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Biomedical subjects

T R Sharpe

Publications and source records attributed to T R Sharpe.

34 records · Page 2Linked to original sources

Factors affecting physician participation in a state Medicaid program.

Critical to policy planning for a program of national health insurance or a National Health Service is an understanding of the strengths and weaknesses of current federally-supported health programs. One program which has been subjected to criticism is Medicaid. A major problem facing Medicaid is the high proportion of physicians who refuse to participate in the program, thus preventing the target population from obtaining access to medical care. A telephone survey was conducted to assess the attitudes and behavior of a stratified random sample of physicians regarding their participation in a Medicaid program. Physicians were asked to identify major advantages and disadvantages of the program to individual patients, to society and to their medical practice. Non-participants were asked to identify the major reasons why they did not participate in the program. Medical specialty was the only significant demographic determinant of participation. Inadequate reimbursement, excessive paperwork, patient abuses of the program and bureaucratic complexity were among the most prominent factors contributing to nonparticipation. Implications of these findings are discussed with respect to the role of primary care providers' perceptions in the planning of future national health programs.

Adolescent↗

Use of vitamin-mineral supplements by AFDC children.

Slightly more than 11 percent of the 1,616 children in Northern Mississippi households receiving Aid to Families with Dependent Children regularly used vitamins, according to the 540 personal interviews conducted in this study. Of the vitamins used, about 20 percent were obtained by prescription. Participation in Early and Periodic Screening, Diagnosis and Treatment (EPSDT) was found not to be related to vitamin use. The pharmacy was the main source of vitamins, which most frequently were those widely advertised on television. It is suggested that pharmacists, physicians, and EPSDT personnel might take a more active role in nutrition counseling. The population is poor by definition and rural by study design. In the face of these facts, it was interesting to find that the most often used vitamin was Flintstones, one of the more expensive brands of children's vitamins. Some other vitamin products used, in descending order of frequency were One-A-Day vitamins, generic prenatal vitamins, and Neo-Vadrin with Iron. Data on shopping behavior and sources of products indicate that the population may not be making the best use of products or funds. Informal counseling by pharmacists at the point of sale has the potential to reduce these problems.

Adolescent↗

Evaluation of the use of rural health clinics: attitudes and behaviors of primary care physicians in service areas of nurse practitioner clinics.

In response to concerns of the directors of Rural Health Initiative projects in Mississippi, a study was conducted to examine factors related to use of rural health clinics. This report focuses on attitudes and behaviors of primary care physicians in the service areas of four clinics staffed by nurse practitioners. Data for this evaluation were obtained via mail questionnaires sent to 41 primary care physicians in the service areas of the clinics. Usable responses were received from 25 (61.0 percent) of the physicians. The data indicate that a majority of these physicians approve of the nurse practitioner concept. Although there is evidence to support a positive correlation between previous experience and knowledge concerning nurse practitioners and physician acceptance of the nurse practitioner concept, only about half of the physicians reported that anyone had ever contacted them to talk about the clinic. Only about a quarter of the physicians had ever visited the rural health clinic, but 60 percent indicated that they would like to do so. These findings indicate a need to develop closer working relationships with all primary care physicians in the service area of a rural health clinic. The data indicate that when such a closer relationship existed, physicians were satisfied with the outcome of interactions. Twelve (48 percent) physicians stated that they had patient(s) referred to them by the clinic. Among these physicians 77.8 percent were satisfied with the information that they had received on the patient's condition. Fewer physicians (8 or 32.0 percent) reported that they had received a call from the nurse practitioner clinic to consult about one of the physician's patients. The physicians were satisfied with the outcome of the consultation in each instance that was reported.

Ambulatory Care Facilities↗