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Biomedical subjects

L A Aday

Publications and source records attributed to L A Aday.

At least 55 records · Page 3Linked to original sources
PubMed1988

Home care for ventilator-assisted children: implications for the children, their families, and health policy.

This article presents findings from a national study of home care programs for ventilator-assisted children conducted between 1984 and 1987 by the Center for Health Administration Studies at The University of Chicago. These findings point to the issues that need to be addressed in the development of policies surrounding both the delivery and the financing of services for these children and their families: (a) ventilator-assisted children are a widely varying group with diverse needs; (b) most families report that though they are glad to bring their child home, many difficult adjustments are required to do so; (c) full-time nursing care offers support to families but also intrudes on their privacy; (d) both families and children need social and psychological support once the child is home; (e) the needs of the child and the family may change over time; and (f) the financial burden of having a child on a ventilator at home can be a big stress on the family.

Child↗
PubMed1987

National Study of Internal Medicine Manpower: XI. Internal medicine residency and fellowship training in the 1980s.

The number of residents beginning training in internal medicine continued to increase slightly in 1985-86. However, the total number of residents in internal residency training decreased slightly from the previous year due to a decrease in the number of second- and third-year residents. The proportion of first-year residents who were foreign-trained physicians decreased from 21% to 20%, and the proportion of residents who finished training and went on to subspecialty training in 1985 decreased substantially to 56%. The number of physicians entering residency and fellowship training in internal medicine considerably exceeds the number projected by the Graduate Medical Education National Advisory Committee. In this article, we discuss implications of these trends for medical education and practice.

Fellowships and Scholarships↗
PubMed1986

National Study of Internal Medicine Manpower: X. Internal medicine residency and fellowship training: 1985 update.

The number of medical school graduates entering internal medicine residency training was at an all-time high in 1984-85. Although the number of first-year residents who were foreign-trained physicians did not differ greatly from the 1983-84 census, the number of first-year residents who were U.S. medical school graduates was much higher than the previous year largely because the number of graduates from U.S. medical schools increased substantially in 1984. The number of internal medicine fellowship programs and the number of fellows in 1984-85 were also at an all-time high. Foreign-trained physicians represent 22% of those in residency training and 20% of those in fellowship training. Of every 100 who completed residency training, 61 went on to a first year of subspecialty fellowship training, a number up slightly from the previous year. The increasing numbers of residents and fellows being trained in internal medicine, combined with the preference for subspecialization and the substantial proportion of foreign-trained physicians being trained, are discussed against the background of pending legislation to reduce federal assistance for graduate medical education.

Education, Medical↗
PubMed1985

Hospital-sponsored medical groups: their impact on access to primary care in rural communities.

Rural communities have traditionally been underserved in terms of the availability of primary medical care services and providers. The Robert Wood Johnson Foundation launched a major program in the mid-1970s to improve the delivery of primary care to previously underserved rural, small town, inner city and other urban communities through their Community Hospital Program (CHP). This program provided grant funds to over 50 community hospitals throughout the country to develop primary care-oriented group practices. Twelve of the 53 programs eventually funded were sampled for a national evaluation of the impact of the CHP groups on access to care in the communities they served. The analyses reported here summarize the access impact of this innovation on the four rural and small town communities included in the larger evaluation. Baseline surveys in these four communities established that, in general, access was poorer in the rural areas, in particular, compared to the national average. The new groups tended to attract a cross-section of the communities they served. In general, they tended to do as well or better as other sources of care in the area in providing access to care. The most successful groups were those that most closely mirrored the traditional private practitioner--"family doctor"--model of care.

Community Health Services↗
PubMed1984

The national profile of access to medical care: where do we stand?

This paper presents analyses of recent national survey data on access to medical care. In particular, information on major access indicators and special problems associated with the economic and political climate of the 1980s collected in a 1982 national telephone survey of 6,610 United States adults and children, representing some 4,802 families, is compared with previous national surveys for key population subgroups--by age, place of residence, income, race, insurance coverage, and type of regular source of care. In general, the findings show that favorable progress has been made, but some inequities continue to persist. Some traditionally disadvantaged groups are more likely to have a regular family doctor, private insurance coverage, have been to a doctor, or had certain preventive tests and procedures than was true for them in the past. On the other hand, compared to the more economically and/or socially advantaged groups in 1982, they have still not "caught up" entirely. There also is evidence that they may be hardest hit by the exacerbation of the financial barriers to care that result from unemployment, inflation, and cutbacks in health program eligibility and benefits that have characterized the decade of the 1980s.

Adolescent↗
PubMed1984

Hospital-sponsored primary care: II. Impact on patient access.

This article, the second of two, considers the impact of a nationwide demonstration of 53 community hospital sponsored group practices (CHPs). Surveys of a sample of the communities in which the CHPs were introduced suggest that about half of the communities were socioeconomically and, to some extent, medically disadvantaged. The CHPs tended to attract people who had previously not had a regular source of care or who used hospital outpatient departments or emergency rooms, as well as patients of established primary care physicians. Access to care and satisfaction appeared to be as good or better for CHP patients compared to regular patients of physicians in the target areas. The programs did not increase the use of inpatient services, emergency rooms, or hospital outpatient departments. The findings suggest that at present community hospital sponsored group practices would not have a profound effect on access to care if adopted nationally, but that targeted implementation by hospitals in lower income and minority communities can improve patient opportunities for appropriate primary care services.

Consumer Behavior↗
PubMed1983

Uses of the 1980 census for Hispanic health services research.

The 1980 Census data provide a valuable resource for health services research on Hispanics. Hispanics are the fastest growing minority group in the United States and yet there is a paucity of large-scale empirical research on their health care and access needs. This paper describes how the census can assist in: 1) estimating the overall health care needs of this group, 2) identifying target groups within the Hispanic population who may have special health care problems (e.g., children, elderly, pregnant women, etc.); and 3) using other data sources to improve the quality of studies carried out on Hispanics. It also discusses problems in using the census for Hispanic health services research and some strategies for dealing with these problems.

Educational Status↗
PubMed1983

Exploring dimensions of access to medical care.

This paper examines the dimensions of the access concept with particular attention to the extent to which more parsimonious indicators of access can be developed. This process is especially useful to health policy makers, planners and researchers in need of cost-effective social indicators of access to monitor the need for and impact of innovative health care programs. Three stages of data reduction are used in the analysis, resulting in a reduced set of key indicators of the concept. Implication for subsequent data collection and measurement of access are discussed.

Consumer Behavior↗
PubMed1981

Potentials of local health surveys: a state-of-the-art summary.

This paper provides a state-of-the-art summary of the potentials and limitations of local surveys for assessing health problems in local areas. The information they provide may be helpful for a variety of purposes such as measuring the need for services, planning programs to address these needs, and evaluating their impact. Particular advantages of surveys are that they: provide information on the needs of people who have not sought care; permit special studies of particular target groups; provide data on variables which are only available from "asking" people; enable information to be collected on a range of correlates and indicators of health care behavior; provide an opportunity for examining relationships among variables; and permit well-timed community estimates of the impact of experimental programs. Limitations include the validity and reliability of survey data, and the costs and other problems of survey implementation.

Health Services Research↗