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Biomedical subjects

M Schlesinger

Publications and source records attributed to M Schlesinger.

At least 181 records · Page 10Linked to original sources
PubMed1987

The privatization of health care and physicians' perceptions of access to hospital services.

Health care in the United States is increasingly delivered by for-profit providers, by multi-facility corporations, and under conditions of price-based competition. The joint influence of these three trends is examined through data drawn from a 1984 survey of physicians conducted by the American Medical Association. For-profit ownership and price competition are reported to restrict admission for the poor and uninsured; the effects of system affiliation are shown to be more complex. Policy responses to future restrictions on access are discussed.

Attitude of Health Personnel↗
PubMed1987

Paying the price: medical care, minorities, and the newly competitive health care system.

The newly competitive health care system reflects both an excess supply of health care providers and a greater sensitivity to price among those purchasing health services. These dual pressures are felt in public programs as well as in private markets. A competitive ethos is also changing popular expectations of the appropriate relation between health care institutions and their communities. These changes offer opportunities for enhanced access to health care for some black Americans, but portend dire restrictions on access for the least-advantaged blacks. They also threaten to reduce significantly the influence exerted by black communities over their local health care providers.

Black or African American↗
PubMed1986

Competitive bidding and states' purchase of services: the case of mental health care in Massachusetts.

Over the past two decades states have significantly increased their use of competitive bidding to purchase health and social services from private agencies. Competitive contracting is thought to facilitate program administration, to reduce costs, and to increase the quality of delivered services. We evaluate these claims in light of Massachusetts' experience with competitive contracting for mental health care. We find that few of the expected benefits are achieved. In practice, supposedly competitive bidding systems often degenerate into administratively complicated negotiations between the state and private monopolies. This results in higher costs and lower quality of services. In light of this negative assessment, three strategies for reform are proposed and evaluated.

Competitive Bidding↗
PubMed1986

A new autoreactive monoclonal antibody specific for the Thy-1 antigen.

The present study describes the development of a new IgM monoclonal autoantibody reactive with the Thy-1 antigen. The C16-31 monoclonal antibody (mAb) was considered as autoreactive because it reacted with thymus cells of both the C3H and BALB/c strains, which were involved in the development of the antibody. The antibody was reactive with thymus cells in both immunofluorescent and cytotoxic tests. It also showed a weak immunofluorescent reactivity with peripheral T-lymphocytes. The identification of the specificity detected by the C16-31 mAb as the Thy-1 antigen was based on the following criteria: C16-31 mAB displayed a preferential reactivity with Thy-1.2 bearing thymus cells, rather than with Thy-1.1 bearing thymus cells. The tissue distribution of the antigen detected by the C16-31 antibody by direct tests and by direct tests and by adsorption experiments was in accordance with that characteristic for Thy-1. It was high on brain tissue and on thymus cells, and considerably lower on peripheral T-lymphocytes. Coating of thymocytes with C16-31 antibody blocked their reactivity with other monoclonal Thy-1 antibodies. Conversely, coating of thymus cells with rabbit anti-brain serum (RABR) inhibited the binding of C16-31. The C16-31 mAb differed from the Thy-1 autoantibodies described previously in its relatively strong reactivity with brain tissue and its considerably weaker reactivity with peripheral T-lymphocytes. Moreover, C16-31 mAb showed a preferential allospecificity for Thy-1.2, only in its reactivity with thymocytes. In contrast, it reacted equally well with brain tissue from either Thy-1.2 or Thy-1.1 mice.

Animals↗
PubMed1986

Transmission of acquired immune deficiency syndrome (AIDS) by a blood transfusion given in 1979 in Israel.

AIDS developed in a blood donor-recipient pair in Israel. Transmission of HTLV III/LAV probably occurred via a blood transfusion in November 1979. The donor was asymptomatic at the time of blood donation, but initial symptoms of AIDS-related complex developed in the donor 3 months later and in the recipient 6 months following the blood transfusion.

Acquired Immunodeficiency Syndrome↗
PubMed1986

On the limits of expanding health care reform: chronic care in prepaid settings.

Health Maintenance Organizations have become a favored vehicle for reform of the American health care system, while controlling costs and assuring quality. But for populations with a high prevalence of chronic disease--the elderly or the mentally ill--HMOs may fall short of meeting needs. Three stages of reform are proposed for adapting the principle of prepayment to better serve enrollees with chronic illness.

Aged↗
PubMed1986

Profits under pressure. The economic performance of investor-owned and nonprofit health maintenance organizations.

This study assesses the economic performance of investor-owned and private nonprofit health maintenance organizations by comparing their costs and revenues, controlling for other characteristics of the plans and the areas in which they are located. Data are drawn from a sample of 173 HMOs operating in 1983, one quarter under proprietary auspices. For-profit plans have average costs 10% higher than their nonprofit counterparts, primarily due to higher expenses for ambulatory care. Average revenues are also higher in investor-owned HMOs, although this difference is one third the size of the estimated difference in costs. The paper concludes with a discussion of the implications of these findings for both the future performance of the HMO industry and public policy affecting prepaid health care.

Costs and Cost Analysis↗
PubMed1986

Ketotifen, disodium cromoglycate, and verapamil inhibit leukotriene activity: determination by tube leukocyte adherence inhibition assay.

Peripheral blood leukocytes (PBL) from asthmatic individuals lose their former ability to adhere to glass when incubated with leukotriene C4 (LTC4). A modified leukotriene-induced leukocyte adherence inhibition (LAI) assay was therefore used to study the ability of anti-asthmatic drugs to abrogate such activity. Ketotifen, disodium cromoglycate, Verapamil, and dimethpyridene, all at concentrations of 2 X 10(-6) M, were co-cultured with 2 X 10(-7) M LTC4 and their effect on the LTC4-induced LAI determined. Verapamil, Ketotifen, and disodium cromoglycate all inhibited the LTC4 activity while the H1 antagonist, dimethpyridene, did not. These results suggest that the beneficial effect of Verapamil, Ketotifen, and disodium cromoglycate in bronchial asthma is probably as calcium antagonists that cause the inhibition of leukotriene activity.

Calcium↗
PubMed1985

Establishment of the Amsalem T-cell line from a patient with acute lymphoblastic leukemia. Expression of E-receptor-associated antigens in cells incapable of forming E-rosettes.

A new T-cell line (Amsalem) was established from the peripheral blood of a patient with pre-T leukemia. Amsalem cells are unique in that they possess antigenic determinants associated with the E-receptor, yet fail to form rosettes with sheep red blood cells (SRBC). Amsalem cells were found to possess morphological and cytochemical features characteristic of T-lymphocytes, and were sensitive to the cytotoxic effect of rabbit antisera specific for T-cell antigens. In immunofluorescent tests with monoclonal antibodies, Amsalem cells showed a strong reactivity with the OKT-11A and A-22 antibodies, specific for the E-receptor. The cells were reactive with OKT-4 and showed a very weak reactivity with OKT-6 and OKT-8. No reactivity was found with the OKT-3, Leu 7, Leu 11, and OKM1 antibodies. Amsalem cells failed to form rosettes with SRBC; however, mouse anti-Amsalem serum inhibited the formation of E-rosettes. It is concluded that the Amsalem cell line is a line of pre-T leukemia cells characterized by a dissociation between its inability to form E-rosettes and the presence of antigenic constituents of the E-receptor.

Antibodies, Monoclonal↗