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Biomedical subjects

V D Hennelly

Publications and source records attributed to V D Hennelly.

9 recordsLinked to original sources
PubMed1983

Out-of-plan use and disenrollment: outgrowths of dissatisfaction with a prepaid group plan.

Two opposing theories have been suggested to describe the relationships among member dissatisfaction with a prepaid group practice (PGP), the choice to go outside for care normally covered by the plan, and disenrollment from the PGP: 1) out-of-plan use--a consequence of dissatisfaction, precedes disenrollment and 2) dissatisfaction produces two independent effects--out-of-plan use and disenrollment. Preliminary results are reported on an evaluation of these relationships based on a sample of 1823 families at the Medical Care Group of St. Louis. Dissatisfaction is found to be the most important predictor of both out-of-plan use and disenrollment. However, no direct relationship exists between the latter two variables. This result lends support for the model, which specifies that PGP members respond differently to dissatisfaction with the plan; some go outside the PGP for their care while others simply disenroll.

Consumer Behavior↗
PubMed1983

Disenrollment from a prepaid group plan. A multivariate analysis.

Although high annual disenrollments from prepaid group practices (PGPs) present significant problems to the manager, studies on this subject generally have been limited to simple descriptions of the phenomenon. The authors' approach utilizes multivariate techniques--discriminant analysis and logistic regression--to overcome the simplicity of these bivariate studies. It allows an examination of the significant correlates of disenrollment in a stepwise manner that adjusts for the effects of all variables included in the models. Two surveys conducted by the Medical Care Group of St. Louis (MCGSL) provide data for this research. After classifying the sample of 2,402 families as continuous enrollees, voluntary disenrollees, and mandatory disenrollees, the analyses show that these groups represent significantly different member populations. The variables that significantly and independently discriminate among them include sociodemographic characteristics (subscriber age, race, education and occupation, and family size and income), satisfaction level with the plan, and presence of alternatives to the PGP (nonplan family members and coverage by alternative health insurance). These findings suggest that voluntary and mandatory disenrollment behavior may be more complex than previously considered. Moreover, the PGP manager is faced with perplexing problems in attempting to control this troublesome phenomenon.

Analysis of Variance↗
PubMed1982

The use of epidemiologic methods as the bridge between prevention and social work practice.

The concepts, scope and methods of epidemiology as well as the application of these tools to preventive social work practice for both policy setting and case management are described. Using data concerning lead poisoning, two areas are discussed. These are: 1) the stages of prevention and its implication for practice, and 2) definitions of the epidemiologic concepts of population-at-risk, prevalence, incidence, case rate, relative risk, attributable risk, and epidemiologic causal models. Finally, suggestions for using epidemiologic knowledge and methods in formulating policy for, and programs pertaining to, prevention in social work practice are set forth.

Child↗
PubMed1980

Deterrents to family enrollment in a prepaid group practice.

Research suggests that there are three prime deterrents to enrollment for persons who are attracted to prepaid group practice (PGP): 1) reluctance to change imbedded habits; 2) low expected utilization (low risk); and 3) payment for health insurance through employment. This study tests the influence of these enrollment barriers by examining families of new PGP members who are grouped according to whether their family members joined (FP) or remained outside (IP) the PGP under examination. The two groups of families do not differ in health status or past utilization as proxies of expected use of medical services. They do, however, differ according to the presence of a regular source of care. Although more IP than FP families report prior physician ties, the influence of this factor is diminished when other family characteristics are accounted for in a multivariate analysis. The variables explaining the most variance in enrollment type are family size, employment status and income. IP families are typically small (often without children), have two employees and a low adjusted family income. Although many PGPs have attempted to attract this family type through multitiered rate systems, it is doubtful that this approach can be effective in the long run. The broad practice of job-centered health insurance provides these families no systematic mechanism for combining their employee benefits to purchase a family plan and therefore little incentive to join a PGP family plan. Changes in the way health insurance is obtained are encouraged.

Adult↗
PubMed1979

Continuity of medical care: its impact on physician utilization.

Past research in continuity of medical care has generally examined its determinants or its consequences. A model is proposed which combines these lines of research and incorporates a continuity measure as a process and specifying variable. The validity of this model is tested with a set of data consisting of 1,410 persons with major illness episodes. Results show that the model is supported, at least in part. Variables that significantly influence the number of ambulatory visits to a physician include the patient's payment method, the severity of his illness and his referral status. Moreover, the practice type of the usual physician emerges as a significant determinant of physician utilization when the level of continuity is controlled. The use of this more comprehensive model in future studies on continuity is indicated.

Ambulatory Care↗
PubMedDate not supplied

Hospital-based medical office buildings: report of a national study.

In recent years, many hospitals have developed campus-based medical office buildings (MOBs) as a means of providing physicians with proximal office space and increasing patient days through a more committed medical staff. A nationwide survey was conducted among 1,252 non-government, not-for-profit hospitals with 200 or more beds to understand both the significant factors associated with their development and their overall characteristics. Among the 686 hospitals which responded to the survey, the significant determinants of MOBs were medical school affiliation, religious affiliation/ownership, and location in the western part of the country. Three hundred eleven hospitals reported that they had (or were currently constructing) MOBs; they were most often owned directly by the hospital, housed 30% of the active medical staff, operated at capacity, and made a small profit for the hospital.

Data Collection↗