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Biomedical subjects

S Zuckerman

Publications and source records attributed to S Zuckerman.

At least 73 records · Page 4Linked to original sources
PubMed1985

Competition and medical groups. A survivor analysis.

This paper extends the survivor analysis of medical practice provided by Frech and Ginsburg (1974). Changes in the distribution of medical practice sizes are examined for the periods 1965-69, 1969-75, and 1975-80. Through 1975, we find that, almost uniformly, all sizes of medical groups were found to be optimal. In particular, the optimality of large (100 or more physicians) multi-specialty groups was strongly confirmed. Later data, however, suggest that the equilibrium size distribution may have shifted. For the 1975-80 period only large multi-specialty groups continue to be in the optimal size range. In addition, we find some evidence that suggests that solo practices may be optimal in some geographic regions.

Catchment Area, Health↗
PubMed1984

Physician practice patterns under hospital rate-setting programs.

Earlier studies of hospital rate-setting programs have focused primarily on their ability to contain the growth in hospital utilization and expenditures. While most analysts recognize the central role physicians play in influencing health care utilization and expenditures, regulatory programs have been directed primarily at the hospital. At this time, it is unclear what impact, if any, these programs have had on physicians. Our study presents a preliminary analysis of this issue based on data from 1978 to 1982. When we compared average incomes, fees, and utilization of physician services in states with hospital rate regulations with those in states without such programs, we found significant differences. Average net incomes grew at a 1.9% slower annual rate in states with strict hospital regulatory programs. If hospital regulation is having some impact on physicians, both the physician and hospital sector should be considered when evaluating the ability of these programs to contain health care costs.

Economics, Hospital↗
PubMed1984

Variation in the growth and incidence of medical malpractice claims.

This study analyzes the incidence of medical malpractice claims since 1976, using data drawn from the 1982 core survey of the American Medical Association's Socioeconomic Monitoring System. The data show that, on average, physicians incurred twice as many claims per year in the years 1976 to 1981 as they did during their careers prior to that period. Using Tobit analysis, we find the annual frequency of claims to be greater among surgeons, obstetricians and gynecologists (OBGs), physicians in group practice, and physicians in states which apply the legal doctrine of informed consent. In addition, we find that the number of years since medical residency is positively related to physicians' claims incidence during the first 27 years of practice, and that OBGs and medical specialists who spend more time with their patients per office visit incur fewer claims.

Data Collection↗
PubMedDate not supplied

Stability of mycophenolate mofetil as an extemporaneous suspension.

OBJECTIVE: To evaluate the physical and chemical stability of a suspension of mycophenolate mofetil (MMF) prepared in the hospital from commercially available MMF capsules. METHODS: Suspensions of MMF were prepared at room temperature and stored at 5, 25, 37, and 45 degrees C over a period of 50 to 210 days. The contents of MMF and its degradation product, mycophenolic acid, in the suspension were measured at various time points by HPLC. RESULTS: MMF suspensions were stable (as determined by the presence of > or = 90% of the labeled amount) at 45 degrees C for at least 11 days, at 37 degrees C for at least 28 days, at 25 degrees C for at least 28 days, and at 5 degrees C for at least 210 days. The suspension was also physically stable at 5 degrees C during the entire test period. CONCLUSIONS: The compounded MMF suspension was stable for at least 11 days at all the temperatures studied and for as long as 210 days at 5 degrees C. This formulation appears to be clinically acceptable and provides a convenient dosage form for pediatric patients and for adults during the early postoperative period.

Chromatography, High Pressure Liquid↗
PubMedDate not supplied

Medicaid managed care in thirteen states.

This study examines the recent expansion of Medicaid managed care from the perspective of the thirteen states in the Urban Institute's Assessing the New Federalism project. States are moving to managed care for Medicaid both to improve beneficiaries' access and to control the growth in program costs. However, we find that despite dramatic growth in enrollment during this decade, few states are enrolling the elderly or the disabled--the most expensive Medicaid beneficiaries. We also conclude that cost-savings objectives are often at odds with goals of contracting with mainstream plans and protecting safety-net providers.

Cost Savings↗
PubMedDate not supplied

Trends in Medicaid physician fees, 1993-1998.

This study uses data on Medicaid physician fees in 1993 and 1998 to document variation in fees across the country, describe changes in these fees, and contrast how they changed relative to those in Medicare. The results show that 1998 Medicaid fees varied widely. Medicaid fees grew 4.6 percent between 1993 and 1998, lagging behind the general rate of inflation. This growth was greater for primary care services than for other services studied. Relative to Medicare physician fees, Medicaid fees fell by 14.3 percent between 1993 and 1998. Medicaid's low fees and slow growth rates suggest that potential access problems among Medicaid enrollees remain a policy issue that should be monitored.

Data Interpretation, Statistical↗
PubMedDate not supplied

Understanding the recent growth in Medicare physician expenditures.

This study employs several large Health Care Financing Administration data sets for 1983 and 1985 to examine the recent growth in Medicare physician services. The study concludes that the recent growth (approximately 15% in real terms between 1983 and 1985) has been more rapid in areas with higher incomes per capita and suggests that this may be related to faster adoption and diffusion of new medical technologies in these areas. The volume of physician services had grown considerably faster for those specialists who utilize newer procedures and technologies than for those who do not. The study also provides evidence that the sharp increase in assignment rates in recent years because of the introduction of the physician participation program also contributed to the growth in physician services during this period. Medicare's prospective payment system, which controlled hospital payments and encouraged hospitals to become more efficient, had at most a small positive impact on the growth in Part B spending. Finally, the freeze on physician's fees did not seem to have had a major impact on the volume of physician services.

Diffusion of Innovation↗