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Biomedical subjects

T W Hu

Publications and source records attributed to T W Hu.

At least 55 records · Page 3Linked to original sources
PubMed1991

Medical technology transfer in major Chinese medical schools.

This paper examines how the decision-making process and its consequences affect medical technology transfer in major Chinese medical schools. Data are from a 1987 survey of 13 key medical universities, directly supervised by the Ministry of Public Health in the People's Republic of China. This paper limits itself to four types of laboratory equipment--electron microscopes, UV/VIS spectrophotometers, high-performance liquid chromatographs, and polygraphs. Decisions on the transfer of medical technology have been more decentralized in China since the economic reform in 1978. The major reason for schools to import these four types of equipment is their dissatisfaction with the quality of domestic products. Chinese medical schools depend heavily on the information provided at medical equipment exhibits and their neighboring schools. Their decisions to acquire the equipment are based more on the quality and service available than on the prices. Chinese medical schools face serious infrastructure problems in acquiring and maintaining these pieces of equipment. A number of suggestions are made for improving the efficiency of medical technology transfer in China.

China↗
PubMed1991

Cost-effectiveness of alternative approaches in treating severely mentally ill in California.

Given the rising costs of health care and the decrease in public expenditures on mental health care, policy-makers and program managers must identify cost-effective approaches for treating severely mentally ill patients. During the last year, there have been two major cost-effectiveness studies implemented in California. One initiated by Santa Clara County and funded by the National Institute of Mental Health compares the cost-effectiveness of two existing community-based treatment and case-management approaches. The other study, which compares the cost-effectiveness of capitation funding of services for the severely mentally ill, was initiated by the State of California and is currently being implemented in two counties. This article describes the cost-effectiveness evaluations of these two programs and provides preliminary results of the case-management program.

California↗
PubMed1991

Ethnic populations in public mental health: services choice and level of use.

BACKGROUND: Barriers to access and use of mental health care by Asians, Blacks, and Hispanic Americans have been a source of concern for many years. Limitations in our knowledge base persist regarding patterns of use in public sector programs of certain services. Using a sample of almost 27,000 persons, this study examined access and level of use by ethnic minority groups of emergency services, inpatient care, individual outpatient visit, and case management. METHODS: Data from the management information systems of San Francisco and Santa Clara counties were analyzed for fiscal year 1987/1988. Multivariate models were evaluated at two stages, reflecting whether or not a service had been used, and if used, the level of use. RESULTS: Asians and Hispanics used less emergency and inpatient but more outpatient care than did Whites; Blacks used more emergency and less outpatient care. CONCLUSIONS: Ethnicity continues to play a role in understanding the utilization of mental health services. Regarding emergency and inpatient care, Asian and Hispanic patterns of use appear relatively favorable, whereas the patterns of Blacks continue to be problematic.

Black or African American↗
PubMed1991

Urinary incontinence: nursing home staff reaction toward residents.

1. ISQ-SR is a reliable and valid tool to measure psychological stress associated with working with urinary incontinent patients. 2. ISQ-SR can be used to measure efficacy of continuing education programs aimed at reducing staff stress associated with urinary incontinence. 3. Eighty percent of the staff reported that they looked for ways to help patients with their incontinence all the time, but only 50% said that they felt comfortable working with urinary incontinent patients all of the time. 4. Sixty-three percent of the staff reported that they felt frustrated about working with urinary incontinence some of the time, indicating a need for continuing education.

Aged↗
PubMed1991

Who seeks HIV testing? The impact of risk, knowledge, and state regulatory policy on the testing decision.

This study examines the determinants of an individual's decision to be tested for HIV infection. Using data from the 1988 AIDS Knowledge and Attitudes Survey we develop and test a conceptual model of the factors that impact the testing decision. We estimate the impact that individuals' risk characteristics, sociodemographic characteristics, knowledge about HIV infection, and access to testing have on their decision to be tested. We also examine the impact of state confidentiality policies on the testing decision. Our results indicate that risk group membership, knowledge about HIV infection, and the sociodemographic characteristics of the individual exert a significant impact on the decision to receive an HIV test. In addition, state policies that preserve confidentiality also have a significant effect on an individual's decision to be tested.

AIDS Serodiagnosis↗
PubMed1990

Profile of urinary incontinent elderly in long-term care institutions.

This article presents a profile of incontinent elderly in long-term care institutions. One hundred thirty-three frail elderly women were recruited from seven nursing homes in central Pennsylvania for a three-year clinical trial to test the effectiveness of a behavioral therapy on urinary incontinence. All of the patients had more than one medical diagnosis. Eighty percent had cardiorespiratory conditions; the most prevalent diagnoses were cardiovascular diseases. Eighty percent had one or more neurological diseases, including "organic brain syndrome" (47%) and senile dementia (30%); 44% had arthritis/rheumatism. Half of the patients showed severe cognitive impairment; only 12% showed no cognitive impairment. Sixty-three percent were totally dependent; 68% used wheelchairs, 61% were chairbound; 50% had impairments in vision, one-third in hearing, and 14% in speech. Normal bladder capacity, absence of detrusor instability, and satisfactory bladder emptying, as evidenced by low residual urines, was found in 41% of the patients, suggesting that incontinence in this elderly group may not be a primary bladder problem, but rather that mental and physical disabilities may be a more important underlying cause of incontinence in these patients. An important finding in this study is that 34% of the patients had detrusor instability. It is theoretically possible that pharmacologic therapy with anticholinergic agents or imipramine could improve incontinence in this group. Five percent were found to have large residual urine volumes in association with high-capacity bladders suggesting overflow incontinence as the cause of their daily leakage. Pelvic relaxation and stress leakage was far less common in this elderly group of nursing home patients than in young and middle-aged women.

Activities of Daily Living↗
PubMed1990

The cost-effectiveness of disposable versus reusable diapers. A controlled experiment in a nursing home.

Because caring for incontinent elderly in nursing homes is so time-consuming and costly, this topic is of interest to nursing home administrators. A comparison of disposable products with reusable cloth diapers suggests that the disposable product used in the controlled study could save nursing homes approximately $161 to $248 per year per person. Although product costs were similar, the cost savings on laundry favored the disposable product. The study found the disposable product superior to the cloth reusable diaper after the skin condition of the participants was measured.

Clothing↗
PubMed1990

Cost effectiveness of training incontinent elderly in nursing homes: a randomized clinical trial.

This study used a randomized clinical trial with 133 incontinent elderly in seven nursing homes to evaluate the effectiveness of a behavioral training therapy and its cost implications. The training program lasted three months, and a 22-week follow-up period examined the durability of the treatment effect. The therapy became effective after six weeks of training. By the final months of training, the treatment participants' wet episodes had been reduced by 0.6 episode per day, or a 26 percent reduction over baseline, and improvement was maintained during the follow-up period. Trainees with a high frequency of incontinence during baseline, relatively more cognitive residents, and residents with a normal bladder capacity responded better to this behavioral program. The cost of training was the equivalent of about one hour of nursing aide time per patient day. The reduction in incontinence during the follow-up period resulted in some small savings in laundry costs and supplies used, and some quantitatively unmeasurable but detectable improvement in psychosocial well-being among the trainees. Since the central figure in implementing this training protocol is the nursing aide, it is important to find an organizational management scheme that will stimulate nursing aides to reduce incontinence among nursing home residents.

Aged↗
PubMed1989

A clinical trial of a behavioral therapy to reduce urinary incontinence in nursing homes. Outcome and implications.

One hundred thirty-three incontinent women in seven nursing homes were assigned randomly to a 13-week behavior therapy program for urinary incontinence or to a control group that received usual incontinence-related care. The therapy became effective after 6 weeks of training. By the final month of training, the treatment women's wet episodes had been reduced by 0.6 episodes per day, a 26% reduction over baseline. This reduction in the number of wet episodes was statistically significant, both with respect to this group's baseline levels of incontinence and in comparison with the performance of the control women. The number of wet episodes in the control group remained about the same throughout training and the 22-week follow-up period. The treatment women improved partly because they learned to request help, a response prompted and reinforced by the program. Trainees with a high frequency of incontinence during baseline, the more cognitively intact residents, and residents with normal bladder capacity responded better to this behavior therapy program.

Aged↗
PubMed1989

Cost-effectiveness of intensive clinical and case management compared with an existing system of care.

Using controlled experimental methods, this investigation compares treatment outcomes and costs of an intensive clinical and case management program with those of an existing system of care for severely mentally ill clients. The results indicate that after 24 months the treatment group did not improve significantly in psychosocial adjustment and reported life satisfaction, although intermediate changes were apparent. The experimental treatment program did not cost significantly more than the comparison condition, and both groups demonstrated a cost reallocation away from 24-hour and emergency care toward outpatient and case management service. Policy implications and limitations regarding generalizability are discussed.

Cost-Benefit Analysis↗
PubMed1988

Reduction of urinary incontinence in nursing homes: does it reduce or increase costs?

Labor and supply costs associated with the care of urinary incontinent patients in three nursing homes were measured. First, normal nursing home changing patterns and their associated costs were measured. Second, the costs were documented when patients were checked by research staff and changed on an hourly basis as needed. Nursing home staff changed patients significantly less frequently than patient voiding as detected by the hourly checking system. Thus, cost of incontinence during the hourly checking condition ($3.35) per 12-hour patient-day was significantly higher than the cost normally incurred in nursing homes ($1.52) per 12-hour patient-day. The cost of an incontinence rehabilitation program, which significantly reduced incontinence episodes, was contrasted to the cost of incontinence as measured under both of the previous conditions. The rehabilitation program produced significant labor and supply savings only when compared with the hourly checking and changing system. Maintaining patients in a more continent condition costs significantly more than the direct incontinence cost normally incurred by the nursing home. Quality of life and other second-order benefits must be considered if continence rehabilitation is to be judged cost-effective.

Aged↗
PubMed1986

The economic impact of urinary incontinence.

This article provides a conceptual framework for estimating the economic impact of urinary incontinence on the society. Using this framework, the cost of urinary incontinence is estimated to be about $8 billion annually: $2 billion for nursing homes and $6 billion for the community setting. Because of a lack of reliable epidemiologic and health care utilization data, these estimates should be considered primarily illustrative. They do, however, underline the potential economic benefits to the society of reducing the incidence of urinary incontinence among the elderly.

Aged↗
PubMed1984

Health-related economic costs of the Three-Mile Island accident.

On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.

Costs and Cost Analysis↗