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At least 235 records · Page 13Linked to original sources
PubMed1988

Is outcome for general practitioner obstetricians influenced by workload and locality?

Maternal and perinatal morbidity and transfer patterns were examined to assess the influence of the number of deliveries performed by each general practitioner obstetrician and the distance from specialist care. There were statistically significant differences in transfer patterns between urban and rural practitioners and between those practitioners delivering fewer than twenty per year and those delivering twenty or more per year. Antenatally, rural practitioners transferred more of their patients to the base hospital and those practitioners delivering fewer than twenty per year had higher transfer rates than those delivering twenty or more per year. During labour the transfer rate was lowest for rural practitioners delivering more than 20 babies per year. Urban practitioners in comparison to rural practitioners delivered a significantly greater proportion of women who were considered to have a moderate or high obstetric risk. No association was found between the number of deliveries undertaken by general practitioners both urban and rural and maternal and neonatal morbidity. The proportion of women and neonates who had a score which indicated a less favourable outcome for maternal and neonatal morbidity, was higher for urban practitioners than for rural practitioners.

Delivery, Obstetric↗
PubMed1988

The nature and content of physician telephone calls in a private practice.

Telephone encounters received by two physicians in a private rural family practice setting were examined over a 61-day sampling period. A total of 1,264 calls were received during the study period, with 905 (71.6 percent) being received in the office setting. An average of 10.4 calls per physician were received each day, and a mean of 16.2 minutes per physician was spent each day with telephone encounters. Each call was brief, lasting 1.6 minutes (standard deviation 1.5 minutes); administrative and personal calls each lasted significantly longer than other call categories (F = 20.8, P = .0001). More chronic disease diagnoses tended to be handled during office when compared with nonoffice telephone encounters. The majority of calls (932, or 83.1 percent) did not require a face-to-face visit as judged by the physician. Of the office calls, 58.2 percent were handled by the physicians through a message system rather than a direct physician telephone call. It is estimated that uncharged care over the telephone saved patients in this practice up to $150,000 per year.

Female↗
PubMedDate not supplied

Maternal mortality in rural Bangladesh: the Jamalpur District.

During the 12-month period from September 1982 to August 1983, 9,317 live births and 58 maternal deaths were recorded in Melanda and Islampur upazilas in the Jamalpur district of rural Bangladesh, giving a maternal mortality rate of 62.3 per 10,000 live births. Maternal mortality was positively related to maternal age and parity, with the mortality risk rising very sharply beyond age 35 years, and beyond parity four among women aged 25-34 years in particular. The most common causes of maternal death were eclampsia (20.7 percent), septic abortion (20.7 percent), postpartum sepsis (10.3 percent), obstructed labor (10.3 percent), and antepartum and postpartum hemorrhage (10.3 percent). These findings indicate that family planning, by decreasing the likelihood of pregnancy after age 35 and parity four, can help reduce the proportion of women at risk of maternal mortality.

Adolescent↗
PubMed1986

Twenty-five year incidence and prediction of coronary heart disease in two Italian rural population samples. The Italian Research Group of the Seven Countries Study.

1712 men aged 40-59 at entry examination in 1960 and representing 98.8% of defined geographical samples in Northern and Central rural Italy, have been followed up for 25 years with continuous monitoring of mortality and causes of death and repeated examinations for the measurement of coronary heart diseases (CHD) incidence. In 25 years 810 men died from all causes and 198 from CHD. Incidence in CHD-free men at entry, has been 123 per 1000 for CHD death, 151 per 1000 for hard criteria CHD (deaths plus definite myocardial infarction alive) and 305 per 1000 for any criteria CHD (deaths plus definite myocardial infarction, plus possible myocardial infarction, plus angina pectoris, plus other manifestations.

Adult↗
PubMed1986

The natural variability of vital rates and associated statistics.

The first concern of this work is the development of approximations to the distributions of crude mortality rates, age-specific mortality rates, age-standardized rates, standardized mortality ratios, and the like for the case of a closed population or period study. It is found that assuming Poisson birthtimes and independent lifetimes implies that the number of deaths and the corresponding midyear population have a bivariate Poisson distribution. The Lexis diagram is seen to make direct use of the result. It is suggested that in a variety of cases, it will be satisfactory to approximate the distribution of the number of deaths given the population size, by a Poisson with mean proportional to the population size. It is further suggested that situations in which explanatory variables are present may be modelled via a doubly stochastic Poisson distribution for the number of deaths, with mean proportional to the population size and an exponential function of a linear combination of the explanatories. Such a model is fit to mortality data for Canadian females classified by age and year. A dynamic variant of the model is further fit to the time series of total female deaths alone by year. The models with extra-Poisson variation are found to lead to substantially improved fits.

Age Factors↗
PubMedDate not supplied

Infant mortality trends and differentials in Nepal.

Infant mortality trends and differentials are estimated from the 1981 Nepal Contraceptive Prevalence Survey (NCPS) and compared with similar estimates from the 1976 Nepal Fertility Survey (NFS) and the 1981 Census of Nepal. The analysis indicates that infant mortality rates derived directly from the NFS maternity histories are the most accurate. Infant mortality rates derived directly from the NCPS maternity histories are severely underestimated and yield a strongly biased trend that is the reverse of the true downward trend. Indirect estimates of infant mortality trends derived from child survivorship data do not result in a consistent pattern. Infant mortality differentials, when expressed in relative rather than absolute terms, are generally consistent with findings from earlier studies. Possible reasons for data quality differences among the three data sources are discussed.

Actuarial Analysis↗
PubMed1985

Maternal health services and maternal mortality in Papua New Guinea.

Surveys of maternal mortality rates in rural areas of Papua New Guinea over the past thirty years report 2-18 deaths per 1000 live births. The national maternal mortality register commenced in 1970 and reports rates of 2-7/1000 deaths for urban areas and 7-20/1000 deaths for rural areas. However, less than a quarter of maternal deaths are believed to be reported to the register: most of the unreported deaths are unsupervised confinements. Nevertheless obstetrical causes now account for 20% of total admissions to hospital and health centres in Papua New Guinea, and are the commonest causes of admission. The great majority of obstetrical admissions come from urban and periurban areas. Most rural women continue to confine at home where only a small fraction of maternal deaths are reported. It is as yet unclear whether modern health services have made any impact on rural maternal mortality rates. A plea is made for more complete reporting of maternal deaths to the national register of both supervised and unsupervised confinements.

Female↗