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Biomedical subjects

K W Kizer

Publications and source records attributed to K W Kizer.

At least 55 records · Page 3Linked to original sources
PubMed1996

How economic demand influences access to medical care for rural Hispanic children.

OBJECTIVES: In a study of access to medical care, the authors analyzed the relationship between factors influencing demand, local unmet needs, and the availability of physicians in a rural California community. METHODS: The California Department of Health Services screened 1,697 (90%) of children aged 1 to 12 years in McFarland, CA. The relation of demand to unmet needs was examined using multiple logistic regression. Factors influencing demand for medical care were: ability to pay (income, health insurance) desire to purchase care (ethnicity, education, perceived need), and incidental costs (transportation, child care, etc). Questions from the Hispanic Health and Nutrition Survey were reconstrued to fit the demand model. Local need and demand for physicians was compared with state levels to assess whether sufficient physicians were available. RESULTS: Eighty-six percent of the children were of Mexican ancestry. Factors influencing demand were linked with specific unmet needs. Although unmet needs were high, demand was low; 46% of all families were below the poverty level. Although four primary care physicians were needed, only one could be supported in the private sector because of low demand. CONCLUSIONS: Advantages to the demand model are: (1) it shows why medical services are underused and lacking in low-income areas although need is high, (2) it permits an economic rationale for extra services for poor diverse populations, (3) it estimates the amount of resources lacking to assure adequate levels of care, (4) it shows why facilitated access is needed for certain groups.

California↗
PubMed1995

Hospitalization charges, costs, and income for firearm-related injuries at a university trauma center.

OBJECTIVE: To quantify the actual cost of inpatient medical care for firearm-related injuries at a university trauma center. DESIGN: Retrospective case series of all hospital admissions for firearm-related injuries for the 3 years 1990 through 1992. Total inpatient financial data were examined by means of a recently instituted cost-accounting methodology. SETTING: Level I trauma center at a university hospital that provides trauma care and tertiary care to 3.7 million residents of 23 counties. PATIENTS: A total of 787 consecutive patients were admitted to the hospital with firearm-related injuries. Information from the trauma registry and hospital finance records were linked for 750 (95%) of these patients. MAIN OUTCOME MEASURES: Total inpatient hospital charges, costs, revenues, and net income according to payer source. RESULTS: Men aged 15 to 44 years accounted for 77% of patients with firearm-related injuries. The overall mean and median hospital charges per admission were $52,271 and $28,033, respectively, whereas the overall mean and median hospital costs per admission were $13,794 and $7964, respectively. The net income per patient ranged from an average loss of $6980 for each patient having no insurance to an average profit of $28,557 for each patient with a health maintenance organization contract. The losses sustained on nonsponsored and Medicaid patients were more than offset by net income from patients having private health insurance, Medicare, or other insurance coverage such that there was an average profit of $5809 per admission for a firearm-related injury. CONCLUSIONS: Treatment of firearm-related injuries produces net income for this university trauma center by virtue of the cost shifting built into its pricing structure. If data from this institution are extrapolated to the nation, then the actual cost of providing medical care for firearm-related injuries in the United States in 1995 is projected to be $4.0 billion. The majority of this cost will be paid indirectly by private health insurance.

Adolescent↗
PubMed1995

Nail gun injury to the heart.

A case is reported of a patient who sustained a cardiac injury from a 16-penny nail fired from a nail gun and who was successfully treated at a small rural hospital.

Accidents, Occupational↗
PubMed1995

Dehydration and pancreatitis in a child lost in the mountains for 2 days.

An 8-year-old boy became lost while hiking in the Sierra Nevada Mountains of northern California in August 1994. He was found 2 days later, at which time he was dehydrated and admitted to the hospital for rehydration. After admission, he was found to also have mild pancreatitis. Although trauma could not be ruled out as the cause of the pancreatitis, the stress associated with being lost is felt to be an equally likely etiology.

Child↗
PubMed1995

Potential carcinogenicity of chloral hydrate--a review.

Chloral hydrate is commonly used to sedate children for diagnostic or therapeutic procedures. The drug has been extensively used for many years, but there are remarkably few data on its long-term health effects. Concern in this regard is raised by recent studies showing chloral hydrate to be genotoxic, causing chromosome changes and other effects in vivo and in vitro. In addition, chloral hydrate is a reactive metabolite of trichloroethylene, a known carcinogen, and is structurally similar to other carcinogenic intermediates. Two carcinogenicity studies performed using the oral route of administration in mice indicate that the drug is potentially carcinogenic--in one case after a single dose lower than the typical dose used for sedation. Practitioners should be aware of chloral hydrate's genotoxicity and potential carcinogenicity. Discretion in its use seems appropriate until further studies clarify its long term health consequences.

Animals↗
PubMed1993

Alcohol-related mortality in California, 1980 to 1989.

OBJECTIVES: This study sought to examine the impact of alcohol use and misuse on mortality in California during the 1980s. METHODS: Alcohol-Related Disease Impact estimation software and California vital statistics data were used to calculate alcohol-related mortality, mortality rates, and years of potential life lost. Statistical tests were applied to detect significant differences in death rates by sex and race/ethnicity. Time trends in death rates for a subset of alcohol-defined diagnoses were examined using regression analysis. RESULTS: An estimated 6.2% of all deaths for California residents during 1989 were related to alcohol, making it one of the top 10 leading causes of death. Injury diagnoses were major contributors to the total estimated number of alcohol-related deaths and years of potential life lost before age 65. Alcohol-related mortality rates were significantly higher for men and for Blacks. However, age-adjusted death rates for alcohol-defined diagnoses declined significantly from 1980 to 1989. CONCLUSIONS: A structured data-base approach to analyzing mortality data represents an important advance for alcohol research that has implications for policy and program planning. Future refinements and enhancements to the disease impact estimation methodology will add precision to determining how alcohol use and misuse affect public health in California.

Accidents, Traffic↗