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Biomedical subjects

P D Fox

Publications and source records attributed to P D Fox.

At least 37 records · Page 2Linked to original sources
PubMed1990

Risk factors for proliferative sickle retinopathy.

The prevalence, incidence, and risk factors associated with proliferative sickle retinopathy (PSR) were investigated in 786 patients with homozygous sickle cell (SS) disease and 533 patients with sickle cell haemoglobin C (SC) disease. PSR was more common in SC disease, in which there was a significant predominance of males, and it increased with age in both genotypes. In SC disease the risk of developing PSR was highest between 15 and 24 years in males, between 20 and 39 years in females, and in SS disease between 25 and 39 years in both sexes. PSR tended to be bilateral, especially in SC disease. There was no evidence of familial clustering of PSR in SC siblings, and insufficient numbers of SS siblings were available to test for clustering. Haematological risk factors associated with PSR in SS disease were a high haemoglobin in males and a low fetal haemoglobin in both sexes and in SC disease, a high mean cell volume, and a low fetal haemoglobin in females.

Adolescent↗
PubMed1990

Outcome of iatrogenic choroidal neovascularisation in sickle cell disease.

Choroidal neovascularisation developed in 62/66 (94%) eyes followed up for a mean period of 11.2 years after treatment with xenon arc feeder vessel coagulation for proliferative sickle retinopathy (PSR). In 27 eyes the neovascularisation was chorioretinal alone and in 35 eyes choriovitreal. Chorioretinal neovascularisation (CRN) was a benign complication but may convert to choriovitreal neovascularisation (CVN). Late sequelae of CVN included vitreous haemorrhage, posterior vitreous face fibrosis, and tractional retinal detachment. Visual loss (of greater than or equal to 3 Snellen lines for greater than or equal to 3 months) occurred in nine eyes affected by choroidal neovascularisation, though because of other pathology this could not always be attributed to the choroidal neovascularisation. The incidence of visual loss in CVN affected eyes was significantly greater, by survival curve analysis, than in eyes affected by CRN alone. Permanent visual loss from tractional retinal detachment definitely attributable to CVN occurred in 2/35 (6%) eyes.

Adolescent↗
PubMed1990

Findings from the Medicaid Competition Demonstrations: a guide for states.

The Medicaid Competition Demonstrations were initiated in 1983-84 in six States (California, Florida, Minnesota, Missouri, New Jersey, and New York). State experiences in implementing the demonstrations are presented in this article. Although problems of enrolling Medicaid recipients in prepaid plans or with primary care case managers under these demonstrations proved challenging to States, lessons were learned in three key areas: program design and administration, health plan and provider relations, and beneficiary acceptance. Therefore, States considering similar programs in the future could benefit from these findings.

Cost Control↗
PubMed1989

HMO update. Where are they headed?

Health maintenance organizations (HMOs) are undergoing major changes, among them the following: Enrollee growth will continue to be strong, although the rate of growth will diminish. HMOs will develop new product lines, such as offering preferred provider organizations and various cost management services. The competitive environment has become tougher. Quality of care concerns among the public are on the rise. Employers, while generally supportive of HMOs, are also questioning and changing their contractual relationships with them.

Economic Competition↗
PubMed1989

The long-term value of the selected list as a method of controlling drug costs in a district general hospital.

The results of a study aimed at evaluating the long-term effects of the Limited List (now officially referred to as the Selected List Scheme) on inpatient drug costs in a district general hospital (DGH) are presented. Study periods of six months duration were examined before, shortly after, and a further year after implementation of the List on 1 April 1985. Eight therapeutic classes affected by the regulations were examined; in four of these (antacids, expectorants, mucolytics and anxiolytics, hypnotics and sedatives) statistically significant reductions in costs were demonstrated over the study periods. There was no significant change in the costs of the other four classes (vitamins, laxatives, nasal preparations and analgesics). Overall, inpatient expenditure for the hospital showed no significant change. The changes in cost demonstrated can be attributed to the Selected List and occurred despite the prior existence of a local formulary.

Cost Control↗
PubMed1989

Evaluation of the Medicaid competition demonstrations.

In 1983, the Health Care Financing Administration funded a multiyear evaluation of Medicaid demonstrations in six States. The alternative delivery systems represented by the demonstrations contained a number of innovative features, most notably capitation, case management, limitations on provider choice, and provider competition. Implementation and operation issues as well as demonstration effects on utilization and cost of care, administrative costs, rate setting, biased selection, quality of care, and access and satisfaction were evaluated. Both primary and secondary data sources were used in the evaluation. This article contains an overview and summary of evaluation findings on the effects of the demonstrations.

California↗
PubMed1986

Tear and serum antibody levels in ocular herpetic infection: diagnostic precision of secretory IgA.

A sensitive enzyme linked immunosorbent assay (ELISA) was developed to evaluate the potential of herpes simplex virus (HSV) specific antibodies in the diagnosis of herpetic eye infection. The presence of HSV specific secretory IgA (sIgA) in tears was found to be diagnostic of infection. However, serum and tear HSV specific IgG and IgA were not considered reliable indicators of active infection.

Antibodies, Viral↗
PubMed1980

Trends in nursing home expenditures: implications for aging policy.

Nursing home care has become a major governmental responsibility. Public expenditures for nursing home care amounted to $7.3 billion in 1977. They represented 57.2 percent of the $12.8 billion nursing home bill nationally and 12 percent of public spending on all personal health care. Nursing home care absorbs more than one-third of all Medicaid expenditures. This paper explores expenditure patterns in recent years and discusses some of the factors that will influence these patterns in the future. First we analyze recent trends over the five-year period ending 1977. Then we project future utilization based on current age-specific use rates. Finally, we review recent studies on the potential cost of savings of noninstitutional alternatives to nursing home care.

Aged↗