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OBJECTIVE: To test the accuracy and usefulness of a questionnaire to assess risk factors and symptoms of venous disease, quality of life, and dependence on health and social services. DESIGN: Case-control study. SETTING: Multicentre study in three general practices. SUBJECTS: Patients drawn from a larger investigation of prevalence of venous disease. RESULTS: Patients who had venous disease were taller and heavier and had spent more time standing at work than those who did not. It was strongly associated with both number of pregnancies and number of children. There were weak but not significant associations with the wearing of a corset, constipation, and a family history of venous problems. CONCLUSIONS: The questionnaire was able to pick out recognised risk factors, and is suitable for use in studies of patients with venous disorders. It may also provide information about factors that have not yet been accepted. The case-control study is an appropriate way of assessing not only risk factors, but also signs and symptoms, quality of life, and use of health resources in patients with venous disease.
The University of Nebraska Medical Center maintains the Synapse Health Information Network to provide timely clinical and library resource information to health professionals across Nebraska and surrounding regions. The system is in over 115 sites across Nebraska and surrounding regions and maintains over 320 network users.
Cost containment and access to appropriate care are the two most frequently discussed issues in contemporary health policy. Conceiving of the health services available in specific regions as "packages" of diverse items, the authors of this article consider the economic trade-offs among the various resources needed for appropriate care. In the discussion that follows, we examine the trade-offs between two divergent offering of the health care system: high technology medicine and support services. Specifically, we examine several strategies designed to achieve an optimal mix of investments in CT scanners and transportation resources in the South Chicago region. Using linear programming as a method for examining these options, the authors found that 1) the proper location of CT scanners is as important for cost containment as optimal number, and 2) excess capacity in the utilization of a single resource--CT scanners--need not imply inefficiency in the overall delivery of the service. These findings help demonstrate the importance of viewing health care as a package of interrelated services, both for achieving cost containment and for providing access to appropriate care.
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In recent years, three thorough analyses have documented the present status of the availability of neurologists and estimated future needs and availability. The productivity of ongoing training programs would appear to be able to meet the minimal needs for neurologic services by 1985. Pending federal legislation may regulate the total number of residencies available in the future. The American Academy of Neurology has a role in maintaining a data base and analyzing the issues of quality maintenance, utilization of resources, and distribution of personnel.
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The career decisions of national samples of male and female unaccepted applicants to the 1971-72 entering U.S. medical school class are studied in order to determine whether the increasing number of unaccepted applicants is a potential manpower pool for alternative health occupations. The dominant response to rejection among respondents is reapplication to medical school in subsequent years, and the principal determinant of reapplication is receiving postrejection support (usually from family or friends) of the original career intentions. Most of the respondents who do not gain admittance to medical school on reapplications still aspire to doctoral-level degrees, but only half remain in the health area. Those respondents who had formulated contingency career plans in the professions and who had high science aptitude but low math aptitude tended to remain in the health area. A service orientation toward occupations is not associated with remaining in the health area.