A survey of the attitudes and practices of general practitioners in Northern Ireland regarding contraception and abortion was carried out in 1994 and 1995 with a randomized sample of 154 physicians. The vast majority of doctors who received requests for contraceptives from their patients fulfilled those request (94%). Overall, 13% of the doctors said a married patient had requested an abortion in the past three months, and 34% had had a similar request from an unmarried patient.
OBJECTIVE: To assess prescribing practice of Primary Health Care (PHC) workers in church owned health care facilities using WHO drug use indicators. DESIGN: A cross-sectional study in which twenty primary health care facilities were randomly selected. Prescribing indicators were obtained by analysing outpatient records retrospectively for the past 14 months between January 1997 and February 1998. This period was chosen because of compete records of outpatient attendances. Patient care and facility indicators were recorded prospectively during the study period.
The BEACH (Bettering the Evaluation and Care of Health) program, a continuous national study of general practice, began in April 1998 and is now in its eighth year. More than 7500 GPs have participated to date (about one-third of the total workforce) and data are available for about 750,000 encounters. The following overview is designed to disseminate key findings from BEACH, to publicize the annual report, and as a public expression of gratitude to the GP participants without whose generous contribution this study would not be possible.
BACKGROUND: As information is disseminated about best practices, variations in patterns of care should diminish over time. OBJECTIVE: To test the hypotheses that differences in rates of a surgical procedure are associated with type of insurance in an era of evolving practice guidelines and that insurance and site differences diminish with time as consensus guidelines disseminate among the medical community. METHODS: We use lymph node dissection among women with ductal carcinoma in situ (DCIS) as an example of a procedure with uncertain benefit.
Cost-sharing rules for paying physicians have been advanced as a way of generating incentives for the provision of quality care, while recognizing their potential negative effects on production efficiency. However, the optimal sharing rate typically depends on the degree to which the physician acts in the interest of the patient, what we identify as the physician's altruism. Since the degree of altruism is likely to vary across physicians, and to be private information, the standard rules for setting the cost-sharing rate are unlikely to be optimal.
The International Journal of Tuberculosis and Lung Disease: The Official Journal of the International Union Against Tuberculosis and Lung Disease
The World Health Organization and the Revised National TB Control Programme (RNTCP) in India have advocated public-private mix as essential for tuberculosis (TB) control. We conducted a cross-sectional sample survey of private providers (with various qualifications) in Ujjain District, India, to study willingness and motivation to collaborate. Most providers were aware of the RNTCP and had referred patients there. All were willing to collaborate, although the areas for collaboration varied between urban and rural providers.
The European journal of health economics: HEPAC: health economics in prevention and care
To curb the heavily increasing drug budgets some Danish counties have introduced voluntary agreements between general practitioners (GPs) and health authorities. We extend the models of generic prescription by Hellerstein (Rand J Econ 29(1):108-136, 1998) and Lundin (J Health Econ 19:639-662, 2000) to allow for substitution between analogues and use difference-in-difference models to assess the effect on two drug groups (lipid-lowering and rheumatism drugs). For both drug groups we find evidence of a significant effect of the intervention.
Nursing Philosophy: An International Journal for Healthcare Professionals
Compassion unites people during times of suffering and distress. Unfortunately, compassion cannot take away suffering. Why then, is compassion important for people who suffer? Nurses work in a domain where human suffering is evidently present. In order to give meaning to compassion in the domain of professional care, it is necessary to describe what compassion is. The purpose of this paper is to explore questions and contradictions in the debate on compassion related to nursing care.
This paper analyzes and compares the incentive properties of some common payment mechanisms for GPs, namely fee for service (FFS), capitation and fundholding. It focuses on gatekeeping GPs and it specifically recognizes GPs heterogeneity in both ability and altruism. It also allows inappropriate care by GPs to lead to more serious illnesses. The results are as follows. Capitation is the payment mechanism that induces the most referrals to expensive specialty care.
This paper investigates physician altruism toward patients' health benefit using behavioral data from Hennig-Schmidt et al.'s (2011) laboratory experiment. In the experiment, medical students in the role of physicians decide on the provision of medical services. The experimental setup allows us to identify the influence of profits and patients' health benefit on the choice of medical treatment.