Training technicians.
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Biomedical subjects
Publications and source records attributed to P J Patterson.
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In summary, we found that the availability of genetic services for the Medicaid patients with the 11 selected disorders follow the general population distribution for Texas. In general, there is no major geographic factor limiting availability of services. We also found that the calculation of Medicaid dollars paid according to the size of the metropolitan area in which the patient resides indicates that there are fewer Medicaid dollars spent on these 11 genetic disorders per person in the population in the larger metropolitan areas. We conclude that preliminary review of these data indicate that the urban poor may have a greater need for medical services that deal with genetic disease.
We estimated that the payments associated with the 11 selected diseases during 1987 in Texas included $88.2 million from Medicaid and $10.6 million from CIDC for a total of $98.8 million. Patients with these diseases represented 0.83% of Medicaid claims, but 4.68% of Medicaid payments. Medicaid payments for genetic services for patients with these 11 selected disorders in Texas during a nine-month period in 1987 were $10,122, or 0.02% of the total Medicaid payments for these claimants. We conclude that our estimate of the Medicaid payments for these disorders in 1987 of nearly $100 million represents a low estimate of the true medical costs for the care of these patients. This study also indicates that these 11 disorders represent a disproportionate share of Medicaid payments; i.e., these patients show a high ratio of payment per claim. We also conclude from these data that CIDC is a significant source of support for the medical care of these patients in Texas. And, finally, this study suggests that referral for genetic services represents a significant barrier for individuals in need of these services.
Although firearms are significant contributors to intentional and unintentional injuries among children in Texas, little information has been published on this topic. We reviewed all firearm-related deaths occurring among persons younger than 15 years of age in Texas from 1984-1988. There were 337 firearm-related deaths among Texas children 0-14 years of age in this 5-year period. Unintentional deaths and firearm homicides were approximately equal for this age group. Black males ages 10-14 years were at highest risk of firearm-related death. The death rate for males was three times that of females. Death rates from unintentional shootings were highest in rural areas, while firearm homicides and suicides were highest in the largest cities.
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One hundred fifty families who were seen in the pediatric outpatient clinics at The University of Texas Medical Branch, Galveston, were surveyed to learn about firearm possession in the home and its hazards to children. Thirty-eight percent of these families kept at least one gun in their home. Fifty-five percent of this group reported that the gun was loaded at all times, and 10% reported that the gun was kept loaded, unlocked, and within the reach of a child. We identified demographic characteristics of at-risk families and considered national statistics for gun safety. It was concluded that household firearms pose a significant risk to children and that intervention by physicians could help reduce this public health problem.
A work force has been investigated for possible cadmium intoxication. One group who are coppersmiths have an 18.5 per cent prevalence of upper urinary tract stone disease associated with a statistically highly significant hypercalciuria and reduced serum inorganic phosphate. Proof of exposure to cadmium has been confirmed in all workers. The trace element cadmium should be kept in mind when investigating stone formers who exhibit an unexplained hypercalciuria.
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