Search PubMed⌕ Search

Biomedical subjects

R L Ludke

Publications and source records attributed to R L Ludke.

26 records · Page 2Linked to original sources
PubMed1982

An examination of the factors that influence patient referral decisions.

The results of a study to identify the factors that two types of referring physicians, general/family practitioners and general surgeons, consider when deciding whether or not to refer the patient, and where to refer the patient are presented and discussed. The factors for each type of decision were identified initially through interviews with physicians in active practice in Wisconsin and rank ordered according to their relative importance in making the referral decisions. These factors were then used in two alternative normative decision-making models to predict physician referral behavior. Factors related to the kind and quality of medical care the patient would receive appear to be most important in the decisions, with a high level of agreement between and among general/family practitioners and general surgeons as to the relative importance of the factors. Although the normative decision-making models correctly predicted a relatively high percentage of the referral decisions, not all of the factors were found to be important in explaining the behavior of physicians, and were not always consistent with the factors that were reported to be important.

Breast Neoplasms↗
PubMed1981

An examination of the relationships between physicians' clinical and hospital-utilization performance.

To examine the relationships between measures of attending physician teams' clinical and utilization performance, inpatient hospital audits were conducted in 22 Maryland and western Pennsylvania nonfederal short-term hospitals. A total of 6,980 medical records were abstracted from eight diagnostic categories using the Payne and JCAH PEP medical audit procedures. The results indicate weak statistical associations between the two medical care evaluation audits; between clinical performance and utilization performance, as measured by appropriateness of admissions and length of stay; and between three utilization measures. Based on these findings, it does not appear valid to use performance in one area to evaluate performance in the other in order to measure or evaluate and ultimately improve physicians; clinical or utilization performance.

Clinical Competence↗
PubMed1980

A performance comparison: USMG-FMG house staff physicians.

To determine whether differences exist in the performance of United States Medical Graduate (USMG) and Foreign Medical Graduate (FMG) House Staff physicians, inpatient hospital audits evaluating individual physician performance on patient histories and physical examinations were conducted in 14 Maryland and Pennsylvania non-federal, short-term hospitals. A total of 3,204 medical records were abstracted from eight diagnostic categories for 898 house staff physicians, 556 of which were USMGs and 342 were FMGs. The results from these audits indicate that while there is evidence of a strong hospital/type of physician interaction for many of the diagnoses, there was no significant overall difference in performance of USMG and FMG house staff physicians. The largest and most consistent differences in physician performance were associated with hospital characteristics, not physician characteristics.

Clinical Competence↗
PubMed1979

A performance comparison: USMG-FMG attending physicians.

To determine whether patterns of differences in performance exist between United States Medical Graduate and Foreign Medical Graduate attending Physicians, two types of inpatient hospital audits (Payne Process Audit and the Joint Committee on Accreditation of Hospitals' Performance Evaluation Program-P.E.P. Audit) were conducted in 22 Maryland and Pennsylvania non-federal, short-term hospitals. A total of 6,980 medical records were abstracted from eight diagnostic categories for 1,321 attending physicians; 985 of which were USMGs and 331 were FMGs. The results from both audits indicate that while there is evidence of a strong hospital-type of physician interaction for many of the diagnoses, there was no significant overall difference in performance between USMG and FMG attending physicians. The largest and most consistent differences in physician performance were associated with hospital characteristics, not physician characteristics.

Clinical Competence↗