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At least 19 recordsLinked to original sources

HMO versus private care medical systems: a study to determine the aging consumers' satisfaction with medical care under these two systems.

In one community, 175 aging persons (44 HMO and 132 private medical care patients) completed a 20-item scale that measured satisfaction with medical care. Data on demographics, health care utilization, and self-assessed health status were collected to determine whether these variables would relate to HMO membership. Satisfaction scores were compared between HMO and private care medical groups by multivariate analysis of variance. Satisfaction with the doctor-patient relationship and convenience of care was higher in the private medical care group, whereas satisfaction with cost was higher in the HMO group. Furthermore, the HMO group evaluated private medical care and HMO care similarly. The private medical care group rated HMO care less favorably. Additional comments reveal specific areas of satisfaction/dissatisfaction.

Aged↗

[Medical care, medical education, and the job market for physicians: internship in Mexico].

This article endeavors to establish a connection between the emergence and development of internship in Mexico and a series of macrosocial changes, including the extension of Government intervention in medical care, the labor market processes that have led to unemployment among physicians, and the responses of the medical education system. The author considers that this comprehensive analysis will be of use in understanding at least in part the complex dynamics of the influence exerted on each other by medical care and medical education, and particularly how changes in conditions on the labor market for physicians have led to the formulation of ideological paradigms of medical practice and to their institutionalization in the programs of study of the medical schools. The study is also important for developed and developing countries with increasing numbers of physicians and which therefore need to understand the possible causes and effects of this trend.

Developing Countries↗

Extended care: medical care of the elderly disabled.

Geriatric medicine has now been practised as a specialty for 30 years; there is still argument as to its usefulness, and it is not regarded as an attractive career. At the same time there is a large gap between the standard of acute medicine an that offered to people with continuing disabilities, most of whom are elderly. If this area of medicine is to become more effective, it should be an extension of the responsibilities and activities of the medical centre, practised by a hospital based team, complementing the existing activities of the family doctor and the acute hospital. This method would not only raise the standard, but provide opportunity for a reasonable career. Medical care should be arranged according to disability--not according to age. The name 'extended care' referring to the method of practice, could well replace the worn out label of 'geriatric', which gives unnecessary emphasis to old age. But more important than what it is called, is how it is performed.

Aged↗

A pilot study for a randomized clinical trial assessing chiropractic care, medical care, and self-care education for acute and subacute neck pain patients.

OBJECTIVE: To conduct a pilot study in preparation for a full-scale randomized clinical trial assessing conservative treatments for acute and subacute neck pain. Study design Prospective, randomized pilot study. SETTING: Primary contact chiropractic and medical clinics. PATIENTS: Ages 21 to 65 with current episode of neck pain less than 12 weeks in duration. Outcome measures Patient self-report questionnaires and cervical spine motion were assessed at baseline and 3 and 12 weeks post-randomization. INTERVENTIONS: Chiropractic spinal manipulation, prescription medications, and self-care education. RESULTS: Recruitment took place over a 1-month period. Twenty-eight patients were randomized to treatment, and 1 patient (medical care group) refused their treatment assignment and was lost to further follow-up. Twenty-three patients were either "very satisfied" or "completely satisfied" with the care they received in the study. More than half the patients reported 75% or 100% improvement (n = 17). No between-group comparisons were planned or performed due to the small sample size. CONCLUSION: Recruitment of patients appears feasible for a full-scale randomized clinical trial evaluating chiropractic spinal manipulation, medical care, and self-care education for acute and subacute neck pain. Patient and provider compliance with study protocols was excellent, and the pilot study allowed us to further develop and optimize our data collection processes. Although pilot studies such as these require substantial time, money, and effort, they provide valuable information for future research efforts.

Acute Disease↗

Home care, medical care and the new competitive environment.

Health-care organization and financing is rapidly changing in the USA due to competitive pressures. Parallel changes are occurring in other countries. These changes are affecting, and will affect, home care services. Watching these changes, and building on social models, leads one to focus on important developments. These developments include: point of service plans, disease management, outcomes measurement, price and quality competition. These changes will make measured outcomes and demonstrated value essential in home care.

Aged↗

The functions of medical care.

Medical care has several important functions other than restoring or maintaining health. These other functions are assessment and certification of health status, prognostication, segregation of the ill to limit communication of illness, and helping to cope with the problems of illness--the caring function. Medical care serving these "paracurative" functions may legitimately be given indepedently, without associated curing or preventive intent of the provider of care. Although such services do not result in benefits to health, such as extension of life or reduction of disability, they do have other valued outcomes, outcomes not measurable as a gain in personal health status. For example, caring activities may result in satisfaction, comfort, or desirable affective states, even while the patient's health status deteriorates during an incurable illness. The physician's approach to patients, the economist's analysis of the benefits of health services, the planner's decisions about health programs, the evaluator's judgments about the quality of care, or the patient's expectations about treatment are strongly influenced by his assumptions about the purpose of medical care or the proper outcome of the process. When the health worker assumes that the only useful outcome is health, he may consider the paracurative services to be ineffective, inefficient, or undesirable. In contrast, when he recognizes and understands the paracurative functions of medical care, he may better perform his function in the medical care system.

Communicable Disease Control↗