Pub Date : 1992-01-01DOI: 10.1177/002570879204900102
T G Rundall
{"title":"Health services for an aging society.","authors":"T G Rundall","doi":"10.1177/002570879204900102","DOIUrl":"https://doi.org/10.1177/002570879204900102","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 1","pages":"3-18"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20989603","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900105
M Arndt, B Bigelow
{"title":"Vertical integration in hospitals: a framework for analysis.","authors":"M Arndt, B Bigelow","doi":"10.1177/002570879204900105","DOIUrl":"https://doi.org/10.1177/002570879204900105","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 1","pages":"93-115"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20989606","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900403
M K O'Brien, K Petrie, J Raeburn
Clinicians face nonadherence as the norm in everyday medical practice. The literature suggests a number of techniques that are likely to increase adherence when incorporated into regular clinical practices and routines. Central to these guidelines appears to be the doctor-patient relationship. For instance, the physician who uses understandable language, encourages open doctor-patient exchange, fosters participation by patients in their own medical care, and creates a friendly and efficient environment should increase the likelihood of adherence. Clinicians can also check adherence to medication regimens by requesting patients to bring in their pill bottles (or other prescription containers) for a discussion on how the medication appears to be working for them. This should elicit information from the patient about problems related to medication adherence. Since patient variables and social support affect adherence behaviors, eliciting information from patients about their understanding and beliefs regarding their particular illness and treatment, as well as enlisting the support of family and friends, may encourage adherence. Identifying what individual patients perceive as obstacles in following treatment regimens decreases their likelihood of nonadherence; these are difficulties that can be negotiated during the medical interview. Individualizing the treatment and minimizing its complexity may provide the solution that encourages adherent behavior. Frequent reeducation, reinforcement, and encouragement, as well as training in self-management and self-monitoring, will at the very least maximize the patient's comprehension of the illness and his or her motivation for adherence--an especially important requisite for living with a chronic condition. Some patients may even wish to openly solicit family and friends for help in the management and monitoring of their illness and treatment, and to structure their environment to support adherence. Education programs for the patient featuring handouts and pamphlets that provide information about the illness in written and illustrated form have been used successfully. Education programs such as patient-oriented package inserts to accompany the medications and brief written summaries of complex treatment plans may also be useful. The purpose of such patient education adjuncts to illness and treatment lie in the hope that they will enhance the likelihood of following treatment recommendations. Through their use, the reason for the treatment and its potential effectiveness will, it is hoped, be better understood (Ley 1988). Overall, significant advances have been made in adherence research. Measurement systems have become more finely tuned, and the definitions and criteria for adherent behaviors are more clear and precise.(ABSTRACT TRUNCATED AT 400 WORDS)
{"title":"Adherence to medication regimens: updating a complex medical issue.","authors":"M K O'Brien, K Petrie, J Raeburn","doi":"10.1177/002570879204900403","DOIUrl":"https://doi.org/10.1177/002570879204900403","url":null,"abstract":"<p><p>Clinicians face nonadherence as the norm in everyday medical practice. The literature suggests a number of techniques that are likely to increase adherence when incorporated into regular clinical practices and routines. Central to these guidelines appears to be the doctor-patient relationship. For instance, the physician who uses understandable language, encourages open doctor-patient exchange, fosters participation by patients in their own medical care, and creates a friendly and efficient environment should increase the likelihood of adherence. Clinicians can also check adherence to medication regimens by requesting patients to bring in their pill bottles (or other prescription containers) for a discussion on how the medication appears to be working for them. This should elicit information from the patient about problems related to medication adherence. Since patient variables and social support affect adherence behaviors, eliciting information from patients about their understanding and beliefs regarding their particular illness and treatment, as well as enlisting the support of family and friends, may encourage adherence. Identifying what individual patients perceive as obstacles in following treatment regimens decreases their likelihood of nonadherence; these are difficulties that can be negotiated during the medical interview. Individualizing the treatment and minimizing its complexity may provide the solution that encourages adherent behavior. Frequent reeducation, reinforcement, and encouragement, as well as training in self-management and self-monitoring, will at the very least maximize the patient's comprehension of the illness and his or her motivation for adherence--an especially important requisite for living with a chronic condition. Some patients may even wish to openly solicit family and friends for help in the management and monitoring of their illness and treatment, and to structure their environment to support adherence. Education programs for the patient featuring handouts and pamphlets that provide information about the illness in written and illustrated form have been used successfully. Education programs such as patient-oriented package inserts to accompany the medications and brief written summaries of complex treatment plans may also be useful. The purpose of such patient education adjuncts to illness and treatment lie in the hope that they will enhance the likelihood of following treatment recommendations. Through their use, the reason for the treatment and its potential effectiveness will, it is hoped, be better understood (Ley 1988). Overall, significant advances have been made in adherence research. Measurement systems have become more finely tuned, and the definitions and criteria for adherent behaviors are more clear and precise.(ABSTRACT TRUNCATED AT 400 WORDS)</p>","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 4","pages":"435-54"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995622","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900404
W F Koehler, M D Fottler, J E Swan
{"title":"Physician-patient satisfaction: equity in the health services encounter.","authors":"W F Koehler, M D Fottler, J E Swan","doi":"10.1177/002570879204900404","DOIUrl":"https://doi.org/10.1177/002570879204900404","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 4","pages":"455-84"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995623","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900103
T Rice
{"title":"Containing health care costs in the United States.","authors":"T Rice","doi":"10.1177/002570879204900103","DOIUrl":"https://doi.org/10.1177/002570879204900103","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 1","pages":"19-65"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20989604","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900303
J Ehreth
{"title":"Cost methodology in long-term care evaluations.","authors":"J Ehreth","doi":"10.1177/002570879204900303","DOIUrl":"https://doi.org/10.1177/002570879204900303","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 3","pages":"331-53"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20992932","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900402
J M Bronstein, L J Nelson
{"title":"The U.S. medical liability system: conceptual model and proposals for reform.","authors":"J M Bronstein, L J Nelson","doi":"10.1177/002570879204900402","DOIUrl":"https://doi.org/10.1177/002570879204900402","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 4","pages":"399-434"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995621","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900104
D F Fahey
{"title":"Projected responses to changes in physician RBRVS reimbursement: induced-demand theory versus contingency theory.","authors":"D F Fahey","doi":"10.1177/002570879204900104","DOIUrl":"https://doi.org/10.1177/002570879204900104","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 1","pages":"67-91"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20989605","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900202
J Genovich-Richards
{"title":"A poignant absence: sexual harassment in the health care literature.","authors":"J Genovich-Richards","doi":"10.1177/002570879204900202","DOIUrl":"https://doi.org/10.1177/002570879204900202","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 2","pages":"133-59"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20990567","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}
Pub Date : 1992-01-01DOI: 10.1177/002570879204900204
K A Phillips, A Rosenblatt
{"title":"Speaking in tongues: integrating economics and psychology into health and mental health services outcomes research.","authors":"K A Phillips, A Rosenblatt","doi":"10.1177/002570879204900204","DOIUrl":"https://doi.org/10.1177/002570879204900204","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"49 2","pages":"191-231"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879204900204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20990569","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}