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Biomedical subjects

N Goldfield

Publications and source records attributed to N Goldfield.

At least 37 records · Page 2Linked to original sources
PubMed1993

Ambulatory encounter systems: implications for payment and quality.

Many key decision makers are looking to AESs solely for purposes of payment. This approach is unfortunate because many systems could be utilized for both payment and quality management purposes. It is important that the professional quality of care community be aggressive and document, through research and practical demonstration projects, how AESs can be used for both purposes. It is only in this manner that resource consumption can be both accurately analyzed and related to quality improvement.

Abstracting and Indexing↗
PubMed1993

Policy issues in implementation of outpatient prospective payment.

The development of a classification system such as ambulatory patient groups represents a complicated, but primary, step in the long road to implementation. This article provides an introduction to two issues that have been the basis of significant discussion in the APG development process.

Ambulatory Care↗
PubMed1991

Measurement and management of quality in managed care organizations: alive and improving.

Leatherman et al, Schlackman, and McGuirk-Porell et al all provide important examples of how managed care organizations (MCOs) will measure quality in this decade (except for health care status, which none have yet incorporated). All three organizations rely on insurance claims as a data source and quality management as a tool for improving quality; United Health Care and US Health-care use claims data to improve care for the entire membership, a still unrealized potential for MCOs. All three programs, relatively new, can be only minimally evaluated in terms of measurement validity, cost-efficiency, and improvement in the quality of care. The impact of such MCOs depends on policy initiatives, improvements in outcome and process measures, and MCOs' commitment to serve the total population, including the uninsured and Medicaid populations.

Health Services Research↗
PubMed1988

Clinical AIDS update.

In summary, although progress against AIDS is being made, tremendous hurdles still exist. More effective prevention methods such as widely disseminated education programs and an effective vaccine are essential. Effective treatment methods are critical. Coordinated ambulatory care AIDS programs are needed to reduce costs and enhance the quality of life of AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Compliance with mammography recommendations at the work site.

Mammography was recommended to 212 women, according to American Cancer Society guidelines, at the time of a work site-offered periodic health exam (PHE). Sixteen weeks later telephone follow-up determined compliance. A total of 56 (26%) had complied. A second phone contact to 82 noncompliers identified 18 additional women who complied after the first phone contact. Overall compliance (36%) was associated with the presence of physical findings upon breast examination (fibrocystic disease). Compliers did not differ from noncompliers with regard to age, time between PHE and follow-up, or insurance coverage. There was no association between compliance and age greater than or equal to 50 years or previous mammography.

Breast Neoplasms↗
PubMed1987

Ethical considerations of informed consent: a case study.

Presentation is made of a case study concerning a patient with chronic obstructive pulmonary disease who was also discovered to have small cell carcinoma. The patient had indicated many years prior to his hospitalization that if he ever had cancer he would not want to receive chemotherapy. He also indicated to his physician he did not want to hear any 'bad news'. The dilemmas posed by the ethical relationship between consultant and primary care physician and between consultant and patient in such a case are explored. The role of a hospital ethics committee in advising the parties involved is also reviewed.

Carcinoma, Small Cell↗
PubMed1986

Cardiovascular evaluation of adolescents and young adults. Salient aspects of the examination.

Cardiac findings in adolescents and young adults are usually normal, and most murmurs and other abnormalities that are found are benign. However, the primary care physician needs to obtain a complete personal and family history and perform a thorough physical examination to rule out cardiovascular disease and its precursors. Of primary concern are a personal or family history of syncope, family history of sudden death, and several pathologic murmurs such as those caused by mitral valve prolapse and hypertrophic cardiomyopathy. The physician may need to reassure the patient until a definitive diagnosis is made and can also provide accurate information on cardiac disease prevention.

Adolescent↗
PubMed1984

Trends in adolescent development in the People's Republic of China.

Interest in adolescence and adolescent medicine has dramatically increased among medical professionals in the past few years in the People's Republic of China. This article will focus on changing medical practices towards adolescents in the People's Republic since 1949. It is not at all meant to be exhaustive, but rather to indicate the range of medical work extent on adolescent medicine. The 'tasks' of adolescence, as presently understood in the West, such as individuation, separation from family, and sexual identity will be examined in a Chinese context. Changing patterns in birth control, vocational choice, and youth group organizations will then be covered. Finally, attention will be drawn to recent Chinese research on adolescence which has appeared in English language journals. Research for this article comes from a lecture and research period spent in the People's Republic from January to March 1981. Follow-up correspondence and research exchange has continued to this writing. Approximately 25 cities were visited with lectures and professional exchange occurring in six: Beijing, Shanghai, Kaifent, Chengdu, Wuhan and Changsha. Though the cultural context is different, it became clear that there are many similarities between the adolescent process in the United States and the People's Republic of China.

Adolescent↗
PubMed1983

Acanthosis nigricans in adolescents. Two case reports and guidelines for management.

Acanthosis nigricans (AN) is a dermatologic condition of the flexor surfaces of the body consisting of papular hypertrophy, hyperpigmentation, and rugae. AN is commonly associated with malignancy when in adults but is primarily associated with endocrinologic disorders and obesity when found in adolescents. A special search for occult malignancy is not warranted in adolescents with AN unless no associated benign condition is found. Careful follow-up is recommended, however, since AN may be the first indication of a serious systemic disease.

Acanthosis Nigricans↗
PubMed1982

Caring for Indochinese refugees.

A refugee camp in Hong Kong and a health center in Los Angeles provide data on patterns of health care among Indochinese refugees. American physicians need to be aware that incoming refugees use both Western and traditional Chinese models of medical care. In addition, they are subject to special psychologic problems resulting from their past ordeals and their resettlement in a different country. Increased emergency aid should be provided to geographic areas with large concentrations of refugees.

Adult↗
PubMedDate not supplied

The Nixon years: failed national health reform from both parties.

In the November 1991 elections, popular support for national health reform (NHR) enabled Harry Wofford to become a U.S. Senator from Pennsylvania. Since then a bevy of congressional proposals to reform America's health care system have emerged, with even national health insurance, or a single payer system, becoming a prominent contender for the first time in 20 years. National health reform is now a regular feature on the evening news. However, this is not the first time that NHR has attracted national attention. As pointed out in the first article in this series (Physician Executive, March-April 1992, page 23), there have been numerous efforts to enact NHR in the U.S. Each has failed because of strident opposition by interest groups, lack of active presidential interest in the specific legislation, and the absence of strong popular interest.

Family Health↗