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Articles 211 - 218 of 218

Full-Text Articles in Physical Sciences and Mathematics

Prediction Of Fracture In Patients With Acute Musculoskeletal Ankle Trauma, Paula Diehr Jan 1988

Prediction Of Fracture In Patients With Acute Musculoskeletal Ankle Trauma, Paula Diehr

Paula Diehr

X-rays taken for ankle trauma contribute significantly to the cost of health care in this country. In an attempt to find clinical correlates of ankle fracture 36 detailed historical and physical examination variables were collected from 587 consecutive patients with ankle trauma, and ankle x-rays were taken of all patients. The association of each variable with the final diagnosis of fracture, rupture, or sprain was tested; 21 variables were significant predictors of fracture (vs. sprain and rupture) and 15 were not significantly associated with final diagnosis. The variables were used in a linear discriminant analysis to develop a rule which …

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The Effect Of Age On The Care Of Women With Breast Cancer In Community Hospitals, Paula Diehr, Joe Chu Mar 1987

The Effect Of Age On The Care Of Women With Breast Cancer In Community Hospitals, Paula Diehr, Joe Chu

Paula Diehr

We studied the process of care received by 1,680 female breast cancer patients treated in 17 community hospitals. The probability of receiving various diagnostic, consultation, therapy, or rehabilitation services was almost always significantly associated with patient age for one or more disease stages. Most often there was a linear trend for older patients to receive fewer services (e.g., biopsies prior to definitive treatment, number of lymph nodes examined, chemotherapy, radiation therapy) but other age patterns also were found. Age was not significantly associated with clinical staging or estrogen receptors.

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Factors Explaining The Use Of Health Care Services By The Elderly, Paula Diehr, Connie Evashwick Aug 1984

Factors Explaining The Use Of Health Care Services By The Elderly, Paula Diehr, Connie Evashwick

Paula Diehr

The Anderson model of health services utilization, which relates use of service to predisposing, enabling, and need factors, has not often been applied to an elderly population. In this study, the factors of the Andersen model were used prospectively to predict utilization for a population sample of 1,317 elderly persons. Taken alone, the NEED construct was the most important single predictor of use of physician services, hospitalizations, ambulatory care, and home care. PREDISPOSING factors were better predictors of the use of dental services. Some of the variables studied were not related to utilization in the direction that would have been …

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Prediction Of Pneumonia In Outpatients With Acute Cough - A Statistical Approach, Paula Diehr Jan 1984

Prediction Of Pneumonia In Outpatients With Acute Cough - A Statistical Approach, Paula Diehr

Paula Diehr

Cough is the fifth most common reason for physician visits, but data on acute cough have rarely been collected in a standardized manner and have not been analyzed in a multivariate fashion. We report data on 1819 patients presenting with cough, all of whom received a standardized history and physical, and a chest X-ray. Only 48 (2.6%) were found to have an acute radiographic infiltrate (pneumonia). The prevalence of common signs and symptoms is shown for the patients with and without pneumonia. Thirty-two of these findings were significant predictors of pneumonia (p less than 0.05, one-tailed). These 32 did not …

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Use Of Ambulatory Care Services In Three Provider Plans: Interactions Between Patient Characteristics And Plans, Paula Diehr Jan 1984

Use Of Ambulatory Care Services In Three Provider Plans: Interactions Between Patient Characteristics And Plans, Paula Diehr

Paula Diehr

A previous study of low-income enrollees in a closed-panel health maintenance organization (HMO) and a Blue Cross/Blue Shield (BC/BS) plan showed that the effect on the use of health services of the age, sex, health status, previous health care use, race, and family size of the enrollees was different in the two plans. We have replicated this study using the same two provider plans but studying a different group of white collar, middle class enrollees. A third plan, an experimental independent practice association (IPA), was also available for analysis. Utilization was defined as use (yes/no) and the quantity of use …

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Regression Analysis In Health Services Research: The Use Of Dummy Variables, Paula Diehr, Lincoln Nayak Polissar Sep 1982

Regression Analysis In Health Services Research: The Use Of Dummy Variables, Paula Diehr, Lincoln Nayak Polissar

Paula Diehr

Dummy variables frequently are used in regression analysis but often in an incorrect fashion. A brief review of examples in the medical care literature showed that the interpretation of dummy variable regression coefficients and their significance was often incorrect or unclear. This article shows how dummy variables can be used and assessed properly. The importance of testing for the joint effect of a group of dummy variables is stressed. It also gives a standard and useful extension of the dummy variable technique to testing for the effect of collections of variables.

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Acute Headaches; Presenting Symptoms And Diagnostic Rules To Identify Patients With Tension And Migraine Headache , Paula Diehr Jan 1981

Acute Headaches; Presenting Symptoms And Diagnostic Rules To Identify Patients With Tension And Migraine Headache , Paula Diehr

Paula Diehr

Headache is the ninth most common cause of physician visits, but data on acute headaches have not been collected in a standardized manner and have not been analyzed in a multivariate fashion. We report on 726 patients presenting with acute headaches, which were diagnosed as tension (38%), migraine (25%), no diagnosis (30%), and other (6%). The prevalence of 32 signs and symptoms is shown for each group. Four of these findings were significant predictors of tension headache, and 19 were significant predictors of migraine headache (p<.05). Several diagnostic rules are developed which classify nearly 90% of the headaches correctly, using only three to seven of the findings. On a new set of patients the classification was correct over 80% of the time. It is suggested that most acute headaches could be diagnosed over the telephone or by midlevel providers, which would provide substantial cost savings.

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Increased Access To Medical Care: The Impact On Health, Paula Diehr Oct 1979

Increased Access To Medical Care: The Impact On Health, Paula Diehr

Paula Diehr

Many federally financed programs have been launched to improve the access of the poor to medical care, under the assumption that this will improve their health. The effectiveness of these programs, however, has generally been measured by increased utilization rather than by improved health. The few studies which have considered health status have shown small or negative effects. Here, data are presented from a project which provided fully prepaid care to near poor families through existing sources in the community. A group of 748 enrollees was found to report worse health on four of five health indicators after one year …

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