percent of these funds were derived from patient care revenues. Faculty salaries for educational activities added another $376 million to the cost of graduate medical education. Teaching hospitals collected 81 percent of their charges for inpatient care, but only 72.8 percent of charges for outpatient care. However, Medicare and Medicaid reimbursed approximately the same proportion of charges in both settings. The article concludes by arguing that a unified-charge system for paying teaching hospitals would eliminate most of the issues currently associated with the financing of graduate medical education as matters of public policy.

Education, Medical, Graduate↗
PubMed1982

Does income affect mortality? An analysis of the effects of different types of income on age/sex/race-specific mortality rates in the United States.

This article explores the question of whether or not higher incomes are associated with lower mortality rates. Some recent research on this issue has suggested that income either has no effect on or may even be positively correlated with mortality rates. By contrast, earlier studies consistently found a negative relationship--higher income (or economic status) was generally associated with lower mortality rates. This paper extends the prior research in two significant ways. First, the issue is analyzed separately for eight adult and four infant age/sex/race-specific population cohorts. Second, total family income is broken down into several components to investigate whether different types of income have differential effects on mortality rates. In addition, the problem of untangling the joint effects of education and income on mortality also is explored. The results tend to support the hypothesis that higher income is associated with lower mortality rates. However, the magnitude of the impact of income is small, although it is consistently larger for infants than for adults.

Adolescent↗
PubMed1981

Physicians' fees and public medical care programs.

In this article we develop and estimate a model of physicians' pricing that explicitly incorporates the effects of Medicare and Medicaid demand subsidies. Our analysis is based on a multiperiod model in which physicians are monopolistic competitors supplying services to several markets. The implications of the model are tested using data derived from claims submitted by a cohort of 1,200 California physicians during the years 1972-1975. We conclude that the demand for physician's services is relatively elastic; that increases in the local supply of physicians reduce prices somewhat; that physicians respond strategically to attempts to control prices through the customary-prevailing-reasonable system; and that price controls limit the rate of increase in physicians' prices. The analysis identifies a family of policies that recognize the monopsony power of public programs and may change the cost-access trade-off.

Fees, Medical↗