{"title":"More data on post-surgical deaths related to the 1976 Los Angeles doctor slowdown","authors":"Milton I. Roemer","doi":"10.1016/0160-7995(81)90031-9","DOIUrl":"10.1016/0160-7995(81)90031-9","url":null,"abstract":"<div><p>A previous report showed steady decline in the death rate during a ‘doctor slowdown’ (involving essentially the withholding of elective surgery) in Los Angeles County, California—followed by a sharp rise in the death rate as soon as ‘surgery as usual’ was resumed. To determine if this sequence was, in fact, related to post-operative deaths, the actual death certificates for the fortnight after the 1976 slowdown (<em>N</em> = 2574) and those for the corresponding period of 1975 (<em>N</em> = 2663) were examined. Most death certificates, of course, had no indication of surgery done, but comparing deaths associated with surgery in the two periods showed 90 more such deaths in 1976 than in 1975. Separate study of a sample of local hospitals showed withholding of nearly 11,000 elective operations during the slowdown. A widely used average post-operative case-fatality rate for elective surgery of 0.50% would imply avoidance of 55 deaths. The finding of 90 excess deaths associated with surgery in 1976, compared with 1975, therefore, suggests strongly that the sudden rise in the overall Los Angeles County death rate, following the 1976 doctor slowdown, was indeed due, at least in part, to the performance of postponed surgical procedures.</p></div>","PeriodicalId":76948,"journal":{"name":"Social science & medicine. Medical economics","volume":"15 3","pages":"Pages 161-163"},"PeriodicalIF":0.0,"publicationDate":"1981-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0160-7995(81)90031-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18336246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medicare assignment rates and carrier practices: A national study","authors":"Jonah Otelsberg, Charlotte F. Muller, Nina Pascal","doi":"10.1016/0160-7995(81)90030-7","DOIUrl":"10.1016/0160-7995(81)90030-7","url":null,"abstract":"<div><p>Acceptance of assignment by physicians influences the amount of health insurance protection that is provided to the aged by Medicare and the financial burden on the elderly. Assignment rate has been noted as a major issue for health policy. This study uses national data to analyze the effect of socioeconomic variables and carrier discretionary practices on assignment rates.</p><p>The socioeconomic environment in the carrier territories was taken into account by use of variables from the Area Resource File and the AMA. The principal variables of interest were claims investigation, denial, and reduction rates, and processing speed. Additionally, discretionary practices concerned with pricing in the absence of information needed to develop reasonable charges in the standard manner were tested. Factor analysis was used for data reduction.</p><p>The results explained 41% of the variance for all carriers but more was explained when Blue and non-Blue carriers were separated. Variables from the health economy and from carrier practices entered the equations. High investigation and denial rates were associated with low assignment rates.</p><p>While the response of individual physicians to the socioeconomic environment and to certain discretionary practices is not fully explained by analysis on aggregated data at the carrier level, the responsiveness of medical doctors to carrier aggressiveness in claims control is an important finding for Medicare administration.</p></div>","PeriodicalId":76948,"journal":{"name":"Social science & medicine. Medical economics","volume":"15 3","pages":"Pages 153-159"},"PeriodicalIF":0.0,"publicationDate":"1981-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0160-7995(81)90030-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18080913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Issues in health services","authors":"David C. Dale","doi":"10.1016/0160-7995(81)90039-3","DOIUrl":"https://doi.org/10.1016/0160-7995(81)90039-3","url":null,"abstract":"","PeriodicalId":76948,"journal":{"name":"Social science & medicine. Medical economics","volume":"15 3","pages":"Page 199"},"PeriodicalIF":0.0,"publicationDate":"1981-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0160-7995(81)90039-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92120759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C.G. Eriksson , M. Granvik , I. Kindblad , G. Lindgren , L. Nyström , M. Rosén , S. Wall
{"title":"Health problems in a Swedish county—what can we learn from official sources?","authors":"C.G. Eriksson , M. Granvik , I. Kindblad , G. Lindgren , L. Nyström , M. Rosén , S. Wall","doi":"10.1016/0160-7995(81)90029-0","DOIUrl":"10.1016/0160-7995(81)90029-0","url":null,"abstract":"<div><p>In view of the epidemiological responsibility that, according to the new Swedish health legislation, will be laid upon the local county councils, there will be increasing demands to identify and monitor the health status of the local population, e.g. the commune. As part of a large scale collaborative project between a central Swedish health planning institute, a local county council and a research department, this paper focuses on the availability and usefulness of the official statistics. The process of community diagnosis is discussed and illustrated by means of a regional mortality display. It is argued that regional epidemiological data will be of major importance for the future planning of preventive programmes where also non-medical solutions are mandatory.</p></div>","PeriodicalId":76948,"journal":{"name":"Social science & medicine. Medical economics","volume":"15 3","pages":"Pages 143-151"},"PeriodicalIF":0.0,"publicationDate":"1981-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0160-7995(81)90029-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18336245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}