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Biomedical subjects

M P Freiman

Publications and source records attributed to M P Freiman.

23 records · Page 2Linked to original sources
PubMed1985

The rate of adoption of new procedures among physicians. The impact of specialty and practice characteristics.

Four hundred eighty-four physicians were surveyed on the number of new procedures they adopted during a 1-year period. Clear differences were found among specialties. A simultaneous statistical analysis of factors affecting the adoption of new procedures yielded a number of additional significant relationships. Up to an age of approximately 50 years, age has an increasing impact on the number of new procedures adopted by physicians. Beyond that age, it has a decreasing effect. Board certified physicians tend to adopt more new procedures than physicians who are not board certified. Among those physicians in nonurban locations, those in solo practice adopt significantly fewer procedures than those in other practice modes. The implications of these findings for such issues as the rising costs of health care and physician reimbursement systems are discussed.

Adult↗
PubMed1985

Economic impact of transluminal angioplasty.

Using actual bills and follow-up records we attempted to determine the economic impact of percutaneous transluminal angioplasty. The patients selected included forty angioplasties performed early in our experience as well as forty comparable patients who had operations in the same period of time. Clinical follow-up was obtained over four years. The statistics obtained demonstrate the hospital bills for angioplasty were only 24% that of surgical treatment for femoral lesions ($1,329.00 versus $6,112.00) and 16% for iliac lesions ($1,353.00 versus $7,732.00). Using this patient sample and readily available statistical data, we calculated direct national savings for using angioplasty on all patients suitable and used a standard value of life analysis to estimate the value of lives saved by doing the less dangerous procedure. The sum total savings in the United States from using angioplasty in all suitable candidates as opposed to surgery would be $180 million per year for femoral lesions and $117 million for iliac lesions. This could produce a significant savings in medical costs over the coming years.

Actuarial Analysis↗
PubMed1984

Changes in the hours worked by physicians, 1970-80.

The hours worked by physicians are affected by changes in a number of factors, including attitudes towards labor-leisure tradeoffs, the characteristics of the physician workforce, and the level of demand for medical services. This paper analyzes changes in the hours worked per week by office-based physicians over the decade 1970-80. Overall, there has been a statistically significant decline in hours of approximately 3 per cent, or 1.5 hours per week. This decline was fairly uniform across most physician characteristics, although the decline was greater for those in primary care specialties. Female physicians increased their average hours worked, although this increase was not statistically significant. In terms of the delivery of skilled medical services, the decline in total hours was largely offset by an increase in the percentage of total hours devoted to patient care. The question of whether these trends will continue has important implications for the validity of projections of a physician surplus in the near future.

Adult↗
PubMedDate not supplied

Interactions between hospital and nursing home use.

National estimates are provided, for the first time, of the number of hospitalizations in a year for elderly persons who also experience some nursing home use, and patterns for this interaction are described. In 1987, 816,000 persons were transferred from nursing homes to hospitals, constituting 8.5 percent of all Medicare hospital admissions for persons ages 65 and older. Another 347,000 hospital stays involved people admitted from the community and discharged to a nursing home. The reporting of discharge destination on Medicare hospital bill data in 1987 also is analyzed. It was found that these data may have underreported a nursing home as the destination by between 15 and 20 percent. The magnitude of hospitalizations of nursing home residents suggests that programs aimed at improving nursing home care might have an important impact on total days of hospital care, and that it is important to learn more about the optimal use of expensive hospital care.

Aged↗