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Biomedical subjects

T T Wan

Publications and source records attributed to T T Wan.

53 records · Page 3Linked to original sources
PubMed1980

Geriatric day care and homemaker services: an experimental study.

The purpose of this study was to examine the impact of geriatric day care and homemaker services on patient outcomes. Patients were randomly assigned to receive the experimental services in three study samples. In comparing outcomes between the experimental and control groups, it was found that there were significant differences in physical functioning and activity level for the day care samples, in physical functioning and contentment level for the homemaker study sample, and in all of these outcome measures for the combined services group. Among users of the experimental services, increased use of the services was associated with improved outcomes of care. Multivariate analysis of data showed that factors other than the use of the experimental services were more effective in explaining variation in outcomes. Significant factors that affected all four outcome measures in both the day care and homemaker study were primary diagnosis, impairment prognosis, and number of inpatient hospital days.

Activities of Daily Living↗
PubMed1979

Factors associated with increased dental care utilization in five urban, low-income areas.

Survey data were used to measure change in dental utilization in five urban low-income areas as a result of increased financial (Medicaid) and facility (community health centers) access to dental care. The average annual dental visit between the baseline and follow-up surveys showed a dramatic increase in four of the five survey areas. With the exception of Roxbury, Massachusetts, where the rate was already high in the earlier survey, the dental visit rate in the remaining areas increased 33 to 80 per cent compared to an increase of only 7 per cent nationally between 1969 and 1975. Both CHC and Medicaid programs made important contributions to increased dental care. Among persons who saw a dentist in the year in these areas, 25 per cent reported CHC as their usual source of dental care and 46 per cent reported that their dental care costs in the year were borne by Medicaid. In spite of recent increases, however, the average annual dental visit rate was only 1.0 in the five areas compared to 1.6 nationally, which is 60 per cent higher. The generally low dental utilization levels among persons covered by Medicaid or served by CHCs may indicate that much of the increased dental utilization which occurred in these areas was limited to taking care of existing dental problems while neglecting preventive dental care.

Community Health Centers↗
PubMed1978

Interpreting a general index of subjective well-being.

The complex and continuing problem of identifying the relationship between several subjective and objective measurements of health is explored through data from a national health survey. Statistical analyses show that sociodemographic variables among groups are less important than are psychological variables in interpreting subjective well-being.

Adult↗
PubMed1976

Predicting self-assessed health status: a multivariate approach.

Two-stage multivariate analysis was used to examine factors affecting personal perception of health status. In the first stage, sociodemographic variables were used as independent variables in Automatic Interaction Detector (AID) analysis in order to partition the study sample (11,153 civilian noninstitutionalized adults aged 58-63) into subgroups. In the second stage, binary multiple regression analysis was performed on each AID subgroup and on the total sample. Predictors used were indicators of psychological, socioeconomic, and sociomedical well-being. Finally the applicability of these indicators in classifying persons in one of the two categories of perceived health status was examined by discriminant function analysis. Sociomedical health indicators were better explanatory variables of self-assessed health status than socioeconomic or psychological indicators of well-being.

Activities of Daily Living↗
PubMedDate not supplied

Organizational and market determinants of HMOs' performance of preventive practices.

This study validates the measurements of performance of preventive practices and identifies organizational and market factors that affect variations in the preventive care practices of health maintenance organizations (HMOs). Confirmatory factor analysis was used to assess HMO performance, reflecting the rates of five preventive practice services. A structural equation model of the preventive practice performance of HMOs was evaluated. It was discovered that HMOs that employ more board-certified primary care practitioners have a higher rate of preventive care practices and that market competition and market forces do not influence the variation in HMO preventive care practices.

Cholesterol↗
PubMedDate not supplied

A cost and production analysis of hospital dental care programs.

To provide hospital dental programs with useful information about the expansion of dental services and the identification of pertinent financial information, a production function and cost function analysis was performed. Results showed that hospital ownership (public or private) and size of the dental clinics were associated with the cost of providing dental services and the volume of services provided. Among 23 hospitals studied, private hospitals had a much lower cost per visit, had more paid attending dentist staff, paid their resident dentists less, and had significantly more billings paid by Medicaid and by patients than public hospitals. When stratified by ownership and size, these basic differences were accentuated for the small clinics. Except for primarily the Medicaid and self-pay billings, the characteristics of large public and private hospital dental clinics were extremely similar. Multiple regression analysis found that a decrease in cost per visit was associated with more visits to dentists and more to hygienists. Production of dental services could be increased by increasing the number of attending dentists, hygienists, and residents. Preliminary econometric analysis reveals that the optimal mix of attending dentists to resident dentists should be approximately 1.8 full-time equivalent (FTE) resident for every 1 attending FTE dentist to produce the most dental services at the lowest cost.

Costs and Cost Analysis↗
PubMedDate not supplied

Impact of community health centers and Medicaid on the use of health services.

The impact of improved access to health care through the Federal community health center (CHC) and Medicaid programs was examined in five urban low-income areas. Data on access to care and physician, hospital, and dental services utilization were collected by baseline and followup health surveys in the CHCs' services areas. There was a shift in use from hospital clinics to CHCs. Followup surveys indicated that 23 percent of the population reported CHCs as usual source of care. Travel time to source of care was reduced for users of CHCs. Medicaid coverage of the population in the survey areas increased from 16 to 37 percent between the baseline and followup surveys, an interval of 4 to 7 years. Increases occurred in the use of physicians and dental care between the baseline and followup surveys, but the rates scarcely kept pace with the national rates. Respondents who reported CHCs as their usual source of care, however, had a higher rate of physician visits and a lower rate of hospitalization compared with those using private physicians or hospital clinics as the usual source of care. Respondents with Medicaid coverage usually had higher physician and hospital use, irrespective of usual source of care. Both CHC and Medicaid programs contributed to increased use of dental care by providing financial and dental care resources. Although these two programs greatly facilitated the use of health services, disparity in physician and dental utilization remains between the five low-income areas and the averages for the nation.

Adolescent↗